Psychiatria polska最新文献

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.

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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.

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.