Satisfaction with life and coping skills in the acute and chronic urticaria.

BACKGROUND: The purpose of this study was to examine the differences in satisfaction with life and coping strategies between patients with acute and chronic urticaria. SUBJECTS AND METHODS: Sixty patients with urticaria were divided into 2 groups after 6 weeks of standardized dermatology treatment (33 patients with acute and 27 patients with chronic urticaria). At baseline, all patients answered the following questionnaires: Satisfaction with Life Scale (SWLS), Personal Wellbeing Index (PWI-A), The Multidimensional Coping Inventory (COPE) and General questionnaire (age, gender, education, employment, marital status). After six weeks all the participants were re-tested with 2 questionnaires: SWLS and PWI-A. RESULTS: Six weeks after the initial testing there was a statistically significant difference in satisfaction with life between patients with acute and chronic urticaria. Patients with acute urticaria were more satisfied with their lives than patients with chronic urticaria. Also, there was a statistically significant difference in the use of emotion-focused coping, seeking social support for emotional reasons and seeking social support for instrumental reasons. Patients with acute urticaria used emotion-focused coping and sought social support for emotional and instrumental reasons to a greater degree than patients with chronic urticaria. CONCLUSION: Patients with acute urticaria were more satisfied with their lives than patients with chronic urticaria. Patients with acute urticaria used emotion-focused coping and sought social support for emotional and instrumental reasons to a greater degree than patients with chronic urticaria.

Virus etiology of schizophrenia: the characteristics of the "*Little Ice Age" and its consequences.

The data of the "Little Ice Age" (1500-1850) in Croatia and those which applied to human health were especially emphasized were analyzed. They are some which stand out like: importance of the sort of soil and relief, the influence of cutting down of woods and cattle-breeding and especially the war which lasted for 250 years in the territory of Croatia. The important interactions between those parameters were defined. The important correlations were also defined between freezing and long winters as well as wet springs and summers which caused starvation, malnutrition and the increase of infant mortality and also epidemics with enormous psychological stress among people in that period. The result was witch-hunting and burning (which was also advocated in the other parts of Europe) and they sometimes reached the levels of madness. Considering that such events were unknown in the earlier periods (in such proportions) and that (even today) the influence of the slow virus is emphasized in connection to the etiology of schizophrenia so why should't it be supposed that the "Litlle Ace Age" could be the cause of the larger prevalence of schizophrenia in the teritory of Croatia.

Stigmatization of patients suffering from schizophrenia.

For the general public, but also for healthcare professionals, schizophrenia is still one of those areas of medicine connected with feelings of unease, fear and prejudice. These feelings lead to stigmatization and discrimination which are unjust processes which put patients suffering from mental illnesses into undesirable and unequal positions. Aim of this research was to establish the extent of stigmatization of mentally ill patients among the population of healthcare professionals and future healthcare professionals and if they differ from general population. Results show that stigmatization of schizophrenic patients is high among all included populations. Although there were no statistical differences between groups regarding the assessment of schizophrenic patients, nurses employed in psychiatric wards exhibited a tendency towards higher acceptance of schizophrenic patients, as well as better understanding of that illness. This data emphasizes a growing need for continuous education of general population but also of healthcare professionals.

Influence of personality traits on sexual functioning of patients suffering from schizophrenia or depression.

Aim of this research was to establish effects and influence of personality traits on sexual functioning of schizophrenic and depressive patients, compared to healthy individuals. 300 participants were included in this research. For patients suffering from schizophrenia it was established that the more they are open to experience and the less they are neurotic their sexual drive is stronger. For patients suffering from depression it was established that the more they are open to experience and conscientious and the less they are agreeable their sexual drive is stronger. Furthermore, higher openness is a significant predictor for easier sexual arousal and the more those patients are conscientious and the less they are agreeable easier is for them to achieve orgasms. Personality traits proved to be significant predictors of sexual functioning in schizophrenic and depressive patients, but not in healthy individuals.

High doses alprazolam induced amenorrhoea and galactorrhoea.

Alprazolam belongs in the group of anxiolytics, medicaments used for reducing anxiety. As most other drugs, it can cause various adverse events, including hormonal disturbances and imbalance. Prolactin elevation is one such hormonal adverse event that can lead to galactorrhoea, or abnormal milk discharge from the breast and amenorrhoea. In this case report we will present the case of a female patient that developed galactorrhoea while treated with alprazolam, after all physical factors that can also cause these symptoms were excluded.

