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Gajšak T, Milovac Ž, Gereš N, Sučić S, Zoričić Z, Filipčić I. The effect of deep repetitive transcranial magnetic stimulation with an H1 coil on hopelessness in patients with major depressive disorder: A randomized controlled trial. World J Biol Psychiatry 2024; 25:16-25. [PMID: 37727902 DOI: 10.1080/15622975.2023.2251055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 08/16/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVES To assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) with an H1 coil as a treatment for hopelessness in patients with major depressive disorder (MDD). METHODS We conducted a randomised controlled trial in a tertiary psychiatric institution in Croatia, including patients diagnosed with MDD without psychotic symptoms and with clinically relevant hopelessness. High-frequency (18 Hz) rTMS with an H1 coil was administered over four weeks on the left dorsolateral prefrontal cortex. We examined changes in the Beck Hopelessness Scale (BHS) scores. RESULTS We randomly assigned 51 participants to the intervention group (rTMS plus standard therapy) and 52 to the control group (standard therapy). The mean (SD) ages were 50 (12.3) and 50 (10.4) years, and 47% and 52% of the participants were females in the intervention and control groups, respectively. Following treatment, the BHS scores decreased (unadjusted bivariate analysis, p = 0.043; false discovery rate (FDR) >5%). Multivariate analysis revealed that the BHS score was reduced by 10.8% (95% confidence interval (CI: -17.8% to -3.9%) in the rTMS group and 0.7% (95% CI: 7.5% -6.1%) in the control group (p = 0.037; FDR < 5%). CONCLUSIONS rTMS with an H1 coil improved the symptoms of hopelessness in patients with MDD.
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Affiliation(s)
| | | | - Natko Gereš
- Psychiatric Clinic 'Sveti Ivan', Zagreb, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | | | - Zoran Zoričić
- Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, Croatia
| | - Igor Filipčić
- Psychiatric Clinic 'Sveti Ivan', Zagreb, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Medved S, Palavra IR, Gerlach J, Levaj S, Shields-Zeeman L, Bolinski F, Bradaš Z, Madžarac Z, Filipčić I, Rojnić Kuzman M. Changes in substance use and engagement in gaming/gambling in persons with severe mental illness during the COVID-19 pandemic and earthquakes: a community study in two points. Front Psychiatry 2023; 14:1264875. [PMID: 38169718 PMCID: PMC10758456 DOI: 10.3389/fpsyt.2023.1264875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/06/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction External stressors, such as COVID-19 pandemic and earthquake, can cause an increase in substance use and addictive behavior in persons with severe mental illnesses (SMI). We analyzed the changes and predictors of substance use and addictive behavior in SMI during these double disasters in Croatia. Methods Questionnaires exploring the presence of substance or behavior addiction disorder, mental ill health [Depression Anxiety Stress Scales-21 (DASS-21), Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), Obsessive-Compulsive Inventory-Revised], coping mechanisms, and perceived social support [Multidimensional Scale of Perceived Social Support (MSPSS)] were administered among 90 participants with SMI included in the RECOVER-E study in May/June 2020 (first COVID-19 wave, Zagreb earthquake) and in December 2020/January 2021 (second COVID-19 wave, Petrinja earthquake). Results In both time points, a major increase was observed in tobacco smoking (25.0%; 28.6%, respectively) predicted by discontinuation of antidepressants and higher DASS-21 score. Increased sedative use was observed (24.4%; 23.8%, respectively) predicted by higher PSS and ISI scores, lower MSPSS scores, antipsychotic discontinuation and not receiving community mental health team (CMHT) service. Discussion In persons with SMI during a double disaster special attention needs to be given to reducing mental-ill health and stress, providing social support and continuity of psychiatric care, through medications and CMHTs.
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Affiliation(s)
- Sara Medved
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | | | - Sarah Levaj
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Laura Shields-Zeeman
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, Netherlands
| | - Felix Bolinski
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, Netherlands
| | - Zoran Bradaš
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Zoran Madžarac
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Igor Filipčić
- University Psychiatric Hospital Sveti Ivan, Zagreb, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Martina Rojnić Kuzman
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Isaac M, Filipčić I. Editorial: Refugees, migrants and displaced populations need better mental health support. Curr Opin Psychiatry 2023; 36:345-346. [PMID: 37534536 DOI: 10.1097/yco.0000000000000891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Affiliation(s)
- Mohan Isaac
- Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western Australia, Fremantle Hospital, Fremantle, WA, Australia
| | - Igor Filipčić
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Psychiatric Hospital 'Sveti Ivan', School of Medicine, University of Zagreb and Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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Sopek Merkaš I, Lakušić N, Sonicki Z, Koret B, Vuk Pisk S, Filipčić I. Prevalence of posttraumatic stress disorder following acute coronary syndrome and clinical characteristics of patients referred to cardiac rehabilitation. World J Psychiatry 2023; 13:376-385. [PMID: 37383282 PMCID: PMC10294131 DOI: 10.5498/wjp.v13.i6.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/04/2023] [Accepted: 05/25/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND Studies have demonstrated that patients who have experienced acute coronary syndrome (ACS) have an increased risk of developing posttraumatic stress disorder (PTSD) and experiencing worse survival outcomes than those who do not develop PTSD. Nevertheless, the prevalence rates of PTSD following ACS vary widely across studies, and it is noteworthy that in most cases, the diagnosis of PTSD was based on self-report symptom questionnaires, rather than being established by psychiatrists. Additionally, the individual characteristics of patients who develop PTSD after ACS can differ widely, making it difficult to identify any consistent patterns or predictors of the disorder.
AIM To investigate the prevalence of PTSD among a large sample of patients undergoing cardiac rehabilitation (CR) after ACS, as well as their characteristics in comparison to a control group.
METHODS The participants of this study are patients who have experienced ACS with or without undergoing percutaneous coronary intervention and are enrolled in a 3-wk CR program at the largest CR center in Croatia, the Special Hospital for Medical Rehabilitation Krapinske Toplice. Patient recruitment for the study took place over the course of one year, from January 1, 2022, to December 31, 2022, with a total of 504 participants. The expected average follow-up period for patients included in the study is about 18 mo, and currently ongoing. Using self-assessment questionnaire for PTSD criteria and clinical psychiatric interview, a group of patients with a PTSD diagnosis was identified. From the participants who do not have a PTSD diagnosis, patients who would match those with a PTSD diagnosis in terms of relevant clinical and medical stratification variables and during the same rehabilitation period were selected to enable comparability of the two groups.
RESULTS A total of 507 patients who were enrolled in the CR program were approached to participate in the study. Three patients declined to participate in the study. The screening PTSD Checklist-Civilian Version questionnaire was completed by 504 patients. Out of the total sample of 504 patients, 74.2% were men (n = 374) and 25.8% were women (n = 130). The mean age of all participants was 56.7 years (55.8 for men and 59.1 for women). Among the 504 participants who completed the screening questionnaire, 80 met the cutoff criteria for the PTSD and qualified for further evaluation (15.9%). All 80 patients agreed to a psychiatric interview. Among them, 51 patients (10.1%) were diagnosed with clinical PTSD by a psychiatrist according to Diagnostic and Statistical Manual of Mental Disorders criteria. Among the variables analyzed, there was a noticeable difference in the percentage of theoretical maximum achieved on exercise testing between the PTSD and non-PTSD groups. Non-PTSD group achieved a significantly higher percentage of their maximum compared to the PTSD group (P = 0.035).
CONCLUSION The preliminary results of the study indicate that a significant proportion of patients with PTSD induced by ACS are not receiving adequate treatment. Furthermore, the data suggest that these patients may exhibit reduced physical activity levels, which could be one of the possible underlying mechanisms in observed poor cardiovascular outcomes in this population. Identifying cardiac biomarkers is crucial for identifying patients at risk of developing PTSD and may derive benefits from personalized interventions based on the principles of precision medicine in multidisciplinary CR programs.
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Affiliation(s)
- Ivana Sopek Merkaš
- Department of Cardiology, Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice 49217, Croatia
| | - Nenad Lakušić
- Department of Cardiology, Special Hospital for Medical Rehabilitation Krapinske Toplice, Krapinske Toplice 49217, Croatia
- Department of Clinical Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, Osijek 31000, Croatia
- Department of Internal Medicine, Family Medicine and History of Medicine, Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, Osijek 31000, Croatia
| | - Zdenko Sonicki
- Department of Medical Statistics, Epidemiology, and Medical Informatics, School of Public Health Andrija Stampar, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Barbara Koret
- Department of Psychiatry, Clinic for Psychiatry “Sveti Ivan”, Zagreb 10000, Croatia
| | - Sandra Vuk Pisk
- Department of Psychiatry, Clinic for Psychiatry “Sveti Ivan”, Zagreb 10000, Croatia
- Department of Psychiatry and Neurology, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, Osijek 31000, Croatia
| | - Igor Filipčić
- Department of Psychiatry, Clinic for Psychiatry “Sveti Ivan”, Zagreb 10000, Croatia
- Department of Psychiatry and Neurology, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, Osijek 31000, Croatia
- Department of Psychiatry and Psychological Medicine, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
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Zangen A, Zibman S, Tendler A, Barnea-Ygael N, Alyagon U, Blumberger DM, Grammer G, Shalev H, Gulevski T, Vapnik T, Bystritsky A, Filipčić I, Feifel D, Stein A, Deutsch F, Roth Y, George MS. Pursuing personalized medicine for depression by targeting the lateral or medial prefrontal cortex with Deep TMS. JCI Insight 2023; 8:165271. [PMID: 36692954 PMCID: PMC9977507 DOI: 10.1172/jci.insight.165271] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/05/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUNDMajor depressive disorder (MDD) can benefit from novel interventions and personalization. Deep transcranial magnetic stimulation (Deep TMS) targeting the lateral prefrontal cortex (LPFC) using the H1 coil was FDA cleared for treatment of MDD. However, recent preliminary data indicate that targeting the medial prefrontal cortex (MPFC) using the H7 coil might induce outcomes that are as good or even better. Here, we explored whether Deep TMS targeting the MPFC is noninferior to targeting the LPFC and whether electrophysiological or clinical markers for patient selection can be identified.METHODSThe present prospective, multicenter, randomized study enrolled 169 patients with MDD for whom antidepressants failed in the current episode. Patients were randomized to receive 24 Deep TMS sessions over 6 weeks, using either the H1 coil or the H7 coil. The primary efficacy endpoint was the change from baseline to week 6 in Hamilton Depression Rating Scale scores.RESULTSClinical efficacy and safety profiles were similar and not significantly different between groups, with response rates of 60.9% for the H1 coil and 64.2% for the H7 coil. Moreover, brain activity measured by EEG during the first treatment session correlated with clinical outcomes in a coil-specific manner, and a cluster of baseline clinical symptoms was found to potentially distinguish between patients who can benefit from each Deep TMS target.CONCLUSIONThis study provides a treatment option for MDD, using the H7 coil, and initial guidance to differentiate between patients likely to respond to LPFC versus MPFC stimulation targets, which require further validation studies.TRIAL REGISTRATIONClinicalTrials.gov NCT03012724.FUNDINGBrainsWay Ltd.
