Psychiatria polska最新文献

Objectives: This study aimed to determine the prevalence of pica among Polish adolescents aged 15-19 years, to identify the most commonly consumed inedible substances, and independent factors that increase the risk of pica.

Methods: The study was conducted with the participation of 1,696 secondary school students from all over Poland. Multiple random sampling was used. A three-part self-designed questionnaire, which included recall questions, diagnostic questions for pica disorder and an assessment of mental state was used in the study. The study assessed the relationships between selected variables, characteristics for other eating disorders, and drinking (e.g. place of residence, level of physical activity, having siblings or level of parental education). The questionnaire was validated before the study.

Results: 3.2% of respondents ate starch in the form of raw flour, paper or tissue, 5.7% ate nasal discharge and 0.2% ate glass particles. 1.5% of respondents needed to see a specialist because they had eaten a non-nutritive substance. 10% of respondents characterized the severity of family stress above the 90th percentile, similarly, 9.4% of respondents described the high severity of school stress. 37.1% of the respondents engaged in self-injurious behavior.

Conclusions: Diagnostic criteria for pica were met by 5.7% of respondents. The most common non-nutritive substances consumed by respondents were: nasal discharge, raw starch and hair. Independent factors that increased the risk of pica included living in a city, the presence of self-aggressive behavior, the presence of suicidal thoughts and high levels of stress at school.

Introduction: The suicide of a patient can have a profound impact on the emotional state and professional practice of clinicians. The aim of the study was to: (1) determine the prevalence of the psychiatrists' experience of patient suicide; (2) compare doctors' responses to the patient's death conditioned by various causes; (3) identify the impact of patient suicide on the emotional state and professional practice of psychiatrists; (4) identify possible interventions and mental support for doctors.

Material and methods: A comprehensive review of literature in Polish and English was conducted, sourcing from PubMed and Google Scholar with keywords: "patient suicide", "psychiatrists' reactions" and "mental support" databases from 1983 to 7 March 2024. A total of 56 publications, including 41 original research papers and 15 review articles, were analysed using the SANRA scale to ensure the quality of the review.

Results: Between 38.8% and 91.5% of psychiatrists experienced patient suicide in their practice, which involved the following consequences: (1) a change in emotional state (the appearance of sadness, fear, disbelief, anger, grief, shame; less often stress reaction and the syndrome of post-traumatic stress disorder); (2) impact on professional practice (doubt in one's competence, fear of professional responsibility or criticism, increased number of consultations, excessive compliance with safety measures, too frequent hospitalisations of patients). Adequate mental support, including especially from more experienced colleagues and loved ones, significantly reduced the negative reactions of doctors.

Conclusions: It is important to recognise the problem of the enormous emotional burden of a patient suicide death on psychiatrists and the impact on their professional practice, as well as building among them an efficient training and mental support system.

Selecting appropriate psychiatric treatment can be challenging. It is particularly difficult in a group of patients burdened a priori by serious somatic conditions, i.e. kidney or liver failure, neurological diseases or glaucoma. When the use of antipsychotics is warranted, in addition to an adequate clinical effect profile, attention should also be paid to other features of the drug, such as its pharmacodynamic and pharmacokinetic properties and possible side effects. Almost all, with the exception of pimavanserin (not available in Poland), currently regis- tered antipsychotics are D2 receptor antagonists. Second-generation drugs additionally exert significant effects on serotonergic transmission, primarily by blocking 5HT2a receptors. On the other hand, modern third-generation antipsychotics, in addition to antagonism to D2 receptors, also exhibit partial agonism towards dopamine receptors, which allows modulation of dopaminergic transmission. This profile of interactions may influence the type of side effects. The purpose of this paper is to provide practical recommendations on the safety of antipsychotic drugs in groups of patients burdened by somatic conditions frequently encountered in clinical practice, i.e. renal failure, neurological conditions, including Parkinson's disease and epilepsy, liver failure, prostatic proliferation and glaucoma. The paper represents a continuation of recommendations on the use of neuroleptics in patients with somatic diseases.

