Psychiatria polska最新文献

Objectives: Clinical effects observed in cases of oxytocin deficiency can also manifest themselves in disorders of mechanisms responsible, for example, for its secretion. For oxytocin, this function is played by - among others - the cluster of differentiation antigen 38 (CD38). Existing literature along with the correlation between protein CD38 and oxytocin secretion raise interest in the context of their possible relation to the clinical picture and development of the autism spectrum disorders (ASD). The aim of the study was to analyze the correlations between polymorphisms rs3796863 and rs6449197 in gene CD38, the level of gene expression and the clinical picture and the risk of ASD diagnosis.

Methods: The study included 59 individuals with the mean age of 15.05 years with IQ > 90. The participants were divided into two groups: the studied group consisting of 37 persons with confirmed ASD diagnoses and the control group including 22 neurotypical individuals. Diagnosis verification was carried out via the ADOS-2 protocol.

Results: The comparative analysis with the standardized population based on the 1000Genomes database with the presence of clinically significant intensification of ASD traits showed the correlation of alleles "T" of polymorphisms rs3796863 and rs6449197, which are more frequent in the general population and are treated as "wild". In the inter-group analysis, this type of dependency was weaker, and the genotype of the control group was somehow intermediate between the studied group and the standardized population. In the ΔΔCt analysis, the normalized value of the relative expression level of gene CD38 showed that in the studied group the expression level was around 1.1-1.2 times higher than in the control group.

Conclusions: The obtained results show that a significant correlation with the severity of autism spectrum disorder traits is mainly observed in the carriers of wild variants of the studied polymorphisms, in which the related increase in the expression level of gene CD38 is also observed.

During qualification for mechanical circulatory support, the comprehensive assessment of a patient's mental state is an integral element of the overall medical evaluation. It encompasses a range of psychosocial issues, and as such provides information helpful in the selection of a suitable candidate for the required treatment, and sometimes identifies contraindications to it. It allows ensuring that the patient meets expectations regarding both mental health stability and adherence to medical recommendations. It is also helpful in an early detection and diagnosis of mental problems before the surgery, which can increase the possibility of implementation of appropriate treatment and intervention. Due to the lack of generally accepted guidelines, this assessment can be subjective to some extent, especially if it takes place outside experienced transplant centres. This article presents the core principles of mental status evaluation and psychosocial factors increasing the risk of poor prognosis in this group. The article aims to share with psychiatrists and psychologists the clinical experience and comprehensive knowledge about psychosocial eligibility criteria for mechanical circulatory support or heart transplantation.

In 2024, we observe the fortieth anniversary of the publication, where, for the first time, the term of Seasonal Affective Disorder (SAD) was used. Presently, SAD is regarded as a special category of mood disorder. In the American Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V), the seasonality makes a specifier, "with seasonal pattern", both for recurrent depression or Major Depressive Disorder (MDD), and for Bipolar Disorder (BD). The most spectacular phenomenon among SAD is winter depression. Its symptomatology is mostly similar to atypical depression, characterized by excessive sleepiness and carbohydrate craving. SAD can pertain up to one fifth of persons with MDD or BD and is more frequent in women. SAD can be considered as an extreme expression of the central nervous system (CNS) changes related to circannual rhythm of lighting. The seasonal changes of the CNS function apply to the secretion of melatonin, the neurotransmitters dopamine and serotonin and the hypothalamic-pituitary-adrenal axis. In the circadian and circannual processes, a significant role is played by so-called "clock genes". SAD may be a legacy of Homo neanderthalensis. In winter depression, the therapeutic effect is obtained by an exposition to bright light (bright light therapy - BLT) as well as to blue light or using the method of dawn simulation. The therapeutic effect of phototherapy has also been ascertained in non-seasonal depression. As a counterpoint to this mechanism, promising trials have been undertaken in manic states by light restriction using blue light blocking glasses.

