Abstract Introduction: In recent years, numerous studies have focused on the analysis of the primary mechanisms and forms of therapy in children and adolescents with attention deficit hyperactivity disorder (ADHD). The analysis of such topics among similarly diagnosed young adults is only beginning to gain popularity. The present article attempts to answer the question of whether the level of individual temperament traits will predict an increase in the severity of ADHD symptoms in young adults. Materials and methods: The questionnaire study involved 111 young adults aged from 18 to 28 (M= 23; SD= 2.12; 70 women and 41 men). Fifty-one people were included in the clinical group, and sixty were qualified for the control one. The participants of the study completed a health questionnaire and a structured diagnostic interview on ADHD symptoms in adults (DIVA 2.0) and a questionnaire for the diagnosis of basic, biologically determined dimensions of human personality (FCZ-KT (R)). Results: The results indicate a significant role of four temperament traits that may be considered as specific risk factors for the aggravation of ADHD symptoms. These include briskness, rhythm, endurance and activity. Conclusions: In Strelau’s Regulatory Theory of Temperament, the variability of temperament traits (in the Polish population) is attributed in 44% to genetic factors. The remaining 56% indicate non-genetic factors. The obtained results may indicate which factors are important in therapeutic work both in the group of young adults with ADHD symptoms, and may also constitute a source of information for parents or teachers regarding younger children with these symptoms.
{"title":"Temperamental risk factors in young adults with ADHD symptoms","authors":"Natalia Kajka, A. Kulik, Maja Wachnicka","doi":"10.2478/cpp-2020-0013","DOIUrl":"https://doi.org/10.2478/cpp-2020-0013","url":null,"abstract":"Abstract Introduction: In recent years, numerous studies have focused on the analysis of the primary mechanisms and forms of therapy in children and adolescents with attention deficit hyperactivity disorder (ADHD). The analysis of such topics among similarly diagnosed young adults is only beginning to gain popularity. The present article attempts to answer the question of whether the level of individual temperament traits will predict an increase in the severity of ADHD symptoms in young adults. Materials and methods: The questionnaire study involved 111 young adults aged from 18 to 28 (M= 23; SD= 2.12; 70 women and 41 men). Fifty-one people were included in the clinical group, and sixty were qualified for the control one. The participants of the study completed a health questionnaire and a structured diagnostic interview on ADHD symptoms in adults (DIVA 2.0) and a questionnaire for the diagnosis of basic, biologically determined dimensions of human personality (FCZ-KT (R)). Results: The results indicate a significant role of four temperament traits that may be considered as specific risk factors for the aggravation of ADHD symptoms. These include briskness, rhythm, endurance and activity. Conclusions: In Strelau’s Regulatory Theory of Temperament, the variability of temperament traits (in the Polish population) is attributed in 44% to genetic factors. The remaining 56% indicate non-genetic factors. The obtained results may indicate which factors are important in therapeutic work both in the group of young adults with ADHD symptoms, and may also constitute a source of information for parents or teachers regarding younger children with these symptoms.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"58 1","pages":"140 - 153"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77180932","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}
Abstract Objective: The use of corticosteroids might be associated with the sequelae of psychiatric comorbidity – manic and depressive symptoms, psychosis, and cognitive impairment. Case report: We report a case of the 35 years old man who presented seven months period of irritability, occasional low mood, and sleep disturbances without the concurrent hallucinations or delusions. The patient had a history of nephrotic syndrome and for this reason, required prednisolone. The corticosteroid induced irritability that has appeared three months after the treatment has started. The psychiatric examination showed neither the psychomotor retardation, manic or depressed mood, nor hallucinations and delusions. However, the level of irritability was undoubtedly increased. Conclusions: Corticosteroids are drugs commonly used in many systemic diseases. During a psychiatric examination, a careful evaluation is necessary to distinguish the side effects of corticosteroids from the primary psychiatric disorders.
