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P.8.001 Suicide ideation and suicide plans: what are the differences? A study on male psychiatric inpatients
Posters
Addiction P.6.001 Comorbid anxiety and mood disorders in patients with alcohol abuse and alcoholism: a pilot case-control study 1
1
1
K.R. Stoychev , K.M. Ivanov , M.G. Aleksandrova , R.D. Stoychev1 , V.V. Nakov2 , L.Z. Tumbev1 , D.K. Kirov1 . 1 University Hospital, Department of Psychiatry, Pleven, Bulgaria; 2 Private Psychiatric Practice, Sofia, Bulgaria This pilot study aims: (1) To compare lifetime comorbidity of mood and anxiety disorders in a group of in- and outpatients with alcohol abuse and alcoholism and statistically matched group of healthy controls; (2) To study the temporal relationship between alcohol use disorders (AUD) and comorbid mood/anxiety disorder/s and to determine whether the obtained data are consistent with the hypothesis that in most of the cases AUD are secondary to a primary mood/anxiety disorder which has not been identified and treated promptly; (3) To identify possible clinical phenotypes, i.e. particular constellations of disorders that occur together significantly more often than statistically expected; (4) To explore the potential gender effects on the pattern of comorbidity. Material and Methods: 60 individuals (30 controls and 30 patients; 48 males, 12 females) aged 18−60 were screened with alcohol use disorders identification test for presence/absence of alcohol use disorder (AUD) and then were interviewed with composite international diagnostic interview – a fully structured research instrument, which yields a lifetime psychiatric morbidity pattern of each respondent. Since statistical analysis of the derived data is still running, only information about lifetime psychiatric comorbidity of alcohol use disorders group will be presented here. Results: The preliminary results show significant comorbidity in the alcohol use disorders group. Compared to general population surveys, AUD patients from our sample show two times greater lifetime prevalence of anxiety disorders (46.7% versus 25.0%1 ) and mood disorders (36.7 versus 18%1 ). In accordance with general population studies, the most widespread anxiety disorders are specific phobia (particularly acrophobia), social phobia and GAD. An interesting fact is the significant occurrence of PTSD in our sample compared to general population (6.67% versus 0.5−1%). Most prevalent mood disorders are recurrent depressive disorder, single depressive episode and bipolar disorder. A potential clinical phenotype deserving future investigation is the constellation of acrophobia, social phobia, recurrent depressive disorder and alcohol abuse/dependence observed in 5 patients
S165
(16.7%). In nearly 2/3 of all cases mood/anxiety disorders developed prior to AUD. Larger studies are needed to further explore the problem of comorbidity and its potential clinical implications. Reference(s) [1] International Consortium in Psychiatric Epidemiology in: Bulletin of the WHO, 2000, 78.
Other topics P.8.001 Suicide ideation and suicide plans: what are the differences? A study on male psychiatric inpatients I. Mitrev. Medical University, Department of Psychiatry and Medical Psychology, Plovdiv, Bulgaria There are frequent statements in handbooks, training manuals and guidelines for suicide prevention that, in comparison with suicidal ideation alone, the existence of a suicidal plan increases the suicidal threat and indicates a higher level of risk, even necessitating hospitalization. However, clinical and experimental data on the differentiation of different forms of suicidal behaviour are scarce. The present study is an attempt to identify important differences between suicide ideation and suicide plan in a group with a high risk of suicidal behaviour: male psychiatric inpatients. Material and Methods: 134 male psychiatric inpatients, suffering from schizophrenia, other psychotic disorders, and mood disorders were studied during the first five days after admission. Using a structured clinical interview and psychometric rating scales data were collected about the number of suicide attempts and aggressive acts committed throughout their lives, alcohol and tobacco use, depression, hopelessness, family history of suicidal behaviour, current suicide ideation and suicide planning. We analyzed the differences between three groups (no suicidality, suicidal ideas only, and suicidal ideas with plans). The groups of patients were compared on categorical variables through the use of chi-square tests and on continuous variables by t-tests. Results: There were no significant differences in age, alcohol and tobacco use, family history of suicide behaviour and levels of depression between subjects with suicide ideation with and without suicide plan. Compared to patients with suicide ideation without plan, the patients with suicide ideation and suicide plan had committed significantly more suicidal attempts and nearly as much aggressive acts during their lifetime; they also presented
S166
Posters
with non-significantly higher levels of hopelessness. Compared to patients without suicidality, the patients with suicide ideation without suicide plan demonstrated significantly higher levels of depression and hopelessness and heavier family loading for suicide attempts (nearly reaching statistical significance). Conclusions: The main finding of our study is that suicide plans are more closely related to suicide attempts than suicide ideation only. Thus, suicide plans are associated with higher suicidal intent than suicidal ideation. It is possible that despondency and hopelessness contribute are major contributors to the appearance and development of suicide ideation without plans. A better understanding of the differences between suicidal ideation and plans could eventually result in a better understanding of the more serious forms of suicidal behaviour. Further studies with a larger number of subjects are needed.