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Affiliation(s)
| | - Samuel Zibman
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aron Tendler
- Advanced Mental Health Care Inc., Royal Palm Beach, Florida, USA
| | | | - Uri Alyagon
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Hadar Shalev
- Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Psychiatry, Soroka Medical Center, Beer-Sheva, Israel
| | | | - Tanya Vapnik
- Pacific Institute of Medical Research, Los Angeles, California, USA
| | | | - Igor Filipčić
- Psychiatric Hospital Sveti Ivan and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - David Feifel
- Kadima Neuropsychiatry Institute, La Jolla, California, USA
| | - Ahava Stein
- A. Stein - Regulatory Affairs Consulting Ltd, Kfar Saba, Israel
| | | | - Yiftach Roth
- Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Mark S George
- Medical University of South Carolina, Columbia, South Carolina, USA.,Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
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Cvitanušić S, Britvić D, Filipčić I, Frančišković T. PREDICTORS OF CHRONIC COMBAT-RELATED POST-TRAUMATIC STRESS DISORDER GROUP PSYCHOTHERAPY FAVORABLE OUTCOMES; A PROSPECTIVE COHORT STUDY IN CROATIA. Psychiat Danub 2022; 34:455-463. [DOI: 10.24869/psyd.2022.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Filipčić I, Isaac M. Editorial: The mental health in post-COVID-19 era: challenges and consequences. Curr Opin Psychiatry 2022; 35:303-304. [PMID: 35905375 DOI: 10.1097/yco.0000000000000810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Igor Filipčić
- University of Western Australia, Faculty of Health and Medical Sciences, Perth, WA, Australia
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Šimunović Filipčić I, Gereš N, Orgulan I, Vuk Pisk S, Gajšak T, Sučić S, Milovac Ž, Čelić-Ružić M, Zečević Penić S, Matoš T, Dobrović N, Filipčić I. Overview of Studies on the Efficacy of Repetitive Transcranial Magnetic Stimulation on the Severity of Symptoms of Major Depressive Disorder, Conducted in University Psychiatric Hospital Sveti Ivan 2016-2022. Psychiatr Danub 2022; 34:7-9. [PMID: 35643861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This brief report presents the studies on HF rTMS efficacy on major depressive disorder (MDD) symptoms conducted in University Psychiatric Hospital Sveti Ivan from 2016 to 2022. We assessed the clinically relevant effects of rTMS delivered by H1-coil and the figure-8-coil on MDD symptoms severity in the pooled sample of patients. During the last seven years, we enrolled in the studies on MDD 336 patients with a median (interquartile range; IQR) age of 53 (45-61) years, 181 (54%) of them women. We performed interventions with two different coils (8-coil and H1-coil) at 120% of the motor threshold, approximately half with 10 and half with 18 Hz frequency, and > 90% with one daily session during 20 workdays. We offer considerations on how the bulk of our research informed the future direction of our laboratory's studies and clinical work.
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Affiliation(s)
- Ivona Šimunović Filipčić
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
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Gereš N, Šimunović Filipčić I, Sučić S, Milovac Ž, Gajšak T, Zečević Penić S, Orgulan I, Matić K, Filipčić I. Current Status of Repetitive Transcranial Magnetic Stimulation (rTMS) in Croatia and in University Psychiatric Hospital Sveti Ivan. Psychiatr Danub 2022; 34:4-6. [PMID: 35643860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This article reviews the history, evolution, and current status of repetitive transcranial magnetic stimulation (rTMS) in Croatia. University Psychiatric Hospital Sveti Ivan experts performed the first rTMS in 2015 as a first treatment and research group in Croatia. In addition to being a leading center for rTMS in clinical trials and in treating depression, University Psychiatric Clinic Sveti Ivan TMS center continues to research rTMS for depression and other neuropsychiatric disorders and conditions, exploring novel stimulation parameters and individualized treatment protocols. Since 2017 rTMS treatment for MDD in Croatia has been reimbursed by the National Insurance Fund and has been available to hospital and ambulatory patients by indication, and now is widely used in other health centers in Croatia, to treat depression and other neuropsychiatric disorders and conditions, especially when drugs are ineffective or produce harmful side effects.
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Affiliation(s)
- Natko Gereš
- University Psychiatric Hospital Sveti Ivan, Jankomir 11, pp 68, HR-10090 Zagreb, Croatia
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Lovretić V, Kurtović A, Ivezić E, Šago D, Jandrić S, Filipčić I, Restek-Petrović B. Association of Childhood Trauma and Personality Dimensions with the Duration of Untreated Psychosis. Psychiatr Danub 2022; 34:41-50. [PMID: 35467609 DOI: 10.24869/psyd.2022.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Understanding causes and consequences of untreated psychosis is important since the duration of psychosis prior to the treatment initiation is a potentially modifiable prognostic factor, and comprehending its impact on outcome may enhance therapeutic strategies. SUBJECTS AND METHODS This cross-sectional study was performed on a consecutive sample of 105 participants, 47 first episode participants and 58 with multiple episodes. Primary outcome was the duration of untreated psychosis (DUP). We observed three independent variables: childhood trauma measured by Childhood Trauma Questionnaire, psychotic symptoms measured by Positive and Negative Syndrome Scale (PANSS) and personality dimensions measured by the Inventory of Personality Organization (IPO) (primitive defences, identity diffusion and reality testing). All outcomes were observed among total sample and subgroups of first and multiple episode participants. RESULTS Median DUP in total sample was 60.0 (IQR 14.5-285) days. In the subgroup of multiple episode participants, an association between multiple childhood trauma and shorter DUP was found, while no association between DUP and the existence of any specific trauma was found in neither subgroup, or in total sample. With regards to personality dimensions, in the first episode subgroup, significant positive correlations between DUP and primitive defences and reality testing subscales were found, while no correlations in total sample, nor in multiple episode subgroup were observed. Positive symptoms and general psychopathology correlated positively with DUP in total sample, and in first episode subgroup, while in multiple episodes subgroup only a positive correlation with positive symptoms was found. Total PANSS score positively correlated with the DUP only in the first episode subgroup. CONCLUSIONS DUP was not associated with specific type of childhood trauma. First episode participants with longer DUP had predominant primitive defences and severely decreased ability to test reality, while there were no correlations between personality dimensions and DUP in multiple episode subgroup.
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Affiliation(s)
- Vanja Lovretić
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, 10090 Zagreb, Croatia,
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Vukojevic J, Milavić M, Perović D, Ilić S, Čilić AZ, Đuran N, Štrbe S, Zoričić Z, Filipčić I, Brečić P, Seiverth S, Sikirić P. Pentadecapeptide BPC 157 and the central nervous system. Neural Regen Res 2022; 17:482-487. [PMID: 34380875 PMCID: PMC8504390 DOI: 10.4103/1673-5374.320969] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We reviewed the pleiotropic beneficial effects of the stable gastric pentadecapeptide BPC 157, three very recent demonstrations that may be essential in the gut-brain and brain-gut axis operation, and therapy application in the central nervous system disorders, in particular. Firstly, given in the reperfusion, BPC 157 counteracted bilateral clamping of the common carotid arteries-induced stroke, sustained brain neuronal damages were resolved in rats as well as disturbed memory, locomotion, and coordination. This therapy effect supports particular gene expression in hippocampal tissues that appeared in BPC 157-treated rats. Secondly, there are L-NG-nitro arginine methyl ester (L-NAME)- and haloperidol-induced catalepsy as well as the rat acute and chronic models of 'positive-like' schizophrenia symptoms, that BPC 157 counteracted, and resolved the complex relationship of the nitric oxide-system with amphetamine and apomorphine (dopamine agents application), MK-801 (non-competitive antagonist of the N-methyl-D-aspartate receptor) and chronic methamphetamine administration (to induce sensitivity). Thirdly, after rat spinal cord compression, there were advanced healing and functional recovery (counteracted tail paralysis). Likewise, in BPC 157 therapy, there is specific support for each of these topics: counteracted encephalopathies; alleviated vascular occlusion disturbances (stroke); counteracted dopamine disturbances (dopamine receptors blockade, receptors super sensitivity development, or receptor activation, over-release, nigrostriatal damage, vesicles depletion), and nitric oxide-system disturbances ("L-NAME non-responsive, L-arginine responsive," and "L-NAME responsive, L-arginine responsive") (schizophrenia therapy); inflammation reduction, nerve recovery in addition to alleviated hemostasis and vessels function after compression (spinal cord injury therapy). Thus, these disturbances may be all resolved within the same agent's beneficial activity, i.e., the stable gastric pentadecapeptide BPC 157.
