Agnieszka Kruczek, M. Basińska, Izabela Grzankowska
{"title":"Temperamental determinants of coping flexibility in adolescents","authors":"Agnieszka Kruczek, M. Basińska, Izabela Grzankowska","doi":"10.5114/ppn.2019.84354","DOIUrl":"https://doi.org/10.5114/ppn.2019.84354","url":null,"abstract":"","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2019.84354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70509969","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}
M. Basińska, Sandra Przyborowska-Stankiewicz, Agnieszka Kruczek, A. Liebert
Purpose: The question concerning coping competencies among other factors that improve quality of life of the chronically ill seems to be of particular importance. The aim of the study was to examine how private self-awareness defined in terms of rumination and reflection processes is related to flexibility both in thinking and coping as pivotal elements of adaptation to chronic illness. Methods: Participants in the study were 100 patients with non-specific inflammatory bowel diseases (Crohn’s disease and ulcerative colitis). The following instruments were used: the Rumination-Reflection Questionnaire (RRQ) by Paul D. Trapnell and Jennifer D. Campbell, the Cognitive Flexibility Questionnaire by John P. Dennis and Jillon S. Vander Wal, the Flexibility in Coping with Stress Questionnaire by Małgorzata A. Basińska and collaborators, the Short Self-Assessment of Depression and Anxiety by Andrzej Kokoszka, and a sociodemographic questionnaire developed by the present authors. Results: Ruminative tendencies were found to correlate negatively with a single dimension of cognitive flexibility, i.e. sense of control, and with a single dimension of coping flexibility, i.e. repertoire of coping strategies. Both these relationships were strengthened by the presence of self-assessed depression symptoms (the former), and self-assessed anxiety (the latter). The significance of reflective tendencies for flexi- bility was limited to a simple relationship with the dimensions of alternatives, variability and reflectiveness. Conclusions: In the work with people suffering from non-specific inflammatory bowel conditions it is important to reduce the pa- tients’ ruminative tendencies and monitor their anxiety and depression symptoms. If such symptoms are persistent, appropriate interventions seem to be equally important. H2: Relationships of ruminative and reflective tendencies with cognitive flexibility and coping flexibility are mediated by depression and anxiety.
目的:在改善慢性病患者生活质量的其他因素中，有关应对能力的问题似乎特别重要。这项研究的目的是为了研究在反思和反思过程中定义的私人自我意识是如何与思维和应对的灵活性相关的，这是适应慢性疾病的关键因素。方法:研究对象为100例非特异性炎症性肠病(克罗恩病和溃疡性结肠炎)患者。本研究使用了以下工具:Paul D. Trapnell和Jennifer D. Campbell的反思性问卷(RRQ)， John P. Dennis和Jillon S. Vander Wal的认知灵活性问卷，Małgorzata a . Basińska及其合作者的应对压力灵活性问卷，Andrzej Kokoszka的抑郁和焦虑短期自我评估问卷，以及本作者开发的社会人口调查问卷。结果:反刍倾向与认知灵活性的单一维度(控制感)和应对灵活性的单一维度(应对策略库)呈负相关。自我评估的抑郁症状(前者)和自我评估的焦虑(后者)的存在加强了这两种关系。反思倾向对灵活性的意义仅限于与可选择性、可变性和反思性的维度之间的简单关系。结论:在非特异性炎症性肠病患者的工作中，减少患者的反刍倾向和监测他们的焦虑和抑郁症状是重要的。如果这些症状持续存在，适当的干预措施似乎同样重要。H2:抑郁和焦虑介导了反刍和反思倾向与认知灵活性和应对灵活性的关系。
{"title":"Reflective-ruminative tendencies and coping flexibility in patients with non-specific inflammatory bowel diseases","authors":"M. Basińska, Sandra Przyborowska-Stankiewicz, Agnieszka Kruczek, A. Liebert","doi":"10.5114/PPN.2019.86254","DOIUrl":"https://doi.org/10.5114/PPN.2019.86254","url":null,"abstract":"Purpose: The question concerning coping competencies among other factors that improve quality of life of the chronically ill seems to be of particular importance. The aim of the study was to examine how private self-awareness defined in terms of rumination