Psychiatria polska最新文献

Objectives: The aim of the study was to create a Polish adaptation of the Highly Sensitive Person Scale (HSPS), assess its psychometric properties and conduct factor analysis in a group of adults.

Methods: Five hundred two students of the Poznan University of Medical Sciences, aged 19-40 were studied, assessed by the 27-item HSPS, Beck Depression Inventory (BDI) and NEO-FFI Questionnaire. Exploratory and confirmatory factor analysis was performed in two subgroups (N = 250 and N = 252, respectively).

Results: The Polish version was accepted by the authors of the scale. Cronbach's α was 0.90 and the ICC interclass correlation coefficient was 0.95 for retest data. Exploratory factor analysis distinguished a three-factor model of the HSPS scale (EOE, LST and AES factors), and confirmatory analysis confirmed its better fit. The HSPS scale, EOE and LST showed a significant relationship with the BDI and "Neuroticism" and a negative relationship with "Extraversion", while the AES factor was strongly related to "Openness". Women scored higher on all HSPS subscales, HSPS total score and "Conscientiousness".

Conclusions: The Polish version of the HSPS scale is characterized by good reliability, consistency and validity, and the results indicate a three-factor model. We recommend the use of the HSPS scale in Polish conditions by mental health professionals.

Objectives: The study's aim was to determine co-occurrence of psychopathological symptoms and personality predispositions in post-traumatic stress disorder (PTSD) and its dimensions several months after hospitalisation of patients with severe COVID-19 during the 2nd and 3rd waves of the epidemic.

Methods: At 7-8 months after admission, 138 patients completed the PCL-5 and TIPI questionnaires, as well as the HADS and AIS scales. Correlation analysis and stepwise multiple regression analysis were used in the models.

Results: 22.5% of patients met the PTSD criteria. There were no significant differences between women and men in terms of severity of anxiety, depression, sleep disorders, distress and PTSD. Anxiety, sleep disorders and depression co-occurred with PTSD severity. All dimensions of PTSD were associated with anxiety. Intrusion, changes in arousal and reactivity correlated with sleep disorders. Changes in arousal and reactivity were explained by subjective assessment of distress. Negative changes in cognition and mood were related to depression and low levels of extraversion.

Conclusions: There is a co-occurrence of the severity of psychopathological symptoms: anxiety, depression, distress and sleep disorders with the severity of PTDS and its dimensions among patients who have undergone severe COVID-19 in the recent past. A protective factor against post-hospitalisation PTSD is higher level of extraversion.

Objectives: The subject of the study was to assess the therapeutic value of the author's health education programme developed for a group of patients of forensic psychiatry wards conducted in a group of patients long-term isolated from their natural environment. The main goal of the study was to answer the question of whether health education conducted in forensic psychiatry wards is effective and what value it represents in the process of treatment and rehabilitation of patients in forensic psychiatry wards.

Methods: The study was conducted at the State Hospital for the Nervous and Mentally Ill in Rybnik in the forensic psychiatry wards from December 2019 to May 2020. During the study, patients gained knowledge in the field of broad health education. The study group consisted of 67 men between the ages of 22 and 73 with a diagnosis of schizophrenia. The method of measuring twice (before the health education cycle and after its completion) was applied using a proprietary questionnaire of patients' knowledge from the applied educational programme.

Results: After the implementation of the health education programme, there was a significant improvement in patients' knowledge.

Conclusions: Educational activities carried out among patients of forensic psychiatry departments effectively increase their knowledge level.

