Lupine Publishers: Lupine Publishers | Selected Methods of Spatial An...

Lupine Publishers: Lupine Publishers | Selected Methods of Spatial An...: Lupine Publishers- Environmental and Soil Science Journal Spatial analysis in GIS Wednesday is based on complex techniques, the r...

Lupine Publishers | Psychiatric and Medical Comorbiditiesinpatients With Bipolar Disorder: A Hospital Based Study

Lupine Publishers  | Scholarly Journal Of Psychology And Behavioral Sciences

 

Abstract

The two most common bipolar disorders are bipolar I disorder and bipolar II disorder. Comorbid psychiatric disorders usually precede the onset of bipolar disorder. Bipolar disorder often coexists with other Axis I and Axis II disorders. Studies have shown that patients with mood disorders have more comorbid medical illnesses. Research has suggested that that there may be underlying biological mechanisms linking mood disorder and many medical illnesses.The current study will determine the psychiatric and medical disorders in a sample of patients with bipolar affective disorder in a general hospital setting.

Aims and Objectivest: study the socio-demographic profile of patients with Bipolar affective disorder, to study the prevalence of psychiatric comorbidities in patients with Bipolar affective disorder and to study the prevalence of medical comorbidities in patients with Bipolar affective disorder.

Methodology: This cross-sectional study was conducted at the department of Psychiatry, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Medical College and hospital, Bemina, Srinagar, Jammu and Kashmir. Psychiatry department at SKIMS-MC is a General Hospital Psychiatry unit.

Results: In the present study the mean age of patients was 34.3 years, Majority of patients were females, married. In this study, obesity/ weight gain (n=52), chronic headache (n=45), hypertension (n=30), elevated serum lipids (n=28), thyroid disorders (n=19), diabetes (n=12), GERD (n=9), CAD (n=4), epilepsy (n=2), COPD (n=2), bronchial Asthma (n=1), Parkinson’s disease (n=1), CKD (n=1) were among the medical comorbidities. In this study the most prevalent psychiatric disorders in patients with BPAD were Substance use disorder (n=32), somatoform disorders (n=18), Generalized anxiety disorder (n=12), obsessive and compulsive disorder (n=11), panic disorder (n=9), simple phobia (n=7), eating disorders (n=5), social phobia (n=4), and PTSD (n=2).

Conclusion: The current study suggested that patient suffering from bipolar affective disorder are at increased risk of developing medical or psychiatric comorbidities. It is very important for the treating physician to be aware of the prevalent medical and psychiatric conditions patients with bipolar affective disorders and knowledge of these comorbidities help in prevention, early detection and treatment of such illnesses as well will improve treatment response and prognosis in bipolar patients itself. Awareness among healthcare professionals about the risks to which patients withaffective disorders are exposed is of great importance, as the medical illnessesare likely to coexist with a mood disorder, which may help to improvediagnostics and management and therefore clinical and social care for patients. Overall, the presence of comorbidities in BPD has negative prognostic implications for psychological health and for medical well-being and longevity. In order to improve quality of life, prognosis and life expectancy for those with these illnesses, it is important that further researches on this topic should be continued.

Keywords: Bipolar Disorder; Psychiatric Comorbidity; Medical Comorbidity; Anxiety Disorders; Substance Abuse

Background

A complex, chronic mood disorder involving repeated episodes of depression and mania/hypomania is referred as Bipolar disorder [1]. The two most common bipolar disorders are bipolar I disorder and bipolar II disorder. The lifetime prevalence of MDD Is around 12.2% to 16.2% [2,3] while as the prevalence of bipolar disorder are significantly lower, ranging from 0.9% to 4.4% [4,5]. In Bipolar disorder I prevalence has been found to range from 0.8% to 3.3% [6,7] while as in Bipolar disorder II prevalence has been estimated at around 0.5% to 1.1% [8] The presence of more than one disorder in a person, for a defined period of time is referred as Comorbidity[9] Comorbidity can be of three main types:[10]

