Psychiatria polska最新文献

Objectives: Psychosomatic disorders (somatic symptom disorder - SSD) constitute a heterogeneous group of medical conditions characterized by somatic symptoms without explained somatic causes. Due to the complexity of symptoms, they present a significant medical, social and economic challenge, and diagnosing and treating these disorders remains a substantial clinical challenge. The aim of the conducted research was an attempt to identify characteristic patterns in the surface-level brain bioelectrical activity of individuals experiencing psychosomatic disorders. The obtained results may contribute to understanding the pathomechanism of these disorders and developing objective methods for diagnosis and differentiation of functional dysfunctions.

Methods: The study involved a group of 49 individuals: 30 patients with somatic symptom disorder (SSD) and 19 individuals in the control group. Resting-state EEG signals were recorded from the subjects under two experimental conditions (eyes open, eyes closed). The recorded signals underwent quantitative EEG (QEEG) analysis followed by statistical analysis.

Results: EEG signal analysis revealed statistical differences between the studied groups in terms of absolute power in the Alpha band (8-12 Hz) in frontal areas (electrodes F3, Fz, F4) under eyes-open conditions, as well as in the Delta band (1-4 Hz) in the right frontal area (electrode F4) under eyes-closed conditions. Similar changes were not observed in the Beta (12-25 Hz) or High Beta (25-30 Hz) bands.

Conclusions: The detected abnormalities in the surface-level brain bioelectrical activity may indicate potential disturbances in the reception and interpretation of visceral sensations in patients with psychosomatic disorders. The lack of differences in higher frequencies could be helpful in the differential diagnosis between these disorders and other anxiety disorders where psychosomatic symptoms are observed. The obtained results could also be useful in planning protocols involving various neurotherapeutic methods.

Trazodone is a serotonin antagonist/reuptake inhibitor, approved for treating major depressive disorder (MDD). Oral formulations are widely studied and marketed in several countries worldwide while there is little evidence to support use of parenteral formulation. Our narrative review summarizes pharmacological properties and clinical data concerning use of parenteral trazodone in mood disorders. PubMed and Web of Science were used to identify the most relevant literature. The main evidence concerns four studies evaluating efficacy in major depressive disorder and indicates that trazodone was well tolerated and effective. Off-label use in agitation associated with bipolar disorder is also reported in three studies, although prescription of concomitant treatment, as a confounding factor, may have influenced outcome measures. The limited available evidence supports parenteral trazodone use in major depressive disorder and suggests that trazodone is a suitable option in patients at high risk of treatment-emergent mania (TEM).

The Polish standard of treatment with racemic ketamine for patients with depressive disorders was developed by a Working Group appointed by the National Consultant in the field of psychiatry. Despite the wide range of available medications, as many as one-third of depressed patients do not respond to standard antidepressant treatment, raising the need for an ongoing search for new effective and safe therapies. In recent years, the possible role of overactivity of the glutamatergic system in the etiopathogenesis of depression has again attracted the attention of many experts. The possibility of using substances with a modulating effect on the glutamatergic system in the treatment of depressive disorders has been postulated, among others, the long-known anesthetic ketamine, which is a noncompetitive NMDA receptor antagonist. This paper summarizes the results of studies on the efficacy and safety of racemic ketamine (administered intravenously) in the treatment of patients with depressive symptoms in the course of both unipolar and bipolar affective disorder, and, meeting the expectations of many practicing psychiatrists wishing to broaden the range of therapies offered to their patients, presents recommendations on indications, contraindications, precautions and the treatment regimen itself with intravenous ketamine for patients with mood disorders.

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Aim: To create a Polish adaption of the Pregnancy-Related Anxiety Questionnaire - Revised 2 (PRAQ-R2), which is widely used abroad.

Methods: PRAQ-R2 was translated into Polish by independent bilingual speakers. Fortyeight pregnant women completed our survey containing the Polish version of PRAQ-R2, Hospital Anxiety and Depression Scale - Modified (HADS-M), and a short sociodemographic questionnaire. After a week, they were asked to complete the PRAQ-R2 questionnaire again. Parametric statistics were used to assess psychometric properties.

Results: Our study has shown a good test-retest correlation of 0.70. Participants completed the survey twice (in t1 and after one week - in t2). Cronbach's alpha was calculated as 0.847 at t1 and 0.895 at t2. There was a moderate correlation between PRAQ-R2 at both time points and the HADS-M scale and its subscales.

Conclusions: Our Polish adaption of PRAQ-R2 has shown good validity and reliability. It has good internal consistency. Moderate correlation with HADS-M proves that pregnancyrelated anxiety (PrA) is a distinctive disorder from generalized anxiety disorder and depressive disorder. Given the great frequency and the burden of PrA, we believe that PRAQ-R2 should be routinely used among physicians working with pregnant patients.