The paper explores the development of psychotherapy in Polish psychiatry in the interwar period from the perspective of Kurt Danziger's historical psychology. Firstly, the organizational and social context of the development of Polish psychiatric care in the interwar period and its impact on the development of psychotherapy is outlined. Then, the most influential in Poland, European psychotherapeutic developments in the interwar period are reconstructed. Finally, the views of psychiatric personnel of three psychiatric facilities proposing psychotherapy as one of the main means of treatment of mentally ill patients are introduced: Dziekanka Psychiatric Hospital, the Jewish Hospital in Warsaw and Psychiatry and Neuropathology Clinic of the Jagiellonian University in Krakow. Psychiatric personnel from Dziekanka Psychiatric Hospital, directed by Aleksander Piotrowski, understood psychotherapy broadly, as the influence of the environment on the patient's psyche. Psychiatrists of the Jewish Hospital in Warsaw, Adam Wizel, Gustaw Bychowski, Władysław Matecki, and Maurycy Bornsztajn developed psychoanalytically influenced psychotherapy of schizophrenia. Bychowski also advocated for the application of psychotherapy in such neglected groups of patients as children and the intellectually disabled. Jan Piltz and Eugeniusz Artwiński pursued psychotherapy in the treatment of war neuroses at the Psychiatry and Neuropathology Clinic of the Jagiellonian University.

This article is a review of research on savant syndrome from years 2000-2022 - available in PubMed, ResearchGate and Google Scholar databases. Savant syndrome occurs with a frequency of 1.4 per 1,000 people with intellectual disabilities and in 10% of people with a diagnosis of autism spectrum disorders. Autism is the disorder that most often co-occurs with savant syndrome - in about 50% of all people with a savant syndrome diagnosis. Researchers distinguish between: congenital savant syndrome - which affects about 90% of people with the syndrome, and acquired savant syndrome - which occurs in the course of frontotemporal dementia or in people who have experienced trauma to the central nervous system. There are many cognitive theories that explain savant abilities. The anatomical basis of this entity has not been discovered using neuroimaging techniques. To date, no unified theory has been created that reliably explains the etiology and pathomechanism of savant syndrome. Previous neuroimaging studies of people with symptoms of savant syndrome have been conducted on too few subjects. There are indications that magnetic brain stimulation may contribute to a better understanding of the neurophysiological basis of this syndrome.

Aim: The aim of the study was to review the existing research, conducted on animal and human models, regarding the possibility of using low doses of naltrexone (LDN) in treatment of non-suicidal self-injury (NSSI).

Method: The available Polish - and English-language literature on NSSI was reviewed. Relevant studies were identified through an electronic search of PubMed/MEDLINE and Google Scholar databases using the following keywords: non-suicidal self-injury, NSSI, naltrexone, LDN, self-injury, self-harm, and time descriptors 1982-2022. The review was based on information reported in original papers, review articles and case reports. The quality of the article was assessed using the six-point Scale for the Assessment of Narrative Review Articles (SANRA).

Results: Studies conducted on animal models show that use of LDN can prevent habitual self-injury. As far as the possibility of clinical use of LDN in treatment of NSSI is concerned, results of a relatively small number of studies conducted so far confirm the efficacy of using naltrexone 25-50 mg/day to decrease or eliminate self-injurious behaviors in NSSI patients.

Conclusions: The use of LDN in treatment of NSSI seems to be a promising clinical option, whose efficacy, however, needs to be corroborated in a larger number of randomized placebo-controlled clinical trials.

The paper further explores the development of psychotherapy in Polish psychiatry in the interwar period. Jaroszyński attempted to sketch out the idea of "emotional psychotherapy". Stryjeński organized a counseling clinic for the mentally ill, using psychotherapy as one of the means of treatment. Bilikiewicz developed oneiroanalysis - a psychotherapeutic method of dream analysis based on modifications of psychoanalysis. Gottliebowa advocated for the use of psychoanalytically influenced psychotherapy in the gynaecologist practice. Markuszewicz considered psychoanalysis the only psychotherapeutic modality aimed at unearthing the real causes of mental illnesses. Henryk Higier proposed to consider psychoanalysis practically as a method of psychotherapy and saw its heterogeneity as its advantage. Critical views on psychoanalysis as a psychotherapeutic method were delivered by Wirszubski and Mikulski. In general, psychotherapy in Polish psychiatry of the interwar period was highly influenced by psychoanalysis. Moreover, the understanding and practice of psychotherapy in public psychiatric facilities differed from that in private practice. In public psychiatric facilities, it was used mainly to deal with psychoses, so it urged clinicians to modify the classic psychoanalytic approach. In private practice, psychiatrists were dealing mainly with cases of neuroses and therefore could apply standard psychoanalytic procedures. Methods of suggestion, persuasion and hypnosis, characteristic of nineteenth-century psychotherapy, were still in use in Polish psychiatry of the interwar period. The main obstacles to the development of Polish psychotherapy in the interwar period were antisemitic attitudes contributing to hostility towards psychoanalysis, as well as the biological orientation of the majority of the Polish psychiatric society.