and reflection processes is related to flexibility both in thinking and coping as pivotal elements of adaptation to chronic illness. Methods: Participants in the study were 100 patients with non-specific inflammatory bowel diseases (Crohn’s disease and ulcerative colitis). The following instruments were used: the Rumination-Reflection Questionnaire (RRQ) by Paul D. Trapnell and Jennifer D. Campbell, the Cognitive Flexibility Questionnaire by John P. Dennis and Jillon S. Vander Wal, the Flexibility in Coping with Stress Questionnaire by Małgorzata A. Basińska and collaborators, the Short Self-Assessment of Depression and Anxiety by Andrzej Kokoszka, and a sociodemographic questionnaire developed by the present authors. Results: Ruminative tendencies were found to correlate negatively with a single dimension of cognitive flexibility, i.e. sense of control, and with a single dimension of coping flexibility, i.e. repertoire of coping strategies. Both these relationships were strengthened by the presence of self-assessed depression symptoms (the former), and self-assessed anxiety (the latter). The significance of reflective tendencies for flexi- bility was limited to a simple relationship with the dimensions of alternatives, variability and reflectiveness. Conclusions: In the work with people suffering from non-specific inflammatory bowel conditions it is important to reduce the pa- tients’ ruminative tendencies and monitor their anxiety and depression symptoms. If such symptoms are persistent, appropriate interventions seem to be equally important. H2: Relationships of ruminative and reflective tendencies with cognitive flexibility and coping flexibility are mediated by depression and anxiety.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2019.86254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70510501","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}
Marta Hat, P. Błądziński, A. Arciszewska, Artur Kochański, A. Cechnicki
This study conducted Schizophrenia Abstract Purpose: The aim of the study was to assess the opinions of Primary Care Physicians (PCPs) on psychiatry and psychiatrists and on attitudes towards psychiatry among the general population, and to compare PCPs’ views with the results of the research on psychiatrists’ attitudes. Methods: A survey method was used with self-completion questionnaires. The analysis was based on 211 questionnaires. Results: 97% of PCPs state that the primary form of treatment for psychiatric patients should be some form of out-patient health care. 61% of PCPs state that the prestige of psychiatry in the opinion of doctors of other specializations is average, 50% think that majority of psychiatrists are satisfied with their choice of specialization, and 73% believe that the level of responsibility of a psychiatrist is high. 71% of PCPs believe that the funding of psychiatry is on a lower level than in other areas of medicine, 67% believe that psychiatric treatment is moderately effective, while 26% state that it is highly effective. However, PCPs believe that 60% of the society assesses it as moderately effective and 38% as ineffective or mostly ineffective. Conclusions: Almost all PCPs state that the primary form of treatment for psychiatric patients should be community care. They do not see psychiatry as being so underfunded and stigmatized within the society as psychiatrists do. PCPs assess the efficacy of psychiatric treatment to be at a much higher level than do psychiatrists, which may result from a limited contact with the group of severely ill patients. The opinions indicate a need to introduce educational programs for family doctors.
