Postepy psychiatrii neurologii最新文献

Purpose: The aim of this study was to compare the results of the selected neuropsychological tests in patients with newly diagnosed multiple sclerosis (MS) in relation to the selected volumetric brain measurements assessed by magnetic resonance imaging (MRI).

Methods: The study group consisted of 76 patients with newly diagnosed MS. Each patient underwent functional assessment using the Multiple Sclerosis Functional Composite Battery (MSFC), the Kurtzke Expanded Disability Status Scale (EDSS) and evaluation of cognitive function using a battery of tests. The patients also underwent head MRI with the assessment of the volume of the cortex and subcortical structures. Psychological assessment and head MRI were performed before initiating immunomodulatory treatment and after 12 months of follow-up.

Results: Positive correlations were obtained between partial brain volume and Paced Auditory Serial Addition Test (PASAT3"), total volume of grey matter and Selective Reminding Test (SRT) and Brief Visuospatial Memory Test - Recognition Discrimination (BVMT-RD), the cortical volume and PASAT3", SRT, Brief Visuospatial Memory Test - Revised (BVMT-R) and BVMT-RD in assessing the relationship between atrophic changes in brain structures and the severity of cognitive impairment in MS patients at baseline. Significant relationships were found between the volumetric parameters and SRT-D. Positive correlations were obtained between the volumetric parameters and the scores of PASAT3". No significant correlations were found between the severity of cognitive dysfunction and the duration of MS.

Conclusions: There is a clear need to evaluate particular cognitive domains in patients with MS as early as from the onset of the disease, and to perform long-term follow-up of these changes. The assessment of the two most frequently impaired cognitive domains could be a screening indicator for detecting cognitive dysfunction in MS patients.

Purpose: Collet-Sicard syndrome (CSS) is a neurological condition secondary to various neoplastic and non-neoplastic lesions, manifesting as palsy of the lower cranial nerves. This article aims to disseminate knowledge and share insights into this disorder.

Case description: A 58-year-old male presented with a four-month history of progressive dysphagia and dysphonia. Neurological examination revealed cranial nerve IX, X, XI and XII palsy. Imaging demonstrated a focal lesion situated between the internal carotid artery and the jugular vein, ultimately diagnosed as diffuse large B-cell lymphoma. The patient was referred for hematological treatment.

Comment: A constellation of symptoms such as dysphagia, hoarseness or dysphonia, and tongue weakness should alert clinicians to the possibility of CSS. Awareness of the characteristic symptoms of CSS is essential for identifying the underlying cause and reducing delays in diagnosis and treatment.

Purpose: This review mainly focuses on the aetiology of attention-deficit/hyperactivity disorder (ADHD) including genetic, neuro-biological, biochemical and environmental factors. It also emphasizes the possible management of the disorder. This knowledge will be essential for developing therapeutic interventions and prevention measures.

Views: ADHD is a neurodevelopmental psychiatric disorder, characterized by pervasive patterns of inattention, hyperactivity, or impulsivity. Globally, it affects up to 7-10% of elementary school children, and symptoms frequently persist into adulthood. Among adults, 2-5% experience ADHD symptoms worldwide. The aetiology and developmental trajectory of the disorder remain unknown. ADHD is caused by a combination of genetic, psychological, physiological, biochemical, and environmental factors. All of these factors are thought to permanently change the development of the dopaminergic and noradrenergic system, which is a fundamental neurobiological mechanism behind the disorder.

Conclusions: Untreated ADHD can have long-term effects on individuals throughout their lifetime and cause adverse life trajectories such as poor educational and occupational outcomes, substance addiction, accidents, suicide, criminal activity, and co-occurring mental and physical health disorders. Principal management options include psychopharmacological treatments such as group cognitive behavioural therapy and social skills training, parent education programmes, and school-based initiatives, as well as medication employing stimulants and non-stimulants.

Purpose: The bed nucleus of the stria terminalis (BNST) is a tiny nucleus connected by a bundle of axons with the amygdala. The BNST acts as a relay center, coordinating autonomic, limbic, behavioral, neuroendocrine, and motor functions. It plays a key role in anxiety and anxiety-related disorders. This review presents clinical outcomes of deep brain stimulation (DBS) of the BNST in treatment-resistant obsessive-compulsive disorder (trOCD) and treatment-resistant depression (TRD).

