Geschwind Syndrome (GS) comprises a constellation of behavioural traits traditionally associated with temporal lobe epilepsy. These include hyper-religiosity, hypergraphia, altered sexuality, and circumstantial thought p...Geschwind Syndrome (GS) comprises a constellation of behavioural traits traditionally associated with temporal lobe epilepsy. These include hyper-religiosity, hypergraphia, altered sexuality, and circumstantial thought processes. Increasingly, GS features are also observed in other neuropsychiatric conditions. We present a 26-year-old female with bipolar affective disorder in remission who developed GS-like features such as hyper-religiosity, compulsive writing, and atypical romantic ideation, without evidence of seizures, abnormal EEG, or MRI findings. She showed limited response to aripiprazole and partial improvement with behavioural interventions. This case highlights the need for increased recognition of GS features in psychiatric populations, independent of structural or seizure-related pathology.
Metformin is the most widely used oral insulin-sensitizing agent. There is a significant association between long-term metformin therapy and an increased prevalence of vitamin B12 deficiency. Vitamin B12 deficiency is on...Metformin is the most widely used oral insulin-sensitizing agent. There is a significant association between long-term metformin therapy and an increased prevalence of vitamin B12 deficiency. Vitamin B12 deficiency is one of the causes of pseudo-dementia. This paper presents a rare case of pseudo-dementia in a 60-year-old Caucasian woman caused by vitamin B12 deficiency induced by the use of metformin, a vegetarian diet, and smoking. In diabetics with cognitive disorders who are on biguanide therapy, it is necessary to determine the level of vitamin B12 in the serum in order to rule out possible pseudo-dementia and to avoid possible hematological and neurological disorders. Unfortunately, vitamin B12 deficiency remains frequently unrecognized in those patients.
Both somatic and psychiatric abnormalities are not uncommon among politicians. Clinical insights may help to understand their suboptimal decisions and behavior. If a leader is psychotic while other functions are more or...Both somatic and psychiatric abnormalities are not uncommon among politicians. Clinical insights may help to understand their suboptimal decisions and behavior. If a leader is psychotic while other functions are more or less intact, he or she can preserve abilities to remain in a position of power. Grave consequences occur when paranoid ideas persist in a dictator, so that delusions are put into life. Some people suffering from paranoid personality disorder are belligerent against delusional goals. Governments in democracy are more transparent; therefore, it is less probable that power would be kept by mentally abnormal individuals. In the author's opinion, there is danger of a large-scale war thanks to paranoid ideation in Vladimir Putin. Arguments in favor of this hypothesis are discussed here. More expert opinions are needed. In his childhood, Putin was a victim of maltreatment. Reportedly, child abuse statistically predicts psychosis and some other mental disorders. Putin formulated the aims of his military operation, one of them being protecting Russian-speakers from genocide. It is known that ethnic Russians have not undergone genocide. Apparently, this idea is delusional. Many people subscribe to delusions at large. Besides, there is a hypothesis that Putin has hubris syndrome. In conclusion, mental derangements in politicians should be diagnosed by psychiatrists on the basis of language and behavior.
BACKGROUND: Patient safety is considered to be crucial to health care quality. The Hospital Survey on Patient Safety Culture is generally used to assess the safety culture in somatic hospitals and unit level. The present...BACKGROUND: Patient safety is considered to be crucial to health care quality. The Hospital Survey on Patient Safety Culture is generally used to assess the safety culture in somatic hospitals and unit level. The present study investigates the correlation between physicians and nurse providers in patient safety culture in all Slovenian psychiatric hospitals. SUBJECTS AND METHODS: A quantitative cross-sectional, non-experimental study was conducted between November 2017 and February 2018 involving 434 (89.00%) nurses and 55 (11.00%) physicians from six psychiatric hospitals in Slovenia. We used the Slovenian version of the questionnaire of the Hospital Survey on Patient Safety Culture of the US Agency for Healthcare Research and Quality. RESULTS: Exploratory factor analysis for Slovenian psychiatry has given ten dimensions with 40 items. Multivariate regression analysis revealed that four psychiatric hospitals have a poor opinion on the "Management Support for Patient Safety" (F = 4.746, p <0.005). But depending on gender, women on average have a statistically significantly better opinion about the dimension "Management Support for Patient Safety" than men (t -1,995, p <0,047). There are also significant statistical differences between health care professionals who work in locked wards in regard to the two dimensions "Staff Overload and Response to Errors*" (F = 6.557, p = 0.002) and "Teamwork Between Organisational Units of the Hospital*" (F = 5.681, p = 0.004). CONCLUSION: This is the first study on perception of patient safety culture in psychiatric hospitals in Slovenia. Significant statistical differences were identified in seven out of ten dimensions of patient safety culture perception.
