Demographic and Clinical Factors Associated with Depression in 140 Hospitalized Diabetic Patients with Distal Symmetric Polyneuropathy Evaluated Using Beck Depression Inventory and 6-Item Neuropathy Total Symptom Score Questionnaire.

BACKGROUND Diabetic distal symmetric polyneuropathy (DSPN) is one of the most common and costliest long-term complications. The pain and function limitations may lead to depression. This study aimed to assess the influence of demographic and clinical factors on the prevalence of depression among diabetic patients with distal symmetric polyneuropathy (DSPN). MATERIAL AND METHODS A total of 140 patients with diabetic DSPN completed the 21-item Beck Depression Inventory (BDI) measuring characteristic attitudes and symptoms of depression. The intensity of neuropathic complaints was assessed using the Neuropathy Total Symptom Score- 6 items (NTSS-6). Testing for peripheral neuropathy was performed. All patients completed questionnaires, which included anthropometric measures, social parameters, and medical aspects. Statistical analyses were done using STATISTICA 8 PL software. RESULTS Statistically significant relationships were found between the depression symptoms in diabetic patients and the intensity of subjective neuropathy symptoms evaluated by NTSS-6, body mass index (BMI), and education level. On average, each 1-point increase in NTSS-6 predicted a 16% increase in the risk of depression. Each 1 kg/m² increase in the BMI was associated with a 10% increase of depression risk. CONCLUSIONS The study showed the positive quantitative relationship between diabetic DSPN and depression symptoms. The BMI, severity of neuropathy symptoms, and lower level of education had a statistically significant association with the level of depression and may be useful in evaluating the risk of depression among DSPN patients.

Depression and Serum Content of Serotonin in Adult Patients with Atopic Dermatitis.

Atopic dermatitis (AD) is a chronic skin disease with the etiology not yet conclusively established. Recent reports demonstrate the role of serotonin (5-hydroxytryptamine; 5-HT) in the pathogenesis of AD. The aim of this study was to investigate the relationship between the serum content of serotonin and depression in adult patients suffering from severe AD. There were 31 patients of the median age of 41 years enrolled into the study, who suffered from AD since childhood, and a control group that consisted of 14 healthy subjects. AD was diagnosed on the basis of Hanifin and Rajka criteria. The severity of skin lesions was assessed with the SCORing Atopic Dermatitis (SCORAD) index and that of depression with the Montgomery-Åsberg Depression Rating Scale (MADRS) questionnaire. We found that all of the patients with severe AD characterized by SCORAD >50 had depression. Depression was classified as mild and moderate according to the MADRS score. Serotonin content was significantly lower in the patients with severe AD (MADRS >12), and there was an adverse relation between the serotonin content and the score of depression, the features not noticed in the control group. We conclude that severe AD, as expressed by the intensification of skin lesions, associates with depression and with the lowering of serum serotonin content. The findings point attention to the cognitive and affective problems in AD patients which could worsen the course of the skin disease.

Religiosity among women undergoing pregnancy termination for medical reasons: the experiences and views of Polish women.

OBJECTIVES: The study aimed to determine the influence of religious and moral beliefs on contraceptive use, assisted reproduction and pregnancy termination in Polish women requesting a termination of pregnancy for medical reasons. METHODS: Between 1 June 2014 and 31 May 2016, women deemed eligible for a termination of pregnancy for medical reasons at a Polish tertiary care centre received an anonymous questionnaire comprising 65 items. A total of 150 completed questionnaires were collected. RESULTS: Of the respondents, 95% described themselves as Catholics, including 60% practising Catholics. The study revealed a discrepancy between respondents' beliefs and the teachings of the Catholic Church: an overwhelming majority of respondents used contraception, and 79% were in favour of in vitro fertilisation and believed the treatment should be refunded by the state. Interestingly, 66% of the respondents who attended confession did not perceive abortion as sinful. CONCLUSION: The study detected a considerable discrepancy between declared religiosity and individual interpretations of the commandments and teachings of the Catholic Church. Despite stating they were Catholics, most women did not perceive abortion as sinful and did not follow the teachings of the Catholic Church regarding the sacraments for deceased children.

Impact of emotional disorders on semen quality in men treated for infertility.