Antipsychotic drugs/antipsychotics as a group, despite their similar clinical effect, differ both in their chemical structure, pharmacodynamic and pharmacokinetic properties, as well as in the possible side effects of their use. When selecting the appropriate treatment for a patient, the clinician should be guided not only by the expected therapeutic effect, but also weigh the possible side effects, especially in patients burdened with additional somatic conditions. Almost all, with the exception of pimavanserin, which is not available in Poland, of the currently registered antipsychotics are D2 receptor antagonists. Second-generation drugs additionally exert significant effects on serotonergic transmission, primarily by blocking 5HT2a receptors. On the other hand, modern third-generation antipsychotics, in addition to antagonism to D2 receptors, also exhibit partial agonism towards dopamine receptors, which allows modulation of dopaminergic transmission. The aim of this paper is to provide guidance on the selection of antipsychotics for the treatment of psychiatric patients with co-morbid somatic conditions (part I of the recommendations concerns metabolic syndrome, hyperprolactinemia and cardiovascular conditions) based on the risk of possible side effects associated with the use of antipsychotics.

The year 2025 marks the sixtieth anniversary of the publications that first proposed the neurotransmitter hypothesis of the pathogenesis and treatment of affective disorders. This concept, assuming the dominant function of catecholamines (noradrenaline and dopamine), further added with serotonin, is probably the most important theory regarding the biological pathogenesis and psychopharmacology of affective disorders. A history of the discovery of these neurotransmitters and their role in the central nervous system is presented.The catecholamine hypothesis was proposed in 1965 by American researchers Joseph Schildkraut, William Bunney and John Davis. It concerned a deficiency of noradrenaline in depression and its excess in mania, and later, a similar role of dopamine. The serotonin hypothesis of depression was presented in 1969 by the Briton Alec Coppen and the Soviet researchers Izaslaw Lapin and Grigorij Oxenkrug. The neurotransmitter concepts, especially serotonin theory, contributed to the discovery and introduction of new antidepressants. The selective serotonin reuptake inhibitors have become the most frequently used antidepressants nowadays. The introduction of fluoxetine (Prozac) in the USA at the turn of 1980s/1990s was a cultural event. In the 21st century, serotonin has made a career as a hormone of happiness and has appeared in literary works.Also now, the interpretation of the mechanism of action of the majority of antidepressants concerns their enhancement of noradrenergic, dopaminergic and serotonergic transmission in the central nervous system. The therapeutic effect in mania is associated with an inhibition of dopaminergic transmission. Among other neurotransmitters, acetylcholine can be mentioned as an element of the cholinergic-adrenergic hypothesis of mood disorders. Whereas the introduction of ketamine pointed to the role of glutamatergic neurotransmission in the pathogenesis of depression.

Objectives: The aim of the study was to analyse the functioning of emotional conscience in individuals with mood disorders, taking into account the differences between patients with recurrent depression and patients with bipolar disorder. The dependence of the susceptibility to experiencing particular moral feelings on the symptoms of the illness - both on their type and severity - was also a subject of consideration.

Methods: Results from 131 subjects were analysed, including 44 patients with bipolar disorder, 33 patients with recurrent depression and 54 individuals without a diagnosis of mental disorders. More women (67%) than men (33%) took part in the study, the average age of the respondents was 43 years. The following research methods were used: the Hamilton Depression Rating Scale (HAM-D), the Young Mania Rating Scale (YMRS) and the Moral Feelings Scale (SUM-5).

Results: Statistically significant differences were observed between the examined groups in the functioning of emotional conscience assessed using the SUM-5. Patients with mood disorders described themselves as experiencing some of the distinguished moral emotions with different susceptibility than healthy individuals. Similarly, different experiencing of these types of feelings was noticed in groups of patients with recurrent depression and bipolar disorder. The dependence of the functioning of their emotional conscience on the type and severity of experienced symptoms, assessed on the HAM-D and YMRS scales, was also noted.

Conclusions: The emotional conscience of people with mood disorders may have specific features, that are less pronounced in healthy subjects. Taking this into account seems to be an important aspect of understanding patients, helpful when building a healing relationship with them.