1. Comorbidity of physical and psychiatric disorders, e.g. depression and hyperthyroidism;

2. Comorbidity of related disorders, e.g. anxiety and depression; and

3. Comorbidityof disorders indirectly related, e.g. psychotic depression and substance abuse.

Comorbid psychiatric disorders usually precede the onset of bipolar disorder. Bipolar disorder often coexists with other Axis I and Axis II disordersand studies have found that psychiatric comorbidity in bipolar disorder range from 50% to 70% [11], In a Study with bipolar disorder, 65% patients met DSM-IV criteria for at least 1 comorbid lifetime Axis I disorder, whereas 42% had 2 or more Axis I comorbidities, and 24% had 3 or more [12]. Bipolar patients with psychiatric comorbidity had more mixed features, depressive episodes, and suicide attempts; poorer outcome and treatment compliance [10]. In another study, substance use disorders also follow the onset of bipolar disorder [13]. Sixty percent of premature deaths in those with serious mental illness are as a result of general medical conditions [14]. Studies have shown that patients with mood disorders have more comorbid medical illnesses. Researchhas suggested that that there may be underlying biological mechanisms linking mood disorder and many medical illnesses [15-18].

The current study will determine the psychiatric and medical disorders in a sample of patients with bipolar affective disorder in a general hospital setting.

Aims and Objectives

a) To study the socio-demographic profile of patients with Bipolar affective disorder.

b) To study the prevalence of psychiatric comorbidities in patients with Bipolar affective disorder.

c) To study the prevalence of medical comorbidities in patients with Bipolar affective disorder.

Material and Methods

This cross-sectionalstudy was conducted at the department of Psychiatry, Sher-I-Kashmir Institute of Medical Sciences(SKIMS),Medical College and hospital, Bemina, Srinagar, Jammu and Kashmir. Psychiatry department at SKIMS-MC is a General Hospital Psychiatry unit. The study was approved by institutional ethical committee.

The patients attending the hospital outpatient department giving a voluntary consent were included in the study. The present study was conducted on patients with bipolar affective disorder. The sample comprised 100 patients attending psychiatry OPD diagnosed as Bipolar Affective Disorder using ICD 10 during the period of june 2017 to june 2018 [19]. The diagnosis for the study group was confirmed by M.I.N.I (Mini International Neuropsychiatric Interview) [20]. The following inclusion and exclusion criteria were used in the study.

Inclusion Criteria for patient:

a) Patients should fulfill ICD -10 criteria for Bipolar affective disorder.

b) Age of the patient should be 18 years or above.

c) Illness duration of at least 12 months.

d) Patients who are able to provide informed consent.

Exclusion Criteria for patient:

a) Patients aging below 18 years of age.

b) Patients who are not willing to participate.

c) Patients who had medical or psychiatric illness before the diagnosis of BPAD.

Methodology

Instruments:

a) Demographic profile and clinical data sheet of patients. Intake data of each patient was recorded on a specially designed proforma. This consisted of details about age, sex, marital status, educational status, occupation, socioeconomic status, residence, type of family.

b) International Classification of Mental and Behavioral Disorders (ICD-10)

[19] Based on the clinical assessment, the diagnosis was made according to ICD-10 clinical descriptions and diagnostic guidelines.

c) Mini-International Neuropsychiatric Interview (M.I.N.I) [20]

The Mini-International Neuropsychiatric Interview (M.I.N.I.) is a short structured diagnostic interview, developed jointly by psychiatrists and clinicians in the United States and Europe, for DSM-IV and ICD-10 psychiatric disorders.

Results

In the present study the mean age of patients was 34.3 years, Majority of patients i.e. 31% (n=31) were from 30-39 years of age group followed by 26% (n=26) of patients in the age group of 20-29 years ,17% (n=17) in ≥ 50 years,14% (n=14) in the age group of 40-49years and 12% (n=12) < 20years. Majority of BPAD patients were females i.e. 53% (n=53) and males were 47% (n= 47). Among 100 patients most of them were married 63% (n=63) and 37% (n= 37) were unmarried with no formal education i.e. 36% (n=36) , 32% (n=32%) had secondary education, 26% (n=26) were graduate and 6% (n=6) had primary education. Majority of the patient in our study belonged to low socioeconomic status i.e.60% (n= 60) and 40% (n=40) belonged to middle socioeconomic status. Most of patients i.e. 86% (n=86) had rural residence and 14% (n=14) had urban residence (Tables 1-5) and (Figure 1).

In 82% (n=82) of patients there was no family history of psychiatric illness and in 18% (n=18) of patients, mental illness in any other family member was present. In present study, 87% (n=87) of patients, no medical illness was present in family member and 13% (n=13) of patients had medical illness present in family In this study, obesity/ weight gain (n=52), chronic headache (n=45), hypertension (n=30), elevated serum lipids (n=28), thyroid disorders (n=19), diabetes (n=12), GERD (n=9), CAD (n=4), epilepsy (n=2), COPD (n=2), bronchial Asthma (n=1), Parkinson’s disease (n=1), CKD (n=1) were among the medical comorbidities. In this study the most prevalent psychiatric disorders in patients with BPAD were Substance use disorder (n=32), somatoform disorders (n=18), Generalized anxiety disorder (n=12), obsessive and compulsive disorder (n=11), panic disorder (n=9), simple phobia (n=7), eating disorders (n=5), social phobia (n=4), and PTSD (n=2).

