Somatic Illness Research Articles

Public-Private Partnerships: A model for injury prevention and safety promotion – Benefitting communities and NGOs

Abstract Injuries are a leading cause of death up to 45years, and 12% of all hospital beds in Norway are dedicated to accident-related treatments. Addressing injuries poses a significant public health challenge, and preventing accidents is crucial for saving money and resources. The Norwegian Act of Public Health mandates that municipalities promote the population’s health and well-being, contribute to favourable environmental conditions, and prevent mental and somatic illnesses and injuries. This is echoed in various laws and regulations, providing a supportive framework for injury prevention and safety promotion. However, translating these laws and regulations into effective policies and preventive activities necessitates collaboration across sectors and levels. To meet these demands, a public-private partnership for safety has been established through five-year cooperation agreements between the Ministry of Health, Finance Norway (Association for financial and insurance industry in Norway), and the Norwegian Safety Forum (NSF). As a non-profit organization, NSF is a national advocate for safety, specializing in home and leisure injury prevention, road safety and Safe Community initiatives in Norway. Program Description The collaboration aims to reduce accidents and injuries. The agreement secures basic financing for NSF and serves as a platform for knowledge sharing and competence building across sectors. It facilitates seminars and meetings to promote learning among different professions, benefiting municipalities and the public. The collaboration leverages the Ministry’s resources, insurance companies’ data and knowledge, and NSF’s expertise to develop injury prevention programs through dialogue with communities and organizations. This model brings together private-public and NGO perspectives. It also provides enhanced possibilities for coordination on both national and community level, enhancing data and knowledge availability and strengthening capacity for safety promotion.

Extended lifetime expectancy in schizophrenia, role of measurement based care

Lifespan in schizophrenia spectrum disorders (SSD) is up to 20 years shorter than average. Introduction of new antipsychotic pharmaceuticals has not made any major improvement. Parallel care is provided as usual standard care (USD) in out-patients settings. The study aim was to evaluate if inclusion of Measurement Based Care (MBC) may prolong patients' lifespan. In total, 171 patients were followed with annual semi-structured examinations of psychiatric status, social situation, and somatic illnesses over 20 years, by case managers. Findings indicate that MBC contributed to prolonged lifespan in SSD from 55.6 to 69.4 years from beginning to end of the study.

Dropout in elite sport: What stressors and resilience factors are perceived in youth sport climbing?

Introduction & Purpose Psychosocial stress is a major risk factor for the development of a wide range of psychiatric and somatic illnesses (Hughes et al., 2017). Social factors such as perceived autonomy and competence, relatedness and task climate appear to be related to people dropping out of a sport (Balish et al., 2014). To this point in time, the developmental aspects in youth sports are insufficiently described in the literature. Previous studies dealing with dropout have indicated critical aspects on a personal, contextual, chronological, and procedural level (Moulds et al., 2024). The perception of these aspects seems to determine the individual stress experience. Therefore, the aim of the study was to identify stressors and resources in youth sport climbing and to gain a deeper understanding of how these relate to dropout. Methods Guided by the theoretical framework of the bioecological system theory (Bronfenbrenner & Morris, 2006), two active and six non-active climbers between the ages of 18 and 25 were interviewed using a semi-structured interview approach. The non-active climbers were dropouts, defined here as an athlete ending their competitive sport career before reaching their individual performance peak. In this case they were asked about the related circumstances. Active athletes started the interview from their current perspective. Each development-relevant factor (person, process, context, time; Bronfenbrenner & Morris, 2006) was then reflected on in terms of resources and stressors. The inclusion criterion was the qualification for the national team. A qualitative content analysis was carried out according to Mayring and Fenzl (2022). The data was analyzed using MAXQDA 24 software. Results The interviewed climbers addressed the context of family, school, social environment, training, and personal factors. A high level of social interaction was experienced. The topics of bodyweight and nutrition were often reported with negative connotations, particularly impacted by external factors. Communication skills were a consistently mentioned factor as a resource and potential stressor. A lack of individualisation and opportunities for personal development were reported as long-term stress factors. Feelings of responsibility and self-inflicted pressure were described as additional loads. Professional attachment was reported as a personal resource when positively evaluated. Reflection skills were recognised as a helpful stress management tool. As illustrated in Figure 1, the mindset of individuals appears to be shaped by the internal and external interplay of available resources, aspects of motivation and beliefs that are internalised. Discussion & Conclusion Several factors seem to interact modifying an individual’s experience of stress. The perception of stress at a certain point in time must be seen as a combination of the load experienced and the individual available resources. Sport-specific requirements should be considered. Dropout can be one of the consequences of overall stress in competitive sports and should be analysed systemically. The intention was to identify starting points for reducing dropout rates in sports and support health-promoting participation. These are the first results of this project, in which further athletes from climbing and other sports will be interviewed.

