Increased neutrophil/lymphoctye ratio in patients with bipolar disorder: a preliminary study.

BACKGROUND: In this study, it has been aimed to investigate whether neutrophil-lymphocyte ratio (NLR) was higher in non-obese patients with bipolar disorder (BD) than in a healthy control group matched for age, sex, and body mass index, and also to determine if there was an interaction between NLR and severity of the bipolar disorder. SUBJECTS AND METHODS: In this retrospective study, 103 non-obese patients with BD and 126 healthy control subjects were analyzed for complete blood count. The Young Mania Rating Scale (YMRS) was used to determine the severity of the disorder. RESULTS: The NLR was higher in female patients than in female comparison subjects (3.2±2.2; versus 1.7±0.4) (p<0.001). Also, compared with the healthy male subjects, the male patients had significantly higher neutrophil/lymphocyte ratio (3.3±2.4; versus 2.0±0.7) (p<0.001). In the patients with bipolar disorder, NLR did not significantly correlate with severity (as measured with the YMRS) (r=0.052; p=0.204) and duration of the disorder (r=0.045; p=0.301). CONCLUSIONS: Results of this study revealed that patients with bipolar disorder have statistically significant elevated NRL than healthy compares. According to this finding, elevated levels of NLR may be involved in inflammatory pathophysiology of bipolar disorder. Further studies are needed for a better understanding of the mechanism between elevation of NRL in patients with bipolar disorder.

Plasma omentin levels in drug-free patients with schizophrenia.

AIMS: We aimed to investigate plasma omentin concentrations in non-obese, drug-free patients with schizophrenia in comparison with healthy volunteers. METHOD: Thirty-two patients with schizophrenia and 33 control subjects were recruited. Plasma omentin levels were determined by enzyme-linked immunosorbent assay. RESULTS: Plasma levels of omentin (ng/ml) were found to be markedly lower in patients with schizophrenia (median = 7.7, 25th percentile = 6.3, 75th percentile = 604.9) than in controls (median = 486, 25th percentile = 326, 75th percentile = 794.2, p < 0.01). No significant difference was found between drug-free (n = 23) and drug-naive (n = 9) patients with respect to plasma omentin levels. Omentin concentrations correlated negatively with severity of illness, suggesting that patients with more severe pathology had lower fasting levels of omentin (n = 32; r = -0.387; p = 0.029). CONCLUSION: The present results suggest that plasma omentin levels are decreased in physically healthy, non-obese, antipsychotic-free patients with schizophrenia when compared with physically and mentally healthy individuals. To our knowledge, this is the first study that demonstrated the association between omentin and schizophrenia.

Serum levels of omentin are not altered in drug-naive patients with major depression: a pilot study.

BACKGROUND: Decreased plasma levels of omentin, a relatively novel adipokine, are shown to be associated with metabolic abnormalities and proinflammatory states. Although other adipokines such as leptin and adiponectin have been extensively investigated in patients with major depressive disorder (MDD), no studies have evaluated omentin levels in major depression. Therefore, this study sought to test the hypothesis that drug-naive patients with MDD would have lower serum omentin levels than a healthy control group similar in age, sex, and body mass index. SUBJECTS AND METHODS: Thirty patients with MDD (10 men) and 30 healthy control subjects (10 men) were studied. Plasma concentration of omentin, along with other biochemical parameters, was measured after a period of fasting. The severity of depression was determined by the Beck Depression Inventory. RESULTS: No significant difference was found between patients with MDD (723.3±233.8 ng/ml) and healthy comparison subjects (670.7±351.8 ng/ml) in mean plasma concentrations of omentin (p>0.05). There was no significant correlation between plasma omentin levels and depression severity (r=-0.147; p>0.05). CONCLUSIONS: This is the first investigation of omentin levels in patients with MDD. The hypothesis that circulating omentin levels would be different in depressed patients than in healthy controls is not supported by our data.

Elevated neutrophil/lymphocyte ratio in patients with schizophrenia.