Discussion

This study examined the Medical and psychiatric comorbidity in patients with Bipolar Disorder. Bipolar disorder (BPD) is highly prevalent disorder by the presence of comorbid conditions and these comorbidities has negative prognostic implications for psychological and medical well-being and longevity.[16,17] Bipolar disorders are associated with psychiatric and medical comorbidities and simultaneous diagnosis and their treatment is equally important [21,22]. Most patients suffering from bipolar disorder met criteria for 3 or more lifetime psychiatric disorders. Patients with bipolar disorder has impairment even during the period of remission due to physical and psychiatric comorbidities and can lead to disability. WHO classification of disability have placed BPD seventh in the disability cause [23-26], The complex mechanisms underlying the comorbidity in Bipolar disorders may suggest that the causal relationships are likely to be bidirectional [27,28].

In our sample the medical conditions associated with bipolar disorder were Obesity/weight gain(52%), Headache (45%), Hypertension (30%), Elevated serum lipids (28%), Thyroid disorders (19%), Diabetes (12%), GERD (9%), Coronary artery disease (4%), Epilepsy and COPD 2% each, Parkinson’s disease, Bronchial Asthma, and chronic kidney disease 1 % each.

Burden of overweight has increased rapidly over the past decades globally. Obesity/Overweight are emerging as an important public health problem in India [29,30]. In India reported prevalence of overweight in range of 1.5%–24.0%in general population and showed rapid increase [31]. In our study the 53% patients showed weight gain which is higher than the prevalence in general population, Patients with Bipolar disorder tend to be overweight and reason could be the treatment of bipolar disorder especially valproate, carbamazepine, Lithium and antipsychotics which may also increase the risk of other comorbid medical disease [32-36].

Another reason for could be the comorbid eating disorder which includes the excessive carbohydrate consumption and low rates of exercise [37,38]. Headache is prevalent in every country affecting both genders and all socioeconomic levels. In general the percentages of the adult population with an active headache is 46% [41,42].

In our study 47% patients were suffering from headaches which is almost similar to the prevalence of general population. The connection between migraines and bipolar disorder is so strong that over one-third of people living with bipolar suffer from migraines [43,44]. Researchers think that there may be a genetic abnormality in serotonin, dopamine and glutamine neurotransmitters that contributes to both migraine headaches and bipolar disorder [45]. Hypertension is an important public health problem in developed and developing nations [46,47].The prevalence of hypertension in general population is 20.9% and in our study 30% patients with BPAD was suffering from hypertension which is higher than the general population [48]. The link between bipolar affective disorder and hypertension depends upon various factors such as Life styles, obesity and psychotropic medicines in particular second-generation antipsychotics are likely to play a role [49-51].

The effect of psychotropic medications and associated weight gain or the complications of treatment with some atypical antipsychotics may lead to diabetes as well as a marked increase of serum lipids [52]. A bipolar disorder and metabolic disorders, such as coronary artery disease and diabetes type 2, have strong genetic links and may share some common pathophysiological pathways [53]. The comorbidity of thyroid disorder in individuals with bipolar disorders has a well-established link. Lithium a mood stabilizer which is a common treatment for bipolar disorder can also lead to thyroid disorders as a common side-effect of the drug [54]. A higher burden of medical illness is indicative of a more severe illness course, with greater impairment in functioning which has been also seen in previously reported findings.The presence of a medical condition increases the risk of developing a mood episode/ disorder and vice versa [49]. Bipolar disorder often coexists with other Axis I disorders.In our study the psychiatric disorders associated with bipolar affective disorders were Substance use disorder (32%), somatoform disorders (18%), Generalized anxiety disorder (12%), obsessive and compulsive disorder (11%), panic disorder (9%), simple phobia (7%8), eating disorders (5%), social phobia (4%), and PTSD (2%).

Psychiatric disorders with bipolar disorder compared to their rates in the general population are higher and can pose a therapeutic challenge as well as a diagnostic dilemma [55]. A careful assessment, accurate history form bipolar patient is a challenge due to overlap between symptoms of BPAD and other psychiatric conditions.