Pasienter innlagt ved en medisinsk intensivavdeling etter henging 2010–21

Hanging is one of the most common causes of death among young adults in Norway. Our aim was to study the hospital course and cerebral function on discharge in patients admitted to our Medical Intensive Care Unit after hanging without skeletal injury. Retrospective study based on the medical records of patients admitted to the Medical Intensive Care Unit at Oslo University Hospital (OUS), Ullevål after hanging, from January 2010 to December 2021. Cerebral function on discharge was classified according to Cerebral Performance Category (CPC) from grade 1 (normal cerebral function) to 5 (brain death). 135 patients were admitted to OUS after hanging during the period; 60 of these were admitted to the Medical Intensive Care Unit and were included in this study. There were 35 men and 25 women. Mental illness was documented in the medical records of 43 patients, somatic illness in 24, previous substance abuse in 19, and previous suicide attempts in 19. Upon admission, 34 patients had suffered cardiac arrest, and 39 had a Glasgow Coma Scale (GCS) score of 3. The most common complication was pneumonia (n=42). Twenty-seven patients (45%) died, all with a GCS score of 3 on admission, of which 25 had pre-hospital cardiac arrest. Ten became organ donors. Among the 33 survivors, 28 had a CPC score of 1 and five had a CPC score of 2 on discharge. The median lactate concentration at admission was 8.1 mmol/L among those who died versus 3.8 mmol/L among survivors. Hanging has a high mortality rate. Cardiac arrest, a GCS score of 3, and lactic acidosis were more common among those who died than among the survivors. The organ donation rate was high, and most survivors had a good cerebral function, assessed by CPC score.

D’une institution à l’autre : de l’hypercomplexité de l’hôpital à la place singulière des psychologues institutionnels référés à la psychanalyse

ContextThis article aims to open a debate on how our contemporary societal context, both psychically and structurally, shapes the essential institution that is the public hospital. ObjectivesTo achieve this, the authors start with a clinical construction that allows them to highlight the hypercomplexity of the situations encountered daily by those who inhabit these spaces, including patients, their relatives, and the diverse healthcare providers. Following this, they focus on the unique role of the institutional psychologist who is referenced to psychoanalysis. MethodThe situation that opens this text, providing both its starting point and framework, is a clinical fiction. This narrative is composed of fragments from real, recurrently observed situations in our practice, supervision, and research settings – in other words, from foundational cases (Fustier, 2020). We align ourselves with a Freudian tradition, adopting the principle of analytical construction, positing that this situation is an initial level of interpretation of the hypercomplexity we aim to explore throughout this text. ResultsThe hypercomplexity observed and described in this clinical fiction led us to formulate numerous hypotheses and highlight the essential presence of psychoanalysis in hospitals. Psychoanalysis offers the necessary perspective to elaborate and impart meaning to otherwise unthinkable situations. InterpretationsFrom the conjunction of subjective experiences of somatic illness to the institutional issues unique to hospitals – intersected by the divergent representations of healthcare professionals – we emphasize the unique position of the psychodynamically oriented psychologist within this complex system.

Catatonia in the context of somatic illness

Catatonia in the context of somatic illness

Être médecin en prison : perspectives d’avenir et question déontologique

As a consequence of the law passed on January 18th 1994, the responsibility of healthcare was transferred from the judicial system to the public health authorities.Since then, a medical team from a hospital unit offers healthcare to detained patients, after a first medical assessment upon arrival in detention. The healthcare provided is diverse with the aim of prioritising care for the more vulnerable patients, for example with anxiety issues, depression as well as somatic illness. The foundation of carceral medicine is based on equality: to guarantee access to healthcare for all with respect of medical confidentiality.Furthermore, continuity of care must be ensured by creating a link with healthcare professionals "outside" prison, involved in the follow-up of a detained patient after her/his liberation. The latter being a crucial point to enhance the attractivity of carceral medicine.

