Psychiatria polska最新文献

Objectives: Limited data exist on the relationship between diabetes distress (DD), quality of life, and metabolic control in Polish adolescents with type 1 diabetes mellitus (T1DM) during transition to adult care. This study examines associations among Polish 18-year-olds with T1DM as they transition from pediatric to adult diabetes care.

Methods: This cross-sectional study enrolled 110 consecutive patients aged 18 years with T1DM who completed the Problem Areas in Diabetes (PAID) questionnaire and Short Form Health Survey (SF-36v1). Continuous glucose monitoring (CGM) parameters were used to evaluate metabolic control.

Results: Diabetes distress (DD) correlated with all quality of life scales but not with glycemic control. Women reported higher diabetes-related distress (p = 0.017) and poorer mental health (p = 0.009) than men. Smokers demonstrated worse glycemic parameters (p = 0.016) and poorer mental health (p = 0.008). Unexpectedly, poorer glycemic control was associated with better quality of life. A longer disease duration and an earlier age at onset were associated with worse glycemic control.

Conclusions: Diabetes distress is more closely associated with quality of life than metabolic control in Polish 18-year-olds with T1DM. Females, individuals with longer disease duration, and smokers may benefit from targeted interventions emphasizing both psychological support and diabetes education.

Objectives: Schizophrenia spectrum disorders (SSDs) in children and adolescents are rare but clinically severe conditions. In Poland, evidence regarding diagnostic practices and system-level determinants of pediatric SSD diagnoses remains limited. This study aimed to analyze nationwide trends in first-time inpatient diagnoses of SSDs in youth between 2014 and 2019, with a focus on age distribution, diagnostic coding patterns (F20, F21, F25), and selected indicators of service utilization and reimbursement.

Methods: A retrospective register-based analysis was conducted using national inpatient data from the Polish National Health Fund (NFZ) for the years 2014-2019. The study included 9,034 patients aged 0-17 years who received a first-time diagnosis of SSDs coded as F20, F21, or F25 according to ICD-10. Trends in age at diagnosis, diagnostic category distribution, hospitalization volume, and reimbursement indicators were analyzed descriptively over time.

Results: Between 2014 and 2019, 9,034 inpatients aged 0-17 years received first-time SSD diagnoses. Schizophrenia (F20) overwhelmingly predominated across all age groups, while F21 and F25 were rarely used. A shift toward younger adolescents was observed, with a growing proportion of diagnoses in the 13-14-year-old age group and a gradual decline among patients aged 15-17 years. Hospitalization numbers remained relatively stable, while the volume of reimbursed services declined and total refunds increased, suggesting rising per-case costs despite lower service utilization.

Conclusions: The findings indicate a shift toward earlier diagnostic labeling of schizo- phrenia spectrum disorders in Polish youth and a marked overreliance on the F20 code, suggesting diagnostic oversimplification. These patterns are likely influenced by systemic and reimbursement-related factors and by the limited developmental sensitivity of the ICD-10 classification, particularly in pediatric psychiatry. Comparable coding tendencies and age-distribution shifts have been reported in U.S., German, and Scandinavian register-based studies, indicating that the Polish findings reflect administrative and structural influences on diagnostic practice rather than true epidemiological differences. Adoption of developmentally informed classification principles, such as those embodied in DSM-5, may improve diagnostic accuracy, care planning, and resource allocation in child and adolescent psychiatry.

Objectives: The article is the first part of a study aimed at characterizing speech-language therapy care in mental health care of children. It concerns the areas of research and practice.

Methods: The research has an exploratory character. The secondary qualitative analysis of archive data collected from my SLT practice with preschool age children was used.

Results: Preschool children experience a variety of speech, language and communication disorders associated with mental health problems. SLT needs may result from: mental disorders in various stages of their course, prodromal and subclinical states; psychological traits; family history of mental disorders; environmental conditions; migration; other medical conditions; using pharmacotherapy.