BACKGROUND: Inflammatory mechanisms are reported to play important roles in the pathophysiology of schizophrenia. The neutrophil-lymphocyte ratio (NLR) is a simple and easily accessible indicator of the systemic inflammatory response. Our goal was to investigate whether NLR was higher in patients with schizophrenia than in healthy comparison subjects similar in age, sex, and body mass index. SUBJECTS AND METHODS: In this multicenter cross-sectional study, we analyzed 156 non-obese patients with schizophrenia and 89 healthy control subjects for complete blood count. The Brief Psychiatric Rating Scale was used to determine the severity of clinical pathology. RESULTS: The mean ± SD NLR of patients with schizophrenia was significantly higher than that of healthy controls (2.6 ± 1.1 vs. 1.9 ± 0.6, respectively, p < 0.001). NLR did not significantly correlate with severity and duration of schizophrenia (r = 0.065. p > 0.05). CONCLUSIONS: Our findings suggest that NLR levels are increased in physically healthy, non-obese, patients with schizophrenia when compared with physically and mentally healthy individuals. To our knowledge, this is the first study that demonstrated the association between NLR and schizophrenia.

Atypical antipsychotic use is an independent predictor for the increased mean platelet volume in patients with schizophrenia: A preliminary study.

BACKGROUND: Cardiovascular diseases, cardiovascular risk factors, and mortality due to these situations are more frequently encountered in schizophrenic patients when compared with the general population. The mean platelet volume (MPV) is a surrogate biomarker of the platelet activity and an useful prognostic test in cardiometabolic diseases. The aim of this study was to investigate what influenced MPV levels in patients with schizophrenia. MATERIALS AND METHODS: We evaluated hospital records of 60 hospitalized schizophrenia patients. Thirty age- and sex-matched healthy control subjects were also included as a control group. RESULTS: MPV levels were significantly higher in patients who were on atypical antipsychotic drugs than in patients who were not using any drug (9.2 ± 0.8 vs. 8.6 ± 0.8 fL, P = 0.016) and also higher than control group (9.2 ± 0.8 vs. 8.1 ± 0.9 fL, P < 0.001). Furthermore, patients who were not using antipsychotics had higher MPV than control group (8.6 ± 0.8 vs. 8.1 ± 0.9 fL, P = 0.036). Atypical antipsychotic use [Odds ratio (OR) =6.152, 95% confidence interval (CI,) P = 0.003)] and platelet distribution width (OR = 0.989, 95% CI, P = 0.032) were associated with high MPV levels in univariate analysis. In multivariate logistic regression model, only atypical antipsychotics use (OR = 6.152, 95% CI, P = 0.003) was found to be independent predictor of high MPV levels after adjustment of other potential confounders (age, gender, presence of hypertension, diabetes mellitus, hyperlipidemia, and smoking). CONCLUSION: MPV seems to be influenced not only by schizophrenia itself but also by atypical antipsychotic drugs. It might be concluded that schizophrenic patients are under increased risk for cardiometabolic diseases and risk factors and this risk is higher in patients on atypical antipsychotic treatment.

[Anxiety levels and quality of life assessment in patients that underwent an electrophysiologic study due to unexplained palpitations]. / Açiklanamayan çarpinti nedeniyle elektrofizyolojik çalisma yapilan hastalarda yasam kalitesi ve kaygi düzeylerinin degerlendirilmesi.

OBJECTIVES: To compare the quality of life and anxiety levels of patients with normal and abnormal results detected during an electrophysiological study (EPS) that was performed due to undocumented palpitations. STUDY DESIGN: Patients (n=128) who underwent EPS without documented arrhythmia of unexplained palpitations were included in the study. The quality of life and anxiety levels of patients with abnormal EPS results were compared with those with normal results by using the 26-item short form of the World Health Organization quality of life scale and state-trait anxiety inventory. RESULTS: SVT was found in 72 patients by diagnostic EPS. Quality of life scores were significantly poorer in the SVT group than of the normal EPS group (p=0.000-0.001). Likewise, the anxiety scores of the patients in the SVT group were higher than normal in the EPS group (p=0.000). Age, physical quality of life, psychological quality of life, state anxiety and trait anxiety were found to be independent predictors of SVT in multivariate regression analysis. CONCLUSION: The level of anxiety was found to be higher and quality of life was found to be lower in patients with palpitations due to SVT. In clinical practice it should be kept in mind that noticed psychiatric symptoms may be secondary to an underlying arrhythmia in the evaluation of patients with palpitations.

A Comparison of the Relationship Between C-Reactive Protein Levels and Cognitive Functions in Patients with Schizophrenia, First-Episode Psychosis, and Healthy Controls.

