Introduction Schizophrenia (SCH) and bipolar affective disorder (BP) are complex disorders that overlapping both in their clinical symptoms and certain familiar characteristics. They share some common characteristcs but there are also key differences. The frequency of overlapping symptoms between these diseases could give us more information about the current validity of the diagnosis based on existing diagnostic criteria. Similarities within and between these two disorders in the future, can possibly redefine greater reliability of diagnosis. Objectives The aim of the study was to investigate the frequency of overlapping symptoms between BP and SCH. Methods The sample included 159 patients diagnosed with SCH and 61 with BP who were followed over a two year period. The research was conducted at the UCCS Psychiatric Clinic. Assessment of clinical symptoms and diagnosis were performed using a structured clinical interview (SCID I), a list of operationalized criteria (OPSCRIT), a scale for the assessment of positive and negative symptoms (PANSS), a scale for the assessment of manic symptoms (YMRS). Results The overall PANSS score was significantly higher in patients with SCH compared to patients with BP, but on the general psychopatology there are no significant differences betwen SCH and BP. Symptoms of mania are significantly more pronounced in patients with BP compared to those with SCH. Conclusions Our results of overlapping of individual symptoms between SCH and BP can speak infavor of the theory of disease continuum. And can also help us in understanding symptoms and guide us to develop optimal treatment strategies. Disclosure No significant relationships.
Introduction Clozapine is a drug that can cause several side effects. Among the less commonly described is a drug-induced lung disease. Due to its non-specific clinical presentation, it represents a diagnostic challenge. The diagnosis is made based on: 1. Association of exposure to the agent and development of symptoms, 2. Pulmonary infiltration, 3. Exclusion of other causes, 4. Withdrawal of symptoms when the agent is excluded from therapy. To date, there have been only a few descriptions of this condition. Objectives Case report of rare side effect of clozapine. Methods Case report Results Case report: male patient (37) with schizophrenia, was hospitalized after a brutal suicide attempt. The PCR test for COVID-19 that was routinely performed on admission was negative. After the introduction of clozapine into therapy, the patient became febrile. There was a drop in oxygen saturation, a Lung CT scan showed inflammatory changes („ground-glass opacities“), and COVID-19 pneumonia was suspected. Due to the worsening of the mental state, the dose of clozapine was increased. The physical condition further deteriorated: febrile, sO2 declining. After repeated PCR tests for COVID-19 (all negative), interstitial pneumonia caused by clozapine was suspected, and clozapine was excluded from therapy. The physical condition started to improve. Quetiapine was introduced, and occasional episodes of agitation were relieved with intramuscular diazepam. In the following days, the patient’s mental state improved and he was discharged. Conclusions Despite its superiority over other antipsychotics, clozapine was with good rationale ranked third in treatment guidelines for schizophrenia. Disclosure No significant relationships.
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Introduction: Psychiatric disorders have been considered to have seasonal variation for a long time. Goal: The goal of this research is to study the admissions rate of neurotic and somatoform disorders, as well as stress induced disorder in relation to season and climatic factors during 2010/2011. Material and method: The research was conducted at the Psychiatric Clinic, Clinical Center of University in Sarajevo. Randomly selected subjects (aged 5-89 years, 1316 males and 1039 females) N=2355, were interviewed by the Structural Clinical Interview (SCID) which generated DSM-IV diagnoses. In this retrospective-prospective, clinical-epidemiological study subjects were divided into groups according to type of disorders. Correlation between the impact of seasons and the rate of admissions to a Psychiatric clinic was analyzed. Certain data were taken from Federal Hydrometeorological Institute in Sarajevo about the climatic situation for period of the study. Results and conclusions: From the total number of subjects who were admitted to the clinic in the period of 2010/2011 the most common diagnoses were F10-F19, F20-F29, F30-F39, F40-F48, and the suicide attempts as the separate entity. It was found the correlation between certain seasons and the effects of the certain weather parameters at an increased admission rate of subjects with the neurotic, somatoform and stress induced disorders.
Introduction: Numerous epidemiological international studies as well as knowledge based on clinical experience show high prevalence and the importance of the psychiatric comorbidity with depressive and anxiety disorders. Goal: The aim of this study is to analyze prevalence of comorbid anxiety disorders and depression in subjects at the Day Hospital of the Psychiatric Clinic, Clinical Center of Sarajevo University (CCUS) and examine the demographic profile of the patients. Material and methods: Study involved 230 randomly selected patients (aged between 18 and 65 years, N=230, who were hospitalized at the Day Hospital of the Psychiatric Clinic of Clinical center of University of Sarajevo from January 1st to December 31st 2011) and who were interviewed by the Structural Clinical Interview (SCID) which generated ICD-X diagnoses and assessment of the comorbidity. Depressive symptoms were assessed by Beck’s Depression Inventory with 28 items. Anxiety symptoms were assessed with Beck’s Anxiety Inventory scale with 21 items. Study is retrospective, clinical and epidemiological. Results: Of the total number of patients (230) it was determined that 107 (46.5%) have depressive episode; 71 (30.9%) anxiety disorder. Comorbidity of these two disorders was found in 14 (6.1%) cases. Anxiety disorders were more represented in women (61.2%), as well as depressive disorders and comorbidity (70.1% and 85.7%). Subjects with depression on average was 52.9±7.4 years old (range 29-64 years), patients with anxious disorders 50±9.5 years (range 22-65 years) while patients with comorbidity of these two entities was at mean age of 54.5±4.5 years. The least common category of education was retired persons and respondents with university education for all three entities. Hospitalization duration for depression, anxiety, and comorbidity of these two disorders is highest for depression (47.1±9.7 days) and shortest in case of comorbidity (45.9±6.9 days). Conclusion: Depression and anxiety often coexist. When they occur in comorbidity, both anxiety and depression appear to be more severe. Severely depressed and anxious patients have reduced capacity to work and as such represents a considerable burden to the family and the community. Overview of depression, anxiety and the comorbidity of these two diagnoses (listed as primary diagnosis) in the baseline sample showed that there was most patients with depression (107 or 46.5%), followed by anxiety (71 or 30.9%) and comorbidity with 14 patients or 6.1%. Effective assessment, evaluation, diagnosis and treatment can lead to better treatment outcomes in primary care and improved quality of life.
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