Conclusions: Conducting research on speech and language disorders in psychiatry is necessary, but at the same time difficult, especially in the case of children. Interference of developmental, pathological and environmental factors, mutual overlap of symptoms resulting from various conditions, and co-occurrence of disorders must be taken into account. Moreover, great caution should be exercised in interpreting the results of less advanced studies. The area of SLT research and practice is wide and diverse. It is defined by nosological and functional criteria. Cooperation between psychiatrists, psychologists, psychotherapists, and speech-language therapists is needed, both from a research and practical perspective.

Pregnancy induces significant physiological and anatomical changes in a woman's body, which inevitably impact the sexual life of couples, leading to fluctuations in levels of desire and sexual satisfaction for both women and their partners. Sexual desire in pregnant women significantly decreases during the first trimester, increases during the second trimester, and declines again during the third trimester. Women report the lowest sexual desire during the first trimester, while their partners experience the lowest levels during the third trimester. Many couples completely abstain from sexual activity during the third trimester due to concerns about the baby's health and the potential risk of preterm labor. The main risks associated with sexual activity during pregnancy include the possibility of inducing preterm labor, pelvic inflammatory disease, hemorrhage, and (rarely) air embolism. Studies on the impact of sexual activity during pregnancy on preterm labor induction are contradictory, and evidence regarding other complications remains limited. Various sexual problems, primarily related to pain during intercourse and difficulties in achieving orgasm, appear to be common in pregnant and postpartum women. During the postpartum period, these issues may affect up to 90% of women, with pain during intercourse being the most frequently reported problem. Numerous studies have shown that approximately 20% of pregnant women experience mental health disorders, which also contribute to sexual problems within this group. These findings highlight the need for further research and educational support for expecting couples, which could improve their sexual well-being during pregnancy and after childbirth.

Objectives: Non-heteronormative people experience minority stress, which co-occurs with suicidal thoughts, symptoms of depression, lower self-esteem, and low life satisfaction. The aim of the article is to establish the relationship between minority stress experienced by these people and their psychological well-being, and to determine whether internal dialogues mediate this relationship.

Methods: 130 non-heterosexual people aged 18-46 were studied. In addition to the sociodemographic survey, the Minority Stress Scale (MSS), the Functions of Dialogues - Revised Questionnaire (FUND-R) and the Psychological Well-Being Scale (PWBS) were used.

Results: It was found that psychological well-being correlates negatively with aspects of minority stress - expectation of rejection and hiding, but positively with the level of self-disclosure and satisfaction with self-disclosure. Ruminative dialogues mediate the negative relationships between the expectation of rejection and well-being as well as between hiding and well-being, while self-knowing dialogues mediate positive relationships between the level of disclosure and well-being as well as between satisfaction with disclosure and well-being.

Conclusions: In order to improve the well-being of non-heteronormative patients/clients experiencing minority stress, in psychological or psychiatric practice it is worth reducing their ruminative dialogues and replacing them with self-knowing dialogues.

Objectives: Students have been indicated as an at-risk group for developing poorer psychological responses and decreased well-being during the COVID pandemic. The aim of the study was to observe a trajectory of lifestyle changes and its impact on mental health in longitudinal perspective as well as explore the coping strategies used by students during the pandemic and their possible mediating effect on psychopathological symptoms.

Methods: Data were collected via an online survey addressing behavioral changes that occur during the pandemic, as well as psychopathological and PTSD symptoms. It was conducted among university students at two time-points May and June 2020 as well as June and October 2021 with a pooled total number of participants n=2010.

Results: the studied population of Polish university students has experienced significant behavioral and psychological changes due to the COVID-19 pandemic which remained influential after over a year into the crisis.

Conclusions: Previously drawn conclusions regarding risk factors were confirmed - all of the variables associated with worse mental health in the beginning of the pandemic remained significantly related to higher psychopathology and PTSD symptoms over a year later. Partial mediations between all of the explored coping strategies, behavioral changes and psychopathological symptoms could be established.

Background: Olanzapine is widely used for schizophrenia and bipolar I disorder, yet its role in adolescents remains debated due to metabolic risks.

Objective: To review mechanisms, efficacy, safety, pharmacokinetics, and guideline positions of olanzapine in youth, with comparison to adults.