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Affiliation(s)
- Jakša Vukojevic
- Department of Pharmacology, Medical School, University of Zagreb, Zagreb, Croatia
| | - Marija Milavić
- Department of Pathology, Medical School, University of Zagreb, Zagreb, Croatia
| | - Darko Perović
- Department of Pharmacology, Medical School, University of Zagreb, Zagreb, Croatia
| | - Spomenko Ilić
- Department of Pharmacology, Medical School, University of Zagreb, Zagreb, Croatia
| | | | - Nataša Đuran
- University Psychiatric Hospital "Vrapče", Zagreb, Croatia
| | - Sanja Štrbe
- University Clinical Hospital Center "Zagreb", Zagreb, Croatia
| | - Zoran Zoričić
- University Clinical Hospital Center "Sestre Milosrdnice", Zagreb, Croatia
| | | | - Petrana Brečić
- University Psychiatric Hospital "Vrapče", Zagreb, Croatia
| | - Sven Seiverth
- Department of Pathology, Medical School, University of Zagreb, Zagreb, Croatia
| | - Predrag Sikirić
- Department of Pharmacology, Medical School, University of Zagreb, Zagreb, Croatia
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Jelavić S, Bajić Ž, Filipčić IŠ, Čulina IJ, Filipčić I, Aurer A. Periodontal status and the efficacy of the first-line treatment of major depressive disorder. Clin Exp Dent Res 2021; 8:366-373. [PMID: 34729949 PMCID: PMC8874085 DOI: 10.1002/cre2.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/09/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
Objectives The efficacy of treatment of major depressive disorder (MDD) is not satisfactory. Systemic inflammation may play an important role in MDD pathogenesis and treatment outcomes. Periodontal disease is the systemic inflammatory condition. Its prevalence may be as high as 45%. We aimed to assess the association of periodontal status with the outcome of 3‐month first‐line treatment of MDD with selective serotonin reuptake inhibitors. Material and Methods We performed the prospective cohort study during 2018/2019 at Psychiatric Hospital “Sveti Ivan,” Croatia, on a consecutive sample of 43 patients. The outcome was the MDD symptoms severity measured using the Hamilton Depression Rating Scale‐17. The periodontal status was indicated by the clinical attachment loss (CAL). Results Baseline periodontal status had a nonlinear significant and clinically relevant association with the MDD treatment outcome (R2 change of the quadratic term = 0.12; p = 0.027). In patients with good baseline periodontal status the severity of MDD symptoms was significantly improved. When the value of CAL was ≥4.44 mm, indicating the worse periodontal status, further increase in baseline CAL was associated with the worsening of MDD treatment outcomes independently of the baseline depression severity and 14 sociodemographic and clinical predictors of treatment outcome. Conclusions Periodontal healthcare is accessible, and should be utilize in an integrative, multidisciplinary approach not only for the sake of psychiatric patients' quality of life and prevention of periodontal disease, but for the sake of the outcomes of psychiatric treatment as well.
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Affiliation(s)
- Silvana Jelavić
- Department for Extended Treatment and Palliative Care of Men, University Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Žarko Bajić
- Research Unit "Dr. Mirko Grmek", University Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | | | | | - Igor Filipčić
- Department of Integrative Psychiatry, University Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia.,Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,Department of Psychiatry and Psychological Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Andrej Aurer
- Department of Periodontology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Abstract
PURPOSE OF REVIEW Despite a significant body of literature related to the treatment of gambling disorder, there are still an insufficient number of evaluation studies regarding their effectiveness or firm conclusions on specific treatment elements that contribute to it. The aim of this article was to provide a review of scientific results regarding the treatment of gambling disorder, to present the most commonly applied modalities of treatment and to explore the elements of the most successful therapeutic interventions. RECENT FINDINGS A substantial body of literature has shown that the most successful therapeutic protocols are psychological interventions, especially based on cognitive-behavioral therapy/methods and/or motivational interviewing. Other interventions with promising results include different self-help interventions and mindfulness. Interventions such as couples therapy and support groups, may have positive effects in terms of increasing therapeutic adherence and retention, while pharmacotherapy is especially useful in patients with comorbidities. SUMMARY Gambling disorder is a complex mental health problem caused by a wide spectrum of different biological, psychological, and social risk factors. Treatment options for gambling disorder need to be wide, flexible, accessible, and economically justified, providing early inclusion, retention, and sustainability of long-term effects of the treatment, that is, abstinence and higher quality of psychosocial functioning.
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Affiliation(s)
- Davor Bodor
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek
- Psychiatric Hospital 'Sveti Ivan'
| | - Neven Ricijaš
- Department of Behavioral Disorders, Faculty of Education and Rehabilitation Sciences, University of Zagreb
| | - Igor Filipčić
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek
- Psychiatric Hospital 'Sveti Ivan'
- School of Medicine, University of Zagreb, Zagreb, Croatia
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14
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Filipčić I, Šimunović Filipčić I, Sučić S, Milovac Ž, Gereš N, Matić K, Čelić-Ružić M, Zečević Penić S, Orgulan I, Požgaj V, Bajić Ž. A pilot investigation of accelerated deep transcranial magnetic stimulation protocols in treatment-resistant depression. Eur Arch Psychiatry Clin Neurosci 2021; 271:49-59. [PMID: 32449010 DOI: 10.1007/s00406-020-01141-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
Accelerated repetitive transcranial magnetic stimulation (rTMS) protocols are being increasingly studied because of their potential to provide quicker and enhanced treatment efficacy. However, there is a lack of accelerated deep TMS with H1-coil (adTMS) treatment research. This randomized pilot study investigated the efficacy and safety of adTMS protocols. Twenty-eight TRD patients received 20-min sessions twice daily for 10 or 15 days. Primary outcomes were changes in Hamilton Depression Rating Scale (HDRS) scores and discontinuation because of adverse events (AE). Secondary outcomes were response, remission, daily changes in Beck Depression Inventory-II (BDI-II) scores, and AE incidence. HDRS scores decreased by 13 (95% CI 11-17; 59%, 95% CI 45-73%) and 13 (95% CI 11-14; 62%, 95% CI 54-69%) points in the 10- and 15-day protocols, respectively. The adjusted difference between the two protocols was not significant or clinically relevant. Remission was achieved by 38% and 42% after 10-day and 15-day protocols, respectively. The intervention was discontinued because of AEs in 3/33 (9%) patients. The BDI-II decreases were significant and clinically relevant during the first 8 days. Twice-daily adTMS for 10 days seems to be safe and effective, with rapid clinical benefits during the first week of treatment. These promising results warrant further investigation in larger randomized clinical trials comparing adTMS with the standard dTMS protocol.
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Affiliation(s)
- Igor Filipčić
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp 68, 10 090, Zagreb, Croatia. .,Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia. .,School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Ivona Šimunović Filipčić
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Strahimir Sučić
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp 68, 10 090, Zagreb, Croatia
| | - Željko Milovac
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp 68, 10 090, Zagreb, Croatia
| | - Natko Gereš
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp 68, 10 090, Zagreb, Croatia
| | - Katarina Matić
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp 68, 10 090, Zagreb, Croatia
| | - Mirela Čelić-Ružić
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp 68, 10 090, Zagreb, Croatia
| | | | - Ivana Orgulan
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp 68, 10 090, Zagreb, Croatia
| | - Vladimir Požgaj
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp 68, 10 090, Zagreb, Croatia
| | - Žarko Bajić
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp 68, 10 090, Zagreb, Croatia
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15
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Bakija I, Filipčić I, Bogadi M, Šimunović Filipčić I, Gotovac M, Kaštelan S. Comparison of the Schein and Osdi Questionnaire as Indicator of Tear Film Stability in Patients with Schizophrenia. Psychiatr Danub 2021; 33:596-603. [PMID: 34718286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The aim of this research was to determine which of two chosen questionnaires for subjective symptoms of dry eye (Ocular Surface Disease Index and Schein questionnaire) is more reliable in the assessment of dry eye in patients with schizophrenia. SUBJECTS AND METHODS Our research included 80 patients (160 eyes) of both sexes with schizophrenia ranging between the age of 25 and 55 who have been taking one of three antipsychotic drugs namely clozapin, olanzapin, quetiapin for five or more years and were in a stable phase of the disease or remission. All participants were required to satisfy all included and excluded criteria. They all filled out the Schein and OSDI questionnaires for assessment of subjective symptoms. Tear break-up time test (TBUT) for objective evaluation of tear film stability was also performed. In order to determine the correlation between two subjective and objective tests we calculated Spearmans correlation coefficients. RESULTS Obtained results of the correlation between OSDI questionnaire and TBUT test for the right eye was r=-0.73; p<0.01 and for the left eye was r=-0.72; p<0.01. Results of the correlation between Schein questionnaire and TBUT test for the right eye was r=-0.62; p<0.01 and for the left eye was r=-0.60; p<0.01. A detailed analysis shows that there are no statistically significant differences between the correlations. Both subjective questionnaires are statistically significantly and negatively related to the TBUT test, showing that an increase in the results on the OSDI and Schein's questionnaires led to the decreases in the results on the TBUT test. CONCLUSION In patients with schizophrenia the OSDI and Schein questionnaires are equally reliable in the assessment of subjective symptoms of Dry eye disease. Considering that, OSDI is more common in clinical practice and includes questions regarding quality of life, it would have certain advantages and it is recommended for use in patients with schizophrenia.
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Affiliation(s)
- Ivana Bakija
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, 10090 Zagreb, Croatia,
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16
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Kocijan Lovko S, Caratan S, Ivrlač A, Gorišić L, Šimunović Filipčić I, Filipčić I. How to Square a Circle? Psychiatr Danub 2021; 33:702-705. [PMID: 34718306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Psychodynamic group psychotherapy in Daily Hospital for non-psychotic disorders was held through Hangouts program during CoViD-19 pandemic lockdown. In our pilot study we compared patients' impressions and their satisfaction with online program vs. usual, in-person setting program. We analyzed the impressions of group therapists as well. Our conclusion is that according to our patients' impressions and satisfaction, online psychodynamic group psychotherapy is good enough option in extreme situations such as infectious disease pandemic, although it cannot completely replace all the aspects of usual "live" setting.