Health information provided by patients in the doctor's office belongs to the sphere of their private life. Medical confidentiality is intended to prevent unwarranted interference with the content of this information, both by state authorities and private entities. Thus, it is an instrument to protect the individual's constitutional right to privacy and, at the same time, guarantee an effective diagnostic and therapeutic process. For these reasons, access to the information covered by medical secrecy should be exceptional, especially since this data is highly sensitive in nature. This is especially true of psychiatric confidentiality. Contrary to these seemingly obvious assumptions, the Polish legislator introduces into the legal system further legal solutions that seriously interfere in the sphere of information about an individual's health. This makes medical (psychiatric) secrecy an institution of illusory nature and violates the patient's constitutional right to privacy. It also negatively affects the effectiveness of the diagnostic and therapeutic process. The latter requires complete trust in the doctor-patient relationship and, thus, full confidentiality. The article discusses the ratio legis of medical secrecy, the interrelation of psychiatric and medical secrecy, and the prerequisites for abrogating these secrets. It then discusses the relationship between medical confidentiality and other legal duties incumbent on physicians. Against the backdrop of these considerations, legal solutions that reflect the tendency to weaken the legal protection of medical confidentiality and thus pose a real threat to the information covered by it, were analyzed. Słowa klucze.

Eating disorders are a considerable and prevalent problem among adolescents. Due to their significant adverse health consequences, it is of key importance to examine available treatment options and their effects. Despite the shared criteria for eating disorders in adolescents and adults, the diagnostic and therapeutic processes in the former require distinct specialist interventions, including the entire family environment. Available research suggests that family-based treatment (FBT) and enhanced cognitive behavioural therapy (CBT-E) are particularly beneficial in the management of eating disorders and prevention of relapse in young patients. Since clinical perfectionism is postulated to be an important mechanism underlying the development and maintenance of eating disorders, its consideration in therapy may contribute to faster and long-term recovery. This article presents available evidence on the effectiveness of psychosocial interventions in adolescents with eating disorders and clinical perfectionism, with a particular focus on differences in the use of CBT-E and FBT. The presented knowledge may facilitate clinical decisions concerning selection of the most effective methods and forms of intervention adapted to case conceptualisation in adolescents with eating disorders.

Objectives: The aim of the study was to analyze the relationship between personality disorders according to the new ICD-11 dimensional approach and attachment. To do so, we examined ten models of attachment and employed seven questionnaires.

Methods: The study was conducted online and involved a non-clinical group of N = 391 (68% women, 30% men, and 2% - people who marked the "gender - other" category, aged 16-65 yeas; M = 24.91; SD = 7.8). Attachment was measured using seven questionnaires, and the Polish adaptation of the PiCD Questionnaire was used to measure personality disorders according to ICD-11.

Results: The regression analysis revealed a consistent picture of the relationship between insecure attachment (regardless of model) and personality disorders. "Negative Affectivity" and "Disinhibition" are associated with Anxious attachment, while "Detachment" and "Dissociality" with Avoidant attachment. "Anankastia" showed only a sporadic association with attachment.

Conclusions: Attachment (according to theoretical models formed in childhood) is significantly related to personality disorders in adults. In the conducted study, a coherent picture of this relationship was obtained thanks to the use of many conceptualizations and operationalizations of attachment.

Objectives: The aim of the current study was to determine the levels of stress, resilience and the sense of self-efficacy, as well as the influence of resilience and the sense of self-efficacy in shaping stress levels, in a sample of women from various countries of origin.

Methods: The study was carried out on a sample of Ukrainian (N = 82), Polish (N = 102), Slovak (N = 79), and Romanian (N = 42) women using the Sense of Stress Questionnaire, the General Self-Efficacy Scale and the Brief Resilience Scale.

Results: Highest total stress levels were found among Ukrainian women, while the lowest were found among Polish women. Simultaneously, Ukrainian women reported the lowest resilience and sense of self-efficacy levels, while the highest levels of these variables were reported by Slovak and Polish women, respectively. There were also observable countrydependent differences in the moderating effect of the sense of self-efficacy on the relationship between resilience and stress.

