Psychiatria polska最新文献

Objectives: The study's aim was to determine co-occurrence of psychopathological symptoms and personality predispositions in post-traumatic stress disorder (PTSD) and its dimensions several months after hospitalisation of patients with severe COVID-19 during the 2nd and 3rd waves of the epidemic.

Methods: At 7-8 months after admission, 138 patients completed the PCL-5 and TIPI questionnaires, as well as the HADS and AIS scales. Correlation analysis and stepwise multiple regression analysis were used in the models.

Results: 22.5% of patients met the PTSD criteria. There were no significant differences between women and men in terms of severity of anxiety, depression, sleep disorders, distress and PTSD. Anxiety, sleep disorders and depression co-occurred with PTSD severity. All dimensions of PTSD were associated with anxiety. Intrusion, changes in arousal and reactivity correlated with sleep disorders. Changes in arousal and reactivity were explained by subjective assessment of distress. Negative changes in cognition and mood were related to depression and low levels of extraversion.

Conclusions: There is a co-occurrence of the severity of psychopathological symptoms: anxiety, depression, distress and sleep disorders with the severity of PTDS and its dimensions among patients who have undergone severe COVID-19 in the recent past. A protective factor against post-hospitalisation PTSD is higher level of extraversion.

Objectives: The aim of the study was to compare the occurrence of depressive symptoms between a group of patients with MPN (essential thrombocythemia, polycythemia vera, and primary myelofibrosis) treated with interferon-alpha and patients with chronic myelogenous leukaemia (CML) treated with tyrosine kinase inhibitors and to check whether individual side effects may contribute to the occurrence of depressive symptoms.

Methods: The study involved 175 adult patients with MPN and CML who had been treated with IFNα or TKI for a minimum of 3 months. The study used: the David Goldberg Questionnaire (GHQ-28), the Four-Dimensional Questionnaire 4DSQ and our own survey.

Results: Approximately 40% of patients with MPN and almost 20% of patients with CML obtained a moderately and strongly elevated score on the depression scale. The analysis revealed no statistically significant differences between women and men. Bone and joint pain (β=0.196, p=0.013), nausea and indigestion (β=0.191, p=0.007), fatigue (β=0.136, p=0.053), cramps and muscle aches (β=0.159, p=0.038) and diarrhoea (β=0.138, p=0.050) were side effects that affected the possibility of developing depressive symptoms in both groups. The common predictor of depressive symptoms was the number of side effects, the type of illness, and age. The older the person was, the greater the severity of depressive symptoms.

Conclusions: There are significant differences in the prevalence of depression between patients with CML and MPN. Specific side effects of interferon-alpha and TKI treatment influence the occurrence of depressive symptoms. No association between interferon treatment and the development of depression was confirmed.

Since the year 2000, ketamine and its enantiomers have been studied for their antidepressant effects. This paper will briefly summarise the journey of ketamine from an anaesthetic to an antidepressant. The text will present the key mechanisms of its action, as well as the actions of its metabolites. The aim of this article is to describe the role of specific groups of receptors in activation of important metabolic pathways and in production of factors such as mammalian target of rapamycin kinase (mTOR) and brain-derived neurotrophic factor (BDNF), in order to comprehensively present a potential link between ketamine, ketamine's enantiomers and its metabolites with terms such as neuroplasticity and antidepressant action. Another important part of this article is a summary of arguments for and against importance of specific mechanisms of ketamine action and to compare (S) and (R)-ketamine's potential to act as an antidepressant. This article may be particularly helpful for researchers in determining further research directions and serve as a summary of the current state of knowledge regarding the mechanisms of ketamine's action and the latest therapeutic possibilities in the treatment of affective disorders.

The aim of this paper is to present the application of cognitive-behavioral therapy in the treatment of emetophobia. The fear of vomiting (emetophobia) is a specific phobia, the mild form affects over 3% of the population, predominantly women. The main symptoms are associ- ated with the fear of experiencing nausea and other gastrointestinal sensations. These sensations are interpreted as a signal of impending vomiting, leading to discomfort and avoidance of eating and social situations. The symptoms may resemble other somatic and psychological disorders and can co-occur with various mental health conditions. The therapy requires an individualized approach and may be more demanding compared to treating other phobias. The article includes a description of the therapy process with an adult patient struggling with emetophobia. Diagnosis was conducted through an interview and the EmetQ-13 questionnaire. The applied therapeutic techniques are presented, along with an understanding of the symptoms considering therapeutic models explaining the development of emetophobia and the mechanisms sustaining it. Key processes playing a crucial role in dysfunction were identified. After 10 sessions of cognitive-behavioral therapy, the patient no longer met the diagnostic criteria for the fear of vomiting, overcoming avoidance behaviors.