{"title":"Opinions of primary care physicians and psychiatrists \u0000on psychiatry and psychiatrists – a comparison","authors":"Marta Hat, P. Błądziński, A. Arciszewska, Artur Kochański, A. Cechnicki","doi":"10.5114/ppn.2019.89132","DOIUrl":"https://doi.org/10.5114/ppn.2019.89132","url":null,"abstract":"This study conducted Schizophrenia Abstract Purpose: The aim of the study was to assess the opinions of Primary Care Physicians (PCPs) on psychiatry and psychiatrists and on attitudes towards psychiatry among the general population, and to compare PCPs’ views with the results of the research on psychiatrists’ attitudes. Methods: A survey method was used with self-completion questionnaires. The analysis was based on 211 questionnaires. Results: 97% of PCPs state that the primary form of treatment for psychiatric patients should be some form of out-patient health care. 61% of PCPs state that the prestige of psychiatry in the opinion of doctors of other specializations is average, 50% think that majority of psychiatrists are satisfied with their choice of specialization, and 73% believe that the level of responsibility of a psychiatrist is high. 71% of PCPs believe that the funding of psychiatry is on a lower level than in other areas of medicine, 67% believe that psychiatric treatment is moderately effective, while 26% state that it is highly effective. However, PCPs believe that 60% of the society assesses it as moderately effective and 38% as ineffective or mostly ineffective. Conclusions: Almost all PCPs state that the primary form of treatment for psychiatric patients should be community care. They do not see psychiatry as being so underfunded and stigmatized within the society as psychiatrists do. PCPs assess the efficacy of psychiatric treatment to be at a much higher level than do psychiatrists, which may result from a limited contact with the group of severely ill patients. The opinions indicate a need to introduce educational programs for family doctors.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2019.89132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70510891","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: In benzodiazepine (BZD) iatrogenic addiction, doses often run behind the growing level of the patient’s need. This creates experience of deficiency (withdrawal) symptoms, despite continued drug intake. As mirror reflections (negatives) of all the therapeutic actions of the drug, they mimic the original ailment, with extra symptoms. Despite observed resistance to standard treatment and responsiveness exclusively to BZD, these may be misinterpreted as a genuine malady, which dooms the outcome. Such mistakes need to be prevented. Case description: Two patients who began taking BZD to treat anxiety (female) and stress (male), over time became disability pensioners for “drug-resistant” anxiety disorders and “drug-resistant” somatic complaints. These ineffective treatments lasted until the dependence scenario was recognised. Proper treatment (detoxification) eliminated symptoms or made them responsive to standard treatment. Comment: Treating the “mirror” symptoms as a drug-resistant, genuine malady (or new diseases) worsens the patient’s condition and prognosis. Proper identification of the origin of a growing set of symptoms may result in a spectacular improvement.
{"title":"A drug-resistant recurrence of the primary illness or a persistent withdrawal syndrome? “Mirror” symptoms in patients in long-term treatment with benzodiazepines","authors":"Anna Basińska-Szafrańska","doi":"10.5114/ppn.2019.89138","DOIUrl":"https://doi.org/10.5114/ppn.2019.89138","url":null,"abstract":"Purpose: In benzodiazepine (BZD) iatrogenic addiction, doses often run behind the growing level of the patient’s need. This creates experience of deficiency (withdrawal) symptoms, despite continued drug intake. As mirror reflections (negatives) of all the therapeutic actions of the drug, they mimic the original ailment, with extra symptoms. Despite observed resistance to standard treatment and responsiveness exclusively to BZD, these may be misinterpreted as a genuine malady, which dooms the outcome. Such mistakes need to be prevented. Case description: Two patients who began taking BZD to treat anxiety (female) and stress (male), over time became disability pensioners for “drug-resistant” anxiety disorders and “drug-resistant” somatic complaints. These ineffective treatments lasted until the dependence scenario was recognised. Proper treatment (detoxification) eliminated symptoms or made them responsive to standard treatment. Comment: Treating the “mirror” symptoms as a drug-resistant, genuine malady (or new diseases) worsens the patient’s condition and prognosis. Proper identification of the origin of a growing set of symptoms may result in a spectacular improvement.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2019.89138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70510962","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}