This paper examines nosological categories relating to borderlines between psychosis and other clinical categories, introduced by Polish psychiatrists in the interwar period. In the United States, the discussion about the borderline between neuroses and psychoses was urged by the 1938 article by psychoanalyst Adolph Stern. In Poland, nosological categories regarding the borderline between neuroses and psychoses were proposed by Adam Wizel, Maurycy Bornsztajn, Jan Nelken, and Władysław Matecki. Wizel coined the term 'underdeveloped schizophrenia', Bornsztajn introduced 'schizothymia reactiva' and 'hypochondriac (somatopsychic) schizophrenia', Nelken described 'mild schizophrenia', first introduced by Moscow psychiatric school of Rosenstein, and Matecki presented the category of neurosis-like (pseudo-neurotic) schizophrenia. Additionally, Julian Dretler, after studying the borderline between schizophrenia and manic-depressive psychosis, coined the term 'mixed psychosis' and expressed conviction that it is an independent nosological entity. Like in the United States, the majority of Polish pioneers of the nosological studies of borderline cases were influenced by psychoanalysis. As a consequence of World War II and the new regime, which forced dialectical materialism and Pavlovism as an official ideology of psychiatry and condemned psychoanalysis, the categories presented in the article became forgotten and have not impacted Polish psychiatric nosology.

Objectives: The aim of the study was to verify the psychometric properties of the Polish adaptation of the Unified Theory of Acceptance and Use of Technology - Therapist version (UTAUT-T) and to verify the UTAUT-T model in a group of Polish psychotherapists.

Methods: A total of 434 people aged 27-66 (M = 40.78; SD = 7.70), including 337 women and 58 men, took part in an online self-report study, which involved completing three questionnaires: UTAUT-T, the short IPIP-BFM-20 Questionnaire for measuring the Big Five, the Technology Readiness Index (TRI 2.0), as well as answers to questions about the use of digital technologies at work. The following analyses were carried out: confirmatory factor analysis (CFA), reliability analysis using Cronbach's alpha, and theoretical validity analysis - an analysis of the correlation between the subscales of the UTAUT-T instrument and questionnaires enabling the measurement of dimensions which had been indicated in previous research results as related to the acceptance of technology.

Results: The conducted analyses showed that the factor structure of the Polish version of UTAUT-T is the same as of the original tool, and the UTAUT-T model was confirmed in the group of Polish psychotherapists. The Cronbach's alpha reliability coefficient for individual subscales ranged from 0.57 to 0.97. The theoretical validity analysis confirmed the expected correlations between most dimensions of technology acceptance and technology readiness. In addition, there were single very weak correlations observed between technology acceptance and personality traits.

Conclusions: The psychometric properties of the Polish version of UTAUT-T show satisfactory values. The scale can be used to conduct further research. The UTAUT-T model can be utilized to predict the actual use of new technologies by Polish psychotherapists.

The aim of this paper is to briefly present the current knowledge on the definition of relational trauma, place in classifications, prevalence, consequences, and applied therapeutic methods. Reports from many countries indicate that in the relationship with adults, usually parents, on whom the child is dependent for many years, various forms of abuse may occur, related not only to violence, but also to emotional, physical, and intellectual neglect. Behind them, the unregistered area of aversive experiences of children who enter adulthood with the experience of relational trauma is hidden. These adverse childhood experiences significantly affect overall functioning in adulthood. For years, researchers of the phenomenon have been paying attention to the existence of a separate diagnosis related to relational trauma. The 11th edition of the International Classification of Diseases (ICD-11) introduces a new diagnosis: complex post-traumatic stress disorder (Complex PTSD, cPTSD). New methods of therapeutic interventions emerge, and the validation of these methods and explanation of the mechanisms of action is research work for the coming years.

Smoking and nicotine dependence are still one of the main reasons for a number of serious and life-shortening somatic diseases. At the same time, they are more prevalent in mentally ill individuals than in the general population. This work, which constitutes the first part of recommendations of the Polish Psychiatric Association, presents the scale of the phenomenon in the general population and among people with psychiatric disorders, diagnostic criteria of nicotine dependence and nicotine withdrawal. It discusses the impact of smoking and exposure to cigarette smoke on the development and course of psychiatric disorders as well as on the treatment of psychiatric disorders, including interactions between nicotine and psychotropic medications. Many psychiatric patients can reduce smoking or achieve complete abstinence if they are offered adequate motivation and therapeutic support. Contrary to popular belief, smoking cessation and nicotine dependence treatment do not negatively affect the symptoms of psychiatric disorders; patients' mental conditions can improve following smoking cessation therapy. The best results in terms of maintaining abstinence are achieved with a treatment approach that combines pharmacotherapy with psychotherapeutic intervention integrated into routine psychiatric care.

Consciousness is most frequently defined as a subjective experience of mental processes. The phenomenon of consciousness has always been a subject of great interest in various fields of science, including psychiatry, and the most prominent scientists have engaged in research on it. The studies performed in recent years have brought about novel data on the evolutionary and neurobiological attributes of this phenomenon. In the first part of the article, the evolutionary concepts of consciousness are presented, going back to the beginnings of life on our planet. They are proposed by such illustrious scientists as Joseph LeDoux, Daniel Dennett, António Damásio, and Arthur Reber. Each of them presents the issue of consciousness in the context of evolution slightly differently. However, there are many similarities concerning the development of the nervous system and mental life. The second part discusses the novel research on the cognitive and neurobiological components of consciousness. Among many researchers of this issue, we chose the achievements of two British authors such as Chris Frith and Anil Seth. The neuroanatomical and perceptive aspects of both the level and context of consciousness are provided. Besides presenting the contemporary evolutionary and neurobiological concepts of consciousness, the article aims to bring closer the profiles of the prominent researchers of neuroscience mentioned here. This term can be translated into Polish as "neuronauka", although our country's most frequently used name is "neurobiologia."