Psychiatria polska最新文献

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.

Objectives: This study aimed to adapt the shortened version of the Self-Compassion Scale (SCS-SF) into Polish and to evaluate the psychometric properties and factor structure of this new measure.

Methods: The study included 596 adults (aged 18-50) from the general population (459 women). Of these 596, 47 individuals completed the SCS-SF one month later to assess its stability. The adaptation procedure followed the same procedure of the translation of the original version of the scale. Reliability was evaluated in terms of internal consistency and test-retest reliability. Validity was evaluated using correlations between SCS-SF scores and intensity of mindfulness (understood as a trait), life satisfaction, self-esteem, acceptance of experiences, and levels of anxiety and depression. Stability was assessed by intraclass correlation coefficients between two measurements. The factor structure was examined using confirmatory factor analysis.

Results: The results showed that the Polish version of the SCS-SF has good psychometric properties, and scores reflect a single factor - global self-compassion assessment.

Conclusions: The SCS-SF measures a global level of self-compassion and should be useful particularly when respondents' time is limited. To obtain measures of sub-scales of self-compassion, we recommend using a full version of the SCS.

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Objectives: The emotional reactions of therapist in the treatment process constitute the core of therapeutic work, but they are poorly represented in research area. The article presents the results of work on the creation of a new tool the Questionnaire for the Perception of Psychotherapy Process by the Psychotherapist (QPPP).

Methods: The Questionnaire containing 267 statements assessing cognitive, affective and behavioural reactions of psychotherapists in interaction with a specific patient was uploaded on the website. The link to the website, together with a request to complete the questionnaire, was sent to the members of the Psychotherapeutic Societies. The study involved 159 therapists, working mainly psychodynamically (91.95%). The analysis of basic descriptive statistics of test items and exploratory factor analysis by principal components method with varimax rotation were used.

Results: The work resulted in creating a tool consisting of 75 items grouped into 6 scales: Positive cooperation with the patient, Therapist burdened with commitment, Therapist in the centre of negative interest, Therapist with no room for intervention, The overwhelmed/overloaded therapist, The helpless/disengaged therapist. High alpha-Cronbach reliability of all distinguished factors was demonstrated at the level from 0.79 to 0.94. The data analysis also made it possible to create initial sten standards for therapists working in the psychodynamic approach.

Conclusions: A tool was developed to assess emotions of therapist in relation to client. QPPP contains generally understandable terminology, independent of the therapist's dominant modality. The questionnaire can have many practical applications - both scientific and clinical.

Objectives: The aim of the study was to assess the prevalence of psychotropic medication use among adult population in Poland in past 12 months, and to analyse the relationship between psychotropic medication use and sociodemographic factors as well as mental health disorders experienced by respondents.

Methods: Composite International Diagnostic Instrument (WHO CIDI 3.0) was used in Polish survey of general population aged 18-64. Respondents were randomly selected from the population register. Ten thousand interviews were completed with a response rate of 50,4%.

Results: In the general population, psychotropic medicines were used by almost 5% of the respondents in the past 12 months. These medicines were used more often by women, respondents from the oldest age group, with low level of education, retirees, unemployed, singles and residents of small and large cities. Among those experiencing mental health problems in the past 12 months, psychotropic medications were taken by up to 17% of the respondents. Pharmacological treatment was most often endorsed by over 40% of persons with symptoms of major depression and any mood disorders, while approximately 25% of respondents with major depression confirmed antidepressant use. Gender differences were small and mostly insignificant.

Conclusions: The results indicate the need to improve access to mental health treatment and to educate better general practitioners (GPs) for appropriate diagnosing and treatment of mental health disorders.

Since the 1950s, there have been rapid developments in psychiatric pharmacotherapy, resulting not only in more effective treatment of patients, but also in improvements in minimizing adverse effects of therapy. Modern third-generation antipsychotics, in addition to antagonism toward D2 receptors, also exhibit partial agonism toward dopamine receptors. Such a mechanism of action is intended to regulate dopaminergic transmission - inhibit (antagonism) it in pathways where it is excessive (excessive transmission in the mesolimbic pathway in psychotic patients, excessive transmission in the tuberoinfundibular pathway in patients with hyperprolactinemia) and stimulate (agonism) it in pathways where it is too low (mesocortical pathway). This has a beneficial effect on both the reduction of adverse symptoms and the negative, affective and cognitive symptoms of patients suffering from schizophrenia. The purpose of this review article is to present the most important clinical aspects of the use of dopamine D2 receptor partial agonists in the treatment of schizophrenia, using brexpiprazole as an example, and to define the profile of patients to whom this drug could be dedicated - based on recent studies.

Objectives: The aim of this exploratory study is to evaluate whether implicit motor learning impairments observed in schizophrenia (SZ) and bipolar disorder (BD) are associated with the resting state functional connectivity (rs-FC) within large-scale functional networks.

Methods: The study involved 30 BD patients, 30 SZ patients and 30 healthy controls (HC). Implicit motor learning was evaluated with the use of serial reaction time task (SRTT). Prior to the training patients underwent resting state functional magnetic resonance imaging (rsfMRI) examination. We have measured rs-FC within salience network (SAN), default mode network (DMN), frontoparietal network (FPN), sensorimotor network (SMN), limbic network (LN) and visual network (VIN) and their associations with implicit motor learning indices.

Results: rs-FC within SAN, DMN, FPN, SMN, LN and VIN reveal no significant association with implicit motor learning indices. BD, SZ and HC groups did not differ in terms of rs-FC within abovementioned networks.

Conclusions: We have shown that in the studied groups SRTT performance could not be predicted by rs-FC within the major large-scale functional networks, i.e., SMN, FPN, VIN, LN, SAN and DMN. The observation of the independence of implicit motor learning from the initial activity of these systems is important for proper understanding of neuronal underpinnings of this process and planning further neuroimaging research on this topic.