Views: The medical literature search was conducted in MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL). The identified studies were assessed on the basis of patient characteristics, clinical outcomes, and adverse events related to DBS. The reduction of the Y-OCBS in the reported studies ranged from 27% to 66%, with mean reduction of the YBOCS of 45% at a mean of 58 months. The authors of clinical studies also reported enhanced socio-occupational functioning and quality of life. Adverse effects included hypomania, depressive episodes, weight gain, emotional lability, and seizures. However, most side effects were transient and reversible with stimulation adjustments.

Conclusions: Clinical experience with BNST DBS remains limited, with most studies treating trOCD and only two addressing TRD. Reported outcomes suggest reductions in obsessions, compulsions, and affective symptoms, alongside improved daily functioning. The BNST appears to be a promising DBS target for anxiety-related psychiatric disorders.

Purpose: Psychedelic substances are attracting attention for their therapeutic potential in mental health disorders. Emerging research suggests that even negative psychedelic experiences, or "bad trips," may hold therapeutic potential when managed in controlled settings. This narrative review explores the nature of "bad trips", their contributing factors, and their integration into therapeutic practices.

Views: Data for this review were identified through systematic searches of PubMed, PsycINFO, and Scopus using keyword "bad trip", "psychedelic therapy" with the use of Boolean variable AND. Articles were selected based on their relevance, recency, and methodological rigor. Key studies were analyzed to extract findings on psychological mechanisms and therapeutic frameworks related to challenging psychedelic experiences. Bad trips frequently involve intense fear, anxiety, and unresolved traumas. Controlled therapeutic settings allow for these experiences to catalyze emotional processing, trauma resolution, and transformative insights. Historical and contemporary studies highlight long-term mental health improvements following the effective integration of such experiences. Ethical considerations, including informed consent and aftercare, are critical to mitigate risks and optimize outcomes.

Conclusions: While distressing, bad trips may act as catalysts for psychological growth in therapeutic contexts with trained facilitators. Further research is needed to refine therapeutic protocols and elucidate the long-term effects of challenging psychedelic experiences, offering innovative approaches to mental health treatment.

Purpose: The aim of the study was to compare the subjective assessments made by patients with anorexia nervosa (AN) of their faces, including shape and dimensions, with the parameters obtained in the morphometric examination.

Methods: Anorexic female patients were invited to participate in the study, which was a complex research focused on the following specific objectives: 1) patients' facial symmetry evaluation based on a direct analysis by a doctor; 2) the relationship between the patient's body mass index (BMI) and degree of subjective satisfaction with the shape and size of the patient's face; 3) the objective dimensions and shape of the AN patients' faces based on the morphometric test; and 4) the relationship between the type of face shape, defined by the morphometric test parameters, and the subjectively felt degree of patient satisfaction as well as their desire to change their facial appearance.

Results: The faces of all girls involved in the study were found to be symmetrical. Statistical analyses revealed a relationship between the degree of satisfaction with the shape and dimensions of one's face and the desire to change its appearance.

Conclusions: In our study, most female patients with AN were dissatisfied with the appearance of their faces, believing they were wider than they actually were. No significant link was found between facial dissatisfaction and BMI, suggesting that distorted facial perceptions are more likely linked to cognitive and emotional factors than physical conditions.

Purpose: The objective of the study was to examine the relationships between psychological resilience, job satisfaction and secondary traumatic stress among police officers, in order to identify the factors influencing the occurrence of negative consequences of indirect trauma exposure.

Methods: The study included 237 Polish police officers from the prevention and criminal divisions. The analysis was conducted on the results of a survey obtained from 220 respondents who had contact with traumatized clients as part of their work. Their age ranged from 22 to 59 (M = 39.08; SD = 7.00). The majority of the respondents were men (83.2%). A survey and three questionnaires were used in the study, i.e., The Secondary Traumatic Stress Inventory, the Resilience Measurement Scale, and the Job Satisfaction Scale.

Results: The results of the survey indicate that police officers exhibited relatively low levels of secondary traumatic stress symptoms. The study found a negative correlation between psychological resilience, job satisfaction and secondary traumatic stress. Job satisfaction was found to mediate the relationship between resilience and secondary traumatic stress.

Conclusions: Psychological resilience and job satisfaction may serve as protective factors against the development of negative consequences resulting from indirect trauma exposure. The study indicates that job satisfaction may play a slightly more significant role in this regard. Increasing resilience and job satisfaction may alleviate STS symptoms and consequently contribute to increased work efficiency.

Purpose: Recent years have witnessed a renewed interest in research exploring the therapeutic potential of classic psychedelics, such as psilocybin and lysergic acid diethylamide (LSD) in the treatment of mental disorders. However, our knowledge of the epidemiology of their use, factors associated with their recreational consumption, and attitudes toward these substances remains limited.