Symptoms of agitated depression and/or akathisia.

Akathisia is a syndrome characterized by the unpleasant sensation of "inner" restlessness that manifests itself in the inability of sitting still or not moving. Many types of medicaments can cause akathisia as an adverse event of their use and they include: antipsychotics, antidepressants, antiemetics, antihistamines, and psychoactive substances. We will present the case of a 50 year old patient, treated on two occasions for psychotic depression. During the second hospitalization it is possible that antipsychotic treatment combined with an antidepressant caused akathisia or there were symptoms of agitated depression and akathisia present at the same time, which is very difficult to determine in everyday clinical practice. We can conclude that in this case, as in many others, akathisia as a possible adverse effect of psychopharmacs was very hard to identify. Therefore, it is necessary to have akathisia in mind when using certain medicaments, especially when combining several that use the same enzymatic system and consequently raise levels of at least one of them.

Correlation of levels of depressiveness and choice of elective subjects in medical students.

The aim of this research was to establish if a correlation exists between the choice of an elective subject, namely subjects "Depression" and "Diabetes", and levels of depressiveness in medical students. Three groups of third year medical students attending School of medicine, Rijeka University, were tested for the level of depression using Beck's self-evaluation scale. The groups consisted of 30 non-randomly selected students that had enrolled elective subject "Depression" and 29 non-randomly selected students that had enrolled elective subject "Diabetes", and the third group of 30 randomly selected third year medical students that had enrolled none of the previously mentioned elective subjects. Median age of participants in this research was 25.24. The results showed no statistically significant difference in overall level of depressiveness among the groups. By testing for the difference between group pairs, there was a statistically significant difference between depressiveness in students attending "Depression" and "Diabetes", the latter being significantly more depressed (M = 8.30 in "Depression" group; M = 11.41 in "Diabetes" group; p = 0.04). In total there were 33 males and 56 females that participated in this research. Gender difference was also tested, and there was no statistically significant difference between sexes among groups. The difference was found only within the group of students attending "Depression" elective subject, where females scored significantly higher on Beck's questionnaire (z = 2.26; p = 0.03). The analysis of difference between items of the Beck's questionnaire showed statistically significant difference in the item "Feeling of rejection", where students attending elective subjects other then "Depression" scored significantly higher; differences in the items "Urge for punishment" and "Suicidal tendencies" were also found between "Diabetes" and "other elective subjects" group, in favor of "Diabetes" group; in the item "Weight loss" students attending "Diabetes" elective subject scored significantly higher then their peers in both other groups. The results indicate the possibility of a protective role of psycho-educative component provided to the students attending elective subject on depression within medical school environment, that has repeatedly been shown to be stressful and demanding and is beneficial for the onset of depressive disorders.

Ziprasidone as a possible cause of cleft palate in a newborn.

Use of antipsychotic medication during the entire course of pregnancy in patients suffering from schizophrenia is frequently necessary as discontinuation of therapy can lead to relapse of the illness which can be far more severe for the mother, but also for the fetus. That is the case why third generation antipsychotics, so called atypical antipsychotics, are also being used during the pregnancy, but their effects are not fully researched. Use of ziprasidone as a third generation antipsychotic, and its effects during the pregnancy in patients suffering from various mental illnesses is very rarely described in scientific literature. There is even fewer information regarding eventual adverse events of ziprasidone in newborn babies of mothers that have been treated with ziprasidone during the entire course of pregnancy. This paper will be based around a case report of a female patient suffering from schizophrenia who has been treated with ziprasidone during the entire course of her pregnancy and whose newborn baby was diagnosed with a cleft palate (palatoschisis) at the time of birth.

Galactorrhea - side effect of risperidone in combination with depakine chrono in a patient with bipolar disorder.