Delirium is a disorder of consciousness and it is caused by acute brain disfunction in the course of, e.g., severe somatic condition, intoxication or withdrawal syndrome. Delirium management is based on the treatment of the state that caused disturbance in central nervous system. Severe delirium syndromes such as agitation, disorganized behavior or hallucinations require additional pharmacological treatment with antypsychotics. Aripiprazole is used in treatment of schizophrenia, bipolar disorder and Tourette syndrome, but also off-label in delirium. A systematic review of databases was carried out and results were limited to case reports, clinical trials and randomized controlled trials. There is evidence that there is no difference in effectiveness of aripiprazole compared to haloperidol and other atypical neuroleptics. Aripirazole could be a better option in particular groups of patients due to its safer cardiological and metabolic profile as well as better tolerance of treatment. However, data from clinical findings are still insufficient to recommend a routine use of aripiprazole in the treatment of delirium. Therefore, further investigations are necessary to work out new strategy of managing delirium syndrome.

The article presents the provisions currently in force in Polish legislation regarding legal termination of pregnancy. In particular, it refers to the premise of a psychiatrist's decision that the health of a pregnant woman is at risk. Under Polish law, termination of pregnancy is generally prohibited and penalized. However, there are two exceptions to this prohibition. Such a procedure is permitted if: the pregnancy poses a threat to the life or health of the pregnant woman, or if there is a reasonable suspicion that the pregnancy was the result of a prohibited act. The text presents an overview of the relevant regulations and tips on their interpretation and application in everyday medical practice. This issue is particularly important for psychiatrists consulting maternity wards. In addition, the most important mental disorders related to pregnancy and childbirth are described. The clinical features and prevalence of perinatal mood disorders and psychoses are presented. The issue of suicide among pregnant and postpartum patients was also discussed. A sample certificate template was proposed, and guidelines were discussed as to what information and conclusions should be included in the opinion of a psychiatrist.

Aaron T. Beck's cognitive model of depression became the basis for the analysis of cognitive factors as significant correlates and predictors of depression. Psychological mechanisms of depression related to the depressive cognitive triad, the specificity of cognitive schemas and errors in cognitive processing determined the directions of further research on depression. The presented analysis of selected studies confirms and extends Beck's assumptions about the role of cognitive factors in the development and maintenance of depressive symptoms. The analysis of psychological, neuroimaging and biochemical studies provides a broader perspective of understanding both the etiology and mechanisms that sustain the symptoms of depression. The development of neuroimaging research has broadened the knowledge about the brain mechanisms of depression - the presented research combine the theoretical constructs of the cognitive concept of depression with the characteristics of the activity of brain structures and their functional connections. The following conclusions seem to be particularly important for clinical practice: 1) impairment of the cognitive inhibition function in depression reduces the control of negative automatic thoughts - strengthening working memory is important; 2) different brain mechanisms for processing rewards and punishments in people suffering from depression and in healthy people explain the formation of self-esteem - this knowledge can be an important element of psychoeducation in therapeutic work; 3) neuroimaging studies indicate neuronal correlates of cognitive distortions observed in depression - for further research on depression, it would be particularly important to monitor changes in brain activity in the course of its treatment.