Quality of life in survivors of childhood brain tumour and the association of children's diseases on quality of their parents life.

OBJECTIVE: Evaluation of children's quality of life (QoL) after finished brain tumour treatment and the association of children's diseases on quality of their parents' life. METHODS: The study group was consisted of 46 children after brain tumour treatment (aged 4, 5, to 29 years old). The control group was composed of 104 students of primary, secondary, and high schools. One hundred fifty (104 + 46) parents were included in the study. Standardised QoL questionnaires (PEDsQL-4.0, WHOQOL-BREF) were used. Survivors' QoL was assessed from patients' and their parents' point of view, also the association of children's diseases on quality of their parents' life was estimated. RESULTS: QoL of children after brain tumour treatment was lower than in the control group according to the children (P < 0.001) and their parents (P < 0.001). The survivors worst rated their ability to social functioning (P < 0.0010) and physical functioning (P < 0.001) in comparison with self-assessment of healthy children. According to their parents, the functioning of children in all zones was worse than in the control group, mostly in social (P < 0.001) and physical sphere (P < 0.001), too. QoL of children with low-grade tumour was comparable with QoL of children with high-grade tumour). QoL of survivors' caregivers in study was higher than QoL of parents of control groups (P = 0.023). CONCLUSIONS: The quality of patients' life after brain tumour treatment is lower in comparison with healthy children. QoL of the parents of survivor is higher than the QoL of healthy children parents. The assessment of QoL of children after brain tumour treatment should be an inherent element of health monitoring.

Depression, sleep disturbances and anxiety in patients with relapsing-remitting multiple sclerosis: a longitudinal cohort observation.

BACKGROUND: Depression, sleep disturbances and anxiety may affect almost half of the population of patients with multiple sclerosis (MS) and they are major determinants of poor quality of life in young adults. The aim of our study was to assess their incidence in patients with MS in Poland, and whether they change during longitudinal observation in routine clinical practice. SUBJECTS AND METHODS: We included 53 consecutive patients with relapsing-remitting form of MS in this prospective study, who were treated in our department. All patients were examined at the entry to the study and after at least three or more years after study start with 4 standardized questionnaires and clinical scales that were validated in Polish patients: Athens Insomnia Scale (AIS), Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS) and Expanded Disability Status Scale (EDSS). The data from the two time-points were compared. RESULTS: At the entry to the study daytime sleepiness, nighttime insomnia, depression episodes and anxiety were observed in 11.3%, 13.2%, 11.3% and 28.3% of patients, respectively. At the end of the study higher proportion of patients reported any form of drowsiness, depression, insomnia or anxiety, however, the differences were not statistically significant. Except for anxiety, higher proportion of patients reported definite disorders, with the rise from 3.8% to 13.2% having depression and rise from 9.4% to 15.1% having insomnia. Moderate or pathological drowsiness was not reported initially, but it was reported in 5% and 2.5% patients, respectively, at the study end. CONCLUSIONS: The incidence of sleep and mood disturbances in polish patients with MS is quite high, and it is comparable to other studies in patients with MS. Possible mood changes or sleep disturbances in individual patients should be routinely monitored by clinicians.

Empathy among physicians, medical students and candidates.

BACKGROUND: Empathy is one of the crucial personality traits for all medical professionals, including physicians. The importance of empathy in doctor-patient relationship cannot be overestimated, as it is beneficial for both sides. Regrettably, there is evidence for the decline in this trait over the course of medical studies. SUBJECTS AND METHODS: The participants were 509 voluntary respondents: medical school candidates (16.1%), medical students (65%), medical trainees (9.8%), residents (6.3%) and specialists (2.8%). The Interpersonal Reactivity Index (IRI) was administered to them, which is a self-report tool measuring empathy. RESULTS: Gender difference in the IRI score was especially prominent - the mean score for female respondents was 59.83 points, while in men it was 51.16 point (p<0.001). The level of empathy did not differ significantly in the sub-groups divided with regards to the stage of their medical career. However, the total IRI score in women was the highest in the group of doctors, while in post-graduated males it was the lowest. Age of the respondents correlated positively with the perspective taking sub-scale and negatively with the fantasy and personal distress sub-scales. CONCLUSIONS: Empathy is a trait that is rarely being enhanced in medical students during their education. While empathy is crucial for the development of a satisfactory doctor-patient relationship, there is an urgent need to adopt educational programs aimed at reinforcing empathy in medical students.

Evaluation of the level of depression among medical students from Poland, Portugal and Germany.

