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Many somatic illnesses (e.g. hypertension, diabetes, pulmonary and cardiac diseases, hepatitis C, kidney and heart failure, HIV infection, Sjogren's disease) may impact central nervous system functions resulting in emotional, sensory, cognitive or even personality impairments. Event-related potential (ERP) methodology allows for monitoring neurocognitive processes and thus can provide a valuable window into these cognitive processes that are influenced, or brought about, by somatic disorders. The current review aims to present published studies on the relationships between somatic illness and brain function as assessed with ERP methodology, with the goal to discuss where this field of study is right now and suggest future directions. [ABSTRACT FROM AUTHOR]

The problem of the simultaneous history of several diseases, including somatic ones, in one patient is of high relevance in the context of the prevention, diagnosis and treatment of mental disorders. The complexity and multivariance of the relationships of concomitant diseases does not allow us to evaluate their complex interaction according to the concept of comorbidity. The concept of multimorbidity is convenient and promising for studying various aspects of the combination of both mental disorders and their associations with somatic pathology. However, at present, most studies in the area of multimorbidity are based primarily on epidemiological assessments, while much less attention has been paid to the mechanisms of multimorbid conditions. In this review, we consider the main recent approaches related to the study of the multimorbidity of mental disorders and somatic diseases in order to determine the optimal research strategies in this area. Further studies of the etiopathogenetic aspects of multimorbidity, the mechanisms of multimorbid clusters, and the aspects of the course and prognosis of multimorbid diseases are necessary to optimize the concept for both scientific projects and clinical practice. The most important directions for future research on the phenomenon of multimorbidity of mental disorders and somatic diseases are: 1) the study of their shared genetic and molecular mechanisms of development; 2) clinical and fundamental prospective studies of the manifestation, concomitant course and outcomes of multimorbid diseases; 3) study of the effectiveness and tolerability of psychopharmacotherapy in multimorbid patients with various somatic diagnoses, considering the complex interaction of the drugs used.

Introduction: Studies have reported an association between attention deficit hyperactivity disorder (ADHD) and somatic diseases; however, the correlation of mental disorders with the association between ADHD and somatic diseases remains uninvestigated. This study investigated and compared the prevalence of somatic diseases among adults with/without ADHD, stratified by the presence or absence of mental disorders. Methods: This cross-sectional study (October 2020-September 2021), using data (June 2013-September 2021) from a Japanese health insurance claims database, included adult participants with a medical record of and receiving medication for ADHD (ADHD group); the control group (matched 1:5 by age/sex) comprised participants without ADHD. The prevalence and odds ratio (OR; ADHD versus control) of type 2 diabetes mellitus (T2DM), diabetes complications, hypertension, cardiovascular disease (CVD), dyslipidemia, gout and hyperuricemia, chronic obstructive pulmonary disease (COPD), nonalcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH), and atopic dermatitis were investigated. Pooled ORs for stratified analysis were calculated using the Mantel-Haenszel method. Results: In the matched analysis sets, the ORs for all somatic diseases were significantly higher for the ADHD group (n=15,028) versus the control group (n=74,796). On stratified analysis, the Mantel-Haenszel ORs were significant for NAFLD/NASH (1.53; 95% confidence interval [CI]: 1.34, 1.73), diabetes complications (1.39; 95% CI: 1.09, 1.77), and gout and hyperuricemia (1.34; 95% CI: 1.19, 1.51). Furthermore, the stratum-specific ORs for T2DM, hypertension, and dyslipidemia were >1 and <1 in the presence and absence of mental disorders, respectively. The prevalence of all somatic diseases except atopic dermatitis increased with age. For participants aged ≥40 years, the Mantel-Haenszel ORs were significant for all somatic diseases except CVD, COPD, and atopic dermatitis. Conclusions: The prevalence of several somatic diseases, including chronic disorders, was high among adults with ADHD, particularly in those aged =40 years and those with mental disorders. [ABSTRACT FROM AUTHOR]

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Background: Clinical pharmacists significantly improve pharmacotherapy outcomes. Patients with serious mental illness (SMI) represent a group particularly vulnerable to medication mismanagement, potentially benefiting from pharmaceutical care targeting medication appropriateness. Objective: This study aimed to assess the prevalence of inappropriate medication for somatic comorbidities in SMI patients and to evaluate the impact of clinical pharmacist-led interventions. Methods: A pre-post intervention audit involving clinical pharmacist intervention was conducted on SMI patients with somatic comorbidities in a psychiatric clinic in Greece. A comprehensive medication review was undertaken by a clinical pharmacist. The Medicines Appropriateness Index (MAI) and Assessment of Underutilization of medication (AOU) instruments were used to gauge pharmacotherapy appropriateness before and after intervention. Physician acceptance rates and clinical significance were also noted. Statistical analysis employed descriptive and inferential methods, with a significance level set at α = 0.05. Results: A total of 58 patients were reviewed. Most patients (75.86%) were being inappropriately treated at baseline, versus 15.52% post-intervention. The pharmacist proposed 107 interventions of which 104 (97.2%) were physician-accepted. Changes in MAI and AOU identified improved medication appropriateness post-intervention [χ2 = 33.029, p