Magdalena Gugała-Iwaniuk, E. Łojek, W. Lipczyńska-Łojkowska, B. Sawicka, A. Bochyńska, R. Poniatowska, W. Lechowicz, H. Sienkiewicz-Jarosz
Purpose: To examine the dynamics and cognitive indicators of neuropsychological change in patients with mild cognitive impairment (MCI). Methods: A total of 50 patients with MCI diagnosis and a control group of 33 healthy people took part in the study. A multidomain cognitive battery was administered and the volume of both regions of the hippocampus were measured using magnetic resonance imaging. Two assessments were made at a 24 month interval. According to the dynamics of global cognitive decline in two years the MCI patients were divided into stable (sMCI) and deteriorating (dMCI) groups. The three groups were comparable in terms of demographic variables and emotional state. Results: At baseline there was no significant difference between MCI groups on the level of the General Cognitive Functioning Index (GFI); however, the dMCI patients made significantly more errors in their performance. Hippocampal volumes were also similar in the MCI groups. After two years, the dMCI patients showed significant decline in the GFI and verbal memory as compared with the remaining groups. Hippocampal volumes significantly decreased in both MCI groups. There was a moderate relationship between the change in cognitive state and the change in left hippocampal volumetry in the MCI group as a whole (r = 0.4). Cognitive factors of inaccurate recall and perseverations differentiated the sMCI and dMCI patients at baseline (p = 0.04 and p = 0.01, respectively). Conclusions: Our findings suggest that neuropsychological indicators of verbal memory functions and executive aspects of memory seem to have a significant value in predicting cognitive deterioration in MCI patients.
{"title":"Dynamics of neurocognitive change in patients with mild cognitive impairment","authors":"Magdalena Gugała-Iwaniuk, E. Łojek, W. Lipczyńska-Łojkowska, B. Sawicka, A. Bochyńska, R. Poniatowska, W. Lechowicz, H. Sienkiewicz-Jarosz","doi":"10.5114/PPN.2019.86253","DOIUrl":"https://doi.org/10.5114/PPN.2019.86253","url":null,"abstract":"Purpose: To examine the dynamics and cognitive indicators of neuropsychological change in patients with mild cognitive impairment (MCI). Methods: A total of 50 patients with MCI diagnosis and a control group of 33 healthy people took part in the study. A multidomain cognitive battery was administered and the volume of both regions of the hippocampus were measured using magnetic resonance imaging. Two assessments were made at a 24 month interval. According to the dynamics of global cognitive decline in two years the MCI patients were divided into stable (sMCI) and deteriorating (dMCI) groups. The three groups were comparable in terms of demographic variables and emotional state. Results: At baseline there was no significant difference between MCI groups on the level of the General Cognitive Functioning Index (GFI); however, the dMCI patients made significantly more errors in their performance. Hippocampal volumes were also similar in the MCI groups. After two years, the dMCI patients showed significant decline in the GFI and verbal memory as compared with the remaining groups. Hippocampal volumes significantly decreased in both MCI groups. There was a moderate relationship between the change in cognitive state and the change in left hippocampal volumetry in the MCI group as a whole (r = 0.4). Cognitive factors of inaccurate recall and perseverations differentiated the sMCI and dMCI patients at baseline (p = 0.04 and p = 0.01, respectively). Conclusions: Our findings suggest that neuropsychological indicators of verbal memory functions and executive aspects of memory seem to have a significant value in predicting cognitive deterioration in MCI patients.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2019.86253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70510105","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. Czupryna, A. Rogucka, S. Pancewicz, Karol Borawski, M. Róg-Makal, Anna M. Moniuszko-Malinowska
Purpose: Parvovirus B19 is an etiological factor of many disorders, including erythema infectiosum, transient aplastic crisis, pure red cell aplasia, arthritis, non-immune hydrops fetalis and less commonly occurring neurological infections. Case description: In this paper we present the case of a 36-year old man, in whom encephalitis caused by B19 based on multidisciplinary differential process was diagnosed. The patient was a truck driver. This occupation is associated with the risk of infection through contact with contaminated cargo, difficulties in maintaining personal hygiene, risky sexual contacts, and endemic diseases occurring in different latitudes, which may suggest the infection with other pathogens e.g. HIV, and therefore be highly misleading. Comment: We conclude that B19 should be always taken into consideration in the differential diagnosis of encephalitis.