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17
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Primorac D, Juginović A, Filipčić I, Mikula I, Lazibat I, Brkljačić M, Erceg D. Effective Pharmacogenomic-driven Treatment of Major Depression: A Case Report. Psychiatr Danub 2020; 32:428-430. [PMID: 33370742 DOI: 10.24869/psyd.2020.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Dragan Primorac
- St. Catherine Specialty Hospital, Trpinjska 7, 10000 Zagreb, Croatia,
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18
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Šago D, Martić V, Šmida D, Mayer N, Lovretić V, Filipčić I. Telepsychiatry in the Time of the COVID-19 and Earthquake in Zagreb as Odysseus between Scylla and Charybdis. Psychiatr Danub 2020; 32:478-481. [PMID: 33370756 DOI: 10.24869/psyd.2020.478] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In this paper we would like to reveal some of the many challenges during the time of the twofold simultaneous trauma; the COVID-19 pandemic and the devastating earthquake in Zagreb. We described the functioning mode of two Day Hospitals for Early Intervention and Psychotic Disorders at Psychiatric Hospital "Sveti Ivan" during the outbreak of the COVID-19 pandemic. We tried to find ways to ensure the necessary continuation of treatment and to provide continuity in times of uncertainty. The vulnerable group of people treated for mental illnesses faced exceptional psychological demands and was in need for care in these moments. Telemedicine, more specifically telepsychiatry, through online therapy and telephone communication made it possible for people treated for psychotic disorders not to feel isolated and rejected. Health care professionals, in a state of distress themselves, should understand, support, be able to reduce anxiety, and provide stability and constancy. The psychotherapeutic approach and the capacity for mentalization allowed us to turn challenges into opportunities. Rapid changes without delay extended our scope of practice in these extraordinarily difficult times.
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Affiliation(s)
- Daniela Šago
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, 10090 Zagreb, Croatia,
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19
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Šimunović Filipčić I, Ivezić E, Jakšić N, Mayer N, Grah M, Rojnić Kuzman M, Bajić Z, Svab V, Herceg M, Filipčić I. Gender differences in early onset of chronic physical multimorbidities in schizophrenia spectrum disorder: Do women suffer more? Early Interv Psychiatry 2020; 14:418-427. [PMID: 31414567 DOI: 10.1111/eip.12867] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/07/2019] [Accepted: 07/14/2019] [Indexed: 12/11/2022]
Abstract
AIM The association between various physical illnesses and schizophrenia spectrum disorder (SSD) is well-established. However, the role of gender remains unclear. The present study explored the gender-based differences in the prevalence and early onset of chronic physical multimorbidities (CPM) in patients with SSD and the general population (GEP). METHODS We recruited 329 SSD patients and 837 GEP controls in this nested cross-sectional study. The primary outcome was the prevalence of the chronic physical multimorbidities, especially in the youngest age group (<35 years). RESULTS Women with SSD had more than double the odds for having CPM than men (OR = 2.47; 95% CI 1.35-4.50), while the gender-related burden of chronic diseases in controls was nearly the same (OR = 0.89; 95% CI 0.65-1.22). Furthermore, the prevalence of chronic disease in younger women patients was significantly higher than in controls (P = .002), while younger men did not seem to experience this increased comorbidity burden. CONCLUSIONS This study suggests that women with SSD are at increased physical comorbidity risk compared to men, particularly early in the course of psychiatric illness. Tailored and individualized treatment plans must consider this, aiming to deliver holistic care and effective treatment outcomes.
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Affiliation(s)
- Ivona Šimunović Filipčić
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Ena Ivezić
- Department for integrative psychiatry, Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Nina Mayer
- Department for integrative psychiatry, Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Majda Grah
- Department for integrative psychiatry, Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Martina Rojnić Kuzman
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zarko Bajić
- Department for integrative psychiatry, Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Vesna Svab
- University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - Miroslav Herceg
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department for psychotic disorders, Psychiatric Hospital Vrapče, Zagreb, Croatia
| | - Igor Filipčić
- Department for integrative psychiatry, Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia.,Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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20
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Šago D, Babić G, Bajić Ž, Filipčić I. Panic Disorder as Unthinkable Emotions: Alexithymia in Panic Disorder, a Croatian Cross-Sectional Study. Front Psychiatry 2020; 11:466. [PMID: 32581863 PMCID: PMC7282461 DOI: 10.3389/fpsyt.2020.00466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 05/06/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Previous research on alexithymia has led to controversy over its prevalence in panic disorder. The aim of this study was to assess the difference in the prevalence of alexithymia in panic disorder and other anxiety disorders. DESIGN AND METHODS We performed a cross-sectional study on a sample of 71 patients diagnosed with panic disorder and 113 patients diagnosed with other anxiety disorders; both groups were 18-50 years old. Primary outcome was the 20-item Toronto Alexithymia Scale (TAS) score. Secondary outcome was the prevalence of alexithymia defined as a TAS score ≥61. RESULTS Patients diagnosed with panic disorder had a 25% higher score on the TAS subscale of difficulty identifying feelings than patients diagnosed with other anxiety disorders. The prevalence of alexithymia was 27% in patients with panic disorder and 13% in patients with other anxiety disorders. Patients diagnosed with panic disorder had significantly higher odds for alexithymia. CONCLUSIONS The results of our study support the hypothesis of higher prevalence of alexithymia in individuals with panic disorder than in individuals with other anxiety disorders. In addition, difficulty identifying feelings as a salient feature of alexithymia is higher in panic disorder than in other anxiety disorders.
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Affiliation(s)
- Daniela Šago
- Day Hospital for Psychotic Disorder, Psychiatric Hospital Sveti Ivan, Zagreb, Croatia.,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Goran Babić
- Independent Researcher, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Žarko Bajić
- Day Hospital for Psychotic Disorder, Psychiatric Hospital Sveti Ivan, Zagreb, Croatia
| | - Igor Filipčić
- Day Hospital for Psychotic Disorder, Psychiatric Hospital Sveti Ivan, Zagreb, Croatia.,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia.,Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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21
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Caratan S, Todorić Laidlaw I, Mlinac-Jerković K, Lončar Brzak B, Filipčić I, Aurer A. Association of Poor Periodontal Health in Younger Schizophrenia Patients with a Worsening of Symptoms During Remission: a Prospective Cohort Study. Arch Psychiatry Res 2019. [DOI: 10.20471/dec.2019.55.02.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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22
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Bekić S, Babič F, Filipčić I, Trtica Majnarić L. Clustering of Mental and Physical Comorbidity and the Risk of Frailty in Patients Aged 60 Years or More in Primary Care. Med Sci Monit 2019; 25:6820-6835. [PMID: 31507272 PMCID: PMC6753844 DOI: 10.12659/msm.915063] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background This study aimed to identify the clustering of comorbidities, cognitive, and mental factors associated with increased risk of pre-frailty and frailty in patients ≥60 years in a primary healthcare setting in eastern Croatia. Material/Methods There were 159 patients included in the cluster analysis who were ≥60 years and who underwent four-month follow-up. The first cluster contained 50 patients, the second cluster contained 74 patients, and the third cluster contained 35 patients. Clinical parameters were identified from electronic health records and patient questionnaires. Laboratory tests, anthropometric measurements, the number of chronic diseases, the number of prescribed medications were recorded. Frailty was determined using the five criteria of Fried’s phenotype model. Levels of anxiety and depression were recorded using the Geriatric Anxiety Scale (GAS) and the Geriatric Depression Scale (GDS), and the Mini-Mental State Examination (MMSE) score assessed cognitive impairment. Logistic regression models were used to identify predictors of frailty and pre-frailty. Results Three overlapping clusters of phenotypes predicted frailty, and included obesity (n=50), multimorbidity with mental impairment (n=74), and decline in renal function with cognitive impairment (n=35). The predictors of outcome included increasing age, number of chronic diseases, inflammation, anemia, anxiety, and cognitive impairment, and reduced muscle mass. Conclusions In patients ≥60 years in a primary healthcare setting, multimorbidity predictors of pre-frailty and frailty included a decline in cognitive function and renal function.
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Affiliation(s)
- Sanja Bekić
- General Medicine Private Practice Enterprise, Osijek, Croatia.,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - František Babič
- Department of Cybernetics and Artificial Intelligence, Faculty of Electrical Engineering and Informatics, Technical University of Košice, Košice, Slovakia
| | - Igor Filipčić
- Department of Psychological Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Ljiljana Trtica Majnarić
- Department of Internal Medicine, Family Medicine and The History of Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,Department of Public Health, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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23
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Filipčić I, Šimunović Filipčić I, Milovac Ž, Sučić S, Gajšak T, Ivezić E, Bašić S, Bajić Ž, Heilig M. Efficacy of repetitive transcranial magnetic stimulation using a figure-8-coil or an H1-Coil in treatment of major depressive disorder; A randomized clinical trial. J Psychiatr Res 2019; 114:113-119. [PMID: 31059991 DOI: 10.1016/j.jpsychires.2019.04.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/21/2019] [Accepted: 04/23/2019] [Indexed: 10/26/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is an evidence-based treatment option for major depressive disorder (MDD). However, comparisons of efficacy between the two FDA-approved protocols of rTMS modalities are lacking. The aim of this industry-independent, randomized-controlled, single-blind trial was to evaluate clinical outcome of the two FDA-approved rTMS protocols delivered by H1-coil and the figure-8-coil, in MDD patients. A total of 228 MDD patients were randomized to 20 sessions of H1-coil or 8-coil as an adjunct to standard-of-care pharmacotherapy, or standard-of-care pharmacotherapy alone. Baseline MDD symptom severity was almost the same in the three groups. Hamilton depression rating scale (HAM-D17) mean score was 17 (5.3) in H1-coil, 17 (5.4) in 8-coil, and 19 (6.1) in control group. The primary outcome was the proportion of patients achieving remission defined as HAM-D17 score ≤7 at end-of-treatment at week-4. In the intention-to-treat analysis odds ratio for remission was 1.74 (CI95% 0.79-3.83) in H1-coil compared to the 8-coil group. The difference between two rTMS protocols was not significant. Remission rate was significantly greater in both HF-rTMS groups compared to the control: 60% (CI95% 48-71%), 43% (CI95% 31-55%) and 11% (CI95% 5-20%) respectively. The response was significantly better in H1-coil, than in 8-coil group OR = 2.33; CI95% 1.04-5.21 (P = 0.040). The HAM-D17 was lowered by 59% in the H1-coil, 41% in the 8-coil (P = 0.048), and 17% in the control group (P < 0.001 vs H1-coil; P = 0.003 vs 8-coil). Safety, tolerability, and the changes in quality of life were comparable. We confirmed the safety and efficacy of both FDA-approved protocols as adjunctive treatments of MDD. Better response rate and greater reduction of depression severity were observed in the H1-coil group, but without a significant difference in the remission rate between the two rTMS modalities. CLINICAL TRIALS REGISTRATION: Clinicaltrials.govNCT02917499.