Comorbid Substance use disorder was found to exist in 48- 61% of patients with bipolar affective disorder in some studies [56-58]. The significant indicator for the course of bipolar disorderisdrug abusewith regard to the individual and in relation to family history of drug abuse. Patients with bipolar affective disorder are at higher risk for anxiety disorders including generalized anxiety disorder, simple phobia, social phobia, obsessive-compulsive disorder, posttraumatic stress disorder, and panic disorder [59,60]. Substance use and anxiety disorders are higher in patients with bipolar disorder than in general population, similar results were found in our study [61,62].

Conclusion

The current study suggested that patient suffering from bipolar affective disorder are at increased risk of developing medical or psychiatric comorbidities. It is very important for the treating physician to be aware of the prevalent medical and psychiatric conditions patients with bipolar affective disorders and knowledge of these comorbidities help in prevention, early detection and treatment of such illnesses as well will improve treatment response and prognosis in bipolar patients itself.Awareness among healthcare professionals about the risks to which patients withaffective disorders are exposed is of great importance, as the medical illnessesare likely to coexist with a mood disorder, which may help to improvediagnostics and management and therefore clinical and social carefor patients. Overall, the presence of comorbidities in BPD has negative prognostic implications for psychological health and for medical well-being and longevity. In order to improve quality of life, prognosis and life expectancy for those with these illnesses, it is important that further researches on this topic should be continued.

https://lupinepublishers.com/psychology-behavioral-science-journal/fulltext/psychiatric-and-medical-comorbiditiesinpatients-with-bipolar-disorder-a-hospital-based-study.ID.000136.php

https://lupinepublishers.com/psychology-behavioral-science-journal/pdf/SJPBS.MS.ID.000136.pdf

For more Lupine Publishers Open Access Journals Please visit our website: https://lupinepublishersgroup.com/

For more Psychology And Behavioral Sciences articles Please Click 

Here: https://lupinepublishers.com/psychology-behavioral-science-journal/

To Know more Open Access Publishers Click on Lupine Publishers

Follow on Linkedin : https://www.linkedin.com/company/lupinepublishers

Follow on Twitter   :  https://twitter.com/lupine_online

Lupine Publishers: Lupine Publishers | The Benefits of Sports Medicin...

Lupine Publishers: Lupine Publishers | The Benefits of Sports Medicin...: Lupine Publishers | Journal of Orthopaedics Opinion Physiotherapy and Sports Medicine in a new concept focused not only on...

Lupine Publishers: Lupine Publishers | Utilization of Forecasting Glo...

Lupine Publishers: Lupine Publishers | Utilization of Forecasting Glo...: Lupine Publishers | Journal of Textile and Fashion Designing Editorial Considering the importance of technology and the hu...

Lupine Publishers: Lupine Publishers | Is the salvation of life on th...

Lupine Publishers: Lupine Publishers | Is the salvation of life on th...: Lupine Publishers- Environmental and Soil Science Journal Before the advent of modern industry, nature had tangible additions in...

Lupine Publishers: Lupine Publishers | Evaluation of Host Associated ...

Lupine Publishers: Lupine Publishers | Evaluation of Host Associated ...: Lupine Publishers- Environmental and Soil Science Journal Abstract The water quality of many waterways in the state of ...

Lupine Publishers: Lupine Publishers | Crack and Leakage Detection on...

Lupine Publishers: Lupine Publishers | Crack and Leakage Detection on...: Lupine Publishers- Environmental and Soil Science Journal Abstract In this study, a method of water leakage detection s...

Lupine Publishers | Breast Cancer awareness, knowledge and beliefs among Libyan women

Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences

Abstract

Background: Breast cancer (BC) is the most frequent cancer of women. The high mortality in developing countries is associated with late detection, and lack of knowledge among women and adequate screening programmes.

Objectives: The objectives of this study are assess the current level and determinants of knowledge and beliefs regarding (BC), risk factors and various screening methods among Libyan women.

Methods: A cross-sectional descriptive study carried out between September and October 2016 among a sample of adult women in western Libya. Participants were asked to fill a validated questionnaire to investigate their knowledge about the risk factors as well as their awareness and screening behaviours of (BC). Data were collected from 1091 woman.