{"title":"Parvovirus B19 as a cause of encephalitis – a case report","authors":"P. Czupryna, A. Rogucka, S. Pancewicz, Karol Borawski, M. Róg-Makal, Anna M. Moniuszko-Malinowska","doi":"10.5114/PPN.2019.84357","DOIUrl":"https://doi.org/10.5114/PPN.2019.84357","url":null,"abstract":"Purpose: Parvovirus B19 is an etiological factor of many disorders, including erythema infectiosum, transient aplastic crisis, pure red cell aplasia, arthritis, non-immune hydrops fetalis and less commonly occurring neurological infections. Case description: In this paper we present the case of a 36-year old man, in whom encephalitis caused by B19 based on multidisciplinary differential process was diagnosed. The patient was a truck driver. This occupation is associated with the risk of infection through contact with contaminated cargo, difficulties in maintaining personal hygiene, risky sexual contacts, and endemic diseases occurring in different latitudes, which may suggest the infection with other pathogens e.g. HIV, and therefore be highly misleading. Comment: We conclude that B19 should be always taken into consideration in the differential diagnosis of encephalitis.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2019.84357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70509820","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 objective of this study was to review the literature to find scientific evidence about the mechanisms involved in orofacial sensory interaction, including trigeminal and special sensory modalities. Views: Conscious sensory perception depends on peripheral external and internal stimuli, which are integrated and processed in central neural centres in order to promote the sensory experience through learning and memory. In the orofacial region, besides somatosensory inputs, there are special sensory modalities (gustation, olfaction, vision and audition) that interact with trigeminal ascendant inputs in a way that makes this area of the body unique. Moreover, the trigeminal nerve may have an important role due to the complex functions of this region, including breathing, feeding and detecting threats. In recent decades the development of equipment accurate enough to detect sensory thresholds has produced a wide range of evidence about orofacial interaction, which allows for the possible development of a unified underlying theory on this issue. Conclusions: The trigeminal system seems to mediate olfactory and gustative sensations in cortical associative centres, and sensory peripheral neural inputs are modulated by physiological and pathological conditions. Future experimental studies should seek to clarify the mechanisms involved in this interaction, and the role of pathological states in abnormalities of sensory thresholds and perception.
{"title":"Sensory interaction theory: revision of the craniofacial region","authors":"S. Siqueira, M. Teixeira","doi":"10.5114/ppn.2019.84358","DOIUrl":"https://doi.org/10.5114/ppn.2019.84358","url":null,"abstract":"Purpose: The objective of this study was to review the literature to find scientific evidence about the mechanisms involved in orofacial sensory interaction, including trigeminal and special sensory modalities. Views: Conscious sensory perception depends on peripheral external and internal stimuli, which are integrated and processed in central neural centres in order to promote the sensory experience through learning and memory. In the orofacial region, besides somatosensory inputs, there are special sensory modalities (gustation, olfaction, vision and audition) that interact with trigeminal ascendant inputs in a way that makes this area of the body unique. Moreover, the trigeminal nerve may have an important role due to the complex functions of this region, including breathing, feeding and detecting threats. In recent decades the development of equipment accurate enough to detect sensory thresholds has produced a wide range of evidence about orofacial interaction, which allows for the possible development of a unified underlying theory on this issue. Conclusions: The trigeminal system seems to mediate olfactory and gustative sensations in cortical associative centres, and sensory peripheral neural inputs are modulated by physiological and pathological conditions. Future experimental studies should seek to clarify the mechanisms involved in this interaction, and the role of pathological states in abnormalities of sensory thresholds and perception.