Background: There are several hypotheses on what causes schizophrenia, some of which include inflammatory responses. Additionally, it might be challenging to control and treat cognitive abnormalities, which represent the primary symptoms, and may be related to inflammation. This study aims to determine whether there is a relationship between C-reactive protein levels and cognitive abilities by assessing neuropsychological tests of drug-free patients with schizophrenia and first-episode psychosis. Methods: The patient group consisted of 36 patients with schizophrenia or "first-episode psychosis," while the control group comprised 31 healthy people. The control group consisted of healthy participants without any medical or psychiatric diseases. Structured Clinical Interview for DSM-5 axis I disorders was applied for diagnosis, while Wisconsin card sorting test, Stroop color and word test, trail making tests, Rey auditory verbal learning test, and digit span test were applied for cognitive assessment of both groups. Clinical characteristics of patients were evaluated by using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the Calgary Depression Scale for Schizophrenia. The patient group and healthy control group were evaluated in terms of inflammation levels. The C-reactive protein levels were measured, and their relationship with cognitive status was examined. The serum samples were analyzed by the immunoturbidimetric method in C-reactive protein C8000 Architect (Abbott, Ill, USA) to measure the C-reactive protein levels. Results: C-reactive protein levels were found to be higher in the patient group (P = .003), while the Scale for the Assessment of Negative Symptoms and Scale for the Assessment of Positive Symptoms scores were found to be positively correlated with C-reactive protein levels. Cognitive functions in the patient group were significantly lower compared to the healthy group. There was a statistically weak correlation between C-reactive protein and the number of word color reading errors in the Stroop test, which was associated with complex and frontal attention; however, no correlation was found with digit span test, Rey auditory verbal learning test, or Wisconsin card sorting test points. Conclusion: Elevated peripheral levels of C-reactive protein are associated with poorer cognitive function in patients with first-episode psychosis and schizophrenia, particularly, complex attention associated with the Stroop test. Inflammation may have an impact on cognitive impairment in psychosis.

Serum cortisol and dehydroepiandrosterone-sulfate levels in schizophrenic patients and their first-degree relatives.

AIMS: Alterations in cortisol and dehydroepiandrosterone sulfate (DHEA-S) levels are thought to play a role in the pathophysiology of neuropsychiatric disorders, including schizophrenia. The aim of this study was to investigate the role of serum cortisol and DHEA-S in the pathophysiology of schizophrenia. METHODS: Sixty schizophrenic patients, 70 healthy first-degree relatives, and 60 healthy volunteers were included. Sociodemographic characteristics, data regarding disease duration and severity, as well as ongoing and previous drug use were recorded. Serum cortisol and DHEA-S levels were measured. RESULTS: Serum cortisol and DHEA-S levels were significantly higher in the schizophrenia group compared with the first-degree relatives and controls (P < 0.05). Serum cortisol levels in the first-degree relatives were significantly higher than in the healthy controls (P < 0.05). There was no significant difference between the first-degree relatives and healthy-controls in terms of DHEA-S levels and between the three groups in terms of serum cortisol/DHEA-S ratios. CONCLUSIONS: Elevated serum cortisol levels in schizophrenic patients might be associated with the role of cortisol in the pathophysiology of schizophrenia. Also, the elevation of serum cortisol levels in first-degree relatives compared to controls suggests that similar pathophysiological processes might have a role in individuals without any disease symptoms, but with a genetic predisposition for schizophrenia. Elevated serum DHEA-S levels might be the result of a compensatory response to elevated cortisol levels. Serum cortisol and DHEA-S levels may be used as a biological marker for the diagnosis of schizophrenia; however, further studies with larger sample sizes are warranted to support this finding.

Are the C-reactive protein/albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (NLR) novel inflammatory biomarkers in the early diagnosis of postoperative complications after laparoscopic sleeve gastrectomy?

PURPOSE: C-reactive protein/albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are new generation inflammatory markers that have been investigated for use in determining disease prognosis or postoperative morbidity and mortality after many open surgeries. The aim of this study is to investigate the efficacy of CAR, NLR, and PLR on the early detection of postoperative complications (POC) after laparoscopic sleeve gastrectomy (LSG). MATERIAL-METHOD: The study included 448 patients, 16-65 years of age, who underwent LSG between 2015 and 2019. C-reactive protein (CRP) and albumin levels were measured on postoperative day 1 and 3 and CAR values were obtained. NLR and PLR values were evaluated preoperatively and on postoperative day 1 and 3. Statistical analyses were performed using the SPSS version 21.0 and MedCalc. RESULTS: A total of 326 patients with a mean age of 37 ± 11 years were analyzed. Both CAR1 and CAR3 values were correlated with the development of complications (r = 0.3, r = 0.3, respectively p < 0.001). Pre-op NLR value was found to be a significant risk factor on complication development (OR = 1.943, p = 0.043). The cut-off value for CAR1 and CAR3 were found as 0.78 and 1.25 mg/dL in ROC analysis (AUC = 0.808, AUC = 0.832, respectively). PLR3 value was diagnostic among other PLR values in the determination of POC (AUC = 0.703 Youden index = 0.36 p = 0.014). CONCLUSION: The most significant diagnostic value for the determination of POC was CAR3. It was followed by CAR1, CRP3, CRP1, and PLR3 values. Only preoperative NLR was found as a risk factor for the development of POC.