Results: The results of the study showed the majority of women participated in the study were aware of BC early warning signs and symptoms with over 90% of the women were able to list at least one symptom of breast cancer correctly. The most frequent warning sign identified was breast lump (91.0 %), followed by discharge from the nipples (80.6%). Also, 565 (52.7%) of those surveyed were aware that increasing age was associated with a higher incidence of breast cancer and 747 (68.3%) of the respondents identified positive family history as a risk factor for breast cancer. Moreover, 62% of female participants know how to perform SBE, and only 59% ever performed BSE. The majority of women in the study (92%) would seek medical advice if they discovered a mass in the breast whereas, about half of those (59%) would consult a male doctor.

Conclusions: Women participated in this study were fairly informed about BC risks and warning signs; the results appear to reflect growing awareness of women regarding BC screening methods. health education message should be presented and delivered in a culturally-sensitive manner and tailored to provide simple and clear information and avoid false beliefs and misconceptions about the disease, its screening methods and management options.

Keywords: Breast cancer; Breast cancer self-examination; awareness; Libya

Introduction

Breast cancer is the most common cancer in women both in the developed and less developed world. It is estimated that worldwide over 508 000 women died in 2011 due to breast cancer. Although breast cancer is thought to be a disease of the developed world, almost 50% of breast cancer cases and 58% of deaths occur in less developed countries [1]. Breast cancer (BC) represents 10% of all cancers diagnosed annually and the second principal cause of cancer deaths in women worldwide [2,3]. The incidence of new cases is expected to rise from 10 million in 2002-15 million by 2025, with 60% of those cases occurring in developing countries. Data from the Arab world have placed breast cancer at the number one position with almost half of cases occurs in women under the age of 50 [4]. In Libya, breast cancer is accounting for more than 25% of all cancer in females with age-standardised mortality rate of 10.9 per 100,000 [5]. Breast cancer survival rates vary greatly worldwide, ranging from 80% or over in North America, Sweden, Japan and Australia to around 60% in Brazil and Slovakia and below 40% in Algeria [6].

The low survival rates in less developed countries can be explained mainly by the lack of early detection programmes, resulting in a high proportion of women presenting with late-stage disease, as well as by the lack of adequate diagnosis and treatment facilities [1]. WHO promotes breast cancer control within the context of comprehensive national cancer control programmes that are integrated to non-communicable diseases and other related problems. Comprehensive cancer control involves prevention, early detection, diagnosis and treatment, rehabilitation and palliative care. Raising general public awareness on the breast cancer problem and the mechanisms to control as well as advocating for appropriate policies and programmes are key strategies of population-based breast cancer control [1].

Screening and early detection is widely recognized as being a principal factor in reducing the mortality from breast cancer [7]. However, previous studies reported that most breast cancer patients present at advanced stages of the disease which emphasise the need for increasing awareness and improved screening programmes including self-examination, clinical breast examination and mammography [8,9]. In 2011, a comparison of the clinic-pathological and epidemiological features of breast cancer in Libya to corresponding data from patients from Nigeria and Finland has reported that approximately 51% of Libyan patients were classified in stages 3 and 4 [10,11]. Also, research has shown poor levels of knowledge towards risk factors awareness and screening methods even among young and educated women [12-18].

Knowledge deficiency may lead to delayed presentation with advanced stages when little or no benefit is derived from any form of therapy. For presentation at an early stage, women must be “breast aware”; they must be capable of identifying symptoms of BC through routine practice of screening [19]. Assessment of the current level of breast cancer awareness and knowledge toward risk factors and screening methods is crucial for the development of awareness campaigns and programmes for women to decrease the burden of the disease and mortality. Therefore, the study will be conducted to assess the current level and determinants of knowledge and beliefs regarding breast cancer, risk factors and various screening methods among Libyan women.

Materials and Methods

A cross-sectional descriptive study carried out between September and October 2016 among a sample of adult women in western Libya. Women participating in the study were interviewed using pre-tested validated questionnaire. The questionnaire included 49 questions pertaining three sections:

I. socio demographic characteristics of women participating in the study;

.

II. knowledge of breast cancer risk factors and warning signs;

III. Knowledge and awareness of women towards breast cancer screening methods knowledge (BSE, CBE, and mammography).

Knowledge Scoring

The questionnaire consisted of 23 items that assessed students’ knowledge related to breast cancer (13 questions related to BC risk factors and 10 questions related to BC warning signs0 and 20 items that assessed students’ knowledge regarding breast cancer screening methods. These questions were then scored; each correct response was scored one (1) point and each wrong or “don’t know” was scored zero (0). A correct response was based on literature and current practice. The knowledge index was calculated for each participant by summing the number of correct answers. The total score of the participants’ knowledge regarding breast cancer is 23 (100%). The knowledge level was categorised as “low” for scores within 0-49%, “moderate” for scores within 50-79% and “high” for scores within 80-100% [20]. These scores were then used to assess the relationship between socio-demographic factors and level of breast cancer knowledge and warning signs.