Risperidone, as all atypical antipsychotics, can cause hyperprolactinemia which can in turn lead to galactorrhea. Mood stabilizers, one of which is valproic acid and its derivate "Depakine Chrono", are rarely linked with symptomatic hyperprolactinemia and do not alter prolactin concentrations. This case is based around a patient suffering from a bipolar disorder that has been psychiatrically treated in an outpatient clinic during four years. Bipolar disorder treatment was started with carbamazepine, but later it was discontinued due to adverse events and extreme increase of liver transaminases. Treatment was continued with introduction of lithium, but the patient stated that she could not tolerate it. Subsequently, her endocrinologist advised for lithium discontinuation due to very severe osteoporosis. At the beginning of 2009, lithium was discontinued and Depakine Chrono was introduced. Due to patient's psychotic decompensation it was necessary to introduce risperidone into treatment and soon afterwards her psychotic symptoms settled. After several months of treatment her mood lowered, she began to feel sedated, psychomotorically retarded and that lead to dose lowering of Depakine Chrono and risperidone, at which point galactorrhea as a serious adverse event occurred. Occurrence of galactorrhea at lower risperidone doses in this case might be partially explained by recent studies that showed that lower doses of risperidone can also improve psychic state, but could also cause adverse events. Although galactorrhea, as a direct consequence of hyperprolactinemia caused by risperidone has mainly been researched with higher doses of this atypical antipsychotic, we have to keep in mind that lower doses could also cause serious adverse events.

Amenorrhoea - consequence of combined treatment with sulpiride and risperidone in a patient suffering from schizophrenia.

It is well documented that sulpiride causes hormonal adverse events, like amenorrhoea and galactorrhea, due to its mechanism of action. Furthermore, risperidone can produce amenorrhoea and galactorrhea also, due to its mechanism of action, which differs from that of sulpiride. This case report is of a patient that was treated with large doses of sulpiride, but did not develop an adverse event like amenorrhoea. However, when risperidone was introduced into therapy it leads to the onset of amenorrhoea. Gynecologist saw it as the beginning of menopause. General practitioner questioned the existence of an intra-cerebral process that could produce amenorrhoea as well. Therefore, the patient was sent to perform an MRI of the brain, under work diagnosis of pituitary adenoma, which was later ruled out as a cause of the illness. Well experienced psychiatrist linked the loss of menstruation with the adverse event profile of sulpiride and therefore gradually discontinued sulpiride from therapy, while risperidone was left and subsequently menstrual cycle was restored. Good knowledge of adverse events profile of antipsychotic medication used, especially when used in a combination, allows us to correctly question appearance of adverse events, to adequately treat them and lowers the cost of unneeded medical procedures.

Posttraumatic stress disorder and depression as comorbid disorders.

INTRODUCTION: Depression is the most frequent disorder of today. It is unique for the fact that it can become a comorbid illness with almost any other psychiatric disorder. Premorbid depression is also a risk factor for the development of PTSD, while at the same time traumatic experience is a risk factor for the development of depression. These facts show us that a close connection between these two diagnostic entities exists. Aim of this research was to analyze the levels of depressiveness in patients that were hospitalized and patients that were treated in the Day hospital. Also, to establish the connection of age, time spent in combat (war), length of treatment and number of hospitalizations with the results from the Beck's depression inventory. SUBJECTS AND METHODS: Participants were divided into two groups, 36 patients that were treated for PTSD in a hospital setting and 64 patients that were treated in the Day hospital. Participants completed Beck's self-evaluation inventory for depression, as it assesses the degree of depression. RESULTS: Two groups did not differ regarding to age, time spent in combat (war), the length of treatment and level of depressiveness assessed by Beck's depression inventory. Score on Beck's depression inventory was significantly positively correlated with the age of participants and the number of hospitalizations. Older participants and participants that were hospitalized more often score higher on Beck's depression inventory. CONCLUSION: Results show that there is no difference between the two groups of participants of differing levels of depressiveness, but depression most often presents as severe depression in both groups of participants. Older participants and participants that were hospitalized more often are more depressed. This research points to the fact that it is necessary to treat PTSD and depression at the same time, because parallel treatment of these comorbid disorders leads to a decrease of the rate of suicide, due to the fact that depression is often the leading cause of suicide.

Dimensions of human spirituality, layman understandings of health and limits of medicine.

The essence of human uniqueness and what is special about humans is spirituality. What is unique to every human being is his: language, sociability, politic, science, art, technical and working attitudes, playing games, fun and laughter, as well as religiosity and ethical attitudes. All of these dimensions are based upon spirituality or even the human spirit. This paper aims to relate all these dimensions of human spirituality to the sick person and establish to what extent that person is imbued with them and whether he can rely on them. Furthermore, this paper attempts to shed some light on the limits of medicine, especially as seen by Ivan Illich. In the end we are left with a series of questions, and possibly with an indisputable fact that the person who is suffering physically or mentally is "saved" by his most amazing unique trait--his religiosity.

Hereditary predisposition and sexual self-concept in schizophrenia.