OBJECTIVE: Semen quality depends on factors such as lifestyle, environment, and hormone secretion. OBJECTIVE: The purpose of the study was to assess the correlation between emotional disorders and the secretion of selected hormones, and to assess the impact of these disorders on semen quality. METHODS: The study covered 60 fertile and 112 subfertile males. The sperm was obtained by masturbation, and examined directly after liquidation according to the 2010 criteria of the World Health Organization. The research instruments used were: the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI). A morning blood sample (5 mL volume) was obtained and sent to an authorized laboratory to assess serum levels of testosterone, LH, FSH, prolactin, SHBG, DHEA-S and cortisol. RESULTS: In the group of infertility patients, higher BDI scores were correlated with significantly decreased testosterone levels (p=0.001), and increased prolactin and cortisol (p<0.001); statistically significant negative correlations were also found between BDI score and SHBG and DHEA-S (p<0.001) levels. Higher STAI-1 and STAI-2 in the low-fertility group were associated with higher mean prolactin and cortisol levels (p<0.001). Sperm count was shown to be correlated with BDI, STAI-1 and STAI-2 scores (p<0.001). Semen volume also correlated with BDI, STAI-1 and STAI-2 scores (p<0.001). CONCLUSION: Depression and anxiety in subfertile males are associated with lower secretion of SHBG and DHEA-S, and higher secretion of cortisol and prolactin. Depression and anxiety in male patients cause decreased semen volume and sperm density.

Searching for Medical Substances Safe for Mother and Child, Facilitating the Delivery of Pain Management and Decreasing Exhaustion--Evaluation of Obstetric Gel by Pregnant Women.

The aim of the present study was to determine whether applying obstetric gel, a noninvasive method of pain management that is safe both for the mother and the child, during labor influences delivery satisfaction by facilitating pain management and decreasing exhaustion. Forty-seven primiparous women were included in the study: 23 on whom during the delivery gel was used and 24 whose delivery proceeded without the use of a gel (control group). The following research tools were used for the evaluation of satisfaction with the course of the delivery: Visual Analogue Scale (VAS), self-authorship survey, and the State-Trait Anxiety Inventory. There were no significant differences in intensification of pain in the first and second periods of delivery, exhaustion after delivery and intensification of pain in the second period of delivery, and increased anxiety between the study group and the control group. Our results suggest that application of obstetric gel during the first and second period of delivery does not significantly influence women's satisfaction with the course of delivery.

Increased levels of proteins of the acute inflammatory phase in the peritoneal fluid of women with advanced stages of endometriosis.

OBJECTIVES: Most investigators agree that endometriosis is associated with a state of subclinical, non-infectious peritoneal inflammation. The objective of the study was to assess concentrations of two markers of the acute inflammatory phase proteins, haptoglobin and ceruloplasmin, in peritoneal fluid of endometriotic women. MATERIAL AND METHODS: 229 women who underwent diagnostic or therapeutic laparoscopy were included in the study Minimal, mild, moderate and severe endometriosis according to ASRM was confirmed in 119 women (study groups), whereas 110 patients suffered from simple serous or dermoid ovarian cysts (reference groups). Haptoglobin and ceruloplasmin concentrations in the peritoneal fluid samples aspirated during laparoscopy were measured using commercially available radial immunodiffusion kits. RESULTS: The concentration of haptoglobin in the peritoneal fluid of women with endometriosis was significantly higher as compared to patients with serous and dermoid ovarian cysts. Significantly higher haptoglobin level was observed in patients with severe and moderate endometriosis as compared to women from both reference groups. No significant difference in the peritoneal fluid ceruloplasmin levels was found between patients with endometriosis and women from reference groups. However, it was noted that ceruloplasmin levels are higher in the subgroup of patients with severe endometriosis as compared to both reference groups and women with mild disease. CONCLUSIONS: Our results support the hypothesis that endometriosis is associated with subclinical inflammation within the peritoneal cavity It may be speculated that pro-inflammatory stimuli strong enough to cause an increase in acute inflammatory phase proteins peritoneal fluid concentrations are observed only in the advanced stages of the disease.

Andropause - state of the art 2015 and review of selected aspects.

