M. Głuszak, Małgorzata Pazderska-Głuszak, Agata Gut-Lepiech, A. Wierzbicka, T. Litwin, I. Kurkowska-Jastrzębska
Purpose: Limbic encephalitis (LE) is a rare but necessary condition to consider when experiencing cognitive disorders, seizures, and psychiatric disorders. Case description: This article presents a case of a 28-year-old patient with uncontrolled disease history, with systemic symptoms of viral infection and prolonged convulsive seizure status. Based on clinical symptoms, magnetic resonance imaging of the brain and cerebrospinal fluid test results revealed LE. After treatment and rehabilitation, the patient returned to work. Comment: Limbic encephalitis was first described in 1960. In terms of aetiology, we divide LE into non-infectious (a para nitrogen syndrome primarily associated with small cell lung cancer) and infectious cases (caused by herpes simplex virus). Other cases of autoimmune diseases have also been reported – non-paraneoplastic limbic encephalitis (NPLE), in which the presence of antibodies against the antigen of the neuronal membrane is observed. Non-paraneoplastic LE variants are examples of potentially reversible LE variants.
{"title":"Non-paraneoplastic variant of limbic encephalitis – case report","authors":"M. Głuszak, Małgorzata Pazderska-Głuszak, Agata Gut-Lepiech, A. Wierzbicka, T. Litwin, I. Kurkowska-Jastrzębska","doi":"10.5114/ppn.2017.72438","DOIUrl":"https://doi.org/10.5114/ppn.2017.72438","url":null,"abstract":"Purpose: Limbic encephalitis (LE) is a rare but necessary condition to consider when experiencing cognitive disorders, seizures, and psychiatric disorders. Case description: This article presents a case of a 28-year-old patient with uncontrolled disease history, with systemic symptoms of viral infection and prolonged convulsive seizure status. Based on clinical symptoms, magnetic resonance imaging of the brain and cerebrospinal fluid test results revealed LE. After treatment and rehabilitation, the patient returned to work. Comment: Limbic encephalitis was first described in 1960. In terms of aetiology, we divide LE into non-infectious (a para nitrogen syndrome primarily associated with small cell lung cancer) and infectious cases (caused by herpes simplex virus). Other cases of autoimmune diseases have also been reported – non-paraneoplastic limbic encephalitis (NPLE), in which the presence of antibodies against the antigen of the neuronal membrane is observed. Non-paraneoplastic LE variants are examples of potentially reversible LE variants.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2017-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2017.72438","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70508136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Bronowski, Katarzyna Chotkowska, Magdalena Rowicka
Purpose: The article aims to provide a comprehensive characterization of people with schizophrenia using the Patient’s Clubs, with particular consideration of the parameters of the healing process, such as social networks and the level of social relations. Methods: The study was completed in 2009-2011. It involved patients suffering from schizophrenia, who used the services of such Clubs. The control group were participants of other community treatment programs, who did not benefit from the Clubs. Data were collected, using the Sociodemographic Questionnaire, the Questionnaire of the course of Illness and the Questionnaire of Community Support System, prepared specially for this research, as well as the Bizoń Evaluation of Environmental and Social Support, the Birchwood Social Functioning Scale and the Scale of the General Mental Status Examination GAS. Results: In comparison with users of other programs, the Clubs participants use their services much longer, i.e. 83 months, on average. They have slightly more numerous social networks than those who do not participate in Clubs. The level of social functioning of patients was also examined. Those benefiting from the support of Clubs achieved higher results in scales ‘exiting isolation’ and ‘self-reliance implemented’. Significant part of the Clubs participants Clubs used at the same time other support programs, first of all the Occupational Therapy Workshops (26%) and the Environmental Self-Help Houses (39%). Conclusions: Participation in Clubs facilitates a stable and long-term support for people with mental illness experience. It is worth remembering that, when referring patients to such, the participants have great interpersonal potentials social resources to cope well with the symptoms of the disease. This may be an important form of support in returning to independent living. When creating or modifying the Clubs’ programs, we should emphasize on the access to activities associated with natural, and not only institutional forms of social life. Clubs may also become the basis for building a self-help movement of people with mental illness experience.