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Affiliation(s)
- Igor Filipčić
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
| | | | | | | | | | - Ena Ivezić
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Silvio Bašić
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Neurology, Dubrava University Hospital, Zagreb, Croatia
| | - Žarko Bajić
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Markus Heilig
- Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
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Jeleč V, Bajić Ž, Šimunović Filipčić I, Portolan Pajić I, Šentija Knežević M, Miloloža I, Radić-Krišto D, Benjak T, Jakšić N, Šagud M, Wang W, Filipčić I. Utilization of somatic healthcare in Croatian patients with schizophrenia spectrum disorder, major depression, PTSD and the general population. BMC Psychiatry 2019; 19:203. [PMID: 31253196 PMCID: PMC6599369 DOI: 10.1186/s12888-019-2190-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 06/23/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Utilization of somatic healthcare services is highly predictive of the development of chronic physical illnesses and increased mortality risks. The objective of this study was to assess the differences in healthcare utilization among patients with schizophrenia spectrum disorders (SSD), major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) and the general population in Croatia. METHODS We enrolled 566 Croatian participants from the general population, 282 with SSD, 178 with MDD, and 86 with PTSD. The primary outcome was a self-reported specialist consultation for non-psychiatric (e.g., somatic) causes within the previous 12 months. RESULTS Although SSD patients with chronic physical illnesses were significantly more often hospitalized for physical illness than the general population, the proportion of patients who had a specialist consultation were equal in SSD and the general population. MDD and PTSD patients had significantly higher adjusted odds for specialist consultation than the general population and SSD patients (MDD compared to SSD: OR = 2.14; 95% CI 1.27-3.59; PTSD compared to SSD: OR = 2.03; 95% CI 1.00-4.10). CONCLUSIONS SSD patients' utilization of somatic healthcare is equal to the general population, despite their increased healthcare needs. However, their utilization is lower than in MDD and PTSD patients and, therefore, probably not adequate. TRIAL REGISTRATION The study protocol was registered at ClinicalTrials.gov ( NCT02773108 ) on May 16, 2016.
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Affiliation(s)
- Vjekoslav Jeleč
- 0000 0004 0631 385Xgrid.412095.bDepartment of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia ,City Office for Health, Zagreb, Croatia
| | - Žarko Bajić
- Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia
| | | | | | | | - Ivan Miloloža
- 0000 0001 1015 399Xgrid.412680.9Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Delfa Radić-Krišto
- 0000 0004 0367 1520grid.411045.5Division of Hematology, Merkur University Hospital, Zagreb, Croatia ,0000 0001 1015 399Xgrid.412680.9Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Tomislav Benjak
- 0000 0000 8878 5439grid.413299.4Croatian Institute of Public Health, Zagreb, Croatia
| | - Nenad Jakšić
- 0000 0004 0397 9648grid.412688.1Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marina Šagud
- 0000 0004 0397 9648grid.412688.1Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia ,0000 0001 0657 4636grid.4808.4School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Wei Wang
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry, Zhejiang University College of Medicine, Hangzhou, China
| | - Igor Filipčić
- Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia ,0000 0001 1015 399Xgrid.412680.9Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia ,0000 0001 0657 4636grid.4808.4School of Medicine, University of Zagreb, Zagreb, Croatia
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Filipčić I, Šimunović Filipčić I, Milovac Ž, Gajšak T, Sučić S, Ivezić E, Orgulan I, Zecevic Penic S, Požgaj V, Bajić Ž. Efficacy of repetitive transcranial magnetic stimulation using a figure-8-Coil or an H1-Coil in treatment of major depressive disorder. A randomized clinical trial. Encephale 2019. [DOI: 10.1016/j.encep.2019.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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26
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Vuk Pisk S, Matić K, Gereš N, Ivezić E, Ruljančić N, Filipčić I. Hyperprolactinemia - side effect or part of the illness. Psychiatr Danub 2019; 31:148-152. [PMID: 31158115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Hyperprolactinemia is associated with side effect of antipsychotics in people suffering from psychotic disorders. However, increased prolactin levels (mlU/L) were found in patients suffering from the first psychotic episode who were not receiving antipsychotic therapy. The assumption of this study is that the abnormality in the level of prolactin is associated with the effect and influence of the disease, not the therapy that is carried out. SUBJECTS AND METHODS Study involved 54 female patients hospitalized in Psychiatric hospital "Sveti Ivan", whose average age was 33.9 years. All patients had been diagnosed with a psychotic disorder (according to MKB-10, F20-F29). 18 patients had their first psychotic episode, while 36 patients had relapses of psychotic disorder. The methods used were: PANSS scale and measurement of prolactin concentration (Immunoanalyzer ACCESS 2, CLIA method). Arithmetic mean, standard deviations, correlation coefficient, Mann Whitney U test and the chi-squared test were used. RESULTS 75.5% of patients had prolactin values above the reference values (min 121, max 4192 ml/L). In a sample of patients with first psychotic episode, 77.8% had elevated prolactin levels, while among re-hospitalized patients, elevated levels had 74.2%. Statistically significant results were obtained: patients with higher pronounced symptoms had higher prolactin values, especially particles on PANSS: P1 (delusions), N4 (Apathy), G15 (preoccupation) and G16 (active avoidance). CONCLUSION Elevated prolactin in patients has been demonstrated regardless of antipsychotic therapy, therefore the question of etiology of hyperprolactinemia in psychotic disorders is questionable. The association of hyperprolactinemia with the severity of the clinical picture has also been demonstrated, higher prolactin values indicating a stronger clinical picture, which calls into question the protective role of prolactin in psychotic disorders.
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Affiliation(s)
- Sandra Vuk Pisk
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, 10090 Zagreb, Croatia,
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Gerlach J, Koret B, Gereš N, Matić K, Prskalo-Čule D, Zadravec Vrbanc T, Lovretić V, Skopljak K, Matoš T, Šimunović Filipčić I, Filipčić I. Clinical Challenges in Patients with First Episode Psychosis and Cannabis Use: Mini-Review and a Case Study. Psychiatr Danub 2019; 31:162-170. [PMID: 31158117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The influence of cannabis use on the occurrence, clinical course and the treatment of the first psychotic episode (FEP) is well documented. However, the exact link is still not clearly established. The aim of this article is to review and report the noticed increase in the number of hospitalizations of young people with a clinical appearance of severe psychotic decompensation following cannabis consumption and to show the clinical challenges in treatment of the FEP. The case study describes the clinical course of a five selected patients with a diagnosis of the FEP and positive tetrahydrocannabinol (THC) urine test who were hospitalized in a similar pattern of events. They all have a history of cannabis consumption for at least 6 years in continuity and were presented with severe psychomotor agitation, disorganisation, confusion and aggression at admission. Although the chosen drug to treat all patients was atypical antipsychotic and benzodiazepines, the course of the disorder and the clinical response to therapy were noticeably different in each patient. The clinical presentation of FEP in cannabis users can be atypical and highly unpredictable from mild psychotic symptoms to severe substance intoxication delirium. In clinical practice clinicians treating new onset psychosis need to be watchful for cannabis and synthetic cannabinoids induced psychosis. Pharmacotherapeutic interventions include prompt and adequate use of the benzodiazepine, second-generation antipsychotic, and mood-stabilizers. Further research in the pharmacotherapy of cannabis-induced psychosis is required.
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Affiliation(s)
- Josefina Gerlach
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, HR-10090 Zagreb, Croatia, josefina.gerlach @pbsvi.hr
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Šago D, Lovretić V, Habuš K, Ivezić E, Bogović Dijaković A, Đogaš VV, Filipčić I. Improving the quality of life during treatment in the Day hospital for early intervention in Psychiatric Hospital "Sveti Ivan". Psychiatr Danub 2019; 31:190-195. [PMID: 31158121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND The Day hospital for early intervention is a time-limited structured therapeutic program based on different psychotherapy and socio-therapy techniques. The aim of this study was to examine the outcomes of the Day hospital treatment for early intervention on self-esteem, and quality of life, and to determine which patients benefit the most from the program. SUBJECTS AND METHODS The study was conducted on 124 patients with an early phase of psychosis who were treated at the Day hospital. They filled out Rosenberg Self-Esteem Scale, and WHOQOL-BREF upon the admission and again after three months of the treatment. Interaction effects were examined between their sociodemographic characteristics (gender, age, employment status), clinical features (first episode of psychosis or longer duration of illness), and results on applied questionnaires. RESULTS After three months of the treatment, patients evaluated their self-esteem, overall quality of life and satisfaction with different QoL domains (physical and psychological health, environment) as significantly improved. Younger patients had greater increase in estimated self-esteem compared to older patients. No other significant interactions were found. CONCLUSION Notwithstanding the limitations of this study, we may conclude that the findings are encouraging and may assist with development of more effective therapeutic approaches.