OBJECTIVE: Aim of this research was to establish possible differences in sexual self-perception among acute and chronic schizophrenic patients, taking into consideration their hereditary predisposition. METHODS: Two groups of schizophrenic patients were analyzed, consisting of 100 acute and 100 chronic schizophrenic patients, treated at the Psychiatric clinic Rijeka, in the period 1998-1999, taking into consideration their hereditary predisposition and influence of that predisposition on seven aspects of sexual self-perception: sexual self-scheme, sexual consciousness, readiness for sexual action sexual adventurism, level of negative emotions towards one's sexuality, perception of one's sexual self-competence, sexual satisfaction. RESULTS: Results show that hereditary predisposition in chronic schizophrenic patients has a negative effect on some of the aspects of sexual self-perception: sexual self-scheme and sexual satisfaction. Therefore, patients with hereditary predisposition achieve lower results than those without hereditary predisposition. CONCLUSION: We can conclude that hereditary predisposition negatively influences certain aspects of sexual self-perception in chronic schizophrenic patients, and that it does not influence aspects of sexual self-perception in acute schizophrenic patients.

Psychopharmacotherapy and spirituality.

Although the connection between spiritual and physical has been acknowledged since the oldest of human civilizations and emphasized in almost all of religions, It has taken a lot of time for that connection to gradually recover its lost meaning. As it is evident that many diseases and illnesses can not be explained purely by physical causes nor treated with purely physical methods there is a growing interest in spirituality and its usability in the treatment of various diseases and states, as well as in everyday life. Despite the fact that a sense of positive, nourishing and healing power of faith is deeply rooted in every religion, objective and empirical research of that connection has been avoided for centuries, and those studies which were conducted are only rudimentary, on the outskirts of empirical science. Scientific literature regarding spirituality and mental health points to a conclusion that spirituality and faith are positively correlated with positive therapeutic outcome and the possible explanation for that can be found in the fact that spirituality and religiosity can satisfy some of the basic needs of psychiatric patients. Efficacy of psychiatric treatment improved with the introduction of psychotropic medicaments and psychotherapeutic techniques, but the outcome is still not satisfying because relapse, recidivation and discontinuation of therapy occur very often. On the other hand, spirituality and religiosity play a very significant role in the healing process because they provide people with strength and will to fight their problems and disease itself. Psychopharmaceuticals are evidently irreplaceable in the therapy of mental disorders, but they are only one of the segments of the overall therapy. In order to adequately answer to the spiritual and religious needs of their patients, psychiatrists, psychologists and related health care professionals are faced with the need for expanding scientific concepts which served as the basis for development of many psychiatric methods and techniques.

Influence of religion on sexual self-perception and sexual satisfaction in patients suffering from schizophrenia and depression.

OBJECTIVE: It is well documented that religion has an impact on mental health of both healthy people and mental health patients. However, scientific research regarding the influence of religion on sexual experiences and sexual self-perception in mental health patients and healthy people is very scarce. GOAL: Therefore, our goal was to research how and in what measure religious and atheistic views of patients suffering from depression and schizophrenia and healthy people influence their sexual functions and sexual self-perception. SUBJECTS AND METHODS: This research was conducted on 100 patients suffering from schizophrenia and 100 patients suffering from depression, while 100 healthy individuals served as a control group. DMS-IV criteria were used when diagnosing schizophrenia and depression. In order to research the aspects of sexual self-perception we used Bezinovic's questionnaire and Arizona sexual experience scale (ASEX) to research the aspects of sexual intercourse. RESULTS: Results show that Roman-Catholic patients suffering from schizophrenia experience greater sexual satisfaction than Eastern-Orthodox or atheist schizophrenic patients. Among patients suffering from depression in regard to their differing religious views there were no significant differences regarding sexual satisfaction or the aspects of sexual self-perception. Furthermore, there is a significant difference among healthy individuals when taking into consideration religious views. We established that Muslims have a significantly stronger sexual drive then atheists, Roman-Catholic or Eastern-Orthodox individuals. Compared to Roman-Catholic and Eastern-Orthodox individuals, atheists have better consciousness of their own sexuality. CONCLUSION: We can conclude that religious views have an influence on sexual functioning and sexual self-perception of patients suffering from depression and schizophrenia and also healthy individuals. Thus, further research on a bigger sample of participants--not only of those religious denominations covered in this research, but also of those that are less present in our society and of other mental health disorders and illnesses--is needed.