Statistical Analysis

Data were translated to English and analysed using SPSS version 17 (SPSS Inc., Chicago, IL). Descriptive statistics including means, standard deviation, frequencies, and percentages were obtained for all continues and categorical variables as appropriate. Chi-square test was used to examine the association between the respondents’ socio-demographic variables and knowledge of breast cancer.

Ethical Considerations: Permissions were obtained from the local health directorate and prior orientation of participants was carried out. The data collection tools were anonymous, and data confidentiality was maintained throughout the study.

Results

The mean age of the 1091 women enrolled in the study was 33.2 (SD 9.6; age range: 18-61) years. Most participants (71.8%) were aged less than 40 years and there were 501 (45.8%) single respondents; 463 (42.2) were students; 996 (79.6%) had a university degree and 930 (93.4%) had no family history of breast cancer (Table 1).

Table 1: Socio-demographic Characteristics of the Participants.

Section A of Table 2 shows respondents’ knowledge of risk factors for breast cancer; The women surveyed had a fair knowledge of BC risk factors; 565 (52.7%) of those surveyed were aware that increasing age was associated with a higher incidence of breast cancer and 747 (68.3%) of the respondents identified positive family history as a risk factor for breast cancer. However, only third of the participants answered correctly about the effect of early menarche (31.9%) and late menopause (37.5%). The majority of women participated in the study were aware of BC early warning signs and symptoms with over 90% of the women were able to list at least one symptom of breast cancer correctly. The most frequent warning sign identified was breast lump (91.0 %), followed by discharge from the nipples (80.6%). Only 566 people (52.4%) acknowledged that weight loss could be a warning sign of breast cancer (Table 2).

Table 2: knowledge regarding Breast cancer risk factors and warning signs among study participants.

The results showed that 62% of female participants know how to perform SBE, and only 59%% ever performed BSE. The majority of women in the study (92%) would seek medical advice if they discovered a mass in the breast, whereas, about half of those (59%) would consult a male doctor. Regarding screening methods, women were more familiar with BSE. Only 20% of participants were not aware of BSE, compared to 40% of women who were not aware of ultrasound as a BC screening method. In total, women who didn’t know any screening methods constituted only 4%. While, 45% of women were familiar with the five screening methods [20].

Figure 1: Distribution of breast cancer risk factors and warning signs knowledge scores.

Table 3: Relationship between knowledge scores and demographic variables of the respondents.

Figure 1 shows the distribution of the knowledge scores amongst the respondents. The median score was 15 with 782 (71.5%) of women scoring >50% and 240 (22%) had a good score of o 80% or more. Age of the participants, marital status and their level of education did play a significant role in determining the knowledge attitude, while positive family history of breast cancer in a first degree relative as well as a history of breast problem were not significantly associated with BC knowledge (Table 3). Almost 50% of those with good knowledge score aged between 26-35 years and 75% had a university degree. Whereas only 8% of participants with good knowledge score had a positive family history breast cancer or a previous breast problem.

Discussion

Breast cancer is the most common of all female cancers in Libya [5]. In this study, the knowledge and practice among general population in western Libya was explored. The main findings were that level of awareness of risk factors and early warning signs of BC was moderate, with 71.5 % having good knowledge, also the study showed that 59.2% of women participated in the study perform BSE. The level of knowledge about breast cancer and the screening behaviour is generally poor in Arabic region compared to the developed world [6,10,17]. In the present study, respondents answered correctly that the commonest symptom of breast cancer is a breast mass. Our results are consistent with those of similar studies carried in Saudi Arabia [21,22] and Kuwait [23].

The present study showed that women demonstrated higher knowledge of breast cancer screening and risk factors and were more likely to perform BSE compared to other recent studies in neighbouring countries [24-26]. Similar to previous studies [23,25,27] the most familiar methods was BSE followed by CBE and mammography. As it was expected, satisfactory knowledge scores were more common among younger participants and those with higher educational levels. However, unlike other studies in the region [24-25] and worldwide [28], the anticipated fact that women who had a breast problem or positive family history of BC would have better knowledge scores could not be demonstrated in the present study. The study revealed that about two thirds of the participants shared a misconception that early menarche and late menopause were not risk factors for BC. This finding was supported by a previous study [29].