BACKGROUND: Depression is a serious illness affecting health, family and professional life of many people of all sectors of society. It also concerns students, regardless of their geographical location. The Beck Depression Inventory (BDI) is a proper tool to brief check of the level of depression because it has high correlation with depression. The aim of this study was to assess and compare the level of depression among medical students from Poland, Portugal and Germany. SUBJECTS AND METHODS: Students from different countries were asked to fill in an electronic form containing the BDI. The form was created separately for each country, using official translation of the BDI, approved by the competent psychiatric association. Google Drive software was used for the electronic form, and Stat soft Statistica v10 software for statistical analysis. RESULTS: There were statistically significant differences (p<0.05) in terms of average score of the BDI and of the proportion of the scores more than 10 points of medical and technology students among kinds of studies and countries. The average score of the BDI of medical students: Poland: 13.76±9.99 points; Germany: 8.49±7.64 points; Portugal: 7.37±7.67 points. The average score of the BDI of technology students: Poland: 12.42±9.66 points; Germany: 10.51±8.49 points; Portugal: 9.25±8.97 points. The proportion of the scores more than 10 points of medical students: Poland 56.32% (285/506) Germany 34.92% (154/441) Portugal 26.03% (82/315). The proportion of the scores more than 10 points of technology students: Poland 55.01% (368/669) Germany 43.82% (156/356) Portugal 37.57% (136/362). CONCLUSIONS: The highest depression score among medical and technology students according the BDI was found in Poland. A proper monitoring of depression is required, as well as rapid and appropriate help for those who suffer from it.

Evaluation of the utility of Liebowitz Social Anxiety Scale and Barratt Impulsiveness Scale in the diagnosis of social anxiety, impulsivity and depression.

BACKGROUND: Often mental disorders are serious problems concerning psychological well-being. They require comprehensive and specialized psychiatric and psychological help, but there are no public methods of controlling your mental state. The aim of study was the evaluation of the utility of Liebowitz Social Anxiety Scale and Barratt Impulsiveness Scale in the diagnosis of social anxiety, impulsivity and depression. SUBJECTS AND METHODS: The study included 85 persons. The study group had 34 patients treated in an open ward of the Department of Psychiatry and Psychotherapy of Medical University of Silesia in Katowice. The control group included 51 persons without mental disorders. Three self-rating questionnaires were used: Beck Depression Inventory, Barratt Impulsiveness Scale and Liebowitz Social Anxiety Scale. Statistica v10 Statsoft software was used for statistical analysis. RESULTS: The analyzed groups had significant differences in terms of Beck Scale (U Mann-Whitney test p=0.000001). Average score in study group: 22.94±12.50; in control group: 7.15±6.44. Groups had significant differences in terms of Liebowitz Scale (U test Mann-Whitney test, p=0.000164). Average score in the study group: 60.41±30.30; in control group: 35.01±23.94. Groups had significant differences in terms of Barratt Scale (t-student test p=0.000601). Average in study group: 66.35±9,49; in control group: 59.54±7.87. Significant positive correlation was observed between the results of Beck Scale and Liebowitz Scale (r=0.64465). Correlation was not observed between the results of the Liebowitz and Barrat (r=0.12091 and Beck and Barrat (r=0.21482). CONCLUSIONS: The intensity of the Liebowitz Social Anxiety Scale is directly proportional to the severity of depression according to the Beck Depression Inventory. The degree of impulsivity by Barrat Impulsiveness Scale does not correlate with the level of depression according to Beck Depression Inventory. The analyzed scales are relevant in the diagnosis of mental disorders.

"Claw your way"--Machiavellianism among the medical community.

BACKGROUND: Machiavellianism is a personality trait characterized by emotional detachment and tendency to manipulate others to achieve one's own goal. It is presumed that people high in Machiavellianism would more likely choose business-related occupations, whereas low Machiavellians would prefer helping professions, therefore medical professionals are expected to be low-Machs. SUBJECTS AND METHODS: This is a questionnaire study on 509 respondents: medical school candidates (16.1%), medical students (65%), medical trainees (9.8%), residents (6.3%) and specialists (2.8%) aimed at assessing the level of Machiavellianism, as measured with Mach-IV score, a self-report questionnaire. RESULTS: The overall mean Mach-IV score was 59.24±6.07. The highest mean Mach-IV score, 61.80±6.94, was found in the group of medical school candidates. The lowest mean Mach-IV score, 57.61±7.88, was reported in the group of registered specialists. Male gender was found to be positively correlated with the mean Mach-IV score, which in women was 58.97±6.08 and in men it was 60.16±6.01. There was a negative correlation between the mean Mach-IV score and the age of post-graduate participants. When we divided all participants into subgroups of "low Machs" (<60 points) and " high Machs" (≥60 points), we found that both subgroups were similarly numerous--49.5% and 50.5%, accordingly. The highest representation of "high Machs" was found in the subgroup of medical studies candidates (65.85%), then in the students (47.73%) and in the group of post-graduates (45.16%). Gender differences remained statistically significant--47.33% of women and 60.18% of men were "high Machs". CONCLUSIONS: Machiavellianism level among medical candidates, students and doctors is relatively high, however is gradually decreasing with the progress of career.