Magdalena Piegza

Anxiety and depression and their influence on the quality of life after total hip replacement: preliminary report.

Objective. The study investigated health-related quality of life in relation to mental status (anxiety and depression) and demographic factors in patients before and after total hip replacement due to osteoarthrosis. Methods. The SF-36, HADS, socio-demographic data questionnaire was delivered to a group of 184 subjects (108 females, 76 males) at the mean age at the time of surgery of 59 years. Questionnaires were delivered to the subjects 2 weeks before the surgery and 6 months after the operation (by mail). Results. Patients after hip replacement showed significant improvement in health-related quality of life in most domains of SF-36 score and summary scale of PCS (Physical Component Summary Scale) and MCS (Mental Component Summary Scale). They also showed improvement in mental status. Elderly patients were more likely to show worse score in MCS and PCS before and after surgery. BMI (body mass index) was correlated only with preoperative PCS. Mental status was associated with postoperative PCS and MCS. Patients who were satisfied with the results of the surgery showed higher PCS and MCS score. Conclusion. Hip replacement surgery brings significant improvement to the quality of life. Age and mental status of those patients influence markedly their postoperative performance.

Sense of coherence in patients after limb amputation and in patients after spine surgery

Objective. To assess the score of SOC (sense of coherence), BDI (Beck Depression Scale), STAI ( State and Trait Anxiety Inventory) in three examined groups and correlation of SOC score with sociodemographic data, anxiety and depression. Methods. The SOC, BDI, STAI questionnaires were given to 51 patients after limb amputation, 65 patients after vertebral surgery because of chronic back pain and 40 persons in the control group. Results. Patients after limb amputation achieved the same level of SOC score as the control group. Patients who had higher results on the SOC score rarely suffered from phantom pain. Patients after spine surgery had a lower level on the SOC score than the control group. A lower score of SOC was observed in older, unemployed, poorer educated, subjects taking medicine, who did not report improvement after operation. Patients after limb amputation and patients after spinal surgery were more depressed and anxious than healthy people. Conclusion. Patients with higher SOC results, in both examined groups, were less depressed and anxious.

Cognitive impairment after sudden cardiac arrest

Aim To evaluate the incidence and severity of the impairment of selected cognitive functions in patients after sudden cardiac arrest (SCA) in comparison to patients after myocardial infarction without SCA and healthy subjects and to analyze the influence of sociodemographic and clinical parameters and the duration of cardiac arrest on the presence and severity of the described disorders. Material and methods The study group comprised 30 cardiac arrest survivors, the reference group comprised 31 survivors of myocardial infarction without cardiac arrest, and the control group comprised 30 healthy subjects. The Mini-Mental State Examination (MMSE), the Digit Span test from the Wechsler Adult Intelligence Scale, Lauretta Bender’s Visual-Motor Gestalt Test, and the Benton Visual Retention Test (BVRT) were used to assess the presence of cognitive impairment. An original questionnaire developed by the author was used for overall mental state assessment. Results The Bender test demonstrated a significant difference in the presence and severity of visual-motor skills between the study group and the control group, while BVRT and MMSE revealed increased incidence of cognitive impairment in the study group. The Bender and BVRT (D/D)/SS (version D, method D, scaled score) scales indicated cognitive impairment in 53.3% of these patients, while the BVRT (C/A)/SS test indicated cognitive impairment in 40%. For the reference group, the values were 32.3% and 12.9%, respectively. No correlation was found between the severity of cognitive impairment and the duration of cardiac arrest. Conclusions Impairment of visual-motor skills, short-term visual memory, concentration, and visual-motor coordination occurs much more frequently and is more severe in individuals after SCA than in healthy individuals. Impairment of memory trace storage and recall after delay occurs more frequently in patients after SCA than in patients after myocardial infarction without cardiac arrest and in healthy individuals. SCA duration did not have any influence on the severity of the described disorders.

Analysis of psychiatric consultations in a multidisciplinary hospital patients

UNLABELLED AIM : The aim of the research is the analysis of psychiatric consultations conducted in the multi-disciplinary hospital, establishing the cause of the consultations according to ICD-10 and the analysis of psychiatric consultations regarding their number on particular wards. METHODS Retrospective analysis of medical documentation concerning given consultations in the multidisciplinary hospital in Tarnowskie Góry in the years 2002-2010 has been conducted. In the statistics studies Shapiro-Wilk test, Kruskal-Wallis test, Mann-Whitney U test, Chi-square test of independence and the others have been used. RESULTS In the analyzed years, 3,672 consultations have been done, the mean age of the consulted patients has been 46.9 years. Taking into consideration the sex of the consulted patients, 41.99% of them were female and 58.01% were male. The main diagnoses of all consultations present as follows: F00-F09: 18.82%, F10-F19: 29.58%, F20-F29: 17.70%, F30-F39: 10.29%, F40-F48: 13.83%, F50-F59: 0.16%, F60-F69: 3.21%, F70-F79: 1.77%, F80-F89: 0%, F90-F98: 1.01%, other: 3.62%. The consultations most often have taken place on the following wards: Hospital Admitting Department (13.21%), Hospital Emergency Service (6.97%), Surgery Department (8.42%), Internal Medicine Department (6.51%), Neurology Department (4.82%). CONCLUSIONS The most frequent causes of consultation were addictions, the next were organic and psychotic disorders, neurotic and affective disorders. Consultations most often have taken place at the Hospital Admitting Department/Hospital Emergency Service, Surgery Department, Internal Medicine Department and Neurology Department.

Symptoms of depression and anxiety after cardiac arrest

OBJECTIVES The aim of the study was to assess the incidence of depression and anxiety symptoms in patients after cardiac arrest (SCA) in relation to patients with a history of myocardial infarction without SCA and in healthy individuals. The analysis of the impact of selected socio-demographic and clinical parameters and duration of SCA on the presence and severity of depression and anxiety symptoms in different groups was also performed. METHODS The study involved 30 patients after SCA and 31 patients with a history of myocardial infarction without SCA. The control group consisted of 30 healthy subjects. To assess the mental state, a specially developed questionnaire was used, while the presence and severity of the symptoms were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HAM-A). RESULTS Statistically, a significantly higher average level of depression and a higher incidence of anxiety was demonstrated in patients after a sudden cardiac arrest (study group) and after myocardial infarction (reference group) compared with the control group. There were no statistically significant differences in the incidence of anxiety between the study and reference groups. No impact of the duration of cardiac arrest on the incidence of depression and anxiety symptoms in the study group was observed. CONCLUSIONS In the group of people with a history of cardiac arrest, the most common mental disorder is depression. Anxiety and depression are significantly more frequent in patients with a history of SCA than in healthy individuals. There were no differences in the incidence and severity of depression symptoms in patients after SCA compared to patients after myocardial infarction without SCA. The described socio-demographic parameters and clinical characteristics had no impact on the symptoms of depression and anxiety in the investigated groups.