Ultrasonic harmonic scalpel in total thyroidectomies.

INTRODUCTION: Haemostasis is very important in thyroid surgery. In conventional surgery, electrocoagulation and suture ligation are used for haemostasis; newer techniques include vessel clips, ultrasonic instruments and lasers. The aim of this prospective study was to compare the usage of the ultrasonic harmonic scalpel (UHS) with conventional procedures, in total thyroidectomies, for operation time, blood loss, usage of drain, cost, length of hospitalisation and complications. METHODS: We examined 104 patients who underwent bilateral total thyroidectomy. They were divided randomly into two groups. Patients in Group I (n=54) underwent operations using conventional techniques (electrocautery and suture ligation) while patients in Group II (n=50) underwent operations using the UHS. Operation time, number of ligatures used, blood loss, intra-operative complications, weight of the specimen, necessity of drain, postoperative seroma, bleeding, infection, transient or permanent hypocalcaemia, permanent recurrent laryngeal nerve palsy and length of hospitalisation were recorded. RESULTS: The operation time was significantly longer in Group I (conventional) (105+/-16 minutes; mean+/-standard deviation) than Group II (UHS) (77.9+/-12.5 minutes; P<0.001). The mean blood loss was less in patients who were operated on with the UHS (25.3+/-10.2 g) than in patients operated on with conventional methods (59.5+/-33.9 g; P<0.001). The mean number of ligatures used in the UHS group was 5.3, which was significantly fewer than the mean of 51.6 ligatures used in the conventional methods group (P<0.001). Drains were also used less in the UHS operations (12%-59%; P<0.001). CONCLUSION: Use of the UHS in thyroid surgery results in decreased operation time, drain usage and amount of bleeding and does not increase postoperative complications. The UHS is an effective, reliable and less expensive technique for thyroid surgery.

Tardive Dyskinesia Associated with Bupropion.

Present report describes a 46 year old male patient with a diagnosis of major depression who developed tardive dyskinesia during bupropion therapy. Our patient had no history of neuroleptic use and his laboratory and neurologic examinations were normal. He had no family history of neurologic diseases. Although bupropion induced dyskinesia has been previously reported in the literature, it is rare and our case is the first case regarding tardive dyskinesia.

The role of serum inflammatory markers in acute appendicitis and their success in preventing negative laparotomy.

Improving the diagnosis of acute appendicitis in order to prevent unnecessary surgery is crucial. This study was intended to identify the role of serum inflammatory markers in patients with preliminary diagnosis of acute appendicitis with a retrospective design. Eighty-five patients with the preliminary diagnosis of acute appendicitis were recruited in this study within the period of November-December 2003. The average age was 31.8 years (ranged from 15 to 85). There were 62 males (72.9%) and 23 females (27.1%). In addition to performing routine tests, preoperative serum samples were obtained from the patients to measure C-reactive protein, interleukin-6, and interleukin-10. All the patients were operated on for a clinical suspicion of acute appendicitis. Depending on the macroscopic evidence during the operation and the histopathological examination of the specimen, the patients were separated into two groups: the ones who did not have acute appendicitis as the cause for acute abdomen (group I; n = 14) and the ones who had acute appendicitis (group II; n = 71). The ones who had acute appendicitis (group II) were further grouped as noncomplicated appendicitis (group IIA; n = 44) and complicated appendicitis (group IIB; n = 27). Being a male with elevated levels of leukocytes (white blood cells, WBC); C-reactive protein (CRP), interleukin-6 (IL-6); and interleukin-10 increased the probability of having acute appendicitis in patients with evidences of acute abdomen. The risk of complication of acute appendicitis significantly increased when patients had increased levels of C-reactive protein, increased erythrocyte sedimentation rate, and increased interleukin-6 levels, had symptoms for more than 24 h, and were female. Interleukin-10 levels within normal range might be helpful in eliminating the possibility of acute appendicitis. Thus, elevated levels of WBC, IL-6 and CRP might be helpful in confirming a potential diagnosis of acute appendicitis. In addition, normal levels of IL-10 might be of additional help to possibly rule out the diagnosis of acute appendicitis.