{"title":"Patient’s Clubs – underestimated support programmes","authors":"P. Bronowski, Katarzyna Chotkowska, Magdalena Rowicka","doi":"10.5114/PPN.2017.71475","DOIUrl":"https://doi.org/10.5114/PPN.2017.71475","url":null,"abstract":"Purpose: The article aims to provide a comprehensive characterization of people with schizophrenia using the Patient’s Clubs, with particular consideration of the parameters of the healing process, such as social networks and the level of social relations. Methods: The study was completed in 2009-2011. It involved patients suffering from schizophrenia, who used the services of such Clubs. The control group were participants of other community treatment programs, who did not benefit from the Clubs. Data were collected, using the Sociodemographic Questionnaire, the Questionnaire of the course of Illness and the Questionnaire of Community Support System, prepared specially for this research, as well as the Bizoń Evaluation of Environmental and Social Support, the Birchwood Social Functioning Scale and the Scale of the General Mental Status Examination GAS. Results: In comparison with users of other programs, the Clubs participants use their services much longer, i.e. 83 months, on average. They have slightly more numerous social networks than those who do not participate in Clubs. The level of social functioning of patients was also examined. Those benefiting from the support of Clubs achieved higher results in scales ‘exiting isolation’ and ‘self-reliance implemented’. Significant part of the Clubs participants Clubs used at the same time other support programs, first of all the Occupational Therapy Workshops (26%) and the Environmental Self-Help Houses (39%). Conclusions: Participation in Clubs facilitates a stable and long-term support for people with mental illness experience. It is worth remembering that, when referring patients to such, the participants have great interpersonal potentials social resources to cope well with the symptoms of the disease. This may be an important form of support in returning to independent living. When creating or modifying the Clubs’ programs, we should emphasize on the access to activities associated with natural, and not only institutional forms of social life. Clubs may also become the basis for building a self-help movement of people with mental illness experience.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2017-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2017.71475","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47129551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: The study aimed at establishing the relationship between posttraumatic cognitions resulting from traumatic experiences as well as disruption in core beliefs and the level of symptoms of posttraumatic stress (PTSD). Another aim was to check whether the disruption of core beliefs is a mediator between posttraumatic cognitions and symptoms of PTSD. Methods: Results obtained from 57 parents aged 25-57 years (M = 35.38; SD = 8.32), who have dealt with their child’s cancer (men – 47.4%; women – 52.6%) were examined. Three measuring methods were used in the study: the Impact of Event Scale-Revised (IES-R), Posttraumatic Cognitions Inventory (PTCI) and the Core Beliefs Inventory (CBI). Results: The results showed positive associations between posttraumatic cognitions as well as disruption of core beliefs and the severity of PTSD. Challenges for core beliefs act as mediators in the relationship between posttraumatic cognitions and symptoms of PTSD. Conclusions: The experience of a traumatic event usually entails the occurrence of posttraumatic stress symptoms. The severity of these symptoms is determined by, among others, the individual’s beliefs about the world and about themselves. The experience of a child’s cancer is a traumatic experience for parents. Negative cognitions and disruption in key beliefs favour the persistence of PTSD symptoms. Disturbances in beliefs are mediators in the relationship between negative cognitions and symptoms of PTSD. Reducing symptoms of PTSD, and thus recovery, requires a change in beliefs that are distorted by trauma.