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Objectives: Paradoxically helping others exposes the helpers to secondary traumatization. Its determinants include both factors related to work, as well as individual characteristics. The purpose of this study was to determine the relationships between empathy, secondary self-efficacy, and STS.

Methods: The results obtained from 115 therapists (M age = 40.79; SD = 10.57) working with addicted clients were analysed. Three standard measurement tools were used: the Secondary Traumatic Stress Inventory (STSI), the Empathic Sensitivity Scale (EES), and the Secondary Trauma Self-efficacy (STSE) scale.

Results: Only 15.7% of respondents were found to be at high risk of STS disorders. The main predictor of STS was empathic concern. Secondary self-efficacy partly mediated the relationship between empathic concern and STS. Since the rate of secondary traumatization in the group of therapists is not high compared to other professional groups, it is worth paying attention to factors that protect against STS.

Conclusions: To reduce the risk of disorders resulting from secondary exposure to trauma, personal resources, including self-efficacy, should be developed. It is also useful to develop the ability to cope with the trauma of others by applying self-care practices.

Objectives: The aim of the study was to look for a correlation between personal resources, care burden and life satisfaction in carers of people with dementia of the Alzheimer type.

Methods: The study involved 100 family and professional carers providing care for a person with dementia of the Alzheimer type. Carers answered survey questions and completed questionnaires: Orientation to Life Questionnaire - SOC-29, Generalised Self-Efficacy Scale (GSES), Social Support Questionnaire (F-SozU K-22), Depression Assessment Questionnaire (KPD), Perceived Stress Questionnaire (KPS), Involvement Evaluation Questionnaire (IEQ) and Satisfaction with Life Scale (SWLS).

Results: Higher levels of a sense of satisfaction with life were observed in carers who had a higher education, were the sole carer of a person with the disease, and who spent less time providing care. Higher levels of available resources and a lower sense of care burden (fewer depressive symptoms, less involvement in care and less stress) were associated with a higher sense of life satisfaction. Depressiveness of carers and high levels of perceived stress reduce the level of satisfaction with life.

Conclusions: Personal resources play an important role among carers in reducing the burden and maintaining proper levels of life satisfaction. The proper management of the resources available to carers is important to counteract the negative consequences of caregiving.

Objectives: The work concerns the assessment of compliance with patient rights in the area of psychiatric health care during the COVID-19 pandemic.

Methods: The analysis of compliance with patients' rights was made on the basis of complaints submitted to the Office of the Patient Ombudsman. Reports sent to the Department of Mental Health regarding suspected non-compliance with patient rights were retrospectively analyzed. Structure and dynamics indicators were used to assess changes over time.

Results: After analyzing reports since 2020, we have observed a decrease in the number of cases considered by the Department of Mental Health. In 2021, for all rights, there was a decline in the number of applications processed. According to reports on the observance of patients' rights in the area of psychiatric health care, this may be due to the lack of possibility of personal contact with the Psychiatric Hospital Patient Ombudsman. In addition, during the pandemic, a reduction in the number of cases was observed, which was related to limited access to in-person contact. The scope of reported cases also changed during the pandemic. In the years 2018-2021, most cases concerned assistance in asserting rights in matters related to admission, treatment, conditions of stay and discharge from psychiatric hospitals.

Conclusions: Regarding the scope of applications and complaints considered under the provisions of the Act on Patient Rights and the Patient Ombudsman in 2018-2021, most cases concerned the right to health services, followed by the right to information about one's health and the right to consent to the provision of health services. In the case of applications and complaints considered under the provisions of the Mental Health Protection Act in the years 2018-2021, most cases concerned admission and treatment without consent in a psychiatric hospital, the use of direct coercion in accordance with specific regulations and discharge from the hospital of a person treated with consent.

Objectives: The aim of the study was to describe the changes in the postural stabilisation, quality of life, cognitive functions and behaviour of patients with paranoid schizophrenia who have undergone the Snoezelen therapy and the auctorial sensorimotor exercise program.

Methods: The study was conducted on 55 patients aged 55 to 75 years. Group S underwent therapy in the Snoezelen room for nine weeks, group ES underwent the Snoezelen therapy and were also subjected to auctorial sensorimotor exercise programme, and group C were not given any therapeutic intervention. The Biosway portable balance system, the Berg Balance Scale, Tinetti Test and the Timed Up & Go Test were used to evaluate the effects of the therapy.

Results: In group ES, statistically significant changes were observed in all tested indicators; in group S such changes were observed in the Limit of Stability test, Tinetti Test and TUG test; while in group C, no statistically significant changes were found.

Conclusions: The Snoezelen therapy had a significant impact on changes in postural control rations and a reduced risk of falls. The auctorial sensorimotor exercise programme increased the impact of the Snoezelen room on postural stability measured using the Biosway platform and the risk of falls assessed using the TUG test.