BACKGROUND: Mental disorders pose a significant and pervasive public health challenge. During the pandemic, an additional increase in negative affective disorders among students was observed. This study aimed to assess t...BACKGROUND: Mental disorders pose a significant and pervasive public health challenge. During the pandemic, an additional increase in negative affective disorders among students was observed. This study aimed to assess the prevalence of depression, anxiety, and stress symptoms among students after the COVID-19 pandemic and to establish a possible association with sleep quality and physical activity in the student population. SUBJECTS AND METHODS: This cross-sectional study was conducted among first and second-year students at the University of Osijek, Croatia. Mental health was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and physical activity with the International Physical Activity Questionnaire-Short Form (IPAQ-sf). RESULTS: A total of 673 students participated in the study. The overall prevalence of depression, anxiety, and stress symptoms among students was found to be 45.0%, 58.8%, and 39.4%, respectively. Female students exhibited higher scores of depression (t(671)=3.391, p<0.001), anxiety (t(656)=7.482, p<0.001), and stress (t(671)=9.115, p<0.001) compared to their male counterparts. Furthermore, it was established that poorer sleep quality contributed to increased depression (β=0.485, SE=0.102, t=4.754, p<0.001), anxiety (β=0.544, SE=0.094, t=5.754, p<0.001), and stress scores (β=0.573, SE=0.117, t=4.901, p<0.001), while intense physical activity reduced depression (β=-0.364, SE=0.096, t=-3.804, p<0.001), anxiety (β=-0.386, SE=0.089, t=-4.353, p<0.001), and stress scores (β=-0.465, SE=0.110, t=-4.236, p<0.001) among study participants. CONCLUSIONS: A high prevalence of depression, anxiety, and stress was identified among students following the conclusion of the COVID-19 pandemic. Additionally, sleep quality and physical activity could be one of the target points for measures and interventions intended to optimize students' mental health.
PURPOSES: Capacity-oriented workplace-description is on the one hand, the basis for occupational health action, e.g. for reintegration and work adjustment. On the other hand, it is also necessary for preventive action, e...PURPOSES: Capacity-oriented workplace-description is on the one hand, the basis for occupational health action, e.g. for reintegration and work adjustment. On the other hand, it is also necessary for preventive action, e.g. mental hazard analysis or job-matching. When self-ratings are used for a work description, that description must not be confused by an affective judgment about the workplace, e.g. work-satisfaction. Health professionals are especially prone for high workload and potentially a very broad spectrum of work-duties. Studying health professionals is valuable for gaining empirical insights into how these employees, in a similar environment but with different tasks, perceive their work-capacity-demands. Subjective work-perception is an important predictor of work ability. METHODS: The work capacity demands of 122 health professionals were studied, by comparing administrative staff, physicians, psychologists and co-therapists (ergotherapists, sport therapists, social workers, nurses). They all reported their work demands according to the Mini-ICF-APP-WS work demands rating. RESULTS: Different professional groups reported different psychological work-capacity-demands to different degrees. Correlations between the work-capacity-demands and the work condition were low to moderate, indicating discriminant validity. Also, work capacity demands are independent from work ability, which is another validity aspect. CONCLUSION: The work capacity demands rating was able to differentiate between capacity demands in different professional fields, even if the workplace context was the same (employees from similar work environments). The work capacity demands rating can be a useful short rating for mental hazard analysis in health care professions. It gives a differentiated description of workplace demands, which is the basis for creating person-job-fit, by targeted work adjustment, capacity training, or combined interventions.