Studies of the genomic architecture of complex phenotypes, which include common somatic and mental diseases, have shown them to be characterized by high levels of polygenicity, i.e., there are large numbers of genes associated with the risk of developing these diseases. There is interest in establishing the genetic similarity of these two groups of diseases. The purpose of the present review is to analyze genetic studies of the comorbidity of somatic and mental diseases from the point of view of the universality and specificity of mental disorders in somatic diseases, the reciprocal relationships of these types of pathologies, and the modulating influence of external environmental factors on comorbidity. The analysis results point to the existence of a common genetic predisposition to mental and somatic diseases. The existence of genes common to both does not exclude specificity of the development of mental disorders in relation to specific somatic pathologies. We can suggest the existence of genes unique to a particular somatic and comorbid mental illness, as well as genes common to these diseases. Common genes may have varying degrees of specificity, i.e., they are universal in nature, this being apparent, for example, in the development of major depressive disorder in a variety of somatic diseases; common genes can also be specific for only a couple of individual diseases (schizophrenia and breast cancer). Moreover, common genes can have multidirectional effects, which also contributes to the specificity of comorbidity. In addition, the search for common genes for somatic and mental diseases needs account to be taken of the modulating influences of confounding factors (treatment, unhealthy lifestyle, behavioral characteristics), which may also differ in specificity depending on the diseases in question. [ABSTRACT FROM AUTHOR]

One of the newest methods of dealing with stress is museotherapy. It is a conscious use by art therapists of the positive impact of art collected in museums on the mental, physical, spiritual and social well-being of a specific person. This form of adjunctive therapy in the treatment of somatic and mental disorders offers unique benefits. It reduces the harmful effects of stress, improving quality of life with illness and future prognosis, and even accelerating recovery. Museotherapy increases awareness and, thanks to the participation of an art therapist, who establishes a bond with the patient, causes the patient to become more open, more likely to tell their own stories, and share their associations and emotions. This method also develops empathy, which is especially recommended for medical students and doctors as well. Museotherapy has already been introduced in the world to support the treatment of patients. In Canada and France there is a practice of the so-called “prescription museum” and “hospital museum”. In Poland, the pioneer of this therapy is Prof. Robert Kotowski, director of the National Museum in Kielce. This form of therapy is most often used by oncological patients, those with dementia (Alzheimer’s disease, Parkinson’s disease and other), hypertension, diabetes, chronic pain, people on the autism spectrum and also the disabled. Mentioned activities promote creativity and achieve well-being, reduce anxiety, pain, depression, loneliness and insomnia, facilitate overcoming life difficulties, increase self- esteem and acceptance. Modern medicine is also integrated medicine, which combines classical medicine with other forms of therapy, among which museotherapy has a special place.

Hypoactive sexual desire is very often, especially in women. The article presents data on the negative impact of drugs used to treat various disorders of somatic modality, which can lead to a decrease in sexual desire and other sexual dysfunctions. Thus, it is reported about the possible influence of antihypertensive drugs belonging to various groups (non-selective blockers, sympatholytics, central alpha-blockers, drugs that affect adrenergic innervation, diuretics). It is noted that the antihyperlipidemic drug bezafibrate, drugs used to treat adenoma and prostate cancer, can have a negative impact on sexual function. Cimetidine, used to treat gastric and duodenal ulcers, as well as finasteride, used both to reduce the size of the prostate gland and for baldness, have a negative effect on sexual functions. The antifungal agent ketoconazole has an adverse effect on sexual function. Negative effects on libido and other sexual functions may be due to the use of drugs for the treatment of glaucoma (β-adrenergic antagonists and carbonic anhydrase inhibitors). Negative effects on sexual functions, including severe suppression of libido, may result from antiretroviral therapy in AIDS patients (protease inhibitors). Data are also provided on the negative impact on sexual functions of cytotoxic chemotherapy and radiotherapy in malignant neoplasms. In addition, the issue of the negative impact of hormonal contraception in women, which can lead to a decrease or absence of sexual desire, is discussed. [ABSTRACT FROM AUTHOR]

Psychotherapeutic methods acceptable for sanatoriums were analyzed in this work due to the high frequency of borderline mentaldisorders exampled in the general medical practice, including sanatorium-resort institutions, and the frequent prioritizationof psychotherapy (compared to psychopharmacology) for the treatment of such conditions; as well as the lack of structure in thesystematics of psychotherapeutic methods used in the sanatorium treatment conditions, and the frequent lack of convincing evidenceof their effectiveness. Aim. Various group and individual methods that can be used for short-term psychotherapy have been studied. In accordance with the modern principles of evidence-based medicine, an assessment of the available evidence of their effectiveness was carried out. Material and Methods. The RSCI and Medline electronic databases were used, the search was carried out by keywords (names of relevant techniques and mental dysfunctions, such as anxiety, depression, adjustment disorders, stress states, psychosomatics). The efficacy and safety evidence levels were evaluated in accordance with the National Standard of the Russian Federation GOST R 56034–2014. Results. As a result of the work performed, a wide range of psychotherapy methods related to its various directions, applicable in sanatorium-resort conditions (most of them are also suitable for hospitals/rehabilitation centers) is analyzed. Some of them have a high level of evidence, while others have less convincing data, which is often associated with the difficulty of reproducing them in experimental conditions. Conclusion. The information provided may be useful to specialists working in sanatoriums, rehabilitation centers and hospitals, for solving issues of organizing and improving the quality of psychotherapeutic care for patients with concomitant borderline mental disorders as well as for further scientific research.

Depression is a common mood disorder characterised by high comorbidity with other mental and somatic diseases. New studies reveal a shared genetic base for mental core symptoms and somatic comorbidities. Functional analyses showed multiple brain–body pathways involved. This may help considering new therapeutic approaches for depression as a system’s disorder.

