Stefanovski, Branislav

Preferred name

Official Name

Stefanovski, Branislav

Main Affiliation

branislav.stefanovski@medf.ukim.edu.mk

Now showing 1 - 6 of 6

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Depression Intensity in Patients with Schizophrenia
(ID Design 2012, 2011)
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Background: Depressive symptoms are common in schizophrenia and they can occur during any phase of the disorder. Previous studies indicate that depression in schizophrenic patients is generally with mild or moderate intensity. Aim: We undertook this study with the aim of evaluation of the presence and intensity of the depressive symptoms in patients with schizophrenia. Material and Methods: The examined group consisted of 50 patients with schizophrenic disorder, both inpatients and outpatients treated at the University Clinic of Psychiatry, who had prominent depressive symptoms (total score >7 on 17-item Hamilton Depression Rating Scale). The control group consisted of 50 patients with depressive disorder. Differential diagnosis was established on the basis of ICD-10 diagnostic criteria. Patients were evaluated with PANSS, 17-item Hamilton Depression Rating Scale (HAMD) and a questionnaire for demographic and clinical data. Results: The percentage of patients with depressive symptoms among the patients with schizophrenic disorder was 54 %. Schizophrenic patients more frequently presented mild and moderate depression in comparison to the control group in which moderate and severe depression were more frequent. Conclusion: Patients with schizophrenia more frequently present mild and moderate depression.
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Depression and Anxiety in Adolescents and their Caregivers: A Cross-Sectional Study from North Macedonia
(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/Walter de Gruyter GmbH/Walter de Gruyter GmbH, 2023-03-01)
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Kunovski, Ivo
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Bolinski, Felix
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Introduction: Mental health problems have increased internationally during the COVID-19 pandemic. Adolescents and their caregivers form a vulnerable group for the development of mental health problems. However, most data stems from high-income countries, and there is a clear lack of prevalence rates and potential risk factors from Balkan countries. No data is available on the impact of the COVID-19 pandemic on mental health in adolescents and their caregivers in North Macedonia. Materials and methods: A cross-sectional study was conducted on adolescents and their caregivers in a school setting in rural and urban areas of North Macedonia. Survey items assessed symptoms of depression, anxiety, and respondents' fear of COVID-19, as well as a number of risk factors, such as gender and living environment. Results: 506 adolescents and 492 caregivers completed the survey. Symptoms of depression and anxiety were mild to moderate in adolescents and their caregivers. Women and girls generally scored higher than men and boys, and adolescents in high school scored higher than those in elementary school. Prevalence rates for depression were 29.2% for adolescents and 10.4% for caregivers, while rates of anxiety were 23.7% for adolescents and 6.1% for caregivers. Conclusion: This study provides a first insight into the mental health of adolescents and their caregivers after the COVID-19 pandemic in North Macedonia. Further research is required to investigate the relatively low rates of caregivers' mental health problems compared to data from other countries.
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Patient Satisfaction with Use of Telemedicine in University Clinic of Psychiatry: Skopje, North Macedonia During COVID-19 Pandemic
(Mary Ann Liebert Inc, 2021-04)
Haxhihamza, Kadri
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Kalpak, Gjorgji
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Background: There is increasing interest in the use of telemedicine as a means of health care delivery especially in circumstances of pandemics. This is partly because technological advances have made the equipment less expensive and simpler to use and partly because increasing health care costs and patient expectations have increased the need to find alternative modes of health care delivery. Introduction: Telemedicine and telepsychiatry, in particular, are rapidly becoming important delivery approaches to providing clinical care and information to patients in cases wherein the medical resources and the patients are very hard to be brought together with respect to rules of behavior in case of epidemics. The reliance on technology to bridge the obstacles between the patients (consumers) and medical resources (providers) can create problems that impact service delivery and outcomes, but in cases such as this (COVID-19 pandemics), this is virtually the only tool for providing clinical care and information to patients. Materials and Methods: A client satisfaction survey was undertaken in a daily hospital (a part of University Clinic of Psychiatry in Skopje). The anonymous modified