ABSTRACT
OBJECTIVE: People with epilepsy suffer from the stress of living with a chronic, unpredictable disease that can lead to discrimination, misunderstanding, social stigma, and loss of autonomy in activities of daily life, elevating anxiety. Within the scope of this research, we aimed to elucidate the frequency of separation anxiety disorder in adult people with epilepsy and to examine the relationship between separation anxiety symptoms, perceived overprotection, and quality of life in comparison to the control group. MATERIAL AND METHODS: This prospective study was conducted with 105 people with epilepsy and 115 healthy volunteers. All participants were evaluated by a psychiatrist in this study using a DSM-5-based clinical interview. Sociodemographic Data Questionnaire, Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS), Separation Anxiety Symptom Inventory (SASI), Adult Separation Anxiety Questionnaire (ASA-27), Beck Depression Inventory (BDI) were administered to both groups, and Overprotection Scale, Quality of Life in Epilepsy Inventory (QOLIE-31) to only epilepsy group. Hierarchical regression analysis was used to explain the quality of life in epilepsy. Multivariate linear regression analysis was used to explain separation anxiety symptom scores. RESULTS: The rates of education, employment, and living alone were lower in the epilepsy group (p < 0.001, p < 0.001 and p < 0.001). Separation anxiety disorder of adulthood and other psychiatric comorbidities were significantly higher in the epilepsy group (p = 0.029 and p = 0.003). There was a significant negative correlation between the quality of life in epilepsy and separation anxiety symptom level, overprotection, and depression scores (p < 0.001, p = 0.01 and p < 0.01). In the logistic regression analysis, adult separation anxiety symptom level and depression scores were found to be independent factors for quality of life in epilepsy (p = 0.029 and p < 0.01). In patients with epilepsy, depression and quality of life scores were predictors for adult separation anxiety symptoms severity (p = 0.02 and p = 0.01). CONCLUSION: The frequency of diagnosis of separation anxiety disorder in adulthood was significantly higher in people with epilepsy. Overprotective attitudes of families and low quality of life were associated with high levels of separation anxiety.
ABSTRACT
Background: 'Early Intervention in Psychosis' (EIP) services have been associated with improved outcomes for early psychosis. However, these services are heterogeneous and many provide different components of treatment. The impact of this variation on the sustained treatment effects is unknown. Methods: We performed a systematic review and component network meta-analysis (cNMA) of randomised controlled trials (RCTs) that compared specialised intervention services for early psychosis. We searched CENTRAL (published and unpublished), EMBASE, MEDLINE, CINAHL, PsycINFO and Web of Science from inception to February 2023. Primary outcomes were negative and positive psychotic symptoms at 3-month and 1-year follow-up and treatment dropouts. Secondary outcomes were depressive symptoms and social functioning at 1-year follow-up. We registered a protocol for our study in PROSPERO (CRD42017057420). Findings: We identified 37 RCTs including 4599 participants. Participants' mean age was 25.8 years (SD 6.0) and 64.0% were men. We found evidence that psychological interventions (this component grouped all psychological treatment intended to treat, or ameliorate the consequences of, psychotic symptoms) are beneficial for reducing negative symptoms (iSMD -0.24, 95% CI -0.44 to -0.05, p = 0.014) at 3-month follow-up and may be associated with clinically relevant benefits in improving social functioning scores at 1-year follow-up (iSMD -0.52, 95% CI -1.05 to 0.01, p = 0.052). The addition of case management has a beneficial effect on reducing negative symptoms (iSMD -1.17, 95% CI -2.24 to -0.11, p = 0.030) and positive symptoms (iSMD -1.05, 95% CI -2.02 to -0.08, p = 0.033) at 1-year follow-up. Pharmacotherapy was present in all trial arms, meaning it was not possible to examine the specific effects of this component. Interpretation: Our findings suggest psychological interventions and case management in addition to pharmacotherapy as the core components of services for early psychosis to achieve sustained clinical benefits. Our conclusions are limited by the small number of studies and sparsely connected networks. Funding: National Institute for Health and Care Research.
ABSTRACT
INTRODUCTION: Eating disorders (ED) constitute an important group of conditions that commonly occur in adolescents. Gastrointestinal complaints are frequently reported in ED patients. Few studies assessed the association of irritable bowel syndrome (IBS) with ED. The aim of the current study is to determine the prevalence of ED in a group of IBS patients and compare it with a healthy control group and assess the relationship of IBS sub-types, it's duration and severity with ED. PATIENTS AND METHODS: 100 IBS patients diagnosed according to the Rome-IV criteria and a control group consisting of 100 healthy adults, between 18 and 65 years old, were enrolled in this study. Sub-type, duration and severity of IBS were determined. All participants were requested to fill questionnaires to screen for ED. RESULTS: 200 subjects participated in the study. 118(59%) were female and 92(41%) were male. The Eating Attitudes Test (EAT) score was significantly higher in the IBS group (Odds ratio: 5.3 CI 95%:4.3-9.3; p < 0.001). The number of subjects with EAT score >30 was significantly higher in the IBS group (p < 0.001). EAT scores were significantly higher in female IBS patients and in younger patients (p = 0.013 and p = 0.043; respectively). No significant association between the IBS sub-type and EAT score was found (p > 0.05). However, IBS severity and duration positively correlated with EAT scores. DISCUSSION: ED should be considered in the management of IBS patients. Since many psychological factors can exacerbate IBS symptoms a multidisciplinary approach consisting of medical and behavioral therapeutic modalities should be employed for a better management of these patients
INTRODUCCIÓN: Los trastornos de la alimentación (TA) constituyen un grupo importante de afecciones que suelen aparecer en adolescentes. Los pacientes con TA refieren con frecuencia molestias abdominales. La asociación del síndrome de colon irritable (SCI) con los TA se ha evaluado en un número reducido de estudios. El objetivo del estudio actual es determinar la prevalencia de los TA en un grupo de pacientes con SCI y compararla con un grupo de control sano para evaluar la relación de los subtipos de SCI, así como su duración e intensidad con los TA. PACIENTES Y MÉTODOS: En este estudio se incluyeron 100 pacientes con SCI diagnosticados según los criterios Rome-IV y un grupo de control compuesto por 100 adultos sanos de entre 18 y 65 años. Se determinaron el subtipo, la duración y la intensidad del SCI. Se pidió a todos los pacientes que cumplimentaran cuestionarios de detección de TA. RESULTADOS: En el estudio participaron 200 sujetos. Ciento dieciocho (59%) eran mujeres y 92 (41%) eran varones. La puntuación en las pruebas de actitudes alimentarias (Eating Attitudes Test [EAT]) fue significativamente superior en el grupo de SCI (cociente de probabilidades: 5,3; IC del 95%: 4,3-9,3; p < 0,001). El número de sujetos con puntuación de EAT>30 fue significativamente superior en el grupo de SCI (p < 0,001). Las puntuaciones de EAT fueron significativamente superiores en pacientes mujeres con SCI y en pacientes más jóvenes (p = 0,013 y p = 0,043, respectivamente). No se halló una asociación significativa entre el subtipo de SCI y la puntuación de EAT (p > 0,05). Sin embargo, la intensidad y la duración del SCI presentaron una correlación positiva con las puntuaciones de EAT. DISCUSIÓN: El TA debe tenerse en cuenta en el tratamiento de los pacientes con SCI. Puesto que muchos factores psicológicos pueden exacerbar los síntomas del SCI, deberá emplearse un enfoque multidisciplinar compuesto por modalidades terapéuticas médicas y conductuales para un mejor tratamiento de estos pacientes