Postepy psychiatrii neurologii最新文献

Purpose: Behavioral data collected from smartphones can assist artificial intelligence (AI) in assessing and predicting fluctuations in mental states in patients with bipolar disorder (BD). In Poland, the MoodMon online system is used to integrate passive and active data, including voice parameters, for analysis and the issue of alerts based on changes in individual's mental state. The study aims to explore whether active engagement of the patient enhances the efficacy of the advanced MoodMon tool. This clinical trial is embedded in a broader research initiative.

Methods: Methodologically, smartphones were used to automatically collect daily activity data from wristbands and phones of 75 BD patients. Clinical evaluations, using the Hamilton Depression and Young Mania Rating Scales were conducted via a web app, regular visits, calls, or system-initiated contacts after alerts. The MoodMon system, trained on patient data, was compared against clinical evaluations, successfully predicting mental states.

Results: Results showed high alert accuracy: true positive ratio (TPR) at 86.6% (sensitivity) and true negative ratio (TNR) at 98.59% (specificity). Active patient voice data submissions notably improved the prediction of changes or stability in mental states.

Conclusions: Active patient participation in data submission enhances MoodMon's effectiveness as an AI-driven monitoring tool for BD. This underscores the potential of behavioral markers and mobile health applications in mental health care.

Purpose: The aim of the study was to assess spontaneous flexibility, attentional set shifting and cognitive control in alcohol- dependent men in the process of therapy in alcohol addiction treatment units, and to recognise the use of production strategies in visual-spatial mode in this clinical group.

Methods: A total of 72 men participated in the study, 43 were alcohol-dependent (ADS) and 29 were controls (CTR). The Ruff Figural Fluency Test (RFFT), the Color Trails Test part 2 (CTT-2) and the Montreal Cognitive Assessment (MoCA) were administered.

Results: The findings showed that alcohol dependence significantly impacted performance CTT-2 and RFFT, beyond and above age and education. The ADS group performed significantly worse than controls in CTT-2 and all indices of RFFT. A significant interaction effect was observed between group and task type for perseverations, with ADS patients producing fewer perseverations for the first part of RFFT compared to other parts of the test. They also used fewer production strategies than controls.

Conclusions: Our findings highlight that alcohol dependence specifically contributes to explaining the results in terms of reactive flexibility in the aspect of attentional set shifting, as well as spontaneous flexibility in tasks requiring the generation of unique designs in limited time. The alcohol-dependent group demonstrated poor cognitive control, as evidenced by significantly higher number of perseverations. Furthermore, an analysis of the production strategies employed by alcohol-dependent men provided important information about their control and planning capacities. These findings support the recommendation to work with cognitive stimulation in therapeutic work with this population.

Purpose: The concept of emotional needs occupies a key place in Young's theory of early maladaptive schemas (EMS). The primary caregiver's attitude that is ineffective from the point of view of such needs leads to frustration, which is expressed in the personality of the child and in the resulting disorders. The purpose of this paper is to examine the relationship between retrospective evaluation of parenting as a tool for meeting basic emotional needs and the neural correlates of personality - affective neuroscience emotional systems, according to the theory by Panksepp.

Methods: The study involved 65 individuals between the age of 18 and 62 years (mean age: M = 34.09). The following instruments were used: Young Parenting Inventory (YPI) and Affective Neuroscience Personality Scales (ANPS).

Results: Meaningful statistical differences in mothers' and fathers' behavior are related to one domain - Impaired Autonomy and/or Performance (p < 0.001). Within this domain, all schemas reached statistical significance, with fathers showing the strongest influence on the formation of the Failure schema (p = 0.022). Across all schema, the majority of statistically significant results were found in two domains: Disconnection/Rejection and the Impaired Autonomy and/or Performance. Significant statistical correlations between EMS and neural emotional systems were predominantly associated with the Anger and Sadness systems.

Conclusions: Retrospective assessments of maternal and paternal behaviors show the strongest associations with schemas in two EMS domains: Disconnection/Rejection and Impaired Autonomy/Performance. These two domains are further linked to the activation of two neural emotional systems: Anger and Sadness.

Purpose: The aim of the study was to analyse the incidence of aggressive behaviour in patients of an adolescent psychiatric ward towards medical and nursing personnel and to assess the usefulness of the tools used by the authors to describe the incident itself. Currently, Polish literature and practice lack such scales. The tool used in the study was the Polish version of the Staff Observation Aggression Scale-Revised (SOAS-R).

Methods: The study used the results of 71 questionnaires completed by the staff of the adolescent inpatient psychiatric ward after episodes of aggression in patients in the period from August 2015 to August 2019.