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Affiliation(s)
- Daniela Šago
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, 10090 Zagreb, Croatia,
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Gereš N, Matić K, Prskalo-Čule D, Zadravec Vrbanc T, Lovretić V, Skopljak K, Matoš T, Gerlach J, Koret B, Šimunović Filipčić I, Ivezić E, Bajić Ž, Filipčić I. Efficacy of Center for Integrative Psychiatry Multimodal Early Intervention Services in Early-Phase Psychosis on Hospital Readmission. Psychiatr Danub 2019; 31:171-180. [PMID: 31158118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Growing body of evidence has opened new opportunities to enhance treatment outcomes during early-phase psychosis (EPP). The objective of this study was to evaluate the effect of the Centre for integrative psychiatry (CIP) multimodal Early Intervention Services (EIS) on time to relapse in the patients with early-phase psychosis (EPP) during 12 and 24 month period. SUBJECTS AND METHODS We performed a retrospective cohort study on the sample of 454 EPP patients (duration of the diagnosed disorder ≤5 years) admitted to Psychiatric Hospital "Sveti Ivan", Zagreb Croatia, from January 2, 2015, to December 5, 2018, for the acute treatment of EPP. The end of follow up was March 5, 2019. The primary outcome was the time to rehospitalization because of relapse during the 12 months from the hospital discharge. Independent variable was the EIS. RESULTS We analyzed 454 EPP patients, 260 in EIS group and 194 in no EIS group. After the adjustment for twenty possible confounding factors using the Cox proportional hazard regression, patients who received EIS had significantly and clinically relevantly lower hazard for rehospitalization because of relapse during the first 12 months (HR=0.39; CI95% 0.21-0.61; p<0.001), and during the first 24 months from the hospital discharge (HR=0.56; CI95% 0.39-0.80; p=0.003; sequential Holm-Bonferroni corrected pcorr=0.004). CONCLUSIONS Our study indicated efficacy of the CIP multimodal EIS in patients with EPP demonstrated through the time to the hospital readmission because of relapse during the 12 and 24 months from the hospital discharge. These results strongly support the need for implementation of multimodal EIS in all patients with EPP.
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Affiliation(s)
- Natko Gereš
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, HR-10090 Zagreb, Croatia
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Brunelin J, Mondino M, Arns M, Baeken C, Brem AK, Filipčić I, Ganho-Avila A, Palm U, Poleszczyk A, Sauvaget A, O'Shea J, D'Urso G, Poulet E. 3rd European Conference on brain stimulation in psychiatry - From mechanism to medicine. Encephale 2019; 45 Suppl 2:S47-S49. [PMID: 31104764 DOI: 10.1016/j.encep.2019.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- J Brunelin
- Inserm U1028, CNRS UMR 5292, Lyon Neuroscience Research Center - PSYR2 team, centre hospitalier le Vinatier, Lyon university, Lyon, France.
| | - M Mondino
- Inserm U1028, CNRS UMR 5292, Lyon Neuroscience Research Center - PSYR2 team, centre hospitalier le Vinatier, Lyon university, Lyon, France
| | - M Arns
- Research Institute Brainclinics, Nijmegen, The Netherlands; Utrecht University, Department Experimental Psychology, Utrecht, The Netherlands
| | - C Baeken
- Ghent University, Department of Psychiatry and Medical Psychology, Ghent, Belgium; Ghent University, Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Vrije Universiteit Brussel (VUB), Department of Psychiatry, Universitair Ziekenhuis Brussel (UZBrussel), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - A-K Brem
- Max Planck Institute of Psychiatry, Munich, Germany; Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Interventional Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - I Filipčić
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
| | - A Ganho-Avila
- Proaction Laboratory, Faculty of Psychology and Educational Sciences, University of Coimbra, 3001-802 Coimbra, Portugal; Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, 4710-057 Braga, Portugal
| | - U Palm
- Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - A Poleszczyk
- Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - A Sauvaget
- Psychiatry Neuromodulation Unit, Addictology and Liaison Psychiatry Department, CHU de Nantes, Nantes, France; Faculty of Sport Sciences, Laboratory "Movement, Interactions, Performance" (E.A. 4334), University of Nantes, Nantes, France
| | - J O'Shea
- Wellcome Centre for Integrative Neuroimaging (WIN), University of Oxford, UK
| | - G D'Urso
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - E Poulet
- Inserm U1028, CNRS UMR 5292, Lyon Neuroscience Research Center - PSYR2 team, centre hospitalier le Vinatier, Lyon university, Lyon, France
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Filipčić I, Šimunović Filipčić I, Grošić V, Bakija I, Šago D, Benjak T, Uglešić B, Bajić Ž, Sartorius N. Patterns of chronic physical multimorbidity in psychiatric and general population. J Psychosom Res 2018; 114:72-80. [PMID: 30314582 DOI: 10.1016/j.jpsychores.2018.09.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE A growing body of evidence has demonstrated the high prevalence and complexity of chronic physical multimorbidity defined as ≥2 chronic physical illness in people with psychiatric disorders. The present study aimed to assess differences in the prevalence and patterns of self-reported chronic physical illness and multimorbidity in the general and psychiatric populations. METHODS We performed a latent class analysis of 15 self-reported chronic physical illnesses on a sample of 1060 psychiatric patients and 837 participants from the general population. RESULTS Self-reported chronic physical illness and multimorbidity were significantly more prevalent in the population of psychiatric patients than in the general population (P < .001). Psychiatric patients had 27% (CI95% 24% - 30%) higher age-standardized relative risk for chronic physical illness and a 31% (CI95% 28% - 34%) higher for multimorbidity (P < .001). The number of chronic physical illnesses combinations was 52% higher in the psychiatric than in general population (255 vs 161 combinations respectively; P < .001). We identified four distinct latent classes: "Relatively healthy", "Musculoskeletal", "Hypertension and obesity", and "Complex multimorbidity" with no significant differences in the nature of multimorbidity latent classes patterns. The class "Relatively healthy" was significantly less (ARI = -25% (CI95% -30% -21%), and the class "Hypertension and obesity" was significantly more prevalent in the population of psychiatric patients (ARI = 20% (CI95% 17% - 23%). CONCLUSIONS These findings indicate that mental disorders are associated with an increased risk of a wide range of chronic physical illnesses and multimorbidity. There is an urgent need for the development of the guidelines regarding the physical healthcare of all individuals with mental disorders with multimorbidity in focus.
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Affiliation(s)
- Igor Filipčić
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
| | | | | | - Ivana Bakija
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Daniela Šago
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | | | - Boran Uglešić
- Department of Psychiatry, University Hospital Center Split, Split, Croatia
| | - Žarko Bajić
- Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
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Bodor D, Ricijaš N, Zoričić Z, Dodig Hundrić D, Filipčić I. Prevalence of Pathological Gambling among Alcohol Addicts in Outpatient Treatment in the City of Zagreb: a Cross-Sectional Study. Psychiatr Danub 2018; 30:348-355. [PMID: 30267528 DOI: 10.24869/psyd.2018.348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Various types of addictions often co-occur, particularly substance and behavioral ones, which affects the clinical course of mental health disorders as well as the efficacy of therapy and rehabilitation efforts. The present study aims to explore gambling activities and possible gambling addiction among alcoholics in an outpatient treatment in the city of Zagreb. SUBJECTS AND METHODS Gambling activities were assessed in 140 members of alcohol addiction clubs in the City of Zagreb (Croatia). Participants were undergoing treatment after being diagnosed by their psychiatrist with alcohol dependence syndrome based on ICD-10 criteria. Intensity of gambling-related problems was measured using the South Oaks Gambling Screen (SOGS), while intensity of alcohol addiction was assessed using DSM-5 diagnostic criteria for alcohol use disorder. All instruments were self-report forms and were completed using pen and paper in a group context during outpatient treatment. RESULTS Pathological gambling was more prevalent in this clinical subsample than in general populations analysed in other studies. Alcohol addicts showing problematic or pathological gambling behaviors tended to play more highly addictive games (sports betting, slot machines, roulette). However, intensity of gambling-related problems did not correlate significantly with the intensity of alcohol addiction. CONCLUSION These results confirm studies from other countries showing higher prevalence of problematic and pathological gambling among alcohol addicts than in the general population. Gambling behavior in our sample more often involved games with greater addictive potential. These findings suggest that alcohol addicts should be systematically screened for problematic and pathological gambling, which may improve therapeutic efficacy and rehabilitation, as well as reduce relapse in addictive behavior in general.
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Affiliation(s)
- Davor Bodor
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, 10090 Zagreb, Croatia,
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Filipčić I, Šimunović Filipčić I, Gajšak T, Milovac Ž, Sučić S, Ivezić E, Zečević Penić S, Orgulan I, Šebo D, Jeleč V, Bajić Ž. Efficacy and safety of repetitive transcranial magnetic stimulation using an H1-coil or figure-8-coil in the treatment of unipolar major depressive disorder: A study protocol for a randomized controlled trial. Psychiatr Danub 2018; 30:41-46. [PMID: 29546857 DOI: 10.24869/psyd.2018.41] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique with few side effects that has been reported to be effective in the treatment of major depressive disorder (MDD). At present, no randomized controlled trials (RCT) have compared the efficacy and safety of rTMS delivered by the figure-8-coil and the H1-coil. We describe an industry-independent, randomized, controlled, single-blinded, single-center study protocol assessing the differences in efficacy and safety of rTMS for patients diagnosed with MDD with the H1-coil and figure-8-coil as an add-on to stable pharmacotherapy or pharmacotherapy alone. Stimulation protocols follow those that led to the FDA clearance of these treatments for MDD. The sample of 76 patents in each of the three groups will be enrolled and assessed with clinical and neuropsychological tests. The primary outcome is remission rate defined as Hamilton depression rating scale (HAM-D17) score ≤7 at the end of week-4. This clinical trial will address the efficacy and safety of rTMS modalities for MDD. The evaluation of biological markers will also help to elucidate the pathophysiology of MDD and the mechanisms of action of rTMS.