<i>IGF1R</i> rs907806 and <i>GHSR</i> rs572169 genetic variants in fetal macrosomia

BACKGROUND: Being strongly affected by maternal and fetal genetic factors, intrauterine environment plays a critical role in fetal growth. Intrauterine conditions, in turn, are largely determined by the genetic factors. AIM: The aim of this study was to evaluate the effect of the IGF1R rs907806 and GHSR rs572169 genetic variants on the weight of newborns. MATERIALS AND METHODS: This prospective study included 221 mother-newborn pairs. The inclusion criteria were singleton pregnancy and informed consent to participate in the study. The exclusion criteria were severe somatic, oncological and acute illnesses three months prior or during pregnancy, gestational diabetes mellitus, refusal to participate in the study at any stage, and insufficient data. The study groups included patients with type 1 diabetes mellitus (group I), type 2 diabetes mellitus (group II), and no carbohydrate metabolism disorders (group III). Cord blood samples were obtained after delivery. The IGF1R rs907806 and GHSR rs572169 genotypes were determined by polymerase chain reaction with restriction fragment length polymorphism analysis. The main outcomes were delivery of a large for gestational age fetus (weight of more than the 90th percentile INTERGROWTH-21st). The secondary outcomes were diabetic fetopathy, diabetic cardiomyopathy, and neonatal hypoglycemia. RESULTS: In group III, the minor G allele of the IGF1R rs907806 variant was more frequent in large-for-gestational-age newborns (p = 0.017; odds ratio 3.039; 95% confidence interval 1.244–7.424) than in those with a weight of less than 90th percentile. For the GHSR rs572169 variant, no similar trend was observed. This pattern was pronounced in the male newborns only (rs907806 AA vs. AG+GG; p = 0.046; odds ratio 4.229, 95% confidence interval 1.181–15.139). In newborns with hypoglycemia, a higher frequency of the GG genotype of the GHSR rs572169 (GA) variant was observed in the total sample (p = 0.004) and the type 1 diabetes mellitus group (p = 0.0496). CONCLUSIONS: The IGF1R rs907806 variant may affect birthweight in the male newborns of mothers without carbohydrate metabolism disorders. The observed association of neonatal hypoglycemia with the GG genotype of the GHSR rs572169 variant requires further investigation. Genetic factors can contribute to prognostic models of perinatal complications, while improving their early diagnosis opportunities.

Illness and narrative identity: examining past and future life story chapters in individuals with bipolar disorder, diabetes mellitus or no chronic illness

ABSTRACT The purpose of this study was to investigate whether narrative identity challenges are specific to Bipolar Disorder (BD) as a mental illness or a reflection of living with chronic illness. Nineteen individuals diagnosed with BD, 29 individuals diagnosed with Type 1 Diabetes Mellitus (T1DM) and 25 controls without chronic mental or somatic illness identified past and future life story chapters which were self-rated on emotional tone and self-event connections and content-coded for agency and communion themes. Individuals with BD self-rated their past chapters as more negative and less positive, and their chapters were lower on content-coded agency and communion themes compared to T1DM and controls. There were fewer group differences for future chapters, but BD was associated with lower self-rated positive emotional tone and self-stability connections as well as lower content-coded agency and communion themes. The results indicate that narrative identity is affected in individuals with BD above and beyond the consequences of living with chronic illness. This may reflect distinct effects of mental versus somatic illness on narrative identity.