{"title":"Mood disorder induced by prednisolone – an easily overlooked complication","authors":"N. Pang, R. Masiran","doi":"10.2478/cpp-2020-0012","DOIUrl":"https://doi.org/10.2478/cpp-2020-0012","url":null,"abstract":"Abstract Objective: The use of corticosteroids might be associated with the sequelae of psychiatric comorbidity – manic and depressive symptoms, psychosis, and cognitive impairment. Case report: We report a case of the 35 years old man who presented seven months period of irritability, occasional low mood, and sleep disturbances without the concurrent hallucinations or delusions. The patient had a history of nephrotic syndrome and for this reason, required prednisolone. The corticosteroid induced irritability that has appeared three months after the treatment has started. The psychiatric examination showed neither the psychomotor retardation, manic or depressed mood, nor hallucinations and delusions. However, the level of irritability was undoubtedly increased. Conclusions: Corticosteroids are drugs commonly used in many systemic diseases. During a psychiatric examination, a careful evaluation is necessary to distinguish the side effects of corticosteroids from the primary psychiatric disorders.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"49 1","pages":"137 - 139"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82312345","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}
Abstract Introduction: Introduction: Both dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) are important dementia syndromes that overlap in their clinical features and clinical course, neuropathological abnormalities, and also therapeutic approach. Nevertheless it is still unclear whether DLB and PDD are two different disorders that require differentiation or are one clinical entity within a spectrum of Lewy body disease. Currently these disorders are mainly distinguished on the basis of the relative timing of the onset of symptoms of dementia and parkinsonism. The present paper presents current concepts on the pathogenesis of both disorders and their possible overlap. Material and methods: Online databases in the field of DLB and PDD were searched for to find potentially eligible articles. Only most recent articles published after the year 2000 were chosen. Results: The clinical features of DLB and PDD are similar and include dementia with hallucinations and cognitive fluctuations, as well as parkinsonian signs. Also cognitive deficits are similar in PDD and in DLB, with predominance of executive dysfunction, visual-spatial deficits and memory impairment. Neuropathological changes in both disorders involve the presence of Lewy bodies and Lewy neurites within brainstem, limbic and neocortex, as well as loss of midbrain dopamine cells, and loss of cholinergic neurons in the nuclei of ventral forebrain. Conclusions: Similarities in clinical manifestation, neuropsychological deficits and neuropathological abnormalities may suggest that both DLB and PDD are two different phenotypes of the same disorder. This review article presents current knowledge on similarities and differences between these two clinical entities and raises the question whether they require differentiation or not.
{"title":"Dementia with Lewy bodies and Parkinson’s disease dementia-two independent disorders or one clinical entity within a clinical spectrum of synucleinopathies?","authors":"E. Papuć","doi":"10.2478/cpp-2020-0015","DOIUrl":"https://doi.org/10.2478/cpp-2020-0015","url":null,"abstract":"Abstract Introduction: Introduction: Both dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) are important dementia syndromes that overlap in their clinical features and clinical course, neuropathological abnormalities, and also therapeutic approach. Nevertheless it is still unclear whether DLB and PDD are two different disorders that require differentiation or are one clinical entity within a spectrum of Lewy body disease. Currently these disorders are mainly distinguished on the basis of the relative timing of the onset of symptoms of dementia and parkinsonism. The present paper presents current concepts on the pathogenesis of both disorders and their possible overlap. Material and methods: Online databases in the field of DLB and PDD were searched for to find potentially eligible articles. Only most recent articles published after the year 2000 were chosen. Results: The clinical features of DLB and PDD are similar and include dementia with hallucinations and cognitive fluctuations, as well as parkinsonian signs. Also cognitive deficits are similar in PDD and in DLB, with predominance of executive dysfunction, visual-spatial deficits and memory impairment. Neuropathological changes in both disorders involve the presence of Lewy bodies and Lewy neurites within brainstem, limbic and neocortex, as well as loss of midbrain dopamine cells, and loss of cholinergic neurons in the nuclei of ventral forebrain. Conclusions: Similarities in clinical manifestation, neuropsychological deficits and neuropathological abnormalities may suggest that both DLB and PDD are two different phenotypes of the same disorder. This review article presents current knowledge on similarities and differences between these two clinical entities and raises the question whether they require differentiation or not.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"183 1","pages":"161 - 166"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88294418","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}