BACKGROUND: The aim of this study is to determine the effects of the bipolar disorder (BD) pharmacotherapy on the parameters of spectral-domain optical coherence tomography (SD-OCT) including retinal nerve fiber layer (R...BACKGROUND: The aim of this study is to determine the effects of the bipolar disorder (BD) pharmacotherapy on the parameters of spectral-domain optical coherence tomography (SD-OCT) including retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and choroidal thickness (CT). SUBJECTS AND METHODS: The patient group was divided into three subgroups according to the regular use of lithium (Li), sodium valproate plus valproic acid combination (SV-VPA), and any of the antipsychotics (AP). The OCT parameters were measured using the SD-OCT device. RESULTS: There were 36 subjects on Li treatment, 36 on SV-VPA treatment and 28 on AP treatment. In both eyes, RNFL subsectors, GCL, IPL were decreased in the BD group compared to the HC group, while CT increased (p<0.05). In the comparison between the BD subgroups, it was shown that RNFL subsectors, GCL, and IPL were higher in the Li group than in the SV-VPA and AP groups (p<0.05), and CT was similar between the BD subgroups (p>0.05). It was reported that there was a difference between smokers and non-smokers in the BD group only in terms of RNFL subsectors (p<0.05). In the BD group, a significant positive correlation was detected between disease duration, duration of relevant medication use and age and various RNFL parameters (p<0.05), while no relationship was found between GCL, IPL and disorder parameters (p>0.05). CONCLUSIONS: This study compared the OCT parameters of euthymic state BD type 1 subjects with the HC group and showed that RNFL, GCL and IPL were decreased in the BD group, while CT was increased. It has been suggested that the use of Li may play a more effective role in protecting the RNFL subsectors, GCL and IPL than the use of SV-VPA and AP alone.
BACKGROUND: The aim of the study is to determine the changes in insulin-like growth factor 1 (IGF-1) and its receptor (IGF-1R) in the emergence of bipolar disorder and its treatment with olanzapine. SUBJECTS AND METHODS:...BACKGROUND: The aim of the study is to determine the changes in insulin-like growth factor 1 (IGF-1) and its receptor (IGF-1R) in the emergence of bipolar disorder and its treatment with olanzapine. SUBJECTS AND METHODS: Of all 48 adult male albino wistar rats, the control group (n=12) saline, ketamine group (n=12) ketamine (25mg/kg), olanzapine group (n=12) olanzapine (2mg/kg), ketamine+olanzapine group (n=12) ketamine (25 mg/kg) was administered once a day/14 days. Olanzapine (2mg/kg) was administered once a day to the ketamine+olanzapine group between 8 and 14 days. Volume, IGF-1, and IGF-1R gene expression and protein levels were measured in the prefrontal cortex and hippocampus. RESULTS: In the prefrontal cortex, there was a decrease in volume, IGF-1R gene expression, and protein levels in the ketamine group, an increase in IGF-1 gene expression and protein levels in the olanzapine group; an increase in IGF-1R gene expression, IGF-1, and IGF-1R protein levels in the ketamine+olanzapine group. In hippocampus, there was a decrease in volume, IGF-1 gene expression and protein levels in ketamine group, a decrease in volume and IGF-1 protein levels, increase in IGF-1R gene expression and protein levels in olanzapine group; a decrease in volume, IGF-1 protein levels and IGF-1R gene expression and protein levels in ketamine+olanzapine group. CONCLUSIONS: One of the underlying causes of bipolar disorder may be changes in the IGF-1 and IGF-1R regions in the prefrontal cortex and hippocampus. Olanzapine has a neuroprotective effect by increasing IGF-1 and IGF-1R levels in the prefrontal cortex, and a neurodegenerative effect by decreasing IGF-1 and IGF-1R levels in the hippocampus.
Dopaminergic dysfunction has traditionally been associated with psychotic disorders. However, emerging evidence implicates dopamine in a broader range of psychiatric conditions. This review critically reexamines dopamine...Dopaminergic dysfunction has traditionally been associated with psychotic disorders. However, emerging evidence implicates dopamine in a broader range of psychiatric conditions. This review critically reexamines dopamine's role beyond psychosis, focusing on major depressive disorder, anxiety disorders, and obsessive-compulsive disorder (OCD)-three high-burden conditions where current treatments remain suboptimal for many patients. This review is conducted to synthesise and critically evaluate the evidence for dopamine dysfunction as a transdiagnostic mechanism underpinning core symptom domains across depression, anxiety, and OCD. Consistent patterns of dopamine dysregulation were identified in mesolimbic and mesocortical pathways, as well as the cortico-striatal-thalamo-cortical (CSTC) loop. Common symptom dimensions-such as anhedonia, apathy, compulsivity, and cognitive inflexibility-were linked to region-specific dopamine deficits. Furthermore, gene-environment interactions and inflammation-induced suppression of dopamine emerged as shared etiological factors. Dopaminergic agents (e.g., bupropion, pramipexole, aripiprazole), neuromodulatory approaches (e.g., TMS, DBS), and biomarker-guided interventions showed promise, particularly in treatment-resistant or subtype-specific presentations. Dopamine dysfunction is a core, transdiagnostic mechanism in depression, anxiety, and OCD, affecting key circuits involved in reward, motivation, and cognitive control. Integrating dopaminergic biomarkers and interventions into psychiatric care may facilitate personalised treatment and improve clinical outcomes.