Relative Frequency of Blastocystis Subtypes 1, 2, and 3 in Urban and Periurban Human Populations of Arequipa, Peru

Blastocystis is one of the most common protozoa found in the human gut and are genetically diverse and widely distributed around the world. Nonspecific and inconsistent symptoms have been associated with this protozoon; thus, its clinical importance remains controversial. Our aim was to estimate the relative frequency of Blastocystis subtypes 1, 2, and 3, which are the predominant subtypes reported in South America, based on conserved regions of SSU rDNA sequences and determine the factors associated with them. A total of 116 Blastocystis-positive stool samples were processed using conventional PCR with Blastocystis-specific primers. We identified subtype 1 (10.3%), subtype 2 (7.8%), subtype 3 (25.0%), and mixed subtype infections (8.7%). However, we could not identify any Blastocystis subtypes in 48.3% of the samples; therefore, it is likely that other subtypes were present in the area. No association was found between any gastrointestinal symptom and single or mixed Blastocystis subtypes. We found a statistically significant association between Blastocystis subtype 2 and irritable bowel syndrome (OR = 17.8, 95% CI = 1.5-408.4, p = 0.039); however, the number of samples with IBS was small (n= 4). There was no association between the Blastocystis subtypes and any epidemiological variable studied. In rural populations, we only identified subtype 1, while in urban and periurban populations, we identified subtypes 1, 2, and 3.

Aggressiveness and violence in psychiatric patients: a clinical or social paradigm?

OBJECTIVE

Psychiatric disorders are often considered the leading cause of violence. This may be due to a stereotype created by media and general opinion.

METHOD

The Modified Overt Aggression Scale (MOAS) was used to evaluate the severity of aggressive and violent behaviors in 400 patients who attended a post-acute psychiatric service in Milan from 2014 to 2016 and suffered from different psychiatric disorders. The psychopathological clinical picture was evaluated by Clinical Global Impression (CGI). The study also assessed the possible correlation between epidemiologic and sociodemographic factors, clinical variables, and aggression and violence.

RESULTS

Of the total number of subjects, 21.50% showed a MOAS score >0, 11.50% presented mild aggression (0-10 MOAS weighted score), 9% moderate aggression (11-20), and 1% severe aggression (MOAS >20). With respect to violent behaviors, 16% of patients showed a score >0 in one MOAS subscale other than verbal aggression according to violence definition. The severity of clinical picture seemed to be related to higher weighted MOAS score. Multivariate testing of different sociodemographic and clinical variables showed that violence was related to unemployment status, and significantly correlated to compulsory admission (TSO), suicide attempts (TS), and personality disorders, while the severity of clinical psychiatric picture seemed to play a secondary role.

CONCLUSION

Results have shown that personality disorders and sociodemographic factors, including economic factors, seem to be major determinants of violence among patients diagnosed with mental disorders.