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2019.84358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70509840","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: To present the physician’s work ethic of Professor Antoni Kępiński, who, throughout his professional life, emphasized the importance of a sincere, accepting and non-judgemental approach to the patient. This was the only relationship capable, in Professor Kępiński’s opinion, of enabling the practitioner to know the patient and provide successful therapy. Do modern psychiatrists follow this concept? In practice a question arises about the current shape of the psychiatrist-patient relationship and what the relationship should look like. Views: In his numerous publications Antoni Kępiński lists errors made by psychiatrists while diagnosing and treating patients with mental disorders. Such errors can be divided into three groups: the ‘object’ error (the doctor is not treating the patient as a subject but rather as an object, their relationship is not partner-like), the ‘mask’ error (the adoption of an artificial pose that is at odds with the physician’s current actual psychic experience), and the ‘judge’ error (the doctor is judging the patient). Conclusions: Analysis of sample decisions from Regional Medical Disciplinary Boards (okręgowy sąd lekarski — OSL — ‘regional medical court’), and the Supreme Medical Disciplinary Board (Naczelny Sąd Lekarski — NSL — ‘Supreme Medical Court’) involving psychiatrists shows behaviours inconsistent with Professor Kępiński’s high ideals. Errors result mainly from a lack of ability to take a holistic view of the patient and establish appropriate contact with them as a human being. Hence, there is a need to develop the skill of doctor-patient conversation early on, in specialization training, and later throughout the psychiatrist’s entire professional life.
目的:介绍医生的职业道德教授安东尼Kępiński，谁，在他的职业生涯中，强调了一个真诚的，接受和非判断的方法对病人的重要性。在Kępiński教授看来，这是唯一能够使医生了解病人并提供成功治疗的关系。现代精神科医生遵循这个概念吗?在实践中，出现了一个关于精神科医生-病人关系的当前形态以及这种关系应该是什么样子的问题。观点:Antoni Kępiński在他的众多出版物中列出了精神科医生在诊断和治疗精神障碍患者时所犯的错误。这种错误可以分为三类:“客体”错误(医生没有把病人当作主体，而是把病人当作客体，他们的关系不是伴侣式的)，“面具”错误(采用与医生目前的实际精神体验不一致的人工姿势)，以及“判断”错误(医生在判断病人)。结论:对区域医学纪律委员会(okręgowy sąd lekarski - OSL -“区域医学法院”)和最高医学纪律委员会(Naczelny Sąd lekarski - NSL -“最高医学法院”)涉及精神科医生的样本决定的分析表明，精神科医生的行为与Kępiński教授的崇高理想不符。错误主要是由于缺乏对病人的整体看法和与他们作为一个人建立适当联系的能力。因此，有必要在早期，在专业培训中，以及在精神科医生的整个职业生涯中发展医患对话的技能。
{"title":"The ‘good psychiatrist’ standard according to Antoni Kępiński. Examples from the decisions of medical disciplinary boards","authors":"Iwona Wrześniewska-Wal","doi":"10.5114/ppn.2019.92488","DOIUrl":"https://doi.org/10.5114/ppn.2019.92488","url":null,"abstract":"Purpose: To present the physician’s work ethic of Professor Antoni Kępiński, who, throughout his professional life, emphasized the importance of a sincere, accepting and non-judgemental approach to the patient. This was the only relationship capable, in Professor Kępiński’s opinion, of enabling the practitioner to know the patient and provide successful therapy. Do modern psychiatrists follow this concept? In practice a question arises about the current shape of the psychiatrist-patient relationship and what the relationship should look like. Views: In his numerous publications Antoni Kępiński lists errors made by psychiatrists while diagnosing and treating patients with mental disorders. Such errors can be divided into three groups: the ‘object’ error (the doctor is not treating the patient as a subject but rather as an object, their relationship is not partner-like), the ‘mask’ error (the adoption of an artificial pose that is at odds with the physician’s current actual psychic experience), and the ‘judge’ error (the doctor is judging the patient). Conclusions: Analysis of sample decisions from Regional Medical Disciplinary Boards (okręgowy sąd lekarski — OSL — ‘regional medical court’), and the Supreme Medical Disciplinary Board (Naczelny Sąd Lekarski — NSL — ‘Supreme Medical Court’) involving psychiatrists shows behaviours inconsistent with Professor Kępiński’s high ideals. Errors result mainly from a lack of ability to take a holistic view of the patient and establish appropriate contact with them as a human being. Hence, there is a need to develop the skill of doctor-patient conversation early on, in specialization training, and later throughout the psychiatrist’s entire professional life.