Personality disorders (PDs) are related to increased prevalence of somatic diseases. The objective of this follow-up study was to explore somatic morbidity in subjects with PD diagnosed by early adulthood. The initial study population consisted of 508 former adolescent psychiatric inpatients (n=508). Of them, 63 subjects (39 women, 24 men) had a diagnosis of PD, including borderline PD (BPD) (n=38) and other PD (OPD) (n=25). The K-SADS-PL was used to gather information during the adolescent psychiatric hospitalization. The information on in- and outpatient hospital treatments, until the end of 2016, was extracted from the National Care Register for Health Care. 96.8% of subjects with PDs had somatic morbidity during the follow-up period. In comparison of prevalence between BPD and OPD groups, significant differences were found in Infectious and parasitic diseases (BPD vs. OPD, 63.2% vs. 36.0%, p=0.043), Endocrine, nutritional and metabolic diseases (23.7% vs. 0%, p=0.009) and Diseases of the genitourinary system (60.5% vs. 12.0%,

The prevalence of somatic diseases in patients with pneumonia caused by SARS-CoV-2 viruses was assessed, the most common somatic diseases in patients, depending on gender and age groups were identified. 110 patients with viral pneumonia caused by SARSCoV-2 were included in the study. The presence of risk factors for the severe course of the disease, somatic pathology, epidemiological history, changes according to computed tomography and scores on the Charlson comorbidity scale were evaluated. The average age of patients with coronavirus infection caused by COVID-19 with an unfavorable outcome was 75 ± 1,3 years. The most common comorbid combined pathology in this group of patients is postinfarction cardiosclerosis, ischemic cardiomyopathy, and chronic cerebral ischemia. Of the risk factors for severe coronavirus infection, essential arterial hypertension is most common 93.6% (103 patients), age over 65 years old 81.8% (90 patients), diabetes mellitus 66.3% of cases (73 patients) and chronic heart failure 46.3% of cases (51 patients). In this group of patients, the average comorbidity index was 8.9 ± 0.3. Severe lethal disease is most often recorded in people of an older age group with diseases of the cardiovascular system, cerebrovascular pathology and malignant neoplasms. Even patients of young and older age groups had risk factors for poor prognosis. According to the study, the most unfavorable symptoms (fever above 38 оС, shortness of breath and weakness) occur first, 6 days before hospitalization, while the rest appear more often 3-5 days before hospitalization. Patients who have such risk factors as age over 65 years, arterial hypertension and heart failure in combination with symptoms such as fever above 38 оС, shortness of breath and weakness require immediate hospitalization, regardless of the level of hypoxemia and changes according to computer tomography, for further observation and treatment due to the high probability of death.

Despite the achievements of modern medicine, the systemic approach in the treatment and prevention of periodontal diseases is rather limited in clinical dentistry and their genesis is interpreted from local positions. Often, the commonality of the leading mechanisms that initiate the development of pathological processes in various organs and tissues of the body is not taken into account. It is erroneous to assess pathological changes in the organs of the oral cavity as secondary, ie complications of diseases of other body systems. Today, the question of the influence of immunе-inflammatory and pressor neurohumoral disorders, the state of endothelial function on the development and progression of periodontal diseases in patients with cardiovascular, neurological, gastroenterological and rheumatic pathology remains insufficiently studied. Optimization of the use of new treatment schemes will allow not only to effectively control the course of diseases of the tooth-retaining tissues, but also to influence the key links in the development of periodontal tissue lesions on the background of somatic pathology. The aim of the study: on the basis of laboratory data to investigate the effectiveness of polypeptide drugs in patients with inflammatory diseases of periodontal tissues on the background of somatic pathology. Object and methods of research. Treatment was performed on 136 persons with inflammatory and inflammatory-dystrophic diseases of periodontal tissues, which were divided into 2 groups: the main – 75 patients treated with our method and control – 61 persons in whom the curation of periodontal pathology was carried out according to conventional protocols. Determination of levels of interleukin – 1β, interleukin-10, hs-CRA in oral fluid was performed by enzyme-linked immunosorbent assay. Studies of the level of final nitrogen metabolites were performed according to the method based on the reduction of nitrates to nitrites with their determination by reaction using Gris reagent. The research was carried out in compliance with the basic provisions of the «Rules of ethical principles of scientific medical research with human participation», approved by the Declaration of Helsinki (1964- 2013), ICH GCP (1996), EEC Directive № 609 (from 24.11.1986), orders of the Ministry of Health of Ukraine № 690 dated 23.09.2009, № 944 dated 14.12.2009, № 616 dated 03.08.2012. Each patient signed an informed consent to participate in the study, and all measures were taken to ensure the anonymity of patients. Statistical processing of the obtained results was performed on a personal computer using the licensed programs «Microsoft Excel» and «Statistica». Research results. After 1 year of research in the main group, as a result of the application of our proposed method, we investigated the significant improvement and stabilization of these markers of the immune-inflammatory response. Thus, we investigated the decrease in oral fluid levels of IL-1ß – by 42.20 %, the ratio of IL-1ß / IL-10 – by 60.63 %, hs-CRA – by 41.58 %, p

Introduction Mood disorders (MDs) are associated with somatic diseases and tend to aggregate in families. But there are limited studies on the risk of somatic diseases for relatives of patients with MDs. Objectives To assess whether a patient’s mood disorder diagnosis is associated with a family history of somatic disorders. Methods This cross-sectional family study included 36 patients with MDs (66.7% women; age - 32 [11.2] years) and 68 of their relatives, and 23 healthy individuals (56,5% women; age - 30.5 [6.9] years) and 53 of their relatives. A Pearson’s χ2 test was used to compare the frequencies of family history of somatic disease. Logistic regression models were used to determine the independent association of MDs, after adjusting for the effects of sex, age, with binary characteristics. Results Individuals with and without MDs had different frequencies of family history of cardiovascular (66,7% vs. 43,4%; p=0,03) and endocrinological diseases (47,2% vs. 39,1%; p=0,04). There were no statistically significant differences in the frequency of family history of gastrointestinal, pulmonary, urogenital and musculoskeletal diseases (p>0,05). Logistic regression revealed that MDs diagnosis in patients was a risk factor for cardiovascular (p=0.03, OR=3.5) and endocrinological disease (p=0.04, OR=3.7) in their relatives. Conclusions MDs are associated with the aggregation of somatic diseases in families. Future research is needed to clarify the biological reasons for this association. Disclosure No significant relationships.