Inflammatory markers, somatic complaints, use of medication and health care in 11-year-old children at familial high risk of schizophrenia or bipolar disorder compared with population-based controls. The Danish High Risk and Resilience Study - via 11

Purpose Patients with schizophrenia or bipolar disorder are at increased risk of somatic illnesses and have more somatic complaints compared with the general population. Schizophrenia and bipolar disorder are highly heritable. Already during childhood, children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BD) are at increased risk of psychiatric disorders and cognitive and social impairments. Knowledge about physical conditions is sparse. Materials and methods Through blood tests (n = 293), interviews, and questionnaires, we assessed inflammatory markers, somatic complaints, medication – and health care use in 11-year-old children at FHR-SZ, FHR-BD, and population-based controls (PBC). Results Children at FHR-SZ had higher concentrations of leucocytes (mean 6.41, SD 0.73) compared with PBC (mean 5.78, SD 0.27, p = 0.005) and of neutrophilocytes (FHR-SZ: mean 3.11, SD 1.32, PBC: mean 2.70, SD 0.96, p = 0.024). Compared with PBC (26.6%), more children at FHR-SZ (40.5%, p = 0.007) reported somatic complaints. So did caregivers and teachers to children at FHR-BD. Somatic complaints, higher concentrations of leucocytes, and neutrophilocytes were associated with lower levels of physical activity. Children at FHR-BD with psychiatric disorders reported more somatic complaints compared with those without. Conclusion Children at FHR-SZ had higher concentrations of leucocytes and neutrophilocytes than PBC. Children at FHR-SZ or FHR-BP displayed more somatic complaints than controls. Our study highlights rarely explored disadvantage of being born to parents with schizophrenia or bipolar disorder. To enhance understanding of how physical conditions in childhood may interplay with later transition to mental disorders in children at FHR-SZ and FHR-BD, further research is needed.

Municipality-level differences in disability retirement in Finland: The contribution of local social characteristics.

Large differences exist in the risk of disability retirement between Finnish municipalities. This study examined whether individual-level and municipality-level characteristics explain these differences and which municipality-level characteristics are particularly important for the risk of disability retirement. Individual-level register data were supplemented with 10 municipality-level characteristics from various databases. A 20% sample of the Finnish population (N=626,391) was followed for transition to disability retirement from 2016 to 2019 using multilevel Weibull models. Of the total variation in the risk of disability retirement, 4.3% was attributed to the municipal-level and decreased to 1.8% when individual-level characteristics (gender, age, education level and entitlement to special reimbursement for medical expenses, reflecting morbidity) were controlled for. Further adjustment for municipality-level characteristics fully erased the differences between municipalities. The proportion of municipality-level variation was larger for disability retirement due to somatic illnesses than mental disorders. Of the municipality-level characteristics, socioeconomic structure, unemployment rate, poverty, net migration between municipalities, dependency ratio, the amount of tax revenue per capita and morbidity were associated with the risk of disability retirement. The municipality-level variation in the risk of disability retirement is largely explained by the individual characteristics of the inhabitants. However, various characteristics of the municipalities show associations with the risk of disability retirement. Recognizing such factors is essential for shaping policies that mitigate disability retirement risk.

Psychological impact of the covid -19 pandemic on school age children

Introduction: The psychological impact of the COVID-19 pandemic on the general population has been widely studied. However, few studies have been carried out on children, even though they are experiencing a difficult situation and major stress that may expose them to significant psychological suffering. We are interested in how children perceive these emotional changes during the confinement associated with the COVID-19 pandemic. The aim is to understand the impact of the pandemic and containment on children. To do this, we assessed the prevalence of depression, anxiety and perceived post-traumatic stress in school-age children, looking for factors associated with these psychopathological dimensions with a view to better management and intervention to reduce the possible negative effects of this situation. Methodology: This is a cross-sectional study based on gathering information from all primary school pupils in Fez, who responded freely and voluntarily. The study was carried out over a period of two months, from June 2020 to August 2020, using an online self-questionnaire and psychometric evaluation scales: QIPS, CDI, CRIES-13. Results: 330 students met our inclusion criteria. The mean age of our participants was 8.68 ± 1.94 years, with a minimum of 6 years and a maximum of 12 years. There was a slight female predominance, with 168 girls (50.9%) and 162 boys (49.1%). Most of the pupils (95.2%) lived in urban areas, 92.7% of the children had married parents, and 64.5% of our participants had parents with a university education. Almost half of the children had a family income of more than Dhs10,000 per month. Only 2.1% of the children had a psychiatric history, 16.7% of the children had a history of somatic illness, 22.1% of the participants had a family psychiatric history, 11.2% of our participants had experienced a stressful event in their lives and 22.1% had parents who had previously experienced a stressful event. Evaluation of the CRIES-13 scale showed that 39.4% had a positive score of over 30 in favour of significant symptoms of post-traumatic stress disorder, a probable depressive state (CDI score>15) was revealed in 26.1% of the children, and with regard to anxiety disorder, the mean score in our sample was 32.27 (±8.147) with a median of 29. The analytical study showed a statically significant relationship between certain socio-demographic characteristics, namely: parents' low level of education, living with divorced parents, low monthly family income and negative psychological impact during the pandemic. On the other hand, female gender was correlated with the occurrence of anxiety. Our study also revealed other correlations, notably between the presence of a personal history of psychiatric or somatic illness and the occurrence of depression, family psychiatric history, and the experience of a stressful event by the child and parents were factors strongly associated with the three psychological disorders studied. Factors related to the child's lifestyle, such as the practice of physical activity at home, a daily study period of less than 2 hours, and dissatisfaction with distance learning, were associated with psychological distress during confinement. In addition, certain personality traits seemed to be implicated in the worsening of this condition during confinement: the presence of a relative with covid-19, the child's knowledge of the pandemic, and the fear that the pandemic would continue. Conclusion: The COVID-19 pandemic has had a severe impact on the general public, particularly children, psychological interventions identifying and targeting children at risk are urgently needed, and future studies are warranted to design and evaluate the effectiveness of interventions.