self-report questionnaire (short form patient satisfaction questionnaire [PSQ-18]) covering demographic, gender, and age variables was endorsed by 28 participants. The mean age of the subjects was 40.25 ± 22 years, with a small majority of men (18 participants) versus women (11 participants). Results: Overall satisfaction with psychiatric care was high (80.22%). None of the demographic or other variables correlated significantly with satisfaction. Discussion: We had to reduce rate and time length of our face-to-face contacts with patients as a result of pandemics but they were able to reach their doctors virtually at all times. Conclusions: Many mental health professionals are using widely available, commercial software downloaded from the internet to provide care directly to a patient's home.
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Comorbidity in hospitalized patients with schizophrenia
(Elsevier, 2018-03)
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Introduction.– There is an insufficient awareness of comorbidity in schizophrenia on the part of patients, caregivers, health care providers, and researchers. Comorbidity has often been underrecognized and underdiagnosed in psychiatric patients, especially among those with schizophrenia. Objective.– The aim of this study is to analyze comorbidity in hospitalized patients with schizophrenia. Methods.– Medical charts of 96 inpatients with schizophrenia (42 male and 54 female, aged 19-65) were retrospectively analysed in terms of comorbidity. Results.– Comorbid substance abuse was found in 17 patients, 7 patients had personality disorders, while 34 had anxiety disorders. Conclusions.– Comorbid substance abuse leads to poorer medication compliance, higher rates of rehospitalization, poorer adjustment and treatment response in schizophrenia patients. Increased likelihood of violent behaviour and greater use of emergency services are also associated with substance abuse in schizophrenia. Comorbidity has negative impact on treatment outcome in schizophrenia patients which affects the prospects of discharge in this patients and their quality of life Disclosure of interest.– The authors have not supplied their declaration of competing interest.
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Pharmacotherapy of agitation in dementia
(Macedonian Psychiatric Association, 2019)
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Snezana Pejkovska-Dimovska
Although we tend to focus on the cognitive issues ,the behavior of individuals with dementia is often the main problem that leads to institutionalization. Clinical guidelines recommend nonpharmacological approaches as the first choice in the treatment of behavioral and psychological symptoms [1]. Acetylcholinesterase inhibitors (AChEI) are the first-line pharmacological option ,but challenging risky behaviors may persist despite their use. Antipsychotics are indicated in such cases, but there is very limited evidence to support the efficacy and safety of these medications for managing agitation in dementia[2]. Antipsychotics are prescribed most often for this indication and, at the same time, are related to the highest risk of adverse effects and increased mortality. Compared with the common population, lower doses should be used and titrated gradually. When choosing the medication, pharmacokinetic and pharmacodynamic interaction with AChEI and memantine used by majority of patients with dementia should be considered [3][4].
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Globulin levels in acute and chronic psychotic patients
(Morressier, 2019-07-11)
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Pejkovska Dimovska, S
Background : A number of studies suggest that psychiatric symptoms, particularly at early stages of the illness, may be alleviated by targeting affected peripheral pathways such as the immune/inflammatory system. [1] [2] Objective: To analyze globulin levels in acute and chronic psychotic patients. Materials and methods: To 141 hospitalized patients (92 male and 49 female, 94 diagnosed with acute psychotic disorder (F20.0,F21,F23,F25), 47 diagnosed with chronic psychotic disorder (F20.5) according to ICD-10 criteria in Psychiatric Hospital Skopje, Macedonia, globulin test was performed [3]. All patients were aged 18-62 years (mean age, 40 years). Reference range for calculated globulin (CG) was from 27 to 35g/L. Comparative data analysis was applied. Results: From 94 acute psychotic patients (61 male and 33 female), 60 patients (37 male and 23 female) or 63,8% had low CG. In chronic psychotic group, from 47 patients (31 male and 16 female), 18 patients ( 11 male and 7 female) or 38,3% had high CG There were no patients with high CG in acute psychotic group and no patients with low CG in chronic psychotic group. Conclusions: Some findings suggest that innate immunity may be depressed early in the course of a psychotic illness and elevated later in the schizophrenia disease process [4]. While there have been significant advances in our understanding of basic neuroscience over the years, this has not translated into psychiatric clinical practice.

Stefanovski, Branislav

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