Abstract Paranoid schizophrenia is a chronic, psychotic disorder which can be treated with long-acting injectable (LAI) antipsychotic drugs. There are risperidone (Risperdal Consta®), olanzapine (Zypadhera®), paliperidone (Xepilon®) and aripiprazole (Abilify Maintena®) currently available. The aim of this study was to present a case history of the patient to whom monthly injections of aripiprazole effectively prevented both relapses of psychotic symptoms and hospitalizations. Case report: A 55-year-old male patient with a 13-year history of paranoid schizophrenia has been effectively treated with aripiprazole (LAI) (400mg, every 4 weeks). During the last 8 years of treatment his mental state has been stabilized, without any acute psychotic symptoms and without any anxiety, or violent behaviours. Moreover, there have been no psychotic symptoms, or suicidal thoughts, or tendencies recordered. Therefore, no hospitalization has been required. However, despite the treatment, negative symptoms such as blunted affect, cognitive dysfunction and social withdrawal have been sustained. Discussion: The available articles on aripiprazole (LAI) treatment indicate that it was effective in reducing the positive and negative symptoms of schizophrenia, as well as reducing the frequency and duration of hospitalization. However, the case report of a patient who has not had relapses of psychotic symptoms and suicidal thoughts and has not been hospitalized during 8 years of treatment with aripiprazole (LAI) has not yet been reported. Conclusions: Regular, long-term injections of aripiprazole (LAI) are very effective at preventing positive symptoms of schizophrenia development and preventing both suicidal thoughts and hospitalizations. Therefore, treatment with this drug in everyday practice should be increased.
{"title":"The effectiveness of long-term aripiprazole injections to a patient with paranoid schizophrenia: a case report","authors":"A. Szota, A. Araszkiewicz","doi":"10.2478/cpp-2020-0014","DOIUrl":"https://doi.org/10.2478/cpp-2020-0014","url":null,"abstract":"Abstract Paranoid schizophrenia is a chronic, psychotic disorder which can be treated with long-acting injectable (LAI) antipsychotic drugs. There are risperidone (Risperdal Consta®), olanzapine (Zypadhera®), paliperidone (Xepilon®) and aripiprazole (Abilify Maintena®) currently available. The aim of this study was to present a case history of the patient to whom monthly injections of aripiprazole effectively prevented both relapses of psychotic symptoms and hospitalizations. Case report: A 55-year-old male patient with a 13-year history of paranoid schizophrenia has been effectively treated with aripiprazole (LAI) (400mg, every 4 weeks). During the last 8 years of treatment his mental state has been stabilized, without any acute psychotic symptoms and without any anxiety, or violent behaviours. Moreover, there have been no psychotic symptoms, or suicidal thoughts, or tendencies recordered. Therefore, no hospitalization has been required. However, despite the treatment, negative symptoms such as blunted affect, cognitive dysfunction and social withdrawal have been sustained. Discussion: The available articles on aripiprazole (LAI) treatment indicate that it was effective in reducing the positive and negative symptoms of schizophrenia, as well as reducing the frequency and duration of hospitalization. However, the case report of a patient who has not had relapses of psychotic symptoms and suicidal thoughts and has not been hospitalized during 8 years of treatment with aripiprazole (LAI) has not yet been reported. Conclusions: Regular, long-term injections of aripiprazole (LAI) are very effective at preventing positive symptoms of schizophrenia development and preventing both suicidal thoughts and hospitalizations. Therefore, treatment with this drug in everyday practice should be increased.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"11 1","pages":"154 - 160"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88377704","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. Romaniuk, Konrad Suswał, Aleksandra Skałecka, Maria Gromek, Martyna Kozłowska, P. Krukow
Abstract Introduction: Dyskinesia is a symptom complex in the form of involuntary, repetitive movements of lips, lower jaw, tongue, less often the trunk and limbs. Despite the use of newer drugs in treatment neuroleptics, dyskinesia has not ceased to be a clinical problem. Method: The work is based on a research review for which the Google Scholar database was used as well PubMed. The search range was limited to 2008-2020. We have included descriptive publications tardive dyskinesia only as a consequence of antipsychotic medications. Material: We present the use of tetrabenazine analogues, deep brain stimulation, neuroleptics, benzodiazepines and botulinum toxin in late-suffering patients drug-induced dyskinesias, which may indicate an improvement in your health. Discussion: The first method of treating tardive dyskinesia are withdrawal antipsychotic medications, but for many patients this is impossible. Valbenazine and Deep Brain Stimulation are the most effective in treating Tardive Dyskinesia. Conclusions: There are not enough studies with the highest reliability to create unequivocal recommendations in the treatment of drug-induced tardive dyskinesia.