{"title":"Symptoms of posttraumatic stress among parents struggling with their child’s cancer – the role of negative cognitions and disruption in core beliefs","authors":"N. Ogińska-Bulik, I. Socha","doi":"10.5114/ppn.2017.71278","DOIUrl":"https://doi.org/10.5114/ppn.2017.71278","url":null,"abstract":"Purpose: The study aimed at establishing the relationship between posttraumatic cognitions resulting from traumatic experiences as well as disruption in core beliefs and the level of symptoms of posttraumatic stress (PTSD). Another aim was to check whether the disruption of core beliefs is a mediator between posttraumatic cognitions and symptoms of PTSD. Methods: Results obtained from 57 parents aged 25-57 years (M = 35.38; SD = 8.32), who have dealt with their child’s cancer (men – 47.4%; women – 52.6%) were examined. Three measuring methods were used in the study: the Impact of Event Scale-Revised (IES-R), Posttraumatic Cognitions Inventory (PTCI) and the Core Beliefs Inventory (CBI). Results: The results showed positive associations between posttraumatic cognitions as well as disruption of core beliefs and the severity of PTSD. Challenges for core beliefs act as mediators in the relationship between posttraumatic cognitions and symptoms of PTSD. Conclusions: The experience of a traumatic event usually entails the occurrence of posttraumatic stress symptoms. The severity of these symptoms is determined by, among others, the individual’s beliefs about the world and about themselves. The experience of a child’s cancer is a traumatic experience for parents. Negative cognitions and disruption in key beliefs favour the persistence of PTSD symptoms. Disturbances in beliefs are mediators in the relationship between negative cognitions and symptoms of PTSD. Reducing symptoms of PTSD, and thus recovery, requires a change in beliefs that are distorted by trauma.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2017-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2017.71278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47132277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Stefaniak, Kamil Sorokosz, A. Janicki, J. Wciórka
Purpose: Description of cognitive behavioural therapy (CBT) of a patient diagnosed with paranoid schizophrenia, who experienced chronic negative auditory hallucinations (voices). Case description: Elements of CBT complemented by the use of virtual reality were described. Stages of the therapy of a 40-yearold patient hearing voices constantly for 7 years were presented. During the therapy, the patient was still treated pharmacologically (olanzapine 20 mg/day and risperidone 2 mg/day). Conceptualisation of the problem, therapy plan and the course of selected therapeutic interventions using an avatar were discussed. The empty chair technique supported by the use of the avatar was presented. The effects of 20 therapeutic sessions were evaluated, confirming a significant reduction in the frequency and intrusiveness of voices and sustainability of these effects in the 6-month follow-up. Comment: The described case is an example of a short-term effective therapeutic intervention during which, at the cognitive level, changes were observed in the experienced auditory hallucinations. Thanks to the use of the avatar, it was possible to create a representation of auditory hallucinations and to give them physical features, and, consequently, to work on changing beliefs about the source of these hallucinations. Furthermore, during the therapy, the avatar served as an exponent of critical content which the patient experienced in relations with his father.
{"title":"Use of an avatar in cognitive-behavioural therapy of a person who is chronically experiencing negative auditory hallucinations – case study","authors":"I. Stefaniak, Kamil Sorokosz, A. Janicki, J. Wciórka","doi":"10.5114/PPN.2017.71340","DOIUrl":"https://doi.org/10.5114/PPN.2017.71340","url":null,"abstract":"Purpose: Description of cognitive behavioural therapy (CBT) of a patient diagnosed with paranoid schizophrenia, who experienced chronic negative auditory hallucinations (voices). Case description: Elements of CBT complemented by the use of virtual reality were described. Stages of the therapy of a 40-yearold patient hearing voices constantly for 7 years were presented. During the therapy, the patient was still treated pharmacologically (olanzapine 20 mg/day and risperidone 2 mg/day). Conceptualisation of the problem, therapy plan and the course of selected therapeutic interventions using an avatar were discussed. The empty chair technique supported by the use of the avatar was presented. The effects of 20 therapeutic sessions were evaluated, confirming a significant reduction in the frequency and intrusiveness of voices and sustainability of these effects in the 6-month follow-up. Comment: The described case is an example of a short-term effective therapeutic intervention during which, at the cognitive level, changes were observed in the experienced auditory hallucinations. Thanks to the use of the avatar, it was possible to create a representation of auditory hallucinations and to give them physical features, and, consequently, to work on changing beliefs about the source of these hallucinations. Furthermore, during the therapy, the avatar served as an exponent of critical content which the patient experienced in relations with his father.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2017-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2017.71340","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48035428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: According to current developmental neuroscience, adolescence is a period of heightened sensitivity to rewards that results in the increased tendency towards risk. This paper presents the current state of knowledge on the consequences of adolescent sensitivity to rewards and indicates directions for future research. The following sections describe how sensitivity to rewards can be directed towards risk-taking, safe or prosocial behaviour, and improved cognitive performance, depending on different task demands and various social contexts. Views: Studies on adolescent behaviour conducted from the dual systems perspective indicate that heightened sensitivity to rewards can constitute vulnerability. The results gathered in this paper, however, demonstrate that in several situations adolescent sensitivity to rewards can be redirected from risk-taking towards safe or prosocial behaviour, or can result in the increased cognitive performance. Particularly interesting are the findings showing that individual differences in neural reward-related activity during risk and social dilemma tasks performed in a laboratory make it possible to predict risky behaviours (e.g. substance use, skipping school) and depressive symptoms, one year after the study. Conclusions: Investigating consequences of reward sensitivity in various tasks and diverse social contexts can shed more light on the nature of adolescent behaviour and lead to the development of the dual systems perspective.