The term 'male menopause' was first used in 1944 to describe various complaints of ageing men which at least partially mirrored the climacteric symptoms in women. Continuous research resulted in the evolution of opinions about the nature of these complaints, from the clinical syndrome, diagnosed with the use of disease-targeted questionnaires, to a well-defined clinical and biochemical syndrome. The pathophysiological causes - gonad ageing (with a compensatory rise in luteinizing hormone), age-related increase in serum sex hormone-binding globulin (SHBG) levels, the role of visceral adipose tissue as a place for aromatization of androgen to estrogen, and lower sensitivity of testosterone receptors - have been described. However, no consensus was reached as far as the definition, incidence, treatment, and especially testosterone therapy, are concerned. Our review presents the current standpoints, indicating the predictive role of late-onset hypogonadism (LOH) in evaluating male health as well as the current literature reports on the risks and benefits of using testosterone therapy.

The influence of selected socio-demographic variables on symptoms occurring during the menopause.

INTRODUCTION: It is considered that the lifestyle conditioned by socio-demographic or socio-economic factors determines the health condition of people to the greatest extent. The aim of this study is to evaluate the influence of selected socio-demographic factors on the kinds of symptoms occurring during menopause. MATERIAL AND METHODS: The study group consisted of 210 women aged 45 to 65, not using hormone replacement therapy, staying at healthcare centers for rehabilitation treatment. The study was carried out in 2013-2014 in the Silesian, Podlaskie and Lesser Poland voivodeships. The set of tools consisted of the authors' own survey questionnaire and the Menopause Rating Scale (MRS). RESULTS: The most commonly occurring symptom in the group of studied women was a depressive mood, from the group of psychological symptoms, followed by physical and mental fatigue, and discomfort connected with muscle and joint pain. The greatest intensity of symptoms was observed in the group of women with the lowest level of education, reporting an average or bad material situation, and unemployed women. CONCLUSIONS: An alarmingly high number of reported psychological symptoms in the group of menopausal women was observed, and in particular among the group of low socio-economic status. Career seems to be a factor reducing the risk of occurrence of psychological symptoms. There is an urgent need for health promotion and prophylaxis in the group of menopausal women, and in many cases for implementation of specialist psychological assistance.

[Analysis of medical and psychological certificates concerning drivers who drove after alcohol use]. / Analiza orzeczen lekarskich i psychologicznych dotyczacych kierowców, którzy prowadzili pojazdy po spozyciu alkoholu.

BACKGROUND: The aim of the study is to present the health predispositions to drive, assessed during certifying people referred to the Regional Centre for Occupational Medicine in Kielce due to drunk driving or driving after using alcohol. The article mainly presents the results regarding the prevalence of alcohol dependence and other psychiatric disorders in this group. We analyzed health condition at 3 year intervals in the years 2004, 2007 and 2010, adding the population of those who were examined in 2011. MATERIAL AND METHODS: A total of 5701 people were involved, both men and women. Drivers test cards along with the results of biochemical tests and specialist consultations were analyzed. The analysis of the results was performed using the statistical package PQStat 1.4.2.324. RESULTS: Certificates with health contraindications to drive were issued to 6.7% of investigated individuals. Very significant correlation between alcohol dependence syndrome and the level of γ-glutamyl transferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were confirmed. Alcohol dependence was diagnosed in 3.8% of the group. CONCLUSIONS: The health state of the drivers met the required certification criteria necessary for obtaining a driving license in more than 93% of the group. The study revealed many diseases in the group of investigated drivers, including 3.8% of alcohol dependence and 5% of mental disorders. The threat of losing driving license has become an important factor motivating drivers to undertake therapy. However, it seems advisable to develop principles for treatment monitoring and exchange of information between the certifying physician and the treating psychiatrist or psychologist.

[The influence of sociodemografic and medical variables on severity of anxiety and depressive symptoms during particular trimesters of pregnancy]. / Wplyw wybranych zmiennych socjodemograficznych i medycznych na nasilenie objawów lekowych i depresyjnych w poszczególnych trymestrach ciazy.

