Postepy psychiatrii neurologii最新文献

Purpose: Paying attention to the factors affecting the psychological well-being of people with multiple sclerosis (PwMS) is of particular importance, hence the present study investigated the relationship between self-compassion and psychological well-being with the mediating role of resilience.

Methods: This cross-sectional study was performed using an online survey in a sample of 410 PwMS registered with the Guilan MS Society (GMSS) of Iran. The study was conducted in 2021. A demographic questionnaire, Ryff 's Psychological Well-Being Scales (PWB), the Connor-Davidson Resilience Scale (CD-RISC), and the Self Compassion Scale Short Form (SCS-SF) were used to collect data. Data analysis was performed using structural equation modeling.

Results: The model and data were sensibly in agreement. Moreover, bootstrap results showed that all direct path coefficients were significant (t ≥ 1.96). The direct effects of self-compassion and resilience on psychological well-being were significant, with standardized coefficients of 0.69 and 0.21. In addition resilience, with a coefficient of 0.73, was associated with psychological well-being. Furthermore, the indirect effect of self-compassion on psychological well-being with the mediating role of resilience was also confirmed (p ≤ 0.05).

Conclusions: In particular, a higher self-compassion score predicts greater resilience, which is correlated with greater psychological well-being. These findings underscore the need to target the psychological well-being of PwMS through resilience to help them cope with living with chronic conditions.

Purpose: Carpal tunnel syndrome (CTS) is the most common compression neuropathy, which is associated with a significant psy- chosocial and economic burden. In this paper, the literature on the current knowledge about the physiology and pathology of peri- pheral nerves during the course of CTS is reviewed, with a focus on currently used treatment options and the rationale for their use. Epidemiology, risk factors, etiology, clinical features and conservative treatment have been searched for, with