{"title":"Drug-induced dyskinesias, can they be prevented?","authors":"M. Romaniuk, Konrad Suswał, Aleksandra Skałecka, Maria Gromek, Martyna Kozłowska, P. Krukow","doi":"10.2478/cpp-2020-0009","DOIUrl":"https://doi.org/10.2478/cpp-2020-0009","url":null,"abstract":"Abstract Introduction: Dyskinesia is a symptom complex in the form of involuntary, repetitive movements of lips, lower jaw, tongue, less often the trunk and limbs. Despite the use of newer drugs in treatment neuroleptics, dyskinesia has not ceased to be a clinical problem. Method: The work is based on a research review for which the Google Scholar database was used as well PubMed. The search range was limited to 2008-2020. We have included descriptive publications tardive dyskinesia only as a consequence of antipsychotic medications. Material: We present the use of tetrabenazine analogues, deep brain stimulation, neuroleptics, benzodiazepines and botulinum toxin in late-suffering patients drug-induced dyskinesias, which may indicate an improvement in your health. Discussion: The first method of treating tardive dyskinesia are withdrawal antipsychotic medications, but for many patients this is impossible. Valbenazine and Deep Brain Stimulation are the most effective in treating Tardive Dyskinesia. Conclusions: There are not enough studies with the highest reliability to create unequivocal recommendations in the treatment of drug-induced tardive dyskinesia.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"28 1","pages":"95 - 101"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85899195","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. Romaniuk, Konrad Suswał, Aleksandra Skałecka, Maria Gromek, Martyna Kozłowska, P. Krukow
Abstract Introduction: Deep Brain Stimulation can directly alter brain activity in a controlled manner and the effect is reversible. The mechanism is that the electrode acts locally on neural activity, which is transferred to monosynchronous and multisynaptic network connections. Methods: We present studies conducted on a group of patients that show an improvement in mental state after Deep Brain Stimulation. Material: The diseases we included in our work are: Obsessive-Compulsive Disorder, Eating Disorder, Depression and Bipolar Affective Disorder. Discussion: The use of deep brain stimulation can inhibit development of acute state of patients and improve both psychiatric features and the time of remission. The results indicate the greatest effectiveness of Deep Brain Stimulation in Obsessive-Compulsive Disorders. Conclusions: Brain stimulation may be a promising therapeutic target in mental illness. In a properly selected location, it can contribute to a significant clinical improvement however further research in this direction is necessary.
