Psychiatria polska最新文献

Insomnia is one of the most common health problems in developed countries. Its prevalence increases with age, with up to one in two people over the age of 65 experiencing symptoms of insomnia. The older people are also the patients who mostly commonly are among chronic sleep medication users. The aim of this article is to present the current recommendations for the management of insomnia in people over 65 years of age. The recommendations were prepared as a position of an expert panel, which included people from a number of clinical disciplines: family medicine, cardiology, psychiatry, sleep medicine and clinical psychopharmacology. The first step in treating sleep disorders is to establish proper diagnosis and, if possible, to initiate causal treatment. Moreover, cognitive and behavioural therapy for insomnia should also be used as the primary form of treatment, which can be supplemented, if not sufficiently effective, with pharmacological treatment. The main group of drugs used for treating insomnia are nonbenzodiazepine sedative hypnotics (zolpidem, zopiclone, eszopiclone, zaleplon). However, these drugs do not fully meet the needs of people over 65 years of age, primarily with regard to treatment safety. Therefore other classes of medicines, which are used for treatment of mental disorders, are prescribed off-label in this group of patients. Melatonin in a prolonged-release form is also indicated for this age group due to the high safety of the therapy. The management of insomnia in people over 65 years of age is a challenging task, given the need to seek compromise between treatment efficacy and safety. The treatment plan also has to take into account comorbidities as well as drugs used to treat them.

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Objectives: Current research studies reveal many protective and risk factors for relapse among patients with schizophrenia. The main aim of this study was to make an attempt at identifying the relationship between sense of coherence, self-influence on the disease course and quality of life determined by patients' suffering from schizophrenia current state of health.

Methods: The study involved 50 patients, diagnosed with schizophrenia by the ICD-10 criteria, who were/ were not suffering from relapse in 2-year period from last hospitalization. In order to measure sense of coherence, self-influence on the disease course and quality of life, patients were asked to complete: Sense of Coherence Scale (SOC-29), Brief Measure to Assess Perception of Self-Influence on the Disease Course - Version for Schizophrenia and Sense of the Quality of Life Questionnaire.

Results: Statistical analysis revealed no differences in sense of coherence, perception of self-influence on the disease course and quality of life among patient with relapse or during remission. Nevertheless, the relation between sense of coherence and quality of life was observed in both groups. Patients who were suffering from relapse had their metaphysical (spiritual) quality of life also correlated with perception of self-influence on the disease course.

Conclusions: This pilot study leads to conclusion that sense of coherence - along with its manageability and meaningfulness components - may be closely related to psychophysical, psychosocial and subjective quality of life for patients suffering from schizophrenia, both in long remission and currently experiencing a relapse.

The diagnosis of frontotemporal degeneration changes the entire family, being an unexpected and emotionally burdening experience for all the individuals in the family. Confrontation with problems that are diametrically different from those that occur in the family system without a person with a major neurocognitive disorder requires the development of new coping strategies. If these coping mechanisms are to be useful, they should undergo successive modifications that consider the progression of the neurodegenerative disease and the dynamics of the family system. Providing the information on different aspects of this group of diseases is the basic form of supporting families with frontotemporal degeneration. Growing up in the family with a parent affected by frontotemporal degeneration is a crucial, though non-normative, developmental experience of a child. It results in an irreversible loss of the existing relationship and the necessity to form another relationship with an affected parent. The paper focuses on providing support for a minor. Graphic medicine can be a support tool, which combines verbal communication with graphics, and, as a result, it provides knowledge on health problems and also creates the possibility of expressing emotions triggered by the presence of the disease in the family.

Objectives: Virtual Reality (VR) has been widely used in psychiatry, including psychotic disorders. The main advantage of VR is its high ecological validity and controllability of the virtual environment. Our main goal was to test whether, similarly to computer-generated VR, 360-degree videos are able to elicit a state of social paranoia in prone individuals.

Methods: Sixteen schizophrenia patients and twenty-three healthy individuals were assessed using Leibowitz Social Anxiety Scale and additionally, in the patient group, the Positive and Negative Syndrome Scale (PANSS-6) and Peters Delusional Inventory (PDI) were used. The participants viewed four 360-degree videos with and without social content on a VR headset. Meanwhile, subjects' heart rate was measured continuously. After the exposure, both groups were assessed with Social State Paranoia Scale (SSPS) and asked about momentary anxiety and sense of presence.

Results: The schizophrenia patients reported higher momentary anxiety, although the results of SSPS did not differ significantly between groups. In the control group the heart rate decreased between first non-social and social video, whereas in the patient group it did not differ significantly. There was a significant correlation of paranoid ideation experienced on daily basis (PDI) and elicited in VR (SSPS) in the patient group.

Conclusions: In conclusion, paranoid responses can be triggered in patients with schizophrenia by 360-degree videos.