P.8.002 Quality of life in patients with colorectal cancer one year after surgery D. Karadjova, R. Shishkov, P.M. Petrov. University Hospital ”St Marina”, Clinic of Psychiatry, Varna, Bulgaria Survival rates of colorectal cancer patients have increased throughout the years due to earlier diagnosis, improved diagnostic tests, introduction of adjuvant therapy [3]. The aim of this study was to investigate quality of life (QoL) in patients with colorectal cancer one year after surgery in comparison with the general population. Material and Methods: QoL was assessed in 56 colorectal patients aged 25−82 years one year after surgery and in 50 individuals from the general population matched for age and gender. QoL was assesed using the Questionnnaire of Life Enjoyment and Satisfaction (QLES-Q-SF) and a Structured Clinical Interview. Statistical analysis was done using ANOVA. Results: (1) Significantly lower score of QoL in colorectal cancer patients one year after surgery (54.2) compared to the reference control group (69.4); (2) Both groups reported almost identical mean scores of global health QoL and physical functioning; (3) In contrast, deficits in emotional and social functioning seemed to exist among patients with colorectal cancer; (4) Agespecific comparisons (table) revealed an almost uniform pattern with largest differences between colorectal cancer patients population and controls in the youngest age cohort (<60 years) and virtually no differences among the elderly. Younger cancer patients had significantly lower scores of emotional and social functioning than younger
controls. (5) There was no significant gender and stage-oftumor inter-group differences between the stoma and nonstoma patients; (6) On average, stoma patients had lower scores than non-stoma cancer patients on many functional scales, the largest difference being in social functioning; (7) The Structured Clinical Interview revealed that QoL was influenced not so much by tumor stage and scope of intervention, but by the functional status of the patient.
Patients <60 Patients >60 Controls <60 Controls >60
Physical
Emotional
Social
27 25.2 29.2 26.8
11.2 13.3 14.5 13.8
19.3 23.1 242 23.6
Conclusions: We found that overall QoL and physical functioning of patients with colorectal cancer one year after surgery is comparable to population norms. Deficits in emotional and social functioning represent main factors that continue to impact negatively QoL in colorectal cancer patients even in the long run, affecting most heavily younger patients (2). Reference(s) [1] Arndt, V., 2004, Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study. J Clin Oncol 22, 4829–4836. [2] Blazeby, J., 2000, The role of quality of life assessment in patients with colorectal cancer. Jpn J Clin Oncol 30, 246. [3] Borras, J., 2001, Compliance, satisfaction and quality of life of patients with colorectal cancer receiving home chemotherapy or outpatient treatment. BMJ 322, 826. P.8.003 Measuring psychological distress in a sample of Bulgarian medical students S.P. Popov1 , N. Mateva2 , I. Temenugov3 , I. Yakov3 . University of Medicine, Department of Psychiatry and Medical Psychology, Plovdiv, Bulgaria; 2 University of Medicine, Department of Social Medicine and Health Management, Plovdiv, Bulgaria; 3 Students at the University of Medicine, Plovdiv, Bulgaria 1
Purpose: The objective of the study is to evaluate the personal reaction to distress in a group of medical students. Methods: A group of 103 medical students (62 females and 41 males; mean age 20.5±.26 years, range 19−35 years) were studied. We used the Symptom Check
Addiction P.6.001 Comorbid anxiety and mood disorders in patients with alcohol abuse and alcoholism: a pilot case-control study 1
1
1
K.R. Stoychev , K.M. Ivanov , M.G. Aleksandrova , R.D. Stoychev1 , V.V. Nakov2 , L.Z. Tumbev1 , D.K. Kirov1 . 1 University Hospital, Department of Psychiatry, Pleven, Bulgaria; 2 Private Psychiatric Practice, Sofia, Bulgaria This pilot study aims: (1) To compare lifetime comorbidity of mood and anxiety disorders in a group of in- and outpatients with alcohol abuse and alcoholism and statistically matched group of healthy controls; (2) To study the temporal relationship between alcohol use disorders (AUD) and comorbid mood/anxiety disorder/s and to determine whether the obtained data are consistent with the hypothesis that in most of the cases AUD are secondary to a primary mood/anxiety disorder which has not been identified and treated promptly; (3) To identify possible clinical phenotypes, i.e. particular constellations of disorders that occur together significantly more often than statistically expected; (4) To explore the potential gender effects on the pattern of