{"title":"Deep brain stimulation (DBS) in resistant mental disorders","authors":"M. Romaniuk, Konrad Suswał, Aleksandra Skałecka, Maria Gromek, Martyna Kozłowska, P. Krukow","doi":"10.2478/cpp-2020-0008","DOIUrl":"https://doi.org/10.2478/cpp-2020-0008","url":null,"abstract":"Abstract Introduction: Deep Brain Stimulation can directly alter brain activity in a controlled manner and the effect is reversible. The mechanism is that the electrode acts locally on neural activity, which is transferred to monosynchronous and multisynaptic network connections. Methods: We present studies conducted on a group of patients that show an improvement in mental state after Deep Brain Stimulation. Material: The diseases we included in our work are: Obsessive-Compulsive Disorder, Eating Disorder, Depression and Bipolar Affective Disorder. Discussion: The use of deep brain stimulation can inhibit development of acute state of patients and improve both psychiatric features and the time of remission. The results indicate the greatest effectiveness of Deep Brain Stimulation in Obsessive-Compulsive Disorders. Conclusions: Brain stimulation may be a promising therapeutic target in mental illness. In a properly selected location, it can contribute to a significant clinical improvement however further research in this direction is necessary.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"3 1","pages":"84 - 94"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81853612","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}
Abstract Introduction: In psychiatry and psychology stigmatization consists in labelling a person suffering from a disorder with the stigma of mental illness, associated with numerous negative stereotypes that are established in both individual and social mentality. Objective: The aim of the present article is to present the phenomenon of self-stigma from the perspective of psychiatric patients, including patients suffering from schizophrenia, to scientific consideration. The state of knowledge: The available data on this subject suggests that schizophrenia is particularly stigmatized, and the degree of stigmatization of patients with this diagnosis is worsening. Self-stigma plays a significant role in various areas of patients’ lives, sometimes discouraging them to continue therapy. Psychiatric patients have to face not only the symptoms of their disorders, but also stigmatization. In the event patient’s self-stigmatization of mental illness occurs, a responsible psychiatrist and psychologist conducting the therapy has the moral obligation to supervise the process of psychiatric and psychological assistance in the context of the aforelisted issues. Conclusions: The problem of self-stigmatization of a psychiatric patients is a topical issue that is well worth further exploration in order to better understand and help patients more effectively.
{"title":"Psychiatric, psychological and ethical determinants of the phenomenon of self-stigmatization of mental illness – literature review","authors":"E. Soroka, M. Stepulak","doi":"10.2478/cpp-2020-0006","DOIUrl":"https://doi.org/10.2478/cpp-2020-0006","url":null,"abstract":"Abstract Introduction: In psychiatry and psychology stigmatization consists in labelling a person suffering from a disorder with the stigma of mental illness, associated with numerous negative stereotypes that are established in both individual and social mentality. Objective: The aim of the present article is to present the phenomenon of self-stigma from the perspective of psychiatric patients, including patients suffering from schizophrenia, to scientific consideration. The state of knowledge: The available data on this subject suggests that schizophrenia is particularly stigmatized, and the degree of stigmatization of patients with this diagnosis is worsening. Self-stigma plays a significant role in various areas of patients’ lives, sometimes discouraging them to continue therapy. Psychiatric patients have to face not only the symptoms of their disorders, but also stigmatization. In the event patient’s self-stigmatization of mental illness occurs, a responsible psychiatrist and psychologist conducting the therapy has the moral obligation to supervise the process of psychiatric and psychological assistance in the context of the aforelisted issues. Conclusions: The problem of self-stigmatization of a psychiatric patients is a topical issue that is well worth further exploration in order to better understand and help patients more effectively.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"18 1","pages":"59 - 69"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89330640","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}
K. Karakuła, M. Romaniuk, Karol Krupa, M. Futyma-Jędrzejewska, D. Juchnowicz
Abstract Introduction: Cotard’s syndrome (CS) is a rare set of psychopathological symptoms, the main symptom of which is nihilistic delusions concerning the negation of the existence of internal organs or the entire body Aim, material and methodology: The aim of the study is to present a case of a patient treated for postpartum depression who developed Cotard’s syndrome. The patient’s symptoms began immediately after her daughter. The clinical picture was dominated by anxiety and apathy, nihilistic delusions about the atrophy of the urethra and other lower abdominal organs, and olfactory hallucinations - she could smell rot. Discussion: The available literature on Cotard’s Syndrome does not allow us to indicate a certain reason for its development. Perhaps the birth of the first child - the woman doubted herself as a mother, she was afraid that she would hurt the cause of the disorders observed and described by us was transient ischemia of the CNS during delivery. Conclusions: Cotard’s syndrome can develop in the course of many mental and somatoform disorders. The described case is, to our knowledge, the first description of Cotard’s Syndrome in the deprivation period. Difficulties in establishing the etiopathogenesis and pathophysiology of Cotard’s Syndrome translate into therapeutic problems. It has been suggested that the treatment of the underlying disorder on the basis of which CS is developed remains the most effective method of therapy.