Aims: The importance of prenatal maternal somatic diseases for offspring mood and anxiety disorders may be overlooked or undervalued. We conducted the first systematic review and meta-analysis assessing the risk of offspring mood and anxiety disorders in the context of prenatal maternal somatic diseases. Methods: We screened articles indexed in Embase (including Embase, MEDLINE, PubMed-not-MEDLINE), PsycARTICLES and PsycINFO databases up to August 2021. 21 studies were included. We examined the overall associations between prenatal maternal somatic diseases and offspring mood/anxiety disorders. Analyses were stratified according to maternal somatic diseases and follow-up duration. Results: We observed an increased risk of mood and anxiety disorders in the context of prenatal maternal somatic diseases [relative risk (RR) = 1.26; 95% confidence interval (CI) 1.15–1.37, RR = 1.31; 95% CI 1.24–1.38]; maternal obesity(RR = 1.92; 95% CI 1.72–2.11), hypertensive disorders (RR = 1.49; 95% CI 1.11–1.86) and infertility (RR = 1.26, 95% CI 1.14–1.39) were risk factors for mood disorders; maternal polycystic ovary syndrome (RR = 1.61; 95% CI 1.42–1.80), severe obesity (RR = 1.56; 95% CI 1.44–1.68) and moderate obesity (RR = 1.36; 95% CI 1.28–1.44) were risk factors for anxiety disorders. Prenatal maternal somatic diseases increased the risk of mood disorders in childhood and adulthood (RR = 1.71; 95% CI 1.34–2.09/RR = 1.19; 95% CI 1.09–1.30), as well as the risk of anxiety disorders in adulthood (RR = 1.33; 95% CI 1.26–1.41). Conclusion: The results indicate that prenatal maternal somatic diseases are associated with offspring mood and anxiety disorders, and that the associations may be long-lasting. [ABSTRACT FROM AUTHOR]

Abstract Background Depression is frequently accompanied by other mental disorders and various somatic diseases; however, previous comorbidity studies often relied on self-reported data and have not simultaneously assessed the entire spectrum of mental and somatic diagnoses. The aim is to provide a complete picture of mental and somatic comorbidity of depression in routine outpatient care in a high income country with a relatively well equipped health care system. Methods Using ambulatory claims data covering 87% of the German population (age 15+), we designed a cross-sectional study by identifying persons diagnosed with mild, moderate and severe depression in 2017 (N = 6.3 million) and a control group matched 4:1 on sex, 5-year age group and region of residence (N = 25.2 million). Stratified by severity, we calculated the prevalence of 202 diagnosis groups included in the ICD-10 in persons with depression as compared to matched controls using prevalence ratios (PR). Results Nearly all mental disorders were at least twice as prevalent in persons with depression relative to controls, showing a dose-response relationship with depression severity. Irrespective of severity, the three most prevalent somatic comorbid diagnosis groups were ‘other dorsopathies’ (M50-M54), ‘hypertensive diseases’ (I10-I15) and ‘metabolic disorders’ (E70-E90), exhibiting PRs in moderate depression of 1.56, 1.23 and 1.33, respectively. Strong associations were revealed with diseases of the central nervous system (i.e. multiple sclerosis) and several neurological diseases, among them sleep disorders, migraine and epilepsy, most of them exhibiting at least 2- to 3-fold higher prevalences in depression relative to controls. Utilization of health care was higher among depression cases compared to controls. Conclusions The present study based on data from nearly the complete adolescent and adult population in Germany comprehensively illustrates the comorbidity status of persons diagnosed with depression as coded in routine health care. Our study should contribute to increasing the awareness of the strong interconnection of depression with all other mental and the vast majority of somatic diseases. Our findings underscore clinical and health-economic relevance and the necessity of systematically addressing the high comorbidity of depression and somatic as well as other mental diseases through prevention, early identification and adequate management of depressive symptoms.

In this short communication, the editorial board publishes the information on safety of the combined hormonal contraceptive (CHC) Jeanine®, containing the fixed dose combination of dienogest and ethinyl estradiol. This information has been received from the Russian regulatory authority (Roszdravnadzor) and the manufacturer. According to a metaanalysis of four observational studies, women using the dienogest/ethinyl estradiol fixed dose combination had a higher risk of developing venous thromboembolism (VTE) as compared with women taking the CHCs containing the levonorgestrel/ ethinyl estradiol combination. The estimated risk of developing VTE in women taking the dienogest/ethinyl estradiol combination is 8-11 cases of VTE per 10,000 women per year, while in women taking the CHCs containing levonorgestrel, norethisterone or norgestimate the risk is 5-7 cases of VTE per 10,000 women per year. A patient information leaflet amendment is under consideration by the regulatory authorities. For now, however, hormonal contraceptives containing the dienogest/ethinyl estradiol combination accompanied with the previous version of the instruction are still available in pharmacies. Therefore, when prescribing the combined hormonal contraceptives with dienogest and ethinyl estradiol, the obstetrician-gynecologist should discuss these risks with the woman.