comorbidity. Material and Methods: 60 individuals (30 controls and 30 patients; 48 males, 12 females) aged 18−60 were screened with alcohol use disorders identification test for presence/absence of alcohol use disorder (AUD) and then were interviewed with composite international diagnostic interview – a fully structured research instrument, which yields a lifetime psychiatric morbidity pattern of each respondent. Since statistical analysis of the derived data is still running, only information about lifetime psychiatric comorbidity of alcohol use disorders group will be presented here. Results: The preliminary results show significant comorbidity in the alcohol use disorders group. Compared to general population surveys, AUD patients from our sample show two times greater lifetime prevalence of anxiety disorders (46.7% versus 25.0%1 ) and mood disorders (36.7 versus 18%1 ). In accordance with general population studies, the most widespread anxiety disorders are specific phobia (particularly acrophobia), social phobia and GAD. An interesting fact is the significant occurrence of PTSD in our sample compared to general population (6.67% versus 0.5−1%). Most prevalent mood disorders are recurrent depressive disorder, single depressive episode and bipolar disorder. A potential clinical phenotype deserving future investigation is the constellation of acrophobia, social phobia, recurrent depressive disorder and alcohol abuse/dependence observed in 5 patients
S165
(16.7%). In nearly 2/3 of all cases mood/anxiety disorders developed prior to AUD. Larger studies are needed to further explore the problem of comorbidity and its potential clinical implications. Reference(s) [1] International Consortium in Psychiatric Epidemiology in: Bulletin of the WHO, 2000, 78.
Other topics P.8.001 Suicide ideation and suicide plans: what are the differences? A study on male psychiatric inpatients I. Mitrev. Medical University, Department of Psychiatry and Medical Psychology, Plovdiv, Bulgaria There are frequent statements in handbooks, training manuals and guidelines for suicide prevention that, in comparison with suicidal ideation alone, the existence of a suicidal plan increases the suicidal threat and indicates a higher level of risk, even necessitating hospitalization. However, clinical and experimental data on the differentiation of different forms of suicidal behaviour are scarce. The present study is an attempt to identify important differences between suicide ideation and suicide plan in a group with a high risk of suicidal behaviour: male psychiatric inpatients. Material and Methods: 134 male psychiatric inpatients, suffering from schizophrenia, other psychotic disorders, and mood disorders were studied during the first five days after admission. Using a structured clinical interview and psychometric rating scales data were collected about the number of suicide attempts and aggressive acts committed throughout their lives, alcohol and tobacco use, depression, hopelessness, family history of suicidal behaviour, current suicide ideation and suicide planning. We analyzed the differences between three groups (no suicidality, suicidal ideas only, and suicidal ideas with plans). The groups of patients were compared on categorical variables through the use of chi-square tests and on continuous variables by t-tests. Results: There were no significant differences in age, alcohol and tobacco use, family history of suicide behaviour and levels of depression between subjects with suicide ideation with and without suicide plan. Compared to patients with suicide ideation without plan, the patients with suicide ideation and suicide plan had committed significantly more suicidal attempts and nearly as much aggressive acts during their lifetime; they also presented
S166
Posters
with non-significantly higher levels of hopelessness. Compared to patients without suicidality, the patients with suicide ideation without suicide plan demonstrated significantly higher levels of depression and hopelessness and heavier family loading for suicide attempts (nearly reaching statistical significance). Conclusions: The main finding of our study is that suicide plans are more closely related to suicide attempts than suicide ideation only. Thus, suicide plans are associated with higher suicidal intent than suicidal ideation. It is possible that despondency and hopelessness contribute are major contributors to the appearance and development of suicide ideation without plans. A better understanding of the differences between suicidal ideation and plans could eventually result in a better understanding of the more serious forms of suicidal behaviour. Further studies with a larger number of subjects are needed.