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2019.92488","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70511275","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 the study was to review the current data from the literature on resistance to acetylsalicylic acid in patients with ischemic stroke, in particular its incidence, etiological mechanisms, diagnostic tests, its impact on the prognosis for patients who have suffered the stroke and the use of alternative antiplatelet therapies. Views: Acetylsalicylic acid is the most commonly used antiplatelet drug in the treatment and prophylaxis of patients with a diagnosis of ischemic stroke. It inhibits the activation and aggregation of platelets, playing an important role in the etiopathogenesis of ischemic stroke. In many patients, the reduced sensitivity of platelets to acetylsalicylic acid contributes to the ineffectiveness of the treatment. Platelet reactivity tests allow for the estimation of the laboratory resistance to aspirin and determine its impact on the prognosis of patients with ischemic stroke. Conclusions: The incidence of resistance to acetylsalicylic acid is common (5-65%) and has a complex, multifactorial aetiology, which significantly inhibits its therapeutic effect. Aspirin resistance worsens the ischemic stroke patients’ prognosis, both early and long-term, as has a negative impact on their clinical and functional status, mortality, size of ischemic focus and also for the tendency towards the recurrence of cerebrovascular incidents. Alternative therapies are recommended for patients with resistance to acetylsalicylic acid. Further research is required so as to enable aspirin-resistant patients to take advantage of optimized antiplatelet treatment, the effectiveness of which is a priority among this group of patients.
{"title":"The role of resistance to acetylsalicylic acid in patients with ischemic stroke","authors":"A. Wiśniewski, K. Filipska","doi":"10.5114/ppn.2019.92487","DOIUrl":"https://doi.org/10.5114/ppn.2019.92487","url":null,"abstract":"Purpose: The aim of the study was to review the current data from the literature on resistance to acetylsalicylic acid in patients with ischemic stroke, in particular its incidence, etiological mechanisms, diagnostic tests, its impact on the prognosis for patients who have suffered the stroke and the use of alternative antiplatelet therapies. Views: Acetylsalicylic acid is the most commonly used antiplatelet drug in the treatment and prophylaxis of patients with a diagnosis of ischemic stroke. It inhibits the activation and aggregation of platelets, playing an important role in the etiopathogenesis of ischemic stroke. In many patients, the reduced sensitivity of platelets to acetylsalicylic acid contributes to the ineffectiveness of the treatment. Platelet reactivity tests allow for the estimation of the laboratory resistance to aspirin and determine its impact on the prognosis of patients with ischemic stroke. Conclusions: The incidence of resistance to acetylsalicylic acid is common (5-65%) and has a complex, multifactorial aetiology, which significantly inhibits its therapeutic effect. Aspirin resistance worsens the ischemic stroke patients’ prognosis, both early and long-term, as has a negative impact on their clinical and functional status, mortality, size of ischemic focus and also for the tendency towards the recurrence of cerebrovascular incidents. Alternative therapies are recommended for patients with resistance to acetylsalicylic acid. Further research is required so as to enable aspirin-resistant patients to take advantage of optimized antiplatelet treatment, the effectiveness of which is a priority among this group of patients.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2019.92487","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70511343","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}
{"title":"From the Senior Editor","authors":"J. Wciórka","doi":"10.5114/ppn.2019.92483","DOIUrl":"https://doi.org/10.5114/ppn.2019.92483","url":null,"abstract":"","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2019.92483","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70510671","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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