{"title":"Adolescent sensitivity to rewards, risk-taking, and adaptive behaviour: development of the dual systems perspective","authors":"J. Fryt","doi":"10.5114/PPN.2017.70545","DOIUrl":"https://doi.org/10.5114/PPN.2017.70545","url":null,"abstract":"Purpose: According to current developmental neuroscience, adolescence is a period of heightened sensitivity to rewards that results in the increased tendency towards risk. This paper presents the current state of knowledge on the consequences of adolescent sensitivity to rewards and indicates directions for future research. The following sections describe how sensitivity to rewards can be directed towards risk-taking, safe or prosocial behaviour, and improved cognitive performance, depending on different task demands and various social contexts. Views: Studies on adolescent behaviour conducted from the dual systems perspective indicate that heightened sensitivity to rewards can constitute vulnerability. The results gathered in this paper, however, demonstrate that in several situations adolescent sensitivity to rewards can be redirected from risk-taking towards safe or prosocial behaviour, or can result in the increased cognitive performance. Particularly interesting are the findings showing that individual differences in neural reward-related activity during risk and social dilemma tasks performed in a laboratory make it possible to predict risky behaviours (e.g. substance use, skipping school) and depressive symptoms, one year after the study. Conclusions: Investigating consequences of reward sensitivity in various tasks and diverse social contexts can shed more light on the nature of adolescent behaviour and lead to the development of the dual systems perspective.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2017-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2017.70545","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49296567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Kiejna, M. Jakubczyk, S. Chładzińska-Kiejna, P. Baranowski, T. Gondek
Purpose: In Poland, the issue of hospitalising patients against their will and using means of direct physical coercion are regulated by the provisions of Law on Mental Health Protection (LoMHP); however, but no regular studies have been conducted to facilitate monitoring of the incidence of using coercive measures in the entire country. The aim of the study is to assess the incidence of using direct coercion measures on the patients admitted to in-patient wards of psychiatric hospitals and using such measures in Psychiatric Hospital in Wrocław, in the period from 2011 to 2015. Methods: The monitoring questionnaires of LoMHP, data on admissions and basic data characterising compulsory treatment were used. In order to assess the quality of psychiatric treatment and psychosocial rehabilitation, the International Classification of Mental Health Care questionnaire was used. Results: The average of involuntary admissions in the period between 2011 and 2015 amounted to 28.92%. The rates of admissions against the will of the patient based on articles 23, 24 and 29 of LoMHP, and the rate of patients held in hospital based on article 28 of LoMHP were stable in the studied period. The vast majority of involuntary admissions was based on article 23. The ratio of involuntary hospitalisation for 100 thousand residents was on average 65.14. Involuntary admissions usually referred to people with diagnosed F20 (schizophrenia) and F31 (bipolar disorders). Direct coercive measures were used on average on 19.64% hospitalised patients. Conclusions: PThe use of coercion is a common phenomenon in psychiatric institutions in Poland. The ratio of involuntary hospitalisation for 100 thousand residents was within the average values of this ratio in other countries.