P.8.002 Quality of life in patients with colorectal cancer one year after surgery D. Karadjova, R. Shishkov, P.M. Petrov. University Hospital ”St Marina”, Clinic of Psychiatry, Varna, Bulgaria Survival rates of colorectal cancer patients have increased throughout the years due to earlier diagnosis, improved diagnostic tests, introduction of adjuvant therapy [3]. The aim of this study was to investigate quality of life (QoL) in patients with colorectal cancer one year after surgery in comparison with the general population. Material and Methods: QoL was assessed in 56 colorectal patients aged 25−82 years one year after surgery and in 50 individuals from the general population matched for age and gender. QoL was assesed using the Questionnnaire of Life Enjoyment and Satisfaction (QLES-Q-SF) and a Structured Clinical Interview. Statistical analysis was done using ANOVA. Results: (1) Significantly lower score of QoL in colorectal cancer patients one year after surgery (54.2) compared to the reference control group (69.4); (2) Both groups reported almost identical mean scores of global health QoL and physical functioning; (3) In contrast, deficits in emotional and social functioning seemed to exist among patients with colorectal cancer; (4) Agespecific comparisons (table) revealed an almost uniform pattern with largest differences between colorectal cancer patients population and controls in the youngest age cohort (<60 years) and virtually no differences among the elderly. Younger cancer patients had significantly lower scores of emotional and social functioning than younger
controls. (5) There was no significant gender and stage-oftumor inter-group differences between the stoma and nonstoma patients; (6) On average, stoma patients had lower scores than non-stoma cancer patients on many functional scales, the largest difference being in social functioning; (7) The Structured Clinical Interview revealed that QoL was influenced not so much by tumor stage and scope of intervention, but by the functional status of the patient.
Patients <60 Patients >60 Controls <60 Controls >60
Physical
Emotional
Social
27 25.2 29.2 26.8
11.2 13.3 14.5 13.8
19.3 23.1 242 23.6
Conclusions: We found that overall QoL and physical functioning of patients with colorectal cancer one year after surgery is comparable to population norms. Deficits in emotional and social functioning represent main factors that continue to impact negatively QoL in colorectal cancer patients even in the long run, affecting most heavily younger patients (2). Reference(s) [1] Arndt, V., 2004, Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study. J Clin Oncol 22, 4829–4836. [2] Blazeby, J., 2000, The role of quality of life assessment in patients with colorectal cancer. Jpn J Clin Oncol 30, 246. [3] Borras, J., 2001, Compliance, satisfaction and quality of life of patients with colorectal cancer receiving home chemotherapy or outpatient treatment. BMJ 322, 826. P.8.003 Measuring psychological distress in a sample of Bulgarian medical students S.P. Popov1 , N. Mateva2 , I. Temenugov3 , I. Yakov3 . University of Medicine, Department of Psychiatry and Medical Psychology, Plovdiv, Bulgaria; 2 University of Medicine, Department of Social Medicine and Health Management, Plovdiv, Bulgaria; 3 Students at the University of Medicine, Plovdiv, Bulgaria 1
Purpose: The objective of the study is to evaluate the personal reaction to distress in a group of medical students. Methods: A group of 103 medical students (62 females and 41 males; mean age 20.5±.26 years, range 19−35 years) were studied. We used the Symptom Check