{"title":"My Body Is Rotting: A case report of Cotard’s syndrome in a postpartum woman","authors":"K. Karakuła, M. Romaniuk, Karol Krupa, M. Futyma-Jędrzejewska, D. Juchnowicz","doi":"10.2478/cpp-2020-0010","DOIUrl":"https://doi.org/10.2478/cpp-2020-0010","url":null,"abstract":"Abstract Introduction: Cotard’s syndrome (CS) is a rare set of psychopathological symptoms, the main symptom of which is nihilistic delusions concerning the negation of the existence of internal organs or the entire body Aim, material and methodology: The aim of the study is to present a case of a patient treated for postpartum depression who developed Cotard’s syndrome. The patient’s symptoms began immediately after her daughter. The clinical picture was dominated by anxiety and apathy, nihilistic delusions about the atrophy of the urethra and other lower abdominal organs, and olfactory hallucinations - she could smell rot. Discussion: The available literature on Cotard’s Syndrome does not allow us to indicate a certain reason for its development. Perhaps the birth of the first child - the woman doubted herself as a mother, she was afraid that she would hurt the cause of the disorders observed and described by us was transient ischemia of the CNS during delivery. Conclusions: Cotard’s syndrome can develop in the course of many mental and somatoform disorders. The described case is, to our knowledge, the first description of Cotard’s Syndrome in the deprivation period. Difficulties in establishing the etiopathogenesis and pathophysiology of Cotard’s Syndrome translate into therapeutic problems. It has been suggested that the treatment of the underlying disorder on the basis of which CS is developed remains the most effective method of therapy.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"38 1","pages":"102 - 108"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81558125","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}
Wiktor Trela, Cezary Sieńko, M. Futyma-Jędrzejewska, Sebastian Masternak, H. Karakuła-Juchnowicz
Abstract Background: X-linked adrenoleukodystrophy (X-ALD) is an inherited metabolic disease which causes demyelination of the white matter of the brain. The symptoms include mental impairment, progressive paresis, impaired motor coordination, and epileptic seizures. Diagnosis is established mainly by genetic testing. Currently, the recommended treatment is haematopoietic stem cell transplantation (HSCT). Goal: The aim of the study was to present the case of a patient suffering from X-ALD, who developed symptoms of bipolar disorder in the initial phase of the disease prior to the onset of characteristic neurological symptoms. Case presentation: In 2015, a 33-year-old patient was admitted to a psychiatric department due to aggressive behaviour he showed towards his wife and other family members. He had been treated for a depressive episode in 2005, and for a manic episode without psychotic symptoms earlier in 2015. During the successive psychiatric hospitalizations, in addition to psychopathological symptoms, the patient had been observed to have neurological symptoms, which included progressive paraparesis and ataxia. In 2018, based on imaging and genetic tests, the patient was diagnosed with X-ALD. The patient’s condition gradually deteriorated; with time, he was unable to move on his own. During a hospital stay in 2019, he was transferred to an internal medicine department due to a progressive urinary tract infection, which, however, could not be controlled, and the patient died. Conclusions: 1. X-ALD is a rare metabolic illness. In the early stages of the disease, various psychopathological symptoms, including affective disorders, are observed. 2. Early initiation of adequate treatment increases the chances of extending the patient’s life. 3. In the present case, the patient did not die due to the underlying disease, but due to causes typical of bed-bound patients, i.e. complications of progressing infection.