Conclusions: The current study fills the gap on the topic of women's stress during the Russian invasion of Ukraine. This conflict necessitates further studies on women from Ukraine and from neighbouring countries, together with providing evidence-based support to lower the consequences of experienced stress.

The aim of this paper is to review studies available in scientific databases on the effectiveness of cognitive behavioral therapy programmes for separation anxiety disorder in children. The paper also includes a presentation of a clinical description of therapy for a 12-year-old girl with a diagnosis of separation anxiety according to ICD-10. The most widely researched and sole protocol for working with children with anxiety disorders in Poland, the Coping Cat programme, was used as the basic protocol. Its universality is both an advantage and a challenge, as it becomes necessary to adapt the protocol to work with a specific anxiety disorder. This required the authors of this article to review the scientific databases in search of examples of cognitive-behavioural protocol adaptations for treatment of separation anxiety in children. The case study describes the standard use of the Coping Cat protocol which, at some point, stopped delivering the desired results and needed to be modified based on analysis of the revisited conceptualisation together with the supervisor, which made it possible to achieve most of the assumed goals.

Objectives: The main aim of the study was to assess the incidence of metabolic syndrome and its individual components in patients subject to a confinement measure, treated with antipsychotics in mono - or polytherapy. Additional objectives included the analysis of associations between the occurrence of metabolic syndrome and patients' age, psychiatric diagnosis, overweight or obesity, and the presence of addictions to psychoactive substances.

Methods: The study involved 61 patients of the Department of Forensic Psychiatry, including 9 women and 52 men, subject to a confinement measure from September 2019 to August 2021. All parameters of metabolic syndrome and BMI were measured twice, at the beginning of the stay at the Department and after six months of treatment with atypical antipsychotics. Appropriate statistical comparative analyses were then performed.

Results: There was no relationship between the occurrence of metabolic syndrome and the age of the subjects, medical diagnosis, addiction to psychoactive substances, including smoking. It has not been confirmed that the chronic use of atypical antipsychotics with parallel prophylactic and health-promoting effects in conditions of confinement leads to the development of metabolic syndrome and worsens its symptoms, apart from a marked increase in waist circumference and an increase in BMI.

Conclusions: Systematic measurements of BMI and waist circumference during treatment with atypical antipsychotics may be accurate tools in assessing the risk of metabolic syndrome. Long-term confinement hospitalizations should include psychoeducational interventions aimed at minimizing metabolic complications of pharmacotherapy.

Objectives: The aim of the study was to assess the presence of symptoms of sexuality-related disorders (S-RD) in a group of overweight and obese women and the relationship of these symptoms with maladaptive attitudes and beliefs about food, the severity of anxiety and depressive symptoms, alcohol consumption, difficulties in emotional regulation, and the general quality of life.

Methods: The study group (SG) consisted of 44 overweight/obese women, the control group (CG) consisted of 51 women with normal body weight, all aged 18-40 years. The following were used: Sexological Questionnaire, Eating Attitude Test, Eating Beliefs Questionnaire, Alcohol Use Disorder Identification Test, Hospital Anxiety and Depression Scale, and the Quality of Life Questionnaire.

Results: SG showed more severe S-RD symptoms, including sexual dysfunctions and sexual preferences disorders, as compared to CG. In the SG there were more significant correlations between S-RD and the studied variables, especially in the area of difficulties with emotional regulation. Negative and permissive dietary beliefs were significant for S-RD in SG, while positive beliefs were significant in CG. Additionally, the number of S-RD symptoms predicted the quality of life.

Conclusions: The results indicate a relationship between excessive body weight and greater severity of S-RD symptoms, as well as a relationship between the symptoms of S-RD with clinical variables and with the quality of life. Further research exploring the mechanisms of the observed relationships is necessary.