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Affiliation(s)
- Igor Filipčić
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp68, HR-10090 Zagreb, Croatia,
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Todorić Laidlaw I, Mimica N, Momčilović B, Jurasović J, Caratan S, Filipčić I, Vuk Pisk S, Bajić Ž, Drmić S. Trace elements concentrations association with schizophrenia symptoms; A cross-sectional study in Croatia. Psychiatr Danub 2018; 30:164-171. [PMID: 29930226 DOI: 10.24869/psyd.2018.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Significant inconsistencies exist in findings on association of bio-elements (BE) concentrations and schizophrenia. Hypothesis of this research was that different concentrations of BE are associated with different psychopathological schizophrenia symptoms. SUBJECTS AND METHODS This cross-sectional study was performed from 2014 to 2016 at Psychiatric Hospital "Sveti Ivan" and University Psychiatric Hospital "Vrapče", Zagreb, Croatia, on the consecutive sample of 67 patients diagnosed with schizophrenia. BE concentrations were measured by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) at the Institute for Medical Research and Occupational Health in Zagreb. Severity of schizophrenia symptoms was assessed on Brief Psychiatric Rating Scale (BPRS). RESULTS After adjustment for all preplanned possible confounding variables, the first canonical correlation between BE and BPRS dimensions variates were statistically significant (Rc2=0.73; P=0.006). The first pair of canonical variates is defined by BPRS negative dimension (and marginally by positive symptoms and lack of resistance), and copper (Cu), lead (Pb), lithium (Li) and cobalt (Co) (marginally by cadmium (Cd) and nickel (Ni)). CONCLUSIONS Concentrations of different BE are associated with different schizophrenia symptoms. Maximal correlation between BPRS and BE may be achieved with the weighted linear composite of negative schizophrenia symptoms and copper (Cu), lead (Pb), lithium (Li) and cobalt (Co).
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Matić K, Gereš N, Gerlach J, Prskalo-Čule D, Zadravec Vrbanc T, Lovretić V, Librenjak D, Vuk Pisk S, Ivezić E, Šimunović Filipčić I, Jeleč V, Filipčić I. Early Intervention Services for Early-Phase Psychosis - Centre for integrative psychiatry in Psychiatric Hospital "Sveti Ivan", Croatia. Psychiatr Danub 2018; 30:158-165. [PMID: 29864752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND There is a growing body of evidence suggesting that early and effective management in the critical early years of schizophrenia can improve long-term outcomes. The objective of this study was to evaluate time to relapse of the patients with early-phase psychosis treated in the Centre for integrative psychiatry (CIP). SUBJECT AND METHODS We performed a retrospective cohort study on the sample of 373 early-phase psychosis patients admitted to Psychiatric Hospital "Sveti Ivan", Zagreb Croatia: from January 1, 2015 to December 31, 2017. The primary outcome was time to relapse. RESULTS Patients who were admitted to group psychotherapeutic program after the end of acute treatment had 70% lower hazard for relapse (HR=0.30; 95% CI 0.16-0.58). Patients who were included first in the psychotherapeutic program and then treated and controlled in the daily hospital had 74% lower hazard for relapse (HR=0.26; 95% CI 0.10-0.67). CONCLUSIONS In early-phase psychosis, integrative early intervention service has relevant beneficial effects compare to treatment as usual. These results justified the implementation of multimodal early intervention services in treatment of patients with early-phase psychosis.
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Affiliation(s)
- Katarina Matić
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp68, HR-10 090 Zagreb, Croatia
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Šimunović Filipčić I, Filipčić I. Schizophrenia and Physical Comorbidity. Psychiatr Danub 2018; 30:152-157. [PMID: 29864751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Schizophrenia is a severe psychiatric disorder increasingly recognized as a systemic disorder. In addition to the burden and suffering caused by the mental illness itself, individuals with schizophrenia have a high risk for physical illnesses. The life expectancy gap remains 13 to 30 years wider in people with schizophrenia compared to the general population. This premature mortality is caused largely by deaths due to cardiovascular disease, cancer, diabetes mellitus, and other natural causes, poor diagnosis and treatment, and insufficient prevention of modifiable risk factors. Although the links between schizophrenia and physical illnesses are well established, in clinical practice, physical illnesses in patients with schizophrenia are often overlooked, and the mortality gap between general population and people with schizophrenia continues to widen. The physical health of people with schizophrenia is commonly self-neglected but also ignored by people around them and by health systems, resulting in significant physical health disparities and limited access to health services. The root of the problem of insufficient healthcare appear to lie in interrelated contributory factors from illness, patients, and medical and mental healthcare system. Furthermore, a growing body of literature has been indicating the effect of the chronic physical illness on the treatment outcome of psychosis. Premature mortality and disability could be reduced if there was a greater focus on the implementation of strategies that effectively prevent modifiable risk factors from the first psychotic episode and enhance early recognition of physical illnesses, reduce the burden of physical comorbidity and lead to improved health outcomes. Ultimately, to improve treatment outcome and to reduce the suffering of people with schizophrenia, it is crucial to treat physical comorbidity promptly and assertively from the appearance of the first symptoms of the psychotic disorder. The integrative approach and collaborative care within all levels of healthcare providers should be the imperative in clinical practice.
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Affiliation(s)
- Ivona Šimunović Filipčić
- Department of Psychological Medicine, University Hospital Center Zagreb, Kišpatićeva 12, HR 10 000 Zagreb, Croatia,
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Šago D, Filipčić I, Lovretić V, Mayer N. Day hospital for early intervention for individuals with psychotic disorders. Psychiatr Danub 2018; 30:192-197. [PMID: 29864759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In long-term outcome studies on individuals with first-episode psychosis, improved remission and recovery rates perhaps reflect the improved treatment in dedicated early intervention program. The first episode is a critical period in which individuals with psychosis, as well as members of their families, are confronted with the illness for the first time. Until nowadays, treatment of first psychotic episodes in Croatia has usually been provided in hospital setting. The day hospital provides comprehensive therapeutic approach that refers to early systematic application of all available and effective therapeutic methods in the initial phases of psychotic disorders, and aims to attain and maintain remission and recovery, as well as insight and adherence to treatment. The day hospital is a time-limited structured program that comprises diagnostic procedures, treatment and rehabilitation based on various group psychotherapy and socio-therapy approaches. It is cheaper than hospital treatment and preferred by patients and their families. The importance of involving family members along with patients in the therapeutic process is recognized. The aim of this paper is to present the first day hospital for early intervention and treatment of individuals with psychotic disorder, established within Psychiatric hospital "Sveti Ivan", Zagreb, Croatia.
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Affiliation(s)
- Daniela Šago
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, 10 090 Zagreb, Croatia,
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Mayer N, Petrović BR, Grah M, Lovretić V, Filipčić I. Treatment of patients in early phase of psychosis on psychotherapeutic inpatient unit - presentation of the therapeutic programme and evaluation of some aspects. Psychiatr Danub 2017; 29:447-451. [PMID: 28953806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Treatment of early phase of psychosis is important not only for overcoming the acute symptoms but also for the later treatment and attitude towards the illness. Psychotherapeutic approach is an integrative part of this treatment. In Psychiatric hospital "Sveti Ivan" in Zagreb, Croatia both psychotherapeutic and sociotherapeutic methods are used on the inpatient unit for young people with psychosis along with medications. The aim of this work is to present the work on the psychotherapeutic inpatient unit and to investigate whether during the hospitalisation of individuals with first psychotic episode changes occur in attitudes towards medications, quality of life, insight and self-esteem. SUBJECTS AND METHODS 37 individuals with first psychotic episode (20 men, 17 women) completed the following battery of questionnaires upon hospital admission and before discharge: Drug attitude inventory (DAI-10), The World Health Organization Quality of Life (WHOQOL), Insight scale and Rosenberg's Self-Esteem Scale. RESULTS Before being discharged from hospital, patients assessed their quality of life as significantly improved over time (p=0.000), especially concerning their physical health (p=0.004), psychological health (p=0.004), and satisfaction with their environment (p=0.001). Also, positive trends were observed in attitudes towards drugs and self-esteem. No changes were shown regarding patients' insight. CONCLUSIONS The findings are encouraging: during treatment on psychotherapeutic inpatient unit, significant improvement in quality of life was observed, as well as positive trends in self-esteem and attitudes towards medications.