{"title":"Admission without consent and use of means of physical coercion on the example of psychiatric hospital in Wrocław","authors":"A. Kiejna, M. Jakubczyk, S. Chładzińska-Kiejna, P. Baranowski, T. Gondek","doi":"10.5114/ppn.2017.70544","DOIUrl":"https://doi.org/10.5114/ppn.2017.70544","url":null,"abstract":"Purpose: In Poland, the issue of hospitalising patients against their will and using means of direct physical coercion are regulated by the provisions of Law on Mental Health Protection (LoMHP); however, but no regular studies have been conducted to facilitate monitoring of the incidence of using coercive measures in the entire country. The aim of the study is to assess the incidence of using direct coercion measures on the patients admitted to in-patient wards of psychiatric hospitals and using such measures in Psychiatric Hospital in Wrocław, in the period from 2011 to 2015. Methods: The monitoring questionnaires of LoMHP, data on admissions and basic data characterising compulsory treatment were used. In order to assess the quality of psychiatric treatment and psychosocial rehabilitation, the International Classification of Mental Health Care questionnaire was used. Results: The average of involuntary admissions in the period between 2011 and 2015 amounted to 28.92%. The rates of admissions against the will of the patient based on articles 23, 24 and 29 of LoMHP, and the rate of patients held in hospital based on article 28 of LoMHP were stable in the studied period. The vast majority of involuntary admissions was based on article 23. The ratio of involuntary hospitalisation for 100 thousand residents was on average 65.14. Involuntary admissions usually referred to people with diagnosed F20 (schizophrenia) and F31 (bipolar disorders). Direct coercive measures were used on average on 19.64% hospitalised patients. Conclusions: PThe use of coercion is a common phenomenon in psychiatric institutions in Poland. The ratio of involuntary hospitalisation for 100 thousand residents was within the average values of this ratio in other countries.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2017-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2017.70544","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70508113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Sniecikowska, M. Głuch-Lutwin, Adam Bucki, P. Mierzejewski, M. Kołaczkowski
Purpose: The article reviews the current state of knowledge about functional selectivity (biased agonism) at G protein-coupled receptors (GPCRs), with a particular focus on serotonin 5-HT 1A receptors. Views: Recently, functional selectivity has been one of the fastest growing topics in GPCRs pharmacology. Research on this phenomenon allowed identification of signal transduction pathways which can be preferentially targeted to achieve improved therapeu- tic effects or, conversely, which are associated with adverse effects. Oliceridine, a phase III clinical candidate for treatment of pain, is an example of a functionally selective ligand of µ-opioid receptors that preferentially activates signal transduction via G proteins rather than β-arrestin. Biased agonism, or the ability to preferentially activate specific signalling pathways, has been identified for many therapeutically important GPCRs, such as µ-opioid receptors, α 1 - and β 2 -adrenoceptors, dopamine D 2L and D 1 receptors, angiotensin 1A receptor, as well as 5-HT 2 and 5-HT 1A serotonin receptors. The recently discovered compounds F15599 and F13714 have been identified as functionally and regionally selective ligands of 5-HT 1A receptors. These compounds constitute a new generation of pharmacological tools with high therapeutic potential, which is currently being investigated for the treatment of disorders including Parkinson’s disease, depression and Rett syndrome. Conclusions: Functional selectivity (biased agonism) enables separation of the therapeutic effect from the adverse effects, so far considered to be intrinsically linked to the mechanism of action, by preferentially targeting signal transduction pathways associated with beneficial effects. It may therefore offer new opportunities for improved development of more effective and safer drugs. neurons (reduction of breathing regularity). Activation of 5-HT 1A receptors in the hippocampus and hypothalamus can lead to cognitive impairment, and a disruption of thermoregulation and neuroendocrine control. F15599, a biased agonist at the postsynaptic 5-HT 1A receptors located in the cerebral cortex and brain stem, may have a wider margin between the therapeutic activity and side effects associated with activation of other subpopulations of 5-HT 1A receptors
{"title":"Functional selectivity – chance for better and safer drugs?","authors":"J. Sniecikowska, M. Głuch-Lutwin, Adam Bucki, P. Mierzejewski, M. Kołaczkowski","doi":"10.5114/ppn.2017.70548","DOIUrl":"https://doi.org/10.5114/ppn.2017.70548","url":null,"abstract":"Purpose: The article reviews the current state of knowledge about functional selectivity (biased agonism) at G protein-coupled receptors (GPCRs), with a particular focus on serotonin 5-HT 1A receptors. Views: Recently, functional selectivity has been one of the fastest growing topics in GPCRs pharmacology. Research on this phenomenon allowed identification of signal transduction pathways which can be preferentially targeted to achieve improved therapeu- tic effects or, conversely, which are associated with adverse effects. Oliceridine, a phase III clinical candidate for treatment of pain, is an example of a functionally selective ligand