Abstract Objectives Unmet needs are common in older patients and should be assessed via suitable instruments. The adapted German version of the Camberwell Assessment of Need for the Elderly (CANE) represents an often used tool to determine the needs in older individuals. Evidence on the psychometric properties of the CANE is still pending. Methods A sample of 231 patients with common somatic and psychiatric diseases were interviewed about their needs including their caring relatives and general practitioners (GPs). Frequencies of unmet needs were evaluated across the different perspectives. Interrater agreement, convergent and discriminant validity were evaluated. Results On average, psychiatric patients reported more unmet needs than somatic patients, particularly regarding to psychological distress and behavior. The interrater agreement was higher in the somatic subgroup than in the psychiatric subgroup, and higher between patients and relatives compared to patients and GPs. Evidence for construct validity was reported. Conclusions Patients with common somatic and psychiatric disorders report specific unmet needs that should be considered in healthcare. Moderate to good psychometric characteristics were found for the CANE. The use of valid instruments to record needs in health and nursing care can be useful and represents an important starting point for targeted interventions and effective treatment.

The purpose of the study is to assess how female students of adolescence with somatic diseases percept physical activity during physical education lessons according to the Borg scale. Research materials and methods. 98 girls from a special medical group at PE classes, aged 18-19, studying at the Technical University of Irkutsk (Russia) in the 2019-2020 academic year took part at our research work. All students, according to their existing diseases, were divided into 6 groups. According to the Borg RPE scale (Borg, 1998), the girls evaluated the level of their muscle tension personal perception when performing physical exercises in a training session in the range from 6 points (very light level) to 20 (extremely heavy). The interrelation of the physical activity severity perception with the girls' functional characteristics of the cardiovascular and respiratory systems was studied. The indicators of the Robinson index and hypoxic samples of Stange and Genche (timed expiratory capacity) were calculated. The girls' physical fitness was studied using a battery of motor tests. Research results. It is established that the physical activity perception severity level depends on the type of somatic disease. Girls with cardiovascular and respiratory systems diseases perceive the dynamic load in PE classes as «hard», this fact is confirmed by the results of a questionnaire on Borg scale. They have significantly low indicators values of some functional characteristics of the cardiovascular system, motor qualities and hypoxic samples of Stange and Genche (p<0,05). Conclusions. The research work, carried out by us, showed that female students from the special medical group of the university perceive the volume and intensity of physical activity differently. For girls with digestive system, visual organs and genitourinary system diseases, physical activity corresponds to the aerobic load threshold (130-140 beats/min). In girls with respiratory organs and musculoskeletal system organs diseases, physical activity was at the upper limit of the aerobic load threshold (150-160 beats/min). In girls with a cardiovascular system disease, the load corresponded to an anaerobic regime of physical work (170-180 beats/min). Therefore, we recommend that PE teachers use Borg scale in their work for operational pedagogical control in the classroom and the curriculum correction for students with somatic diseases. [ABSTRACT FROM AUTHOR]

Objectives: Unmet needs are common in older patients and should be assessed via suitable instruments. The adapted German version of the Camberwell Assessment of Need for the Elderly (CANE) represents an often used tool to determine the needs in older individuals. Evidence on the psychometric properties of the CANE is still pending. Methods: A sample of 231 patients with common somatic and psychiatric diseases were interviewed about their needs including their caring relatives and general practitioners (GPs). Frequencies of unmet needs were evaluated across the different perspectives. Interrater agreement, convergent and discriminant validity were evaluated. Results: On average, psychiatric patients reported more unmet needs than somatic patients, particularly regarding to psychological distress and behavior. The interrater agreement was higher in the somatic subgroup than in the psychiatric subgroup, and higher between patients and relatives compared to patients and GPs. Evidence for construct validity was reported. Conclusions: Patients with common somatic and psychiatric disorders report specific unmet needs that should be considered in healthcare. Moderate to good psychometric characteristics were found for the CANE. The use of valid instruments to record needs in health and nursing care can be useful and represents an important starting point for targeted interventions and effective treatment. [ABSTRACT FROM AUTHOR]

With the improvement of treatments, a growing number of survivors with childhood or adolescent central nervous system (CNS) tumor are parenting their own children. We aimed to explore the risk of somatic diseases among children of these survivors compared to population controls. Children of survivors with CNS tumor below age of 20 were identified between 1973 and 2014 by combining the several Swedish registers. Five children without parental CNS tumor were matched randomly to generate the population comparisons. Relative risk (RR) and absolute excess risk (AER) were calculated for overall somatic diseases, and hazard ratio (HR) was calculated for specific type of somatic diseases. A total of 2231 somatic disease diagnoses were identified in children of survivors with a cumulative incidence rate of 94.77 per 1000 person‐years, whereas the rate was 92.79 in matched comparisons thus resulting in an overall RR of 1.02 (95% CI = 0.98‐1.07) and AER of 1.98 (95% CI = −2.06, 6.13). Specifically, five of 1364 children of survivors had CNS tumor with an incidence rate of 0.21 per 1000 person‐year, whereas the rate was 0.04 in children of matched children, generating a HR of 4.91 (95% CI = 1.42‐16.96). Children of male survivors were at a statistically increased risk of malignancy, as well as infectious and parasitic diseases. In conclusion, no significantly higher risk of overall somatic diseases was found in children of survivors with CNS tumor before the age of 20, but children with a paternal diagnosis of CNS tumor had significantly increased risk of malignancies and infectious and parasitic diseases. What's new? Survivors of central nervous system (CNS) tumors are at higher risk of experiencing late adverse effects on reproductive function. However, it remains unknown if the tumor or related treatments subsequently affect the physical health of their offspring. This population‐based study did not find an association of parental CNS tutors in childhood or adolescence with the risk of overall somatic diseases in the offspring. Nonetheless, an increased risk was observed in preterm born children, and children of male survivors had an increased risk of malignancies and infectious and parasitic diseases, calling for a tailored surveillance strategy. [ABSTRACT FROM AUTHOR]