Results: The most frequent object of aggression was medical and nursing personnel (57.8%), self-harm was less frequent (4.6%). Other patients (7.1%) or objects (16.2%) were relatively rarely the victims. The most common form of aggression was aggression using hands. It occurred in 80% of cases. It turned out that half of the aggressive behaviour using hands (punches, blows) took place between 2:00 p.m. and 8:30 p.m.

Conclusions: SOAS-R seems to be an effective tool in incident assessment both at the level of causes and, what seems most important, the consequences of aggressive behaviour. It can also be used to analyse staffing at particular times of the day, week, or even month. The phenomenon of aggression requires more precise, constant, and time-based observation which allows the implementation of appropriate procedures and the overcoming of many stereotypes related to aggressive behaviour and its impact on the relationship between the medical and nursing staff and the patient.

Purpose: Schizophrenia is a chronic condition that is associated with various comorbidities, including metabolic ones. Particular attention has been paid to the metabolic dysfunction-associated steatotic liver disease (MASLD), the liver equivalent of the metabolic syndrome. It is postulated that ferroptosis, a form of novel cell death connected with iron overload and lipid peroxidation, may be an interplaying factor in both of these conditions. This review aims to show the specific role of ferroptosis in the development and possible progression of MASLD among patients with schizophrenia. It will be accompanied by a consideration of the probable causes of the associations that occur.

Views: Scientific reports suggest that there may be a genetic predisposition, in terms of ferroptosis, to the development of both schizophrenia and MASLD. Moreover, the role of poor dietary habits, specifically a high-fat diet and insufficient antioxidant intake, in excessive lipid peroxidation and iron overload is emphasized. Additionally, intestinal permeability, caused by iron overload, may contribute to a state of inflammation within the liver tissue. Finally, we cannot forget about the impact of antipsychotic drugs on the ferroptosis process - some of them may initiate this process through carbohydrate-lipid metabolism dysregulation, or causing hepatocyte iron overload, as well as disturbing cellular redox balance.

Conclusions: The process of ferroptosis should be considered as one of the possible pathways which predispose a group of patients with schizophrenia to the development and progression of MASLD. Finding a possible marker of ferroptosis among the mentally ill population may be helpful in the identification of a subgroup of patients particularly vulnerable to steatotic liver disease.

Purpose: While traditional theories suggest a link between language lateralization and handedness, recent evidence indicates more complex neural networks underlying speech processing. This study aimed to investigate the involvement of the left and right hemispheres in speech production using repetitive transcranial magnetic stimulation (rTMS).

Methods: A cohort of 58 healthy volunteers with a median age of 23 (range 19-34) were included in the study. With the use of the Edinburgh Handedness Inventory (EHI), 43 individuals were determined to be right-handed, 13 left-handed, 2 mix-handed and subsequently subdivided according to handedness decile values. rTMS was applied with 2Hz frequency and 2 seconds of duration over the left and right hemispheres to trigger speech arrest while counting downwards.

Results: Overall prevalence of speech arrest was 96.6%. Twenty-four subjects developed speech arrest after stimulation exclusively over the left hemisphere (42.9%), two people exclusively over the right hemisphere (3.5%) and 30 participants bilaterally (53.6%). Notably, the right-handed exhibited speech arrest predominantly over the left hemisphere, while the left-handed showed more variability. Receiver operating characteristics analysis revealed handedness deciles as predictors of speech lateralization. Individuals with handedness values over the 2nd right decile of EHI were more likely to have speech arrest over the left hemisphere, while left-handed over the 7th left decile were more likely to show speech arrest after rTMS over the right hemisphere.

Conclusions: This study highlights the complexity of the relationship between speech lateralization and handedness. Further research using rTMS may provide insights into the neural mechanisms underlying speech processing and enable further studies on the treatment of aphasia.

Purpose: Skeletal-related events (SREs) are common complications of bone metastases that include the need for radiation or surgery to bone, pathological and radiological fractures, and hypercalcemia. Available data indicate that significant bone pain is associated with SREs, leading to an increased risk of death, higher medication costs, and reduced quality of life for patients. Bisphosphonate agents and denosumab are therapeutic options for preventing SREs in advanced cancer patients with bone metastases. This study aims to compare the effect of denosumab and zoledronic acid in SREs, with a particular focus on pain-related SREs.

Views: Three scientific databases - PubMed, the Cochrane Library, and Google Scholar - were selected and searched for articles published in English up to March 2023. Also, a manual search of related articles was conducted. From the systematic search, four randomized clinical trial studies were identified and further assessed using the Cochrane Collaboration Risk of Bias Tool.