Chronic insomnia, REM sleep instability and emotional dysregulation: A pathway to anxiety and depression?

The world-wide prevalence of insomnia disorder reaches up to 10% of the adult population. Women are more often afflicted than men, and insomnia disorder is a risk factor for somatic and mental illness, especially depression and anxiety disorders. Persistent hyperarousals at the cognitive, emotional, cortical and/or physiological levels are central to most theories regarding the pathophysiology of insomnia. Of the defining features of insomnia disorder, the discrepancy between minor objective polysomnographic alterations of sleep continuity and substantive subjective impairment in insomnia disorder remains enigmatic. Microstructural alterations, especially in rapid eye movement sleep ("rapid eye movement sleep instability"), might explain this mismatch between subjective and objective findings. As rapid eye movement sleep represents the most highly aroused brain state during sleep, it might be particularly prone to fragmentation in individuals with persistent hyperarousal. In consequence, mentation during rapid eye movement sleep may be toned more as conscious-like wake experience, reflecting pre-sleep concerns. It is suggested that this instability of rapid eye movement sleep is involved in the mismatch between subjective and objective measures of sleep in insomnia disorder. Furthermore, as rapid eye movement sleep has been linked in previous works to emotional processing, rapid eye movement sleep instability could play a central role in the close association between insomnia and depressive and anxiety disorders.

Biobehavioral approach to distinguishing panic symptoms from medical illness.

Panic disorder is a common psychiatric diagnosis characterized by acute, distressing somatic symptoms that mimic medically-relevant symptoms. As a result, individuals with panic disorder overutilize personal and healthcare resources in an attempt to diagnose and treat physical symptoms that are often medically benign. A biobehavioral perspective on these symptoms is needed that integrates psychological and medical knowledge to avoid costly treatments and prolonged suffering. This narrative review examines six common somatic symptoms of panic attacks (non-cardiac chest pain, palpitations, dyspnea, dizziness, abdominal distress, and paresthesia), identified in the literature as the most severe, prevalent, or critical for differential diagnosis in somatic illness, including long COVID. We review somatic illnesses that are commonly comorbid or produce panic-like symptoms, their relevant risk factors, characteristics that assist in distinguishing them from panic, and treatment approaches that are typical for these conditions. Additionally, this review discusses key factors, including cultural considerations, to assist healthcare professionals in differentiating benign from medically relevant symptoms in panic sufferers.

