Browsing by Author "Jerotić, Stefan (57207916809)"

Introduction: Prescribing trends in maintenance therapy of patients with primary psychotic disorders (PSD) may vary worldwide. Present study aimed to investigate prescription patterns in a sample of outpatients with PSD from Serbia. Methods: In a sample of 73 PSD outpatients we analysed the rate of antipsychotic polypharmacy and psychotropic polypharmacy, concomitant continual benzodiazepine use, and associations between therapy, psychotic symptoms and quality of life. Results: Maintenance therapy (median daily dose 321 mg of chlorpromazine equivalents) predominantly consisted of monotherapy with second generation antipsychotics (45.2%), followed by antipsychotic polypharmacy based on first and second generation combination (25.0%). The median number of psychotropic drugs was 3. Benzodiazepines were continually prescribed to more than 60% of patients (mean daily dose 2.9 ± 2.0 mg lorazepam equivalents). Patients with benzodiazepine use had significantly more psychotropic medications and more antipsychotic polypharmacy, poorer quality of life and more severe psychopathology in comparison to another group. Conclusion: The present study demonstrated new information regarding the prescription patterns of psychotropic drugs in outpatients with PSD in Serbia, amplified with clinically relevant information. This study also revealed distinct prescription patterns concerning antipsychotic/benzodiazepine polypharmacy. Overall, such findings are likely to contribute to improving clinical practice and care for patients with PSD in general.Keypoints Present exploratory research aimed to elucidate trends of antipsychotics polypharmacy and concomitant use of psychotropic medications including benzodiazepines in the maintenance treatment of outpatients with schizophrenia and other psychotic disorders, amplified with clinically relevant information (symptoms and quality of life). ‘Antipsychotic (AP) polypharmacy’ was defined as concurrent use of more than one AP for at least 1 month; ‘Psychotropic polypharmacy’ was defined as the combination of AP and a different class of psychotropic drugs medication for at least one month. The median number of prescribed psychotropic drugs was 3 (mean 3.1 ± 1.1) and the average AP daily dose was moderate (median 321 mg of chlorpromazine equivalents). However, the rates of AP polypharmacy (45.2%) and benzodiazepine prescription on a continual basis ('60%) found in our sample could be considered relatively high. Outpatients with higher AP daily dose and higher BPRS symptom score were receiving more benzodiazepines. For improvement of the local, as well as general clinical practice and care for patients with psychotic disorders, and for education in psychiatry, such analyses need to be done on a regular basis and on larger samples. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Objectives Pre-electroconvulsive therapy (ECT) evaluation is an essential part of ECT preparation, a standard treatment in the psychiatric field. However, no routine pre-ECT evaluation has been published so far. This preliminary study aimed to explore different practices in pre-ECT evaluation across European countries. Methods The data were collected as a snowball sample approach using an online survey from September 2019 to April 2020. The final analysis included data from 18 clinics placed in 16 European countries. Results Regulations on the pre-ECT evaluation were found in 9 countries. All clinics reported doing complete blood count, serum electrolytes, and renal function analysis as a part of regular laboratory testing, alongside with a cardiovascular assessment. Ten clinics reported using psychiatric scales. Six clinics reported doing a cognitive assessment, of which all had regulations on the pre-ECT evaluation. Not one evaluation had the same sets of procedures and diagnostics. Conclusions The differences in assessment approaches mirror high variability of the pre-ECT evaluation practice across Europe. Cognitive assessment and objectification of psychiatric symptoms should be a regular part of the pre-ECT evaluation because of the monitoring of the most common adverse effect and observing the clinical response to ECT. Standardization of the pre-ECT evaluation and ECT in general would remove criticisms and opposition to the treatment, make it based on the best of our knowledge, and provide a method respectful of patients' best interests and rights. © Wolters Kluwer Health, Inc. All rights reserved.

