Browsing by Author "Stašević, Milena (57191279941)"

Background/Aim. Adherence to the guidelines of Good Clinical Practice (GCP) during the treatment of specific disorders is considered a guarantee of the implementation of a uniform, evidence-based clinical practice in psychiatry. The aim of this study was to analyze the concordance of prescribing patterns of antipsychotic drugs with the recommendations of good clinical practice in Serbia and an insight into the effects that introduction of the National Guideline for the Diagnosis and Treatment of Schizophrenia had on the prescribing practice in this area. Methods. Noninterventional, observational study was conducted at the Clinic for Mental Disorders "Dr Laza Lazarevic" in Belgrade. It included a consecutive sample of 675 previously untreated patients, hospitalized from January 1st, 2012 to December 31st, 2015, dismissed with a discharge diagnosis of any of schizophrenia spectrum disorders. The data about demographic and clinical characteristics of patients, characteristics of prescribers and prescribed antipsychotics were obtained retrospectively, from the patients' medical records. For the analysis of primary data, the descriptive statistical methods and methods for testing statistical hypotheses were used. A method of logistic regression was used to identify the factors associated with adherence to the GCP recommendations. Results. Totaly, 446 (66.1%) of subjects were treated with antipsychotic monotherapy. After the introduction of National Guideline for the Diagnosis and Treatment of Schizophrenia prescribing of second generation antipsychotic monotherapy (78.41% vs. 63.5%, respectively; p < 0.001) increased significantly compared to the previous period. The factors independently associated with adherence to the recommendations of the GCP were the year of hospitalization, the age of the prescriber, and the age and education of the patient. Conclusion. After the introduction of the National Guide to Good Clinical Practice for the Diagnosis and Treatment of Schizophrenia there have been significant, but insufficient changes in the prescribing patterns of antipsychotics during the treatment of the first psychotic episode in Serbia. © 2019 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. Delirium is an acute or subacute, and most frequently reversible syndrome of higher cortical functions disturbances that is manifested as generalized disorder. If not prevented, it is associated with various adverse outcomes. The aim of this study was to determine the connection between the markers of inflammation and lethal outcome in patients diagnosed with delirium, hospitalized in the psychiatric intensive care unit. Methods. This retrospective study included 120 patients hospitalized in the psychiatric intensive care unit in whom examination of differences in inflammation markers was done. The examinees have been divided into two groups: the case group of 40 patients who died during the hospitalization, and the control group of 80 examinees who were discharged with the diagnosis Post delirium status. The following variables were taken into account: age, gender, clinical diagnosis of infection (pneumonia and urinary tract infection), laboratory parameters (total of white blood cells, granulocytes, monocytes, C-reactive protein - CRP) and type of delirium (withdrawal or organic). Results. The average age of the patients was 50.3 ± 13.1 years. The patients who survived delirium, were on the average 10.5 years younger than the deceased (p < 0.001). More than half (57.5%) of the deceased had pneumonia. There was a statistically significant correlation between pneumonia and lethal outcome in the patients with delirium (p < 0.001). The examinees with lethal outcome had significantly higher median CRP levels than the group of examinees who survived (75.6% ± 54.0 vs 30.3 ± 42.5 ng/L, p < 0.001). Conclusion. Aiming to better and more precise diagnostics of this complicated and still unclear neuropsychiatric syndrome it would be useful to consider introduction of more precise diagnostic algorithms in every unit of intensive care. That would significantly reduce the number of delirium diagnosis overlook, decrease complication of clinical features and would also reduce the unfavorable outcome rate, therefore the total cost of treatment. © 2016, Vojnosanitetski Pregled. All rights reserved.

Introduction/Objective Previous studies suggest that the number of suicides and suicide attempts will increase due to the COVID-19 pandemic. The aim of this study was to investigate the impact of the COVID-19 pandemic on the frequency and characteristics of suicide attempts in the Republic of Serbia. Methods The study observed two periods: the period from March to August 2020 (the COVID period) and the same period of the previous year (the non-COVID period). The observation during the mentioned periods encompassed patients who were examined at the Dr. Laza Lazarević Clinic for Mental Disorders in Belgrade due to suicide attempts (1987 persons during COVID period and 2300 persons during the non-COVID period). Results Concerning suicide attempts, a statistically significant difference between the observed periods was registered in respect to the total number of monthly clinical examinations, monthly distribution of suicide attempts, patients’ gender and age, mode of suicide attempt, and the diagnostic category. Binary logistic regression determined that statistically significant factors that can influence the suicide attempt were year, months, patients’ gender and age, and diagnostic category. Conclusion COVID-19 pandemic creates the increased exposure of the people to suicide risk factors, which points to the significance of consistent monitoring of mental health during the COVID-19 pandemic and thereafter. © 2021, Serbia Medical Society. All rights reserved.