Fournier gangrene. Approaches to diagnosis and treatment.

OBJECTIVE: To investigate the factors associated with patients with Fournier's gangrene, and to clarify the effect of diabetes mellitus (DM) as a comorbid disease on morbidity and mortality of patients with Fournier's gangrene. METHODS: Twenty-six Fournier's gangrene patients who were admitted to the Emergency Department of Ankara Numune Teaching and Research Hospital, Ankara, Turkey from 1997 to 2003 were examined retrospectively. RESULTS: The mean age of the patients was 52.8 years. There were 8 female (30.8%) and 18 male (69.2%) patients. The etiological causes were as follows: diseases of the perianal region, history of operations, trauma and injections. Major comorbid disease states were diabetes mellitus (DM) and hypertension. The lesions in Fournier's gangrene were most commonly located in the perineum and genital region. Female patients with diabetes mellitus had significantly unusual extensive involvement, especially abdominal wall involvement. The most frequently isolated pathogen was Escherichia coli, while staphylococcal infection was most commonly seen in the presence of DM. Colostomy was performed on 53.8% of the patients, and cystostomy on 7.6% of the patients. Average time of staying at the hospital was 25 days with a mortality rate of 34.6%. Patients with DM had high mortality rates and stayed longer at the hospital than the non-diabetic patients. CONCLUSION: In addition to early diagnosis, early and aggressive debridement and administration of multiple wide spectrum antibiotics chosen for the causative agent are the golden standard for decreasing the mortality and morbidity. Diabetes mellitus has been found to be an important factor to increase mortality rates of patients with Fournier's gangrene.

Predictors of No-Reflow Phenomenon in Young Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.

No-reflow is of prognostic value in ST-segment elevation myocardial infarction (STEMI) but has not been extensively investigated in young patients. Young patients with STEMI admitted within 12 hours from symptom onset and treated by primary percutaneous coronary intervention (pPCI) were recruited. Patients were classified into 2 groups based on postintervention thrombolysis in myocardial infarction (TIMI) flow grade; no-reflow: TIMI flow grade 0, 1 or 2 (group 1; n = 27; 21 men, mean age: 42 ± 4 years); and angiographic success: TIMI flow grade 3 (group 2; n = 118; 110 men, mean age: 43 ± 4 years). Adjusted odds ratios were 13.79 for female gender (P < .001; confidence interval [CI] = 1.88-101.26), 2.09 for pain to balloon time (P < .017; CI = 1.14-3.812), 12.29 for high TIMI thrombus grade (P = .012; CI = 1.74-86.94), 0.04 for tirofiban use (P < .001; CI = 0.01-0.22), 5.19 for mean platelet volume (MPV; P < .001; CI = 2.44-11.01), and 1.008 for platelet-lymphocyte ratio (PLR; P = .034; CI = 1.001-1.016). In conclusion, female gender, pain to balloon time, high TIMI thrombus grade, tirofiban, MPV, and PLR were independent predictors of no-reflow in young patients with STEMI after pPCI.

A new diagnostic tool for masked hypertension: impaired sleep quality.

INTRODUCTION: The aim of this study was to evaluate the relationship between masked hypertension and impaired sleep quality. Additionally, we evaluated the diagnostic role and prevalence of poor sleep quality among patients with newly diagnosed masked hypertension. MATERIAL AND METHODS: A total of 112 individuals, 72 patients with newly diagnosed masked hypertension and 40 normotensive healthy volunteers, were included in this study. All patients underwent evaluation comprising 12-lead electrocardiography, transthoracic echocardiography, 24-hour Holter ECG, and basic laboratory tests. Additionally, all participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI). RESULTS: The total PSQI score was significantly higher in the masked hypertension group than in the normotensive healthy volunteers (4.13 ±2.43 vs. 2.33 ±1.67, p < 0.001). A PSQI score > 5 was found in 45.8% (n = 33) of patients in the masked hypertension group and 15% (n = 6) of patients in the normotensive group (p < 0.001). The non-dipper pattern was found in 17.5% of the healthy volunteer group and 59.94% (n = 41) of the masked hypertension group (p < 0.001). When we compared the dipping pattern of the masked hypertension groups, there was a significant difference in PSQI score between the dipper and non-dipper groups (4.87 ±3.21 vs. 3.58 ±2.33, p < 0.001). Multiple logistic regression analyses showed that masked hypertension, LV mass, and LV mass index score were independent predictors of poor PSQI. CONCLUSIONS: This study demonstrates impaired sleep quality in subjects with masked hypertension, particularly those with a non-dipper pattern. Additionally, this study indicates that impaired sleep quality may help diagnose masked hypertension, particularly in the non-dipper group.