{"title":"Mental disorders in neurological diseases. Can symptoms of bipolar disorder be the first manifestation of X-linked adenoleukodystrophy? A case report","authors":"Wiktor Trela, Cezary Sieńko, M. Futyma-Jędrzejewska, Sebastian Masternak, H. Karakuła-Juchnowicz","doi":"10.2478/cpp-2020-0011","DOIUrl":"https://doi.org/10.2478/cpp-2020-0011","url":null,"abstract":"Abstract Background: X-linked adrenoleukodystrophy (X-ALD) is an inherited metabolic disease which causes demyelination of the white matter of the brain. The symptoms include mental impairment, progressive paresis, impaired motor coordination, and epileptic seizures. Diagnosis is established mainly by genetic testing. Currently, the recommended treatment is haematopoietic stem cell transplantation (HSCT). Goal: The aim of the study was to present the case of a patient suffering from X-ALD, who developed symptoms of bipolar disorder in the initial phase of the disease prior to the onset of characteristic neurological symptoms. Case presentation: In 2015, a 33-year-old patient was admitted to a psychiatric department due to aggressive behaviour he showed towards his wife and other family members. He had been treated for a depressive episode in 2005, and for a manic episode without psychotic symptoms earlier in 2015. During the successive psychiatric hospitalizations, in addition to psychopathological symptoms, the patient had been observed to have neurological symptoms, which included progressive paraparesis and ataxia. In 2018, based on imaging and genetic tests, the patient was diagnosed with X-ALD. The patient’s condition gradually deteriorated; with time, he was unable to move on his own. During a hospital stay in 2019, he was transferred to an internal medicine department due to a progressive urinary tract infection, which, however, could not be controlled, and the patient died. Conclusions: 1. X-ALD is a rare metabolic illness. In the early stages of the disease, various psychopathological symptoms, including affective disorders, are observed. 2. Early initiation of adequate treatment increases the chances of extending the patient’s life. 3. In the present case, the patient did not die due to the underlying disease, but due to causes typical of bed-bound patients, i.e. complications of progressing infection.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"76 1","pages":"109 - 121"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86337330","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}
E. Sitarz, Iga Dudek, K. Karakuła, Alicja Forma, D. Juchnowicz
Abstract Introduction: The study aims to present 1) a case report of an 18-year-old female patient with borderline personality disorder (BPD) 2) the diagnostic and treatment difficulties in BPD patients. Materials and methods: The review of the literature from the years 1953-2020 searched from PubMed, Google Scholar, and Web of Science databases. Discussion: Patient, 18-years old, hospitalized five times for psychiatric care, presenting self-injurious behaviours, hurting herself within forearms. A patient attempted suicide eight times. She is living with her divorced parents. The patient’s father has a new partner with whom he has children. The patient used marijuana and she was experiencing psychotic symptoms under its influence. She smokes 10 cigarettes per day and drinks alcohol once a week since she was 16 years old. Psychiatric problems appeared when the patient started learning in high school. Conclusions: 1. Borderline personality disorder (BPD) is a serious psychiatric condition of a difficult diagnosis that should be differentiated with many other psychiatric disorders such as an atypical or subclinical course of psychosis, affective disorders, or dissocial personality. 2. A therapeutic process of a person with BPD is based on psychotherapy and personalized treatment strategies, whereas, pharmacological treatment plays only a supporting role during BPD treatment.
摘要:本研究旨在报告1例18岁女性边缘型人格障碍(BPD)患者的病例报告2 BPD患者的诊断和治疗难点。材料和方法:从PubMed、Google Scholar和Web of Science数据库中检索1953-2020年的文献。讨论:患者，18岁，住院5次接受精神科治疗，表现出自残行为，自伤前臂。一个病人曾八次试图自杀。她和离婚的父母住在一起。病人的父亲有了一个新伴侣，他们有了孩子。病人吸食大麻，在大麻的影响下出现了精神病症状。她从16岁开始每天抽10支烟，每周喝一次酒。患者在高中开始学习时出现了精神问题。结论:1。边缘型人格障碍(BPD)是一种难以诊断的严重精神疾病，应与许多其他精神疾病(如非典型或亚临床精神病病程、情感性障碍或反社会人格)区分开来。2. BPD患者的治疗过程以心理治疗和个性化治疗策略为基础，而药物治疗在BPD治疗过程中仅起辅助作用。
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