Inflammation is considered a typical response to tissue injury. At present, we see an increasing number of patients with chronic inflammation, where the damaging factor is unclear. Specifically, the pathogenetic factors of chronic endometritis (СЕ) need to be studied both in the gynecological and somatic aspects of the disease, including the functional state of other organs and systems. Aim: to analyse the microflora of the urinary tract and the intestines in patients with СЕ and various somatic conditions. Materials and methods. The intestinal and urinary tract microflora were assayed using microscopic, microbiological and molecular biological methods. To prevent false positive results and minimize sample contamination, we used our own modification. Results. The intestinal microbiota in patients with СЕ significantly differed from that in relatively healthy controls. We found a relationship between the abnormal colon microflora and the diseases of the upper and lower gastrointestinal tract, in particular, chronic cholecystitis, gastritis, and functional disorders of the intestine. These findings may become important for compbined therapy. Conclusion. The results indicate the need to individualize the pharmacol therapeutic treatment of patients with СЕ, especially those with impaired fertility. The treatment strategy should be based on minimizing the adverse drug effects, and considering the concomitant diseases.

The negative impact of depression on the course and outcome of somatic disorders is well-known and has a solid theoretical basis. The analyses of prospective studies confirm the role of depression as an independent and significant risk factor for widespread chronic somatic disorders including such severe and life-threatening conditions as cardiovascular diseases, diabetes and oncological pathology. The majority of somatic disorders and depression are the part of the big class of hereditary diseases with multifactorial character and polygenic nature. It is likely, that the genetic risk diversity of these diseases in population is close. There is also a high probability of genetic risks levels overlap (or of common «cluster») of two or more diseases in one individual, with one disorder being major depression. In that case such diseases could be considered «genetically comorbid» and manifestation of one disease could alter the risks of other. Precise and informative diagnostic tools could detect subsyndromal depression that could be the prognostic sign of the high risk and rapid manifestation of somatic diseases. Thus, patients with depressive disorder could be considered as a group with high risks of diverse range of somatic pathology. The coalescence of fundamental biomedical scientists and internists (psychiatrists and other physicians) could lead to the elaboration of specific complex preventative measures including social ones.

All large population-based administrative studies currently indicate a significant comorbidity of adult attention deficit hyperactivity disorder (ADHD) with addictive, anxiety and in particular affective disorders. In these investigations the risk for one of these comorbid disorders increased with increasing age of the ADHD patients. The most recent genome-wide association and correlation studies also revealed indications for joint genetic risk factors of ADHD with, in particular unipolar depression, bipolar disorder, autism spectrum disorders, Tourette's syndrome and to a lesser extent schizophrenia. The only psychiatric disorder that was negatively correlated with ADHD was anorexia nervosa. Additionally, cannabis and cocaine use were significantly positively genetically correlated with ADHD. Furthermore, an increased occurrence of some specific somatic diseases could be found in patients with adult ADHD. In particular, obesity, migraine, sleep disorders, asthma and celiac disease showed a significantly positive association with ADHD in several studies. No association was found between ADHD and cardiovascular disease. Here as well there are initial indications of joint genetic risk variants; however, data are still sparse and additional studies are needed before valid conclusions can be drawn. To some extent these associated somatic diseases might be differential diagnoses rather than true comorbidities, for example, obstructive sleep apnea syndrome (OSAS) can lead to ADHD-like symptoms that disappear when the OSAS is sufficiently treated. Therefore, it is important to keep the co-occurrence of psychiatric and somatic disorders in mind during the diagnostics and treatment of adult ADHD patients to improve their general health and quality of life. [ABSTRACT FROM AUTHOR]

Aims: This article analyses excess morbidity amongst homeless shelter users compared to the general Danish population. The study provides an extensive control for confounding and investigates to what extent excess morbidity is explained by homelessness or other risk factors. Methods: Data set includes administrative micro-data for 4,068,926 Danes who were 23 years or older on 1 January 2007. Nationwide data on shelter use identified 14,730 individuals as shelter users from 2002 to 2006. Somatic diseases were measured from 2007 to 2011 through diagnosis data from hospital discharges. The risk of somatic diseases amongst shelter users was analysed through a multivariate model that decomposed the total effect into a direct effect and indirect effects mediated by other risk factors. Results: The excess morbidity associated with shelter use is substantially lower than in studies that did not include an extensive control. Approximately 80% of excess morbidity amongst shelter users is attributed to other risk factors. A large part of the excess morbidity is explained by substance abuse problems and lack of employment, whilst mental illness, low income, low education, civil status and ethnic minority background explain only a limited part. However, when conducting an extensive control for confounding, a significantly higher morbidity was identified amongst shelter users for infectious diseases, lung, skin, blood and digestive diseases, injuries, and poisoning. Conclusions: Ill health amongst homeless shelter users is widely explained by substance abuse problems and other risk factors. Nonetheless, for many diseases homelessness poses an additional risk to the health. [ABSTRACT FROM AUTHOR]

In this paper we share clinical observations and insights regarding the management and treatment of an uncooperative patient requiring an interdisciplinary approach due to diagnosis of delusional disorder, depressive symptoms, alcohol dependence syndrome, numerous complaints related to concomitant somatic diseases, and coronavirus infection (COVID-19). Our aim was to highlight the significance of a holistic approach to the patient, and scrupulous documentation of existing somatic diseases in psychiatric hospital discharge summary reports. Due to the common lack of compliance on the part of psychiatric patients, it proves utterly important to establish cooperation between healthcare providers and families of the mentally ill. Coronavirus infection (COVID-19) becomes another, additional complication in the management of psychiatric inpatients. We believe that the discussed interdisciplinary approach, together with increased family or institutional supervision can contribute to the improvement of psychiatric patients' physical and mental health status as well as general functioning. [ABSTRACT FROM AUTHOR]