The relationship between internet addiction and body mass index in Turkish adolescents.

The purpose of this study was to investigate Internet use patterns and Internet addiction among adolescents and to examine the correlation between Internet addiction and eating attitudes and body mass index (BMI). The study was conducted among 1,938 students, aged between 14 and 18 years. The Internet Addiction Test (IAT), the Eating Attitudes Test (EAT), and a sociodemographic query form were used to collect data. According to the IAT, 12.4% of the study sample met the criteria for Internet addiction. A significant positive correlation between BMI and the IAT (r=0.307; p<0.01) and weekly Internet use (r=0.215; p<0.01) was found. Nine students with Internet addiction (3.8%) and 90 with average Internet use (5.3%) were found to have a possible eating disorder (p>0.05). No relationship was found between the EAT and the IAT and duration of weekly Internet use. Linear regression analysis revealed a significant independent association of the IAT with BMI (r=0.235; p<0.001). These results indicate an association between Internet addiction and BMI. Further studies are needed to describe the causality of this association.

Health-related quality of life in patients with anal fissure: effect of type D personality.

INTRODUCTION: Health-related quality of life (HRQL) is a significant factor in describing the burden of illness and the impact of treatment in patients with gastrointestinal disease. Type D (distressed) personality is defined as the co-occurrence of negative affect and social inhibition. AIM: To assess the prevalence of type D personality in patients with anal fissure and to investigate whether the presence of a type D personality would affect HRQL in patients with anal fissure. MATERIAL AND METHODS: One hundred outpatients with anal fissure with no psychiatric comorbidity were consecutively enrolled, along with 100 healthy controls. Type D Scale (DS14) and General Health Survey Short Form-36 (SF-36) were used in the collection of data. RESULTS: Patients with anal fissure scored lower on physical roles and bodily pain dimensions of SF-36 than healthy subjects (p < 0.05). Thirty-three patients with anal fissure (33%) and 16 controls (16%) had scored above the cut-off score of the DS14 (p < 0.05). Patients with a type D personality were found to score lower on bodily pain and social roles domains of HRQL than patients without a type D personality. CONCLUSIONS: Type D personality was associated with increased perceived bodily pain and social roles in patients with anal fissure. Type D personality construct may be an important consideration when assessing HRQL outcomes. A multidimensional approach may be valuable in the assessment of patients presenting with anal fissure, because a subgroup with type-D personality might benefit from psychological therapies.

The impact of type D personality on health-related quality of life in patients with symptomatic haemorrhoids.

INTRODUCTION: Haemorrhoids are one of the most common reasons that patients seek consultation from a colon and rectal surgeon. Health-related quality of life (HrQoL) is a significant factor in describing the burden of illness and the impact of treatment in patients with gastrointestinal disease. Type D (distressed) personality is defined as the co-occurrence of negative affect and social inhibition. AIM: To assess the prevalence of type D personality in patients with haemorrhoids and to investigate whether the presence of a type D personality would affect HrQoL in patients with haemorrhoids. MATERIAL AND METHODS: One hundred and six outpatients with symptomatic haemorrhoids with no psychiatric comorbidity were consecutively enrolled, along with 96 healthy controls. The Type D Scale (DS14) and the General Health Survey Short Form-36 (SF-36) were used in the collection of data. RESULTS: Of 106 patients evaluated, 29.2% met criteria for type D personality. Patients with haemorrhoids scored lower on bodily pain and vitality dimensions of SF-36 than did healthy subjects (p < 0.001). Patients with a type D personality were found to score lower on bodily pain domain of HrQoL than patients without a type D personality. Linear regression analysis revealed a significant independent association of type D personality with bodily pain dimension of the SF-36 in patients with symptomatic haemorrhoids (r = -0.315, p < 0.01). CONCLUSIONS: Type D personality was associated with increased perceived bodily pain in patients with haemorrhoids. Consideration of type D personality construct personality traits could improve risk stratification in research and clinical practice in this patient group.