Objectives Pre-electroconvulsive therapy (ECT) evaluation is an essential part of ECT preparation, a standard treatment in the psychiatric field. However, no routine pre-ECT evaluation has been published so far. This preliminary study aimed to explore different practices in pre-ECT evaluation across European countries. Methods The data were collected as a snowball sample approach using an online survey from September 2019 to April 2020. The final analysis included data from 18 clinics placed in 16 European countries. Results Regulations on the pre-ECT evaluation were found in 9 countries. All clinics reported doing complete blood count, serum electrolytes, and renal function analysis as a part of regular laboratory testing, alongside with a cardiovascular assessment. Ten clinics reported using psychiatric scales. Six clinics reported doing a cognitive assessment, of which all had regulations on the pre-ECT evaluation. Not one evaluation had the same sets of procedures and diagnostics. Conclusions The differences in assessment approaches mirror high variability of the pre-ECT evaluation practice across Europe. Cognitive assessment and objectification of psychiatric symptoms should be a regular part of the pre-ECT evaluation because of the monitoring of the most common adverse effect and observing the clinical response to ECT. Standardization of the pre-ECT evaluation and ECT in general would remove criticisms and opposition to the treatment, make it based on the best of our knowledge, and provide a method respectful of patients' best interests and rights. © Wolters Kluwer Health, Inc. All rights reserved.

Separation anxiety disorder (SAD) is a diagnostic category included in the group of anxiety disorders within DSM 5. Within ICD 10, SAD is in the group of disorders that occur only in childhood but the proposition of ICD 11 classifies SAD as a part of anxiety disorders, similarly to DSM 5. Although there are studies of the prevalence and most significant psychopathological phenomena that characterize SAD, there is still a distinctive lack of knowledge about this disorder like: its prevalence in the general and clinical population, its relation with other psychiatric disorders, or what is an effective therapeutic approaches to treating adults with this disorder. Some outstanding questions remain and there are no clear answers so far regarding the differentiation of “normality” and pathology related to the SAD, like: (1) is a strong relationship between family members the consequence of specific cultural and social patterns or a pathological pattern that indicates SAD?, or (2) are the pain and suffering resulting from separation from loved ones after wars, natural or other disasters “normal”/common/expected or are they psychopathological manifestations of SAD?, etc. In order to clearly identify SAD as an unambiguous psychopathological category, it is necessary to answer these questions in detail. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

Separation anxiety disorder (SAD) is a diagnostic category included in the group of anxiety disorders within DSM 5. Within ICD 10, SAD is in the group of disorders that occur only in childhood but the proposition of ICD 11 classifies SAD as a part of anxiety disorders, similarly to DSM 5. Although there are studies of the prevalence and most significant psychopathological phenomena that characterize SAD, there is still a distinctive lack of knowledge about this disorder like: its prevalence in the general and clinical population, its relation with other psychiatric disorders, or what is an effective therapeutic approaches to treating adults with this disorder. Some outstanding questions remain and there are no clear answers so far regarding the differentiation of “normality” and pathology related to the SAD, like: (1) is a strong relationship between family members the consequence of specific cultural and social patterns or a pathological pattern that indicates SAD?, or (2) are the pain and suffering resulting from separation from loved ones after wars, natural or other disasters “normal”/common/expected or are they psychopathological manifestations of SAD?, etc. In order to clearly identify SAD as an unambiguous psychopathological category, it is necessary to answer these questions in detail. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

The blood–brain barrier (BBB) is formed by continuous, closely connected endothelial cells, enveloped in the basal lamina, pericytes, and foot extensions of astrocytes. BBB has a vital role in brain metabolism and protects the brain parenchyma from harmful agents present in the systemic circulation. Damage to the BBB and an increase in its permeability have an important role in many neurodegenerative diseases. This paper aims to review the literature on the impact of the BBB damage on psychiatric illness, a largely neglected and under-researched area. Links between BBB impairment and specific neuropsychiatric disorders are described including schizophrenia, affective disorders, dementias with behavioral disorders, and alcohol use disorder, with comparison to typical hereditary small vessel diseases affecting the BBB such as cerebral autosomal dominant arteriopathy with subcortical infarction and leukoencephalopathy and mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes. The authors critically summarize possible pathogenic mechanisms linking BBB damage and these common disorders. © 2022, Serbia Medical Society. All rights reserved.