As women fertility is obviously decreasing at present, a number of people who, being at the reproductive age, suffer from various diseases is only growing and it is truly a vital issue. Chronic endometritis which is a problem in contemporary gynecology and reproductive performance studies may cause menstrual function disorders, anemia, and chronic pelvis pains syndrome. Our research goal was to assess risks of somatic pathology evolvement and life quality of women suffering from chronic endometritis. The focus group was made up of 42 patients at their fertile age who suffered from chronic endometritis (n=42); the reference group consisted of practically healthy females at the same age (n=33) who applied to a gynecologist in order to make a choice on a contraceptive. We detected that women with chronic endometritis had somatic pathologies much more frequently that women from the reference group; such pathologies included chronic gastritis, functional disorders in the bowels, gall-bladder diseases, urinary system diseases, and chronic rhinopharyngitis (relative risks varied from 1.25 to 4.62; p

Background: Depression is frequently accompanied by other mental disorders and various somatic diseases; however, previous comorbidity studies often relied on self-reported data and have not simultaneously assessed the entire spectrum of mental and somatic diagnoses. The aim is to provide a complete picture of mental and somatic comorbidity of depression in routine outpatient care in a high income country with a relatively well equipped health care system. Methods: Using ambulatory claims data covering 87% of the German population (age 15+), we designed a cross-sectional study by identifying persons diagnosed with mild, moderate and severe depression in 2017 (N = 6.3 million) and a control group matched 4:1 on sex, 5-year age group and region of residence (N = 25.2 million). Stratified by severity, we calculated the prevalence of 202 diagnosis groups included in the ICD-10 in persons with depression as compared to matched controls using prevalence ratios (PR). Results: Nearly all mental disorders were at least twice as prevalent in persons with depression relative to controls, showing a dose-response relationship with depression severity. Irrespective of severity, the three most prevalent somatic comorbid diagnosis groups were 'other dorsopathies' (M50-M54), 'hypertensive diseases' (I10-I15) and 'metabolic disorders' (E70-E90), exhibiting PRs in moderate depression of 1.56, 1.23 and 1.33, respectively. Strong associations were revealed with diseases of the central nervous system (i.e. multiple sclerosis) and several neurological diseases, among them sleep disorders, migraine and epilepsy, most of them exhibiting at least 2- to 3-fold higher prevalences in depression relative to controls. Utilization of health care was higher among depression cases compared to controls. Conclusions: The present study based on data from nearly the complete adolescent and adult population in Germany comprehensively illustrates the comorbidity status of persons diagnosed with depression as coded in routine health care. Our study should contribute to increasing the awareness of the strong interconnection of depression with all other mental and the vast majority of somatic diseases. Our findings underscore clinical and health-economic relevance and the necessity of systematically addressing the high comorbidity of depression and somatic as well as other mental diseases through prevention, early identification and adequate management of depressive symptoms. [ABSTRACT FROM AUTHOR]

The aim of the research was to study the prevalence and relative risks of somatic diseases among the workers of the uranium processing leach plant. A single-point full-design cross-sectional study of 912 leach plant workers was conducted. The experimental group consisted of 778 workers of Stepnogorsk bearing plant, located at a distance of 10 km from the leach plant. Prevalence (Pr), gross relative risks (RR), and standardized relative risks (SRR) of somatic diseases were evaluated. Standardization was carried out by gender, age, length of service. The most common somatic diseases among the leach plant workers were arterial hypertension (Pr=246,7 ?; 95 % CL 218,7-274,7); chronic obstructive pulmonary disease (Pr=193,0 ?; 95 % CL 167,4-218,6); chronic gastritis (Pr=174,3 ?; 95 % CL 149,7-198,9). These same diseases had excessive gross relative risks: for arterial hypertension (AH) RR was 2.4 (95 % CL 1.9-3.0); chronic gastritis (CG) RR = 2.1 (95 % CL 1.6-2.7); chronic obstructive pulmonary disease (COPD) RR =2.0 (95% CL 1.6-2.6). Stratification was carried out by gender, age, length of service and SRR was calculated for major somatic diseases. The SRR for AH was 2,8 (95 % CL 2,1-3,7; χ²=48,8; p<0,001); COPD - 2,5 (95 % CL 1,8-3,4; χ²=34,8; p<0,001); CG - 2,4 (95 % CL 1,7-3,4; χ²=29,0; p<0,001). SRRs were higher than similar RR, which may be associated with a more significant impact on the prevalence of the main somatic pathology among nuclear workers of production factors and requires further study of the influence of radiation-toxic risk factors. [ABSTRACT FROM AUTHOR]

Somatic diseases have been associated with an increased risk for subsequent schizophrenia; however, it is unknown whether prior somatic diseases negatively affect early treatment outcomes after a first-time schizophrenia diagnosis. We included all individuals born in Denmark after January 1st, 1977 and first-time diagnosed with schizophrenia between January 1st, 1996 and December 31st, 2015. We identified all life-time somatic hospital contacts and all prescriptions within the year before the first-time schizophrenia diagnosis and followed patients for up to five years regarding risk for schizophrenia (re)-hospitalization (relapse). We performed Cox regression analyses calculating hazard rate ratios (HRR) including 95%-confidence intervals (CI) and adjusted for relevant confounders. We followed a total of 11,856 patients with a first-time schizophrenia diagnosis (58.7% male, mean age 23.1 (SD = 4.7) years) for 39,033 person-years, whereof 5506 (46.4%) had relapse with schizophrenia re-hospitalization during 5-year of follow-up. Somatic hospital contacts ever before (95.4%; HRR = 1.30; 95%-CI = 1.07–1.59), and specifically during the year before schizophrenia diagnosis (42.5%; HRR = 1.36; 95%-CI = 1.11–1.66) were associated with an increased risk of schizophrenia relapse as were a greater number of prior somatic hospital contacts (p < 0.001). Individuals with up to four different prescriptions for somatic medications showed a trend towards a slightly lower risk of relapse. Somatic diseases and health seeking patterns might have an impact on the course of schizophrenia, where severe somatic comorbidity, specifically during the year before first-time schizophrenia diagnosis, seem to negatively affect early treatment course, whereas previous somatic medication use may indicate a better compliance and help-seeking behavior. [ABSTRACT FROM AUTHOR]