Functional Disorders are common medical problems both in primary and in secondary health care. The mechanisms that cause symptoms such as primary pain, fatigue, dizziness are still unknown. Various classifications, including ICD-10 or DSM-5, describe these conditions differently, and new proposals are being developed e.g. in ICD-11, RDoC. Many controversies are evoked by lack of unequivocal explanatory theory. The early psychoanalytical concept has been modified by other explanations, such as immunological abnormalities, dysfunction of vegetative system and HPA axis, central sensitization, diverted processes of perception or predictive processes within cognitive homeostasis dysregulation. Insufficient scientific evidence makes therapies unsuccessful and justifies further study. Psychotherapy, pharmacology and complementary medicine are supplemented by new experimental methods of treatment connected with progress in neuroscience. The recently developed non-invasive Transcranial Direct Current Stimulation (tDCS), Transcranial Magnetic Stimulation (TMS) and - neurofeedback (EEG-NF), based on EEG registration, are undergoing tests. Applying complex mathematical algorithms to localized bioelectrical signal sources makes it possible to modulate and reshape connections of neuronal networks within specific cortex areas. This article presents the current state of knowledge concerning functional disorders, highlighting the ways in which different definitions of FD have an impact on approaches to treatment.

Many people are interested in BDSM practices. Some people practice and others fantasize about participating in these practices. Several elements are related to BDSM practices that are usually unaccepted in a close relationship, such as a strong dependence of one partner on the other or inflicting pain. BDSM practitioners create various relationships, and in a broader context, their communities. From a clinical perspective, an important issue is whether BDSM relation is consensual and serves the personal and relationship development or it can be a premise for the diagnosis of a paraphilic disorder, or recognizing abuse or mechanism of trauma repetition Adequate understanding of the behaviors that may be described by a patient practicing BDSM requires, however, getting to know the specifics of such relationships. The mental and sexual health professional would be able then to evaluate them adequately, without referring to a subjective norm or bias on stereotype or prejudice.

Anodyspareunia (anal dyspareunia) is a phenomenon related to the passive side's feeling of pain or discomfort in anal sex when attempting or completely penetrating the anus. This dysfunction was first described in 1998 by Rosser's team investigating its biopsychosocial correlates in a sample of men who had sex with men. The work is theoretical in nature and is an attempt to integrate the current knowledge on the phenomenon of anodyspareunia. It presents attempts to define the phenomenon and data on its prevalence, possible reasons for its occurrence and further research directions. The analyzed studies show that although the occurrence of anodyspareunia is influenced by both physiological factors (e.g., lack of lubrication, oral or manual stimulation of the anus prior to penetration) and psychological factors, the latter seem to play a decisive role in the experience of pain. Not all people who practice anal sex report pain associated with it, which may lead to the perception of anal dyspareunia.

Objectives: This study examined psychometric properties of the Polish adaptation of a Self-Report Form of the DSM-5 Level of Personality Functioning Scale (LPFS-SR). It is a scale designed to measure general impairment, jointly with a detailed assessment of distinguished components of personality functioning characterized in terms of disturbances in self (identity and self-direction) and interpersonal (empathy and intimacy) functioning - Criterion A in the DSM-5 Alternative Model for Personality Disorders (AMPD).

Methods: The study involved a non-clinical sample of N = 242 adults (52.9% female; Mage = 30.63 years; SDage = 11.81 years). To provide an evaluation of the criterion validity, Personality Inventory for DSM-5 (PID-5), Personality Inventory for ICD-11 (PiCD), Level of Personality Functioning Scale - Brief Form 2.0 (LPFS-BF 2.0), and Big Five Inventory-2 (BFI-2) were administered.

Results: Our data supported that identity, self-direction, intimacy, and empathy components of the LPFS-SR can be characterized by a single, global dimension of personality dysfunction, consistent with the assumption that DSM-5 Criterion A is a relatively homogeneous construct. The LPFS-SR showed good reliability estimates and demonstrated conceptually sound associations with the PD severity index and related measures of personality functioning. Moreover, all the LPFS-SR components manifested at least partial distinction from maladaptive personality traits (i.e., Criterion B in the DSM-5 AMPD).

Conclusions: These findings provide support for the validity of the Polish adaptation of the LPFS-SR as an operationalization of impairment in the core and common features of personality pathology described in the DSM-5 alternative model.

The aim of this systematic review was to determine: 1. alternations of gut microbiota community; 2. intestinal barrier-related markers; 3. relationship between the intestinal ecosystem and health-related factors in AN individuals. We conducted a systematic literature search (PubMed/Embase/ClinicalTrials registry) until 30 September 2020 for studies reporting gut microbiome and intestinal barrier-related markers in patients with AN. Six studies on intestinal microbiota were eligible for this review, including three papers also describing intestinal barrier markers. Among five studies analyzing microbiota diversity, four of them found differences between AN patients and healthy controls (HC). The studies confirm alterations of the markers, which can affect intestinal barrier integrity of patients with ED. The systematic review confirms changes in the gut ecosystem of patients with eating disorder, without a clear consensus of microbiota patterns in AN. Damage of intestinal barrier integrity is poorly documented in AN patients and needs more attention in further studies.