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Affiliation(s)
- Nina Mayer
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, 10000 Zagreb, Croatia,
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Vuk Pisk S, Mihanović M, Filipčić I, Bogović A, Ruljančić N. The impact of obesity on suicidality among female patients suffering from bipolar affective disorder: the indirect role of body dissatisfaction. Alcoholism and Psychiatry Research 2017. [DOI: 10.20471/apr.2017.53.01.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Grah M, Restek-Petrović B, Bogović A, Mayer N, Handl H, Filipčić I. Object Relations and Self-Esteem in young Adults with Schizophrenia in Long-Term Psychodynamic Group Psychotherapy. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IntroductionPsychodynamic concepts describe object relations deficits in patients with schizophrenia originating from their earliest developmental stage, which is due to reduced ability of direct caregivers to adequately stimulate the child, as well as genetic factors. During psychodynamic group psychotherapy, members through psychotherapy gradually release the old family roles and experiment with new models of behaviour and thus change internalized object representations.AimThe aim of this study was to investigate changes in object relationships and self-esteem in the psychodynamic group psychotherapy in young patients suffering from schizophrenia.Subjects and methodsThe study included a total of 41 patients diagnosed with schizophrenia. Before joining the psychodynamic group therapy and after two years of participation in the treatment, all patients completed a test of object relations and the Rosenberg self-esteem scale.ResultsComparison of the results in two time periods showed downward trend results in all tested dimensions of object relations, a statistically significant difference was found for dimension symbiotic fusion: after two years of participation in the psychodynamic group psychotherapy, patients had significantly expressed less need for symbiotic relationships. Self-esteem was higher in the second period of testing, but without statistical significance.ConclusionTaking into account the limitations of this study, we can conclude that the results are encouraging. During psychodynamic group processes in young patients with schizophrenia there is a trend of positive changes in terms of object relations and self-esteem and a significant reduction in the need for symbiotic merging.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Matić K, Šimunović Filipčić I, Bajić Ž, Filipčić I. GERD is associated with the outcome of MDD treatment. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionGastroesophageal reflux disease (GERD) is more prevalent among patients with major depressive disorder (MDD) than in general population, and vice versa. Bidirectional association of GERD and MDD is well documented. Although protective effect for gastric symptoms has been indicated for several antidepressants like trazodone, citalopram, fluoxetine, mirtazapine or fluvoxamine, these findings are sometimes contradictory. Similar may be claimed for antidepressive effect of some proton pump inhibitors. We decided to examine the association of GERD with the long-term efficacy of MDD treatment.ObjectiveTo examine the association of GERD and efficacy of MDD treatment.MethodsThis nested cross-sectional study was done during 2016 at Psychiatric hospital Sveti Ivan, Zagreb, Croatia on the sample of 1008 psychiatric patients. Key outcome was the number of psychiatric rehospitalizations since the first diagnosis of MDD. Predictor was patient-self-declared diagnosis of GERD. Covariates controlled by multivariate analysis of covariance were sex, age, duration of MDD in years, education, marital status, number of household members, work status, clinical global impression scale–severity of MDD at diagnosis, treatment with tricyclic antidepressants (TCA), selective serotonin reuptake inhbitors (SSRI), serotonin-norephinephrine reuptake inhibitors (SNRI), noradrenergic and specific serotonergic (NaSSA) and antipsychotics.ResultsMDD patients with GERD had significantly larger number of psychiatric rehospitalizations (mean = 5.4 (SD 6.82)) than MDD patients with no GERD (mean = 3.1 (SD 4.45)). After adjustment for all covariates, GERD significantly moderated the efficacy of treatment of MDD (P = 0.048; η2 = 0.05) (Figure 1).ConclusionTo treat MDD effectively we should treat GERD as well.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Milovac Ž, Santini M, Pisk SV, Caratan S, Grošić V, Filipčić I. Acute psychosis - anti-NMDA receptor encephalitis phase. Psychiatr Danub 2016; 28:301-303. [PMID: 27658841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Željko Milovac
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, 10 090 Zagreb, Croatia,
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Filipčić I, Filipčić IŠ, Matić K, Lovretić V, Ivezić E, Bajić Ž, Grošić V, Kezić S, Petrović BR, Včev A. Somatic comorbidities are independently associated with the poor health-related quality of life in psychiatric patients. Psychiatr Danub 2016; 28:284-292. [PMID: 27658838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Despite the increased risk, the quality of somatic healthcare is lower for patients with mental illnesses. Currently dominant approach separates physical and mental, primary and secondary healthcare. Objective of our study was to explore whether somatic comorbidities are associated with a poor HRQoL independently of some sociodemographic and clinical factors. Majority of studies have explored particular somatic and psychiatric illnesses. Therefore we decided to access the problem from the general perspective of the universe of somatic and mental illnesses in the large psychiatric institution. SUBJECTS AND METHODS This nested cross-sectional study was done during May 2016 at Psychiatric hospital Sveti Ivan, Zagreb, Croatia on the sample of 506 patients diagnosed with psychiatric illnesses (ICD-10: F00-F99). Key outcome was the lowest 25% results on the SF-36 General health sub-scale, indicating the worst HRQoL. Predictors were all detected somatic illnesses. By multivariate logistic regression we controlled different sociodemographic, vital and clinical factors. RESULTS After adjustment for different sociodemographic and clinical factors, three somatic comorbidities remained independently associated with the worst HRQoL: endocrine, nutritional and metabolic diseases (E00-E90), diseases of respiratory system (J00-J99) and diseases of musculoskeletal system and connective tissue (M00-M99) CONCLUSIONS: Somatic comorbidities in psychiatric patients are associated with the poor HRQoL independently of different sociodemographic, vital and clinical factors and they should be treated seriously and integrally with mental aspects of HRQoL. Early comorbidities detection and adequate pharmacological and psychotherapeutic treatment, as well as the prevention of risk factors, may improve the quality of life and reduce morbidity and mortality of psychiatric patients.
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Affiliation(s)
- Igor Filipčić
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, pp 68, HR-10.000 Zagreb, Croatia,
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Kezić S, Britvić D, Caratan S, Goršić L, Ivezić E, Matić K, Filipčić I. Day Hospital Treatment as a Missing Link for Single Patients with Posttraumatic Stress Disorder (PTSD): a Preliminary Study. Psychiatr Danub 2016; 28:184-187. [PMID: 27287794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The aim of this study was to examine the day hospital treatment outcome on severity of clinical manifestations, general neuroticism and coping mechanisms in patients suffering from chronic combat-related PTSD. SUBJECTS AND METHODS The sample consisted of 38 consecutive patients admitted to the Day Hospital treatment of PTSD during one year observation period. The average age of the sample was 46.03 years. The patients completed 3 self-report measures upon admission to the hospital and upon discharge: The Mississippi scale for combat-related PTSD (M-PTSD), The Crown-Crisp experiential index (CCEI), and The COPE inventory. RESULTS There was no significant change in the severity of clinical manifestations of PTSD, general neuroticism and coping mechanisms among the whole sample. However, compared to married participants and participants with children, single participants and those without children reported higher levels of anxiety when admitted to the hospital, but lower levels at discharge. In addition, patients without children reduced their avoidance behavior during the treatment. CONCLUSION This preliminary study showed that single patients and those without children may benefit more from the day hospital treatment program. Our findings emphasize the importance of social support in the recovery process of severely traumatized persons, and may assist with the development of more effective therapeutic approaches.
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Affiliation(s)
- Slobodanka Kezić
- Psychiatric Hospital "Sveti Ivan", Jankomir 11, 10090 Zagreb, Croatia,
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Bogović A, Ivezić E, Filipčić I. Personal space of war veterans with PTSD - some characteristics and comparison with healthy individuals. Psychiatr Danub 2016; 28:77-81. [PMID: 26938826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND The aim of this study was to determine the size of personal space among war veterans with PTSD, compared to healthy individuals, and to examine its associations with some sociodemographic and clinical characteristics. SUBJECTS AND METHODS Participants were 83 male war veterans with chronic PTSD and 85 healthy male employees of the medical institutions. Preferred interpersonal distances were assessed by using a stop-distance technique, where male and female research assistants approached the participants from four directions (front, behind, left, right). The patients filled out The Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD). RESULTS War veterans with PTSD preferred significantly larger interpersonal distances compared to healthy participants. Larger personal space size was preferred by those who had children, and the largest preferred distances were observed for the approaches from behind. Both samples preferred larger distances when approached by a male person. CONCLUSION The findings of this study contribute to increased understanding of the personal space in patients with PTSD, and may be implemented into prevention of aggressive behavior during psychiatric treatment, and into development of more effective therapeutic strategies.
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Restek-Petrović B, Bogović A, Grah M, Filipčić I, Ivezić E. Personality characteristics of psychotic patients as possible motivating factors for participating in group psychotherapy. Psychiatr Danub 2015; 27 Suppl 1:S364-S370. [PMID: 26417797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND This study aimed to examine the relationship between some personality characteristics of patients diagnosed with psychotic disorders and the quality of their engagement in psychodynamic group psychotherapy. Given that previous research has shown that self-stigma is significantly negatively associated with the engagement of patients, the measure of self-stigma was used as a correlate of patients' motivation to participate in group psychotherapy. SUBJECTS AND METHODS A total of 48 outpatients (52.1% women; mean age 35.30 years) attending group psychodynamic psychotherapy completed The Inventory of Personality Organization, The Pathological Narcissism Inventory, The Measure of Parental Style, The Relationship Questionnaire, and The Internalized Stigma of Mental Illness scale. RESULTS The findings showed that patients with higher levels of self-stigma have unhealthy attachments styles, perceived their mothers' parental style as indifferent and achieved greater scores on narcissistic vulnerability scale. They are also are prone to primitive psychological defences, have poorly integrated identity, and achieved lower scores on reality testing dimension. CONCLUSION Taking into account the limitations of this study, these findings may contribute to improved understanding of the quality of participation and engagement of psychotic patients in group psychotherapy, and may help to develop more effective therapeutic approaches.
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Godan B, Jonovska S, Kulenović F, Filipčić I. 2002 – The use of agomelatine in population of depressive elderly patients. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76937-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Begić D, Popović-Knapić V, Grubišin J, Kosanović-Rajačić B, Filipčić I, Telarović I, Jakovljević M. Quantitative electroencephalography in schizophrenia and depression. Psychiatr Danub 2011; 23:355-362. [PMID: 22075736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Standard (qualitative) electroencephalography (EEG) is routinely used in the diagnostic evaluation of psychiatric patients. Quantitative EEG (qEEG) findings differ between patients with schizophrenia, patients with depression, but results are not consistent. The aim of our study was to determine the differences in qEEG parameters between patients with schizophrenia, patients with depression, and healthy subjects. SUBJECTS AND METHODS The study included 30 patients with schizophrenia, 33 patients with depression, and 30 healthy subjects. All study participants underwent standard EEG. Artifact-free 100-second epochs were selected from the recorded material and analyzed with Fast Fourier Transformation (FFT) analysis. RESULTS The results are presented as absolute spectral power values (μV2) of delta, theta, alpha, and beta components of the EEG spectrum. EEGs were recorded from 12 locations including Fp1, Fp2, F3, F4, F7, F8, T3, T4, P3, P4, O1, and O2. In comparison with healthy subjects, patients with schizophrenia showed increased delta, theta, and beta activity and decreased alpha activity. Similar results were obtained in patients with depression, but in fewer regions. In patients with schizophrenia, delta power over Fp1, Fp2, F4, and F8 regions was increased in comparison with those in patients with depression. Interhemispheric asymmetry was found in patients with schizophrenia and healthy subjects, but not in patients with depression. CONCLUSION The finding that patients with schizophrenia differed from patients with depression in delta power values could be potentially used in differential diagnosis between schizophrenia and depression. The role of qEEG in clinical differentiation between these two mental disorders may be especially important in cases of negative-symptom schizophrenia.
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Affiliation(s)
- Dražen Begić
- Department of Psychiatry, University Hospital Center Zagreb, Kišpatićeva 12, Zagreb, Croatia.
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