The functional or morphological changes associated with systemic diseases make up the bulk of eye pathology. Accordingly, systemic drug therapy for these diseases can affect the eye. Changes of the organ of vision and appropriate ophthalmological advice can assist an internist to diagnose and adequately treat the patient. The article considers possible changes in the organ of vision in the presence of somatic diseases, as well as alterations resulting from drug therapy for these diseases.

Objective: It is largely unknown how depression prior to and following somatic diseases affects mortality. Thus, we examined how the temporal order of depression and somatic diseases affects mortality risk. Method: Data were from a Danish population‐based cohort from 1995 to 2013, which included all residents in Denmark during the study period (N = 4 984 912). Nineteen severe chronic somatic disorders from the Charlson Comorbidity Index were assessed. The date of first diagnosis of depression and somatic diseases was identified. Multivariable Cox proportional Hazard models with time‐varying covariates were constructed to assess the risk for all‐cause and non‐suicide deaths for individual somatic diseases. Results: For all somatic diseases, prior and/or subsequent depression conferred a significantly higher mortality risk. Prior depression was significantly associated with a higher mortality risk when compared to subsequent depression for 13 of the 19 somatic diseases assessed, with the largest difference observed for moderate/severe liver disease (HR = 2.08; 95% CI = 1.79–2.44), followed by metastatic solid tumor (HR = 1.48; 95% CI = 1.39–1.58), and myocardial infarction (HR = 1.40; 95% CI = 1.34–1.49). Conclusion: A particularly high mortality risk was observed in the presence of prior depression for most somatic diseases. Future studies that assess the underlying mechanisms are necessary to adequately address the excessive mortality associated with comorbid depression. [ABSTRACT FROM AUTHOR]

The article tells about periodontal diseases, etiopathogenetic factors for their onset and development, relationship with somatic diseases, and identifies the main ways, methods and types of prevention.

In original article results of the first similar in Russia pilot epidemiological study of androgen deficiency’ prevalence at men with the most frequent and socially-significant somatic pathology at their primary reference of various profile doctors-experts of a primary ambulance link of public health services are presented (Yaroslavl Study). 670 men at the age from 18 till 60 years have taken part in the study at which screening estimation of androgen status on the basis of a questionnaire of Morley and unitary laboratory definition of common testosterone blood level has been executed. Results of study have shown that in ambulance patients stage of rendering of specialised medical aid on the average at 32.8 % of men possible to reveal possible clinical and laboratory criteria of androgen deficiency. However, accurate correlations between possible clinical symptoms of androgen deficiency and common testosterone blood level were didn’t revealed, therefore it is necessary to consider results both clinical, and laboratory inspection for androgen deficiency’ diagnosis statement. Frequency of possible clinical symptoms of androgen deficiency has appeared the greatest at endocrinologist’s patients (49.2 %), further with a small separation went patientsof urologist (45.3 %) and therapist (26.7 %). Among patients of cardiologist not less than 22.7 % of men have possible clinical symptoms of androgen deficiency, and among patients of neurologist – not less than 19.0 %. Laboratory researches have revealed diagnostics low common testosterone blood level at 38.3 % of endocrinologist’s patients, at 50.0 % of patients of urologist, at 45.3 % of patients of therapist, at 46.7 % of patients of cardiologist and at 14.0 % of patients of neurologist. Thus, the conducted pilot epidemiological study has shown high frequency of androgen deficiency among ambulance patients of doctors of various specialities that does the given disease by a socially-significant and interdisciplinary problem of modern medicine.

The objectives of the study were to investigate the associations between night work and disability pension (DP) due to all causes, cardiovascular (CVD), mental, and other diagnoses, adjusting for familial confounding. The material of the study included comprehensive survey data on 27 165 Swedish twins born in 1935–1958 that were linked with DP data for the survey period (1998–2003) to 2013. Night work was assessed as years of working nights at least every now and then, and categorized into not at all, 1–10 years and over 10 years. For statistical analyses, Cox proportional hazards regressions were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). The results of the study indicated that over 10 years duration of night work had an age- and sex-adjusted HR of 1.48 (95% CI 1.11–1.98) for DP due to CVD and 1–10 years of night work an HR of 1.28 (95% CI 1.06–1.55) for DP due to mental diagnoses, but attenuated when covariates were adjusted for. Both 1–10 years (HR 1.27, 95% CI 1.17–1.39) and >10 years of night work (HR 1.20, 95% CI 1.08–1.34) were associated with DP due to all causes and other diagnoses. These risks remained after adjusting for covariates. To conclude, even modest exposure in terms of duration of night work is a risk factor for all-cause DP, but also for DP due to mental and other diagnoses. The risk of DP due to CVD seems to be associated with longer (>10 years) periods of night work. All the associations between night work and DP seem to be influenced by various covariates. [ABSTRACT FROM PUBLISHER]