Depressive symptoms in older prisoners : Results of two studies

The proportion of prisoners aged60 years and above is steadily rising both nationally and internationally. With advancing age the risk of developing physical and mental illnesses also increases. International studies have demonstrated ahigher prevalence of mental disorders among older prisoners compared to the general population; however, there are few data on this, at least for Germany. Collation of empirical data on the presence of depressive symptoms among older prisoners. There were two independent cross-sectional studies conducted in North Rhine-Westphalia (NRW) and Rhineland-Palatinate (RLP), which included prisoners aged50 years and above. In NRW apurely quantitative survey of depressive symptoms was carried out using the German version of the patient health questionnaire (PHQ-D) and in RLP the quantitative measurements using the general depression scale short form (ADS-K) were supplemented by qualitative interviews. In total, data from 315 inmates were available for ajoint analysis (222 from RLP, 93from NRW). Among the prisoners in RLP 63.4% exhibited mild to clinically significant depressive symptoms, while in NRW this was the case for 46.2%. The treatment with antidepressants was carried out only in a small proportion in both federal states. Both surveys showed aclearly elevated prevalence of depressive symptoms compared to the non-prison population. The results also suggest aneed for optimization in terms of treatment. Particularly concerning potential interactions with somatic illnesses, efforts should be made to improve the diagnostics and treatment of depressive symptoms.

Evaluation of Event-Related Potentials in Somatic Diseases - Systematic Review.

Many somatic illnesses (e.g. hypertension, diabetes, pulmonary and cardiac diseases, hepatitis C, kidney and heart failure, HIV infection, Sjogren's disease) may impact central nervous system functions resulting in emotional, sensory, cognitive or even personality impairments. Event-related potential (ERP) methodology allows for monitoring neurocognitive processes and thus can provide a valuable window into these cognitive processes that are influenced, or brought about, by somatic disorders. The current review aims to present published studies on the relationships between somatic illness and brain function as assessed with ERP methodology, with the goal to discuss where this field of study is right now and suggest future directions.

Somatic disorders in patients followed for a psychiatric disorder at the Ar Razi hospital in Morocco

IntroductionSomatic disorders in patients suffering from psychiatric disorders have become an important issue in the overall care of these patientsComorbidity studies show that 30 to 60% of patients consulted or hospitalized in psychiatry present an associated organic pathologyHowever, the detection of somatic conditions in psychiatric patients remains too late and this exposes them to sometimes lethal somatic complicationsObjectivesTo evaluate the prevalence of somatic disorders in patients followed for a psychiatric disorder at Ar Razi hospital in Salé – Morocco, and to determine the associated factorsMethodsWe carried out a cross-sectional study with 80 patients followed for a psychiatric disorder at Ar Razi hospital in Salé presenting clinical signs in favor of an organic pathology and transferred for specialized advice to the medical-surgical services, in the period from September 1st, 2022 until August 31st, 2023.ResultsMost of our patients were male (65%) with ages ranging from 18 to 65 years. Addictive behaviors were found in more than half of our patients.The most frequent reasons for requests for advice from medical-surgical services was the suspicion of an organic cause of psychiatric symptoms in 25% of cases or the presence of an organic warning sign in 30% of cases.The comorbidity of somatic illness and psychiatric disorder was noted in 35% of cases.Somatic comorbidities were essentially: infections and cardiovascular diseases.Side effects of psychotropic drugs were predominantly neurological in 40 % of casesConclusions Somatic comorbidities in patients hospitalized or in consultation in psychiatric hospitals are very common, often unrecognized, hence the need for early screening in order to improve care.Disclosure of InterestNone Declared

Vitamin D, vitamin B12, folate, homocysteine, and major haemato-chemical parameters in patients with mood disorders