Objectives: Mushrooms of the Amanita genus are considered among the most toxic, causing severe poisoning, often resulting in death. However, of the 707 described species within this genus, only around a dozen contain the toxic octapeptides classified as amanitotoxins and phallotoxins. While most representatives of the genus are considered inedible species, there are a few exceptions that are palatable edible species. Amanita muscaria and Amanita pantherina fall into the category of poisonous species, with significant ethnomycological impact on human evolution and sociology, alongside their other psychoactive effects. This study aimed to obtain mycelium of A. muscaria and A. pantherina species under controlled laboratory conditions, using 10 L air-lift bioreactors and to evaluate the obtained material as a potential pharmaceutical raw material containing muscimol and other biologically active compounds of importance, which may have significance in the prevention of depression.

Methods: The resulting biomass was analyzed by RP-HPLC and AAS to identify various organic compounds (indole compounds, sterols, lovastatin, ergothioneine, muscimol, and ibotenic acid) and different bioelements.

Results: Based on the results obtained, it can be concluded that the mycelium of A. muscaria contains several bioactive compounds, such as lovastatin, ergothioneine, and 5-hydroxy-L-tryptophan, at higher levels than A. pantherina.

Conclusions: The determination of muscimol and other bioactive substances, which have not been previously studied, in the biomass obtained through in vitro cultivation, compared to those found in the fruiting bodies, suggests the potential of these species in the treatment of depression. However, further research, including in vitro experiments and subsequent clinical trials, is required.

Objectives: Sharp and Fonagy's conception was framework for a hypothesis regarding mentalization deficits as predictors of depressive disorders in adolescence. According to the theory, the mediators of this relationship would be the child's emotion regulation processes.

Methods: The basis for planning and data analysis was correlation-regression model. A cross-sectional study was conducted on a non-clinical group of 204 adolescents - primary and secondary school students. The Polish versions of the following research tools were used: CDI-2 questionnaire by Kovacs, Reflective Functioning Questionnaire (RFQ-8) by Fonagy, Hypermentalization Questionnaire by Sharp, and Cognitive Emotion Regulation Questionnaire (CERQ) by Garnefski and Kraaij.

Results: Data analyses revealed that the more compromised the ability to mentalize, the greater the severity of depressive symptoms, especially those related to emotional problems: negative mood and low self-esteem. All the diagnostic criteria of the disease are linked to a diminished ability to understand the world of experiences - one's own and those of others. Both hypomentalization and hypermentalization are significant predictors of depressive symptoms in adolescents, with the mediator of this relationship being the triad of maladaptive cognitive emotion regulation strategies: self-blame, rumination, and catastrophizing.

Conclusions: Self-blame constitutes the most common strategy combined with all types of mentalization deficits as well as all symptoms of depression. Whereas catastrophizing constitutes a regulation strategy that is mostly combined with one type of mentalization deficits.The obtained results require further research determining the conditions under which the exaggerated sense of guilt is associated with the occurrence of symptoms of psychopathol- ogy in adolescents.

Objectives: The main objective of the study was to answer the question of whether the clinical condition of the patient and the type of antipsychotic drug used affect the educational opportunities of patients hospitalised in forensic psychiatry departments participating in a health education programme.

Methods: The study was conducted at the State Hospital for the Mentally and Neurologically Ill in Rybnik in the forensic psychiatry wards and lasted from December 2019 to May 2020. During the study, patients gained knowledge of health education. The study group consisted of 67 men aged 22-73 with a diagnosis of schizophrenia. The control group consisted of 40 patients aged 23-72 with the same diagnosis who were not educated. A dual measurement method was used (before and after the health education cycle) using the CGI-S scale and a proprietary questionnaire of patients' knowledge from the applied educational programme.

Results: The study showed that the severity of mental illness symptoms had a significant impact on patients' educational opportunities. The variety of antipsychotic medications used (atypical and classic) did not affect patients' educational opportunities. In addition, the study showed that the educational level of the patients had a significant impact on their educational opportunities.

Conclusions: The effectiveness of educational interventions depends on the severity of symptoms in patients diagnosed with schizophrenia, but does not depend on the type of pharmacotherapy used.