Methods: Narrative synthesis of randomized trials, open-label studies, meta-analyses, and major guidelines (APA, NICE, Canadian), with focused appraisal of pediatric data.

Results: Olanzapine's multi-receptor antagonism (D₂, 5-HT₂A/2C, H₁, muscarinic, α₁) underpins robust antipsychotic effects. In adolescents, short-term RCTs show significant improvement in PANSS/BPRS-C and YMRS versus placebo; efficacy is broadly comparable to risperidone and aripiprazole. Pharmacokinetics are similar to adults, though exposure is ~27-34% higher in youth. Adverse effects-especially weight gain, dyslipidemia, hyperprolactinemia, and glycemic abnormalities-are more pronounced in adolescents. Guidelines endorse olanzapine as an option for schizophrenia and as first-line for acute mania; OFC is recommended for bipolar depression by most but not NICE. LAI olanzapine is not approved <18 years.

Conclusions: Olanzapine is effective in adolescent psychosis and mania but carries substantial metabolic liability. Given no clear efficacy advantage over other SGAs, it is best positioned as a second-line agent in youth, with preference for monotherapy, cautious dosing, and stringent metabolic monitoring. Evidence for benefits on negative and cognitive symptoms in adolescents remains limited.

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Objectives: The article is the second part of the study aiming to describe the role of a speech-language therapy in protecting mental health of children. It concerns the competences of a speech-language therapist in a specialist team, speech and language assessment, diagnosis, and therapy.

Methods: The research has an exploratory character. The secondary qualitative analysis of archive data collected from my SLT practice with preschool age children was used.

Results: The speech-language therapist's competences include speech, language and communication disorders diagnosis and treatment, as well as preventing these disorders. Skills in responding appropriately to the child's current mental state are essential. The most common disorders in people with mental disorders include language, communication and prosody disorders, as well as psychogenic voice and swallowing disorders. The speech-language diagnosis can contribute to the early detection of mental disorders and can be used in differential diagnosis and in the recognition of unclear mental states. Therapy should be individualized properly organized, programmed, and balanced to meet the actual needs of children. Moreover, therapy has an additional preventive value, because efficient use of language has a positive impact on mental health.

Conclusions: Speech-language therapists play an important role in protecting mental health of children. SLT for children who experience mental health problems has its own specificity. The results of speech-language assessment and diagnosis can be used in the process of diagnosing mental disorders. The positive effects of SLT can significantly improve the quality of life of the child and his family, and contribute to the prevention of mental health problems.

Objectives: The aim of the study was to investigate whether the prevalence of self-declared depressive symptoms among adolescents attending secondary schools in Krakow is associated with increased frequency and type of psychoactive substance use, and whether depressive symptoms, viewed as a categorical or dimensional variable, may be important in detecting risk of psychoactive substance use among adolescents.

Methods: A cross-sectional analysis was performed in a group of 1,515 17-year-old students with the use of the Beck Depression Inventory and an original Stimulants questionnaire.

Results: The analysis of the risk of using psychoactive substances was carried out in relation to independent variables expressed as continuous variables. In the group of boys, each additional point on the Beck scale increased the overall risk of substance use by 3.3%, cigarette smoking by 2.7%, drinking alcohol by 2.7%, and drug use by 4%. In the group of girls, each additional point on the Beck scale increased the risk of substance abuse - overall by 3.7%, cigarette smoking by 3.6%, drinking alcohol by 3.1%, and drug use by 5.9%. Depressive symptoms, approached as a continuous variable, increase the risk of psychoactive substance use in both boys and girls, in particular a strong relationship is observed in the group of girls with low severity of symptoms.

Conclusions: The presence of declared depressive symptoms increases the risk of using psychoactive substances, especially alcohol and tobacco, and to a lesser extent drugs, in both boys and girls. The use of a dimensional approach made it possible to identify the relationship between increasing depressive symptoms and psychoactive substance use in the group of girls regarded as 'healthy' ('with a negative screening diagnosis') in the categorical approach.