of µ-opioid receptors that preferentially activates signal transduction via G proteins rather than β-arrestin. Biased agonism, or the ability to preferentially activate specific signalling pathways, has been identified for many therapeutically important GPCRs, such as µ-opioid receptors, α 1 - and β 2 -adrenoceptors, dopamine D 2L and D 1 receptors, angiotensin 1A receptor, as well as 5-HT 2 and 5-HT 1A serotonin receptors. The recently discovered compounds F15599 and F13714 have been identified as functionally and regionally selective ligands of 5-HT 1A receptors. These compounds constitute a new generation of pharmacological tools with high therapeutic potential, which is currently being investigated for the treatment of disorders including Parkinson’s disease, depression and Rett syndrome. Conclusions: Functional selectivity (biased agonism) enables separation of the therapeutic effect from the adverse effects, so far considered to be intrinsically linked to the mechanism of action, by preferentially targeting signal transduction pathways associated with beneficial effects. It may therefore offer new opportunities for improved development of more effective and safer drugs. neurons (reduction of breathing regularity). Activation of 5-HT 1A receptors in the hippocampus and hypothalamus can lead to cognitive impairment, and a disruption of thermoregulation and neuroendocrine control. F15599, a biased agonist at the postsynaptic 5-HT 1A receptors located in the cerebral cortex and brain stem, may have a wider margin between the therapeutic activity and side effects associated with activation of other subpopulations of 5-HT 1A receptors","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2017-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2017.70548","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49261056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Despite the significant increase in the understanding of the hyperkinetic disorder (HKD), our knowledge of the factors associated with the persistence of the disorder and further development of psychopathology is insufficient. The long-term prospective studies have aimed at identifying factors that may determine the adverse course of HKD. Methods: The study group 54 patients (95.1% male) with HKD (mean age 8.1, SD ± 1.7 years at the baseline assessment) was covered by a 12-year observation (mean age of participants: 19.1 ± 1.7 years at the end of the study). Subjects were comprehensively assessed with structured diagnostic interviews and assessments of cognitive functions, including the school and family functioning, the treatment as well as internalizing and externalizing problems. Results: Statistical analysis of the severity of HKD indicated significant reduction in the symptoms after 12 years. The birth complications (OR = 11.187; p = 0.045), chronic conflicts in family (OR = 0.129; p = 0.018) and depression of mother (OR = 6.033; p = 0.045) have proved to be significant risk factors for externalizing disorders in the study group. The single-parent family (OR = 0.099; p = 0.009) and coexistence of mothers’ anxiety disorders (OR = 0.318; p = 0.043) were a significant predictors for the model of internalizing disorders. Only 28 (51.9%) of children used regular systematic therapy. Lack of the systematic treatment was a significant risk factor of transition of HKD to antisocial phenotypes (univariate regression model: R = 0.56; SE = 0.12; p < 0.001). Conclusions: Long-term clinical observation showed that the appropriate systematic treatment until adulthood may significantly reduce undesirable behaviours. Completion of the treatment programme should be monitored systematically for many years, which greatly influences the results of school education and increases the chances for correct psychosocial development. Parents’ mental disorders/conflicts considerably decrease in the treatment effects, thereby increasing the risk of social maladjustment in patients with HKD.
{"title":"After-effects of hyperkinetic disorder (HKD) in prospective longitudinal (12 years) study","authors":"H. Kądziela-Olech","doi":"10.5114/ppn.2017.69373","DOIUrl":"https://doi.org/10.5114/ppn.2017.69373","url":null,"abstract":"Purpose: Despite the significant increase in the understanding of the hyperkinetic disorder (HKD), our knowledge of the factors associated with the persistence of the disorder and further development of psychopathology is insufficient. The long-term prospective studies have aimed at identifying factors that may determine the adverse course of HKD. Methods: The study group 54 patients (95.1% male) with HKD (mean age 8.1, SD ± 1.7 years at the baseline assessment) was covered by a 12-year observation (mean age of participants: 19.1 ± 1.7 years at the end of the study). Subjects were comprehensively assessed with structured diagnostic interviews and assessments of cognitive functions, including the school and family functioning, the treatment as well as internalizing and externalizing problems. Results: Statistical analysis of the severity of HKD indicated significant reduction in the symptoms after 12 years. The birth complications (OR = 11.187; p = 0.045), chronic conflicts in family (OR = 0.129; p = 0.018) and depression of mother (OR = 6.033; p = 0.045) have proved to be significant risk factors for externalizing disorders in the study group. The single-parent family (OR = 0.099; p = 0.009) and coexistence of mothers’ anxiety disorders (OR = 0.318; p = 0.043) were a significant predictors for the model of internalizing disorders. Only 28 (51.9%) of children used regular systematic therapy. Lack of the systematic treatment was a significant risk factor of transition of HKD to antisocial phenotypes (univariate regression model: R = 0.56; SE = 0.12; p < 0.001). Conclusions: Long-term clinical observation showed that the appropriate systematic treatment until adulthood may significantly reduce undesirable behaviours. Completion of the treatment programme should be monitored systematically for many years, which greatly influences the results of school education and increases the chances for correct psychosocial development. Parents’ mental disorders/conflicts considerably decrease in the treatment effects, thereby increasing the risk of social maladjustment in patients with HKD.