AIM: The aim of the study was to research the effect of selected socio-demographic and medical variables on the severity of symptoms of anxiety and depression in different trimesters of pregnancy. MATERIALS AND METHODS: The study was prospective, longitudinal, the group consisted of 314 adult pregnant women. To assess the prevalence of depressive and anxiety symptoms the Hospital Anxiety and Depression Scale (HADS) was used. The results were statistically analyzed. To assess the normal distribution the Shapiro-Wilk test was used. Non-parametric tests: Mann Whitney U test and Kruskal Wallis ANOVA were used due to the distribution of the variables tested against the intergroup comparisons that deviate from the normal distribution. RESULTS: Only the assessment of the financial and housing situation given by the respondents was related to the severity of symptoms of anxiety and depression in the course of the entire pregnancy. The unmarried respondents had greater severity of depressive symptoms in the first and third trimesters. Other socio-demographic variables were not associated with the severity of symptoms of anxiety and depression in different trimesters of pregnancy. Medical variables (associated with an obstetric-gynecological history), such as a history of miscarriage, complications in a previous pregnancy, the mode of delivery in a previous pregnancy, generally did not affect the severity of symptoms of anxiety and depression during pregnancy. Only major symptoms of depression during the third trimester were associated with complications in a previous pregnancy. An unplanned pregnancy turned out to be one of the most crucial variables determining higher severity of anxiety and depression during pregnancy. CONCLUSIONS: The knowledge of socio-demographic and medical factors associated with the severity of symptoms of anxiety and depression during pregnancy may facilitate better monitoring the groups of women being particularly vulnerable to the occurrence of these disorders. The introduction of screening tests regarding anxiety and depression during pregnancy, being carried out systematically in the course of pregnancy provides an opportunity for earlier diagnosis and more rapid implementation of good practice.

[Stigmatization in psoriasis patients]. / Stygmatyzacja osób chorych na luszczyce.

Psoriasis is a chronic disease that affects the skin, nail plates and/or joints in which correlation between the onset of skin changes or more severe symptoms and the psychical condition of a patient is observed. At present it is assumed that stigmatization are events and situations in a person's life that are recognized by the society as those that stigmatize a given person and lead to their rejection and finally downgrade and ruin their social status. Opinions and behaviour patterns of the members of the society create the sigma feeling in a patient and affect his/her psyche. The aim of the present paper is the analysis of the latest data presented in the literature on the sigma feeling in psoriasis patients. In the study, the analysis of the types of stigmatization experienced by patients has been carried out. Life events influence the severity of psoriatic changes, but also psoriasis as a somatic disease affects the everyday life of a patient. Some reactions and behaviours of other people may create the feeling of rejection in social situations and the subjective feeling of being stigmatized. Then, as a result of the sigma feeling, the general health condition, functioning in the society and quality of life are affected.

Epidemiology of the symptoms of menopause - an intercontinental review.

INTRODUCTION: The age of menopause is a time of many changes in the psychophysical-social functioning of women, with reduced ovarian hormonal activity and estrogen levels. The most common, troublesome symptoms of menopause age include depressive disorders, sleep disorders, sexual dysfunction, discomfort associated with muscle pain, joint aches, osteoporosis and characteristic hot flashes. AIM OF THE STUDY: Aim of the study is to determine and compare the rate of menopausal symptoms among women living in continents of both Americas, Africa, Australia and Eurasia. MATERIAL AND METHODS: The results of this work were obtained in 2014 on the basis of the data from a review of the 64 most important studies using the PubMed database. Research published in the period 2000-2014, from Africa, both Americas, Australia and Eurasia, were taken into account. RESULTS: The prevalence of menopausal symptoms in African women is disconcertingly high. Women from South America complain about occurrence of depressive, sexual dysfunctions and discomfort associated with muscle pain and joint aches. Symptoms most reported by women in the United States are pains associated with muscles and joints. Women in Australia suffer mainly due to vasomotor symptoms and sexual dysfunction, while in the group of women surveyed in Asia there is observed an alarming increase in the proportion of women reporting depressive disorders. In Europe there was a much greater incidence of sleep disorders and depressive disorders. CONCLUSIONS: Women around the world suffer from ailments characteristic for the menopausal period regardless of ethnic origin, skin color or socio-demographic factors.

Standards for thyroid laboratory testing, and cognitive functions after menopause.