Conclusions: Denosumab was found to have outcomes that are not inferior to Zoledronic acid in delaying the first incidence of SREs, which include pathologic fracture, radiotherapy to bone, surgery to bone, or spinal cord compression. This review concludes that both therapies effectively reduce pain and prevent SREs in cancer patients at risk.

Purpose: Extracellular vesicles are the subject of many studies in various medical specialties. Their role in neurodegenerative diseases is increasing and they worth introducing in more detail.

Methods: This review was performed following an electronic search of the database PubMed/Medline and Web of Science for English-language articles between 2010 and 2024 in the fields of medicine, molecular biology, and biochemistry. Keywords searches included combinations of the following terms: "extracellular vesicles" OR "exosomes" AND "neurodeg*" AND "microRNA" OR "miRNA" AND "AD" OR "PD" OR "ALS" OR "HD". Articles had to be original work or reviews.

Results: The classification of extracellular vesicles is based on their size or origin. Their content is of key importance in communication between cells and can be treated as a physiological determinant of the normal or pathological condition of a body. The cargo transported in the extracellular space and over longer distances in various body fluids is diversified and may be nucleic acids (DNA, RNA, miRNA) as well as proteins and lipids, and, in the case of apoptotic bodies also a cell's organelles. Exosomes are the most thoroughly studied extracellular vesicles and the most often considered for therapeutic applications. Vesicles carrying biological substances in the body perform three basic functions: participation in a pathological mechanism, a biomarker role that also has diagnostic and prognostic functions, and a role in therapeutic activities. In the case of neurodegenerative diseases, it appears that extracellular vesicles can transport misfolded proteins, initiating pathological processes in previously normal cells.

Conclusions: The transport of various substances enclosed in vesicles seems to be very promising in therapeutic prospects in various diseases, and the possibility of their crossing the blood-brain barrier particularly indicates diseases of the central nervous system. Despite many years of research on extracellular vesicles in the context of neurodegenerative diseases, their practical use is currently limited to studies on animal and cellular models, and their practical application in clinical trials in neurodegenerative diseases is to date extremely rare.

Purpose: Stroke mimics (SMs) are conditions that present similarly to acute cerebrovascular accidents (CVA), potentially leading to diagnostic errors made by physicians or emergency medical teams (EMT). This study aimed to analyse the profile of patients transferred by EMT to the neurological emergency department (NED) with suspected CVA, and to assess the incidence and characteristics of SMs.

Methods: This retrospective study analyzed data from patients admitted to the NED with suspected CVA, transferred by EMT between August 1, 2021 and to January 31, 2022. Data collected included demographic and clinical information obtained both from NED and EMT records.

Results: During the study period, 281 patients with suspected CVA were admitted to the NED, of which 74 (26.3%) were diagnosed as SMs. The most common SMs were seizures (24.3%) and infections (14.9%). CVA occurrence was significantly associated with central facial palsy, speech disorders, pyramidal signs and arterial hypertension, but confusion and active cancer were more commonly linked to SMs diagnosis. Patients whose emergency medical cards were correctly completed were less likely to be diagnosed with SMs compared to those with at least one missing parameter (36% in the CVA group vs. 21% in the SMs group, p = 0.029).

Conclusions: Focal neurological signs are indicative of CVA, whereas confusion and a history of active cancer are more commonly associated with SMs. The accuracy and completeness of data collected by EMTs may play a crucial role in the CVA diagnostic process, potentially reducing misdiagnoses of SMs.

Purpose: This mini-review presents strategies for assessing and treating communication difficulties in individuals with comorbid attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Standardized assessments such as the Clinical Evaluation of Language Fundamentals and the Test of Language Development provide quantitative insights, while pragmatic tools, such as the Pragmatic Language Skills Inventory and the Social Communication Questionnaire provide qualitative measures of social communication skills. A comprehensive assessment also integrates clinical interviews, multi-contextual observations.

Views: A multifaceted approach tailored to individual needs is required to effectively treat communication difficulties. Evidence suggests benefits from social skills training, structured group therapy sessions, and speech and language therapy focusing on expressive, receptive, and pragmatic language skills. Augmentative and alternative communication systems provide support for individuals with limited verbal skills. In addition, the development of supportive academic frameworks, such as Individualized Education Programs or Individualized Accommodation Plans, involves environmental modifications and collaborative educational planning including psychologists, educators, and families.

Conclusions: Comorbid ADHD and ASD significantly impair communication, necessitating precise evaluation and multimodal interventions such as social skills training and augmentative and alternative communication tools. Collaborative, evidence-based approaches enhance functional outcomes and quality of life in affected individuals.