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2017-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2017.69373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70507970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: The aim of this article is to provide a summary of findings concerning the olfactory loss associated with pathological neuro degenerative changes which occur in the course of Parkinson’s disease. Views: Olfactory function deficits occur in the early, prodromal stage of Parkinson’s disease and their severity is much higher, especially compared with other neurodegenerative diseases. Information on characteristics of olfactory loss in Parkinson’s disease is presented in the article. Conclusions: Authors indicate that olfactory function assessment is useful in differential diagnosis of neurodegenerative disorders in their prodromal stage and physiological aging. Olfactory ability evaluation may be also very helpful in differential diagnosis of parkinsonism syndromes. Severity of the olfactory impairment may be a good predictor of neuropsychiatric complications de velopment in Parkinson’s disease.
{"title":"Olfactory dysfunctions occurring in the course of Parkinson’s disease","authors":"Krzysztof Śmigórski, Agnieszka M. Śmigórska","doi":"10.5114/PPN.2017.69376","DOIUrl":"https://doi.org/10.5114/PPN.2017.69376","url":null,"abstract":"Purpose: The aim of this article is to provide a summary of findings concerning the olfactory loss associated with pathological neuro degenerative changes which occur in the course of Parkinson’s disease. Views: Olfactory function deficits occur in the early, prodromal stage of Parkinson’s disease and their severity is much higher, especially compared with other neurodegenerative diseases. Information on characteristics of olfactory loss in Parkinson’s disease is presented in the article. Conclusions: Authors indicate that olfactory function assessment is useful in differential diagnosis of neurodegenerative disorders in their prodromal stage and physiological aging. Olfactory ability evaluation may be also very helpful in differential diagnosis of parkinsonism syndromes. Severity of the olfactory impairment may be a good predictor of neuropsychiatric complications de velopment in Parkinson’s disease.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2017-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2017.69376","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70508085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ewa Poradowska, Katarzyna Szaulińska, A. Wierzbicka, A. Wichniak
Purpose: Shift work disorders (SWD) are caused by the divergence between external requirements concerning sleep-wake cycles during the day and the preferred time of sleep arising from our biological clock. Their symptoms include excessive sleepiness during working hours as well as sleep disorders, deterioration of functioning and numerous adverse health consequences. Case description: Shift work disorders treatment involves the implementation of behavioural interventions in order to promote activity during working hours, improve sleep quality and adapt the endogenous sleep-wake rhythm to a shift work schedule. The pharmacological treatment of SWD involves the use of melatonin or melatoninergic drugs. Comment: The purpose of this article is to present the impact of shift work on health and daily functioning as well as to discuss the treatment methods.
{"title":"Shift work: how do the patients cope with it and what should they do?","authors":"Ewa Poradowska, Katarzyna Szaulińska, A. Wierzbicka, A. Wichniak","doi":"10.5114/PPN.2017.69382","DOIUrl":"https://doi.org/10.5114/PPN.2017.69382","url":null,"abstract":"Purpose: Shift work disorders (SWD) are caused by the divergence between external requirements concerning sleep-wake cycles during the day and the preferred time of sleep arising from our biological clock. Their symptoms include excessive sleepiness during working hours as well as sleep disorders, deterioration of functioning and numerous adverse health consequences. Case description: Shift work disorders treatment involves the implementation of behavioural interventions in order to promote activity during working hours, improve sleep quality and adapt the endogenous sleep-wake rhythm to a shift work schedule. The pharmacological treatment of SWD involves the use of melatonin or melatoninergic drugs. Comment: The purpose of this article is to present the impact of shift work on health and daily functioning as well as to discuss the treatment methods.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2017-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2017.69382","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48411215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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