IntroductionThe potential involvement of the immune and inflammatory systems has been extensively studied in mood disorders (MDs). Despite these findings and despite the fact that the pathogenetic role of altered immunologic and metabolic profiles in MDs is being confirmed in many current studies, there is still a lack of consensus about it, due to controversial results.ObjectivesThe present study aimed to appraise peripheral metabolic parameters (blood glucose, lipoproteins, triglycerides, uric acid, blood urea nitroge [BUN], transaminases and others9 and plasma/serum levels of essential nutrients (vitamin D, B12, folate and homocysteine) in a group of inpatients affected by MDs, as compared with healthy controls.MethodsMethods. Ten ml of venous blood was drawn from fasting subjects. The metabolic parameters and vitamins were measured according to common clinical-chemistry methods.Comparisons for continuous variables were performed by the Student’s t-test for variables that follow a normal distribution, and by the Wilcoxon-Mann-Whitney test for variables not normally distributed. The correlations between biological markers were explored by calculating the Pearson’s correlation coefficient or Spearman rank correlation.Results Most patients showed loer circulating vitamin D levels, in respect to both control subjects (P< .0001) and the normative cut-off values. This finding was paralleled by increased serum homocysteine concentrations i (P<.0001), indicating an imbalance in their methionine metabolism. Homocysteine levels were negatively correlated with vitamin D, vitamin B12 and folate in control subjects, but not in patients. In addition, patients displayed higher blood glucose and lower BUN than controls, indicating an impaired protein-to-carbohydrate metabolism and/or altered nutritional/dietary status.ConclusionsWe provide herein further support to the notion that MD patients are a population where vitamin deficits, dysmetabolism and/or dietary defects are common feature, and, s such, they might be more vulnerable to a variety of somatic illnesses than the general population. This cross-sectional investigation, albeit preliminary, might contribute to improve the characterization and the monitoring of the clinical status of mood disorder patients, as well as to identify new molecular targets for more tailored treatments ad of more pointed health-care intervention,Disclosure of InterestNone Declared

Association of somatic comorbidity and treatment adherence in patients with psychotic disorder

BackgroundIncreased risk for somatic comorbidity in individuals with schizophrenia has been well established. In addition, psychiatric patients with somatic illnesses are more likely to have more psychiatric readmissions. Increased burden of treatment related to chronic somatic comorbidities may be associated with lower adherence to psychiatric medication. MethodsCross-sectional study of 275 patients with schizophrenia spectrum disorder. A general practitioner performed a complete physical health checkup for all participants, including a complete medical examination and laboratory tests. Patients’ adherence, attitudes, insight, and side-effects were evaluated using the Attitudes toward Neuroleptic Treatment Scale. Overall symptomatology was measured using the Brief Psychiatric Rating Scale. Regression analysis was used to investigate interactions and associations among health beliefs, disease burden, and treatment adherence. Separate regression models were utilized to account for the complexity of health behavior and treatment adherence pathways. ResultsPatients’ somatic comorbidity and health behavior were not associated with adherence or attitudes toward antipsychotic treatment. High dose of antipsychotics and obesity were related to the need for medical interventions, while a healthy diet reduced the risk. Higher BPRS score and older age were associated with having somatic symptoms. Somatic comorbidities had no negative effects on treatment adherence or attitudes. ConclusionThis study focuses on exploring possible associations between health beliefs and treatment adherence pathways in patients with psychotic disorders. Contrary to our hypotheses, we found no evidence to support our health belief and diseases burden models and their associations.

Nothing less than a creative triumph: a study of children admitted to hospital for serious somatic illness or injury and their experience of art therapy.

Hospitalization can be an extremely distressing experience for seriously ill and injured children. Art therapy has a well-established clinical history, and recent research has begun to demonstrate its effectiveness in somatic pediatric wards. Descriptive and statistical research indicates that art therapy can alleviate anxiety and fear, improve mood, and enhance communication among children, parents, and healthcare professionals. This study aims to enhance our understanding of the specific elements of art therapy that facilitate a connection with the healthier aspects of the self. A total of 12 hospitalized children, aged 4-12, participated in an art therapy session led by a certified art therapist. Verbalizations during the sessions were recorded, and subsequent observations were synchronized with verbatim transcriptions of audio recordings. A reflexive thematic analysis was conducted to identify relevant patterns of meaning. The study identified four significant dimensions of the children's experiences during art therapy: (1) The child feels safe, (2) The child becomes a competent artist, bursting with creativity, (3) The healthy child emerges, and (4) The child achieves something beyond its limits - a triumph. The active ingredients contributing to effective art therapy include the stimulation of creativity, guided art-making with scaffolding support, task variation, granting children control over the artistic process, encouragement of free expression, and the display of positive regard. This study also delves into the therapeutic alliance, emphasizing its role in facilitating children's learning, self-expression, concentration, and the creation of work they take pride in. Additionally, certain psychotherapy-like interactions, such as control-mastery dynamics, were observed. Nevertheless, more extensive research with larger sample sizes is required to draw broader conclusions.