The results of this study may be influenced by the young age and the relatively high educational level of the surveyed women which may reflect selection bias. A second limitation of the current study is the use of convenience sampling to recruit participants which may limit the generalisability of the findings. Nevertheless, convenience sampling considered a valid data collection method and has been widely used in health education research [30]. In spite of these limitations, the study yielded significant findings that could have implications reorganise the national health education strategy.

Conclusion

women participated in this study were fairly informed about BC risks and warning signs; the results appear to reflect growing awareness of women regarding BC screening methods. However, health education message should be presented and delivered in a culturally-sensitive manner and tailored to provide simple and clear information and avoid false beliefs and misconceptions about the disease, its screening methods and management options.

https://lupinepublishers.com/psychology-behavioral-science-journal/fulltext/breast-cancer-awareness-knowledge-and-beliefs-among-libyan-women.ID.000135.php

https://lupinepublishers.com/psychology-behavioral-science-journal/pdf/SJPBS.MS.ID.000135.pdf

For more Lupine Publishers Open Access Journals Please visit our website: https://lupinepublishersgroup.com/

For more Psychology And Behavioral Science articles Please Click 

Here:https://lupinepublishers.com/psychology-behavioral-science-journal/

To Know more Open Access Publishers Click on Lupine Publishers

Follow on Linkedin : https://www.linkedin.com/company/lupinepublishers

Follow on Twitter   :  https://twitter.com/lupine_online

Lupine Publishers: Lupine Publishers| Waste to Worth - Sludge Contain...

Lupine Publishers: Lupine Publishers| Waste to Worth - Sludge Contain...: Lupine Publishers- Trends in Civil Engineering and its Architecture   Opinion Human activities on earth produce in considerabl...

Lupine Publishers: Lupine Publishers| Waste to Worth - Sludge Contain...

Lupine Publishers: Lupine Publishers| Waste to Worth - Sludge Contain...: Lupine Publishers- Trends in Civil Engineering and its Architecture   Opinion Human activities on earth produce in considerabl...

Lupine Publishers: Lupine Publishers | Domestic Violence Perpetration...

Lupine Publishers: Lupine Publishers | Domestic Violence Perpetration...: Lupine Publishers | Journal of Orthopedics Abstract A face is an index of mind correlation, co-efficient of mind. Domesti...

Lupine Publishers: Lupine Publishers | Fibre Reinforced Composites: M...

Lupine Publishers: Lupine Publishers | Fibre Reinforced Composites: M...: Lupine Publishers | Journal of Textile and Fashion Designing Introduction Today, at the age of developing newer materials, i...

Lupine Publishers | Psychology And Behavioral Sciences

Lupine Publishers | Psycho-Biological Factors of the Formation of Killer Teenagers and Their Prevention

Abstract

The psychobiological factors of the formation of killer teenagers have been investigated. It was established that the neurobiological correlate of aggressive killer organisms is serotonin. Its content in the brain of killer organisms is about 50% lower compared to normal ones. Psychobiological factors of the prevention of killer organisms’ formation, comprising adequate nutrition and physical exercises have been demonstrated.

Keywords: Killer Organisms; Serotonin; Triptophan

Introduction

During last period confrontation between 14-16 years old teenagers resulting in murder, became very frequent. There may be given many examples of tragedies which happened in different countries, when young people have died of multiple wounds. Parents, teachers, representatives of police, school supervisors, psychologists hold active debates by TV-shows and radio transmissions about the necessity to increase vigilance and activity, to conduct additional trainings for supervisors; but nobody asks what is the reason for such cruel behavior among the youth. Several psycho-emotional factors, responsible for the formation of aggressive and killer organisms have been distinguished during our multiyear neurochemical studies [1,2]. These are: 1. the aggressive social surrounding in the family; 2. wrong diet; 3. increased level of sex-hormones (testosterone) in 14-16 years old boy-teenagers; 4. existence of “war” and “murder” genes, caused by chromosomal disorders; and 5. TV transmissions, demonstrating and favoring killing, speculating for the emphatic appreciation of the information by young people.