INTRODUCTION: The aim of the study is to analyze the relationship between normative and non-normative thyroid tests (TSH, TT4, TT3, FT3, FT4, anti-TPO, anti-Tg, AB-TSHR) and the level of cognitive functions in postmenopausal women. MATERIAL AND METHODS: The study group consisted of 383 women from south-eastern Poland, aged 50-65 years. The cognitive functions were evaluated using a diagnostic instrument - Central Nervous System - Vital Signs (CNS-VS). Blood was collected for determination of the following parameters: TSH, TT4, TT3, FT3, FT4, anti-TPO, anti-Tg, AB-TSHR. RESULTS: There were significant differences in NCI, executive functions, psychomotor speed, reaction time, complex attention and cognitive flexibility, depending on the normative and non-normative level of TSH. Women whose level of FT3 was at the lower limit of the normal range obtained poorer results in psychomotor speed, while subjects with levels of FT4 below the standard achieved significantly lower scores for this function. The relationship between NCI and cognitive functions, and the normative and non-normative anti-TPO results, showed significant differences in verbal memory, visual memory, processing speed and reaction time. The level of AB-TSHR reported as normal or above the norm significantly differentiated from the results of NCI, processing speed, executive functions, psychomotor speed, complex attention and cognitive flexibility. CONCLUSIONS: Concentrations of laboratory parameters assessing the thyroid function located within the upper limits of the normal range showed a different relationship with the cognitive performance than concentrations located within the lower limits of the standard.

Comparison of biopsychosocial functioning of women of different nationalities in the perimenopausal period.

INTRODUCTION: The perimenopausal age is a time of many changes in women's health. Changes in women's health affect all spheres of life, because health is not merely the absence of disease or infirmity but full psychological, physical and social well-being. Presentation and comparison of the biopsychosocial functioning of women of different races and nationalities in perimenopause, identification of the most common menopause symptoms occurring among women and their needs. MATERIAL AND METHODS: Work supported with research examples. Using the PubMed database, the medical literature was searched for works that contain the key words menopause and race or ethnicity published between 1996 and 2013 and available in English. Literature in Polish is a supplementary issue. RESULTS: Various demographic processes taking place in the countries of Africa, North and South America, Asia and Europe are the basis for observing the situation in perimenopausal women in these countries. Caucasian women living in North America and Europe most often experience the negative symptoms of menopause, hindering daily functioning, and women living in urbanized countries in Asia best assess their health condition, both psychosocial and physical. CONCLUSIONS: Biopsychosocial functioning of women varies among countries. Developing countries should be given the necessary support and financial information to ensure the health and quality of life in perimenopausal women. In most countries of the world there has been observed the need to promote women's health, particularly research aimed at prevention, increasing physical activity and attention to nutrition.

Can family resources and place of residence play a beneficial role in explaining burnout levels in working men?

INTRODUCTION AND OBJECTIVE: The phenomenon of occupational burnout is a common factor affecting employees' health. In a study on occupational burnout it may happen that variables that are not among the main predictors of burnout can noticeably affect burnout and the main independent variables. The aim of this study was to verify hypotheses about the role of demographic variables in explaining levels of stress and burnout, based on the example of men working as firefighters and 112 emergency operators. MATERIAL AND METHODS: A total of 823 men employed as firefighters and 112 emergency number operators were surveyed. The study applied the LINK Occupational Burnout Questionnaire, the PSS-10 Perceived Stress Scale and a demographic questionnaire. It was followed by an analysis of covariance of qualitative variables and quantitative predictors (ANCOVA). RESULTS: The study showed that living in rural areas was associated with lower levels of burnout among the men in the examined group. A similar relationship was detected for marital status, having children and secondary education. The other main variable, the level of perceived stress and age, showed typical associations with occupational burnout. CONCLUSIONS: The search for the causes of occupational burnout should not be narrowed only to stressors related to the demands of the workplace. Demographic variables are important elements of an employee's non-work environment and often a source of personal strengths. However, it should be remembered that the same factor can have both a protective function as well as a source of additional stress.

Having Children and Being Married Are Predictors of Burnout and Obesity Among Working Men: Effects of Latent Profile Analysis.