Methods: A representative sample of Polish adults (N = 1051) completed an internet-based survey that included demographic questions, assessments of psychedelic substance use, including motivations and contexts, subjective evaluations of psychedelics experience, and attitudes towards psychedelics and psychedelic-assisted therapy (PAT).

Results: Between 4% and 8% of Polish adults, equivalent to approximately 2 million people, have experimented with psychedelic substances at least once in their lives. Men were more likely to use psychedelics than women, with the largest group of users being individuals aged 25-34, primarily residing in urban areas. Curiosity emerged as the most common motivation for use, and home was typically reported as the context. The psychedelic experience was often described as a mixture of pleasant and unpleasant sensations. A substantial proportion of participants expressed indifferent or negative attitudes towards both PAT and psychedelics. However, prior psychedelic use, younger age, and a history of lifetime meditation practice were associated with more positive attitudes.

Conclusions: Approximately 6% of Polish adults, mostly young men living in urban areas, reported using classic psychedelics, particularly LSD and psilocybin mushrooms. Further research and educational efforts are needed to support the scientific exploration of PAT, and to help shift public perceptions of its therapeutic potential.

Purpose: The aim of the paper is to provide an overview of knowledge about changes in blood serum levels of amino acids, purines and pyrimidines in individuals with bipolar disorder, including suggestions for potential ways of modifying the course of the disease using these substances in the diet of people in this group.

Views: According to the majority of the papers in the literature, amino acids, which could possibly be used in tests for bipolar disorder, are closely related to the neurotransmitters considered to be involved in the pathogenesis of the disease. Among them the most important are phenylalanine, a substrate of tyrosine, and following this such neurotransmitters as dopamine, noradrenaline and adrenaline - which play a key role in the regulation of mood and cognitive functions - tryptophan, a precursor of 5-hydroxytryptamine (serotonin), then glycine, serine and threonine (connected with NMDA receptor). Reduced serum levels of branched-chain amino acids (leucine, isoleucine, and valine) are observed in bipolar patients, but some reports have proposed that the usage of them in diet to alleviate manic symptoms is more important clinically. Purines and pyrimidines also play important roles in neurotransmission and neuromodulation, influencing the activity of several neurotransmitters. The most promising data are those concerning adenosine and uric acid.

Conclusions: At the present stage of knowledge and time of writing there is some promising data suggesting directions for further investigation, but the evidentiary value of it remains weak. The problem requires further research, such as the full assessment of patients' profiles for amino acids, purines and pyrimidines, and the confirmation of this approach needs to be established in larger numbers of patients.

Purpose: "Drunkorexia" describes a phenomenon in which alcohol consumption is associated with unhealthy eating habits. The tendency to use extreme forms of weight control is a way to compensate for the planned drinking episodes. The objective of the study was to characterize the phenomenon in a non-clinical group of adults declaring alcohol consumption, and to assess its relationships with alcohol use and disordered eating related variables.

Methods: 286 individuals placed in Upper Silesia, Poland participating in the online research program completed the following online surveys: demographics, AUDIT, EAT-26, CEBRACS, and DMBS. CEBRACS>21 cut off was used to identify the drunkorexia group. The inclusion criteria required an age above 18 and a declaration of alcohol consumption. The exclusion criteria were the self-reported formal diagnosis of alcohol dependence or eating disorders.

Results: Drunkorexia was observed among 43% of the study group. The drunkorexia group had significantly more problems related to alcohol consumption, endorsed higher dieting and eating restrictions, social motives, eating avoidance, and compensatory behaviors. Hierarchical regression showed that higher AUDIT, oral control on EAT-26, social motives for drinking and restrictive eating, eating avoidance, and altering drinking behavior to control calories accounted for 63% of variance in drunkorexia severity. Cluster analysis indicated two distinct groups: one with pronounced disordered eating behaviors and one with pronounced alcohol consumption behaviors.

Conclusions: Drunkorexia appears to be prevalent among people who consume some amount of alcohol without clinical diagnosis of alcohol dependence or eating disorders. Meeting the cut-off for drunkorexia is associated with greater problems related to alcohol use and disordered eating behaviors. The results obtained from the research may suggest drunkorexia as an independent psychological construct with some elements of eating disorders and alcohol abuse. The present study highlights the need to screen for drunkorexia, to educate and support individuals who have difficulties coping with the challenges of their environment or the pressures of the slim body culture.