Since the Italian neurobiologist Giacomo Rizzolatti has discovered mirror neurons in brain, responsible for perception of speech and behavior of surrounding people by a newborn, it becomes clear that if the post natal development of a newborn takes place in an aggressive social surrounding (fight between family members, violence, usage of narcotics, alcohol), the aggressive behavior will be encoded in his genetic apparatus. This information stays in the organism of a person during the whole life and may be revealed in the form of aggressive behavior of a young person [1,2]. Incomplete nutrition is the second factor for murder. We have established that the biogenic amine serotonin is one of the neurobiological correlates for the formation of aggressive and killer organisms. Its deficiency in young organisms may become reason for aggressive behavior and killing [3-8]. Experimentally it was demonstrated that feeding of experimental rats with tryptophanpoor food during 10-12 days, which is the precursor of serotonin, caused decrease of serotonin content for 50% in experimental animals. As a result these organisms turned into killers. If the diet was enriched with tryptophan (100mg), rat-killers turned into peaceful ones, tolerant to frogs and mice. Diversely from normal rats not a single case of murder was mentioned during contact with them. It must be taken into account that in aggressive to animals children content of serotonin, as a rule, is essentially low, as well as in those monkeys, who have lost the leader’s function in their group. Accordingly, the behavior of prestige-lost children must be observed attentively at school [4,5].

For the prevention purposes supplying school buffets with cheeseburgers, prepared of tryptophan-rich Dutch and melted cheese, which is the precursor of serotonin, is desirable. 100 g of Dutch or melted cheese contains 790 and 500 g of tryptophan respectively. This amount of the substance is able to raise thecontent of serotonin in a young organism and essentially decrease his aggressive behavior. It is well known that isolation from the society is one additional powerful factor for the formation of an aggressive person. That’s why the single-child families must take care for social formation of a child with friends in kinder-gardens, to prevent aggression [6].

14-16 years is the crucial age for teenagers and serious changes are mentioned in male hormonal balance at this period. Special experiments were conducted on animals to reveal the relationship between aggression and murder and changes of masculine sexhormones. The experimental rats were castrated. As a result no cases of aggression or killing have been revealed from castrated animals towards mice and frogs. While injection of test animals with testosterone changed the situation in the opposite directioncases of mice and frogs killing by rats became evident. For the prevention the facts of killing the fatigue tests using swimming has been done with experimental rats. The result was interesting: killer rats became again tolerant toward mice and frogs and no case of aggression or murder has been revealed [6,8,9].

Accordingly, our recommendation to school supervisors is to increase the physical activity between-lessons of teenagers for diminishing the content of biologically active compounds in blood, among them of sex-hormones. We hope that the government will try all the best to improve the situation to the direction of aggression elimination and healthy life-style introduction [10,11].

Unfortunately existence of “war” and “murder” genes in sexchromosomes is reality. According to experimental data four groups of aggressive and criminal behavior persons are distinguished:

a) young men with Klinfelter syndrome. They have XXYY set of sex-chromosomes, small testicles, are taller than average; due to mental deficiency it is easy to involve them in criminal.

b) Young males with aberrant XYY or XXYY sex-chromosomes. They are tall, with mental deficiency, are distinguished with aggression and criminal activity.

c) Young men with hereditary disorder of nervous system. They are distinguished with emotional-ethic degradation, epileptic anxiety, dogmatism, schizoid personality and alcoholinduced disorders.

d) 1/4 of the single-egg twins are inclined to criminal activity. These children must be under the permanent observation of psychologists for evaluation of their behavior.

All above mentioned indicates that school psychologist have to know deeply the genetic picture of each school-boy, to forecast their future behavior and prevent possible criminal prevention [3,5,6].

Conclusion

Psycho-social factors of murder formation have been established. It was demonstrated that one of the neural correlates in killer’s brain is serotonin, which content is by 50% lower in brains of aggressive killer organisms. The ways of prevention of aggressive behavior by adequate diet and physical activity is offered

https://lupinepublishers.com/psychology-behavioral-science-journal/fulltext/psycho-biological-factors-of-the-formation-of-killer-teenagers-and-their-prevention.ID.000134.php

https://lupinepublishers.com/psychology-behavioral-science-journal/pdf/SJPBS.MS.ID.000134.pdf

For more Lupine Publishers Open Access Journals Please visit our website: https://lupinepublishersgroup.com/

For more Psychology And Behavioral Sciences articles Please Click 

Here:https://lupinepublishers.com/psychology-behavioral-science-journal/

To Know more Open Access Publishers Click on Lupine Publishers

Follow on Linkedin : https://www.linkedin.com/company/lupinepublishers

Follow on Twitter   :  https://twitter.com/lupine_online