Emergency call-takers and dispatchers' (ECDs) work makes them vulnerable to occupational burnout and health problems. The aim of this research was to apply a Person-Oriented approach in order to examine the relationships between burnout risk factors (having children), personal resources (being married), and health consequences (overweight and obesity) among men working in these positions. The burnout syndrome was assessed among 228 Polish ECDs using The Link Burnout Questionnaire and the method of latent profile analysis (LPA). All ECDs were characterized by high levels of occupational burnout exhibited in 3 out of its 4 dimensions. The LPA allowed us to differentiate 4 patterns of burnout, taking into account socio-demographic variables, the length of employment as ECD and body weight. The need to balance the demands of professional work with having children and marital roles played an important role in predicting the level of professional burnout. There was a relationship between the dimensions of occupational burnout and age, being married, and having children. Being married was associated with a greater intensity of emotional exhaustion, and the level of exhaustion was higher if the employee had children in their care. Health consequences in the form of overweight and obesity can be associated with levels of emotional exhaustion and professional effectiveness. The application of the Person-Oriented approach presents hidden correlations between burnout predictors and health consequences.

Intensification of anxiety, symptoms of depression, and level of social support among women in pathological pregnancy - a cross-sectional preliminary study.

INTRODUCTION AND OBJECTIVE: Women in pathological pregnancy are a group of patients especially exposed to the risk of occurrence of psychological complications. The aim of the study was assessment of the risk of depressive and anxiety disorders, and the relationship between the intensity of symptoms and social support. MATERIAL AND METHODS: The study group were 300 patients hospitalized in the Department of Pathology of Pregnancy. The study was conducted using the State-Trait Anxiety Inventory (STAI), the Hospital Anxiety and Depression Scale (HADS), the Inventory of Socially Supportive Behaviours (ISSB), and an author-constructed socio-demographic questionnaire. RESULTS: The level of State Anxiety (STAI) was higher in respondents from the study group, compared to the control group. The level of anxiety (HADS-A) was higher in the control group than in women from the study group. The level of social informational support was higher in those from the control group, compared to those from the study group. The level of emotional support was lower in respondents from the study group, compared to those from the control group. Instrumental support negatively correlated with the symptoms of depression among women in physiological pregnancy. The lack of evaluative support statistically significantly correlated with anxiety among women hospitalized before labour. CONCLUSIONS: The results obtained suggest the necessity for the substantive preparation of medical and psychological staff employed in departments of pathology of pregnancy to provide proper emotional and informational support for hospitalized women.

Somatic and non-somatic problems connected with psoriasis in pregnancy.

Hormonal, metabolic and immunological changes occurring during pregnancy have significant effects on the function of the skin. Psoriasis is one of the most common dermatological diseases and it is known as a nonspecific dermatosis in pregnancy. The aim of this article is to present the importance of support in the course of psoriasis in pregnant women. Psoriasis may cause recurrent miscarriages, chronic hypertension, diabetes or obesity leading to perinatal complications and premature birth. The coexistence of psoriasis and pregnancy requires emotional prophylaxis, as well as support and psychotherapeutic care. Medical staff requires knowledge of skin diseases and skills to assess a patient's mental state.

[The psychological and social support in patients with psoriasis]. / Potrzeba psychologicznego i spolecznego wsparcia osób chorych na luszczyce.

The meaning of non medical forms of support in the treatment of psoriasis is discussed in the paper. Related with psoriasis negative self image and feeling of stigmatization cause various mental disorders. Stress, depression, mental condition affect the appearance of psoriasis. Because of numerous studies and identify the factors and relationships important for psoriasis, patients can take the appropriate psychological and social support. Relaxation techniques, cognitive-behavioral therapy and support groups have a positive effect on the treatment of psoriasis. They reduce the level of stress in the patient, learn emotional control, adequate self-esteem, which leads to the acceptance of the disease and improve the quality of life of the patient.

[Psychodermatology--the comorbitity of dermatological diseases and mental problems based on the example of psoriasis]. / Psychodermatologia--wspólistnienie chorób skóry i problemów psychicznych na przykladzie luszczycy.

The comorbidity of dermatological diseases with emotional and mental problems and common neuro-immuno-endocrine mechanisms for those disorders became a basis for formation of psychodermatology. The aim of this study is to present the objectives and actions taken by the field of psychodermatology and presentation of selected aspects of psychosocial problems in chronic dermatological diseases based on the example of psoriasis. The analysis of publications related to the subject confirmed the usefulness of psychodermatology activities. All forms of psychosocial support for people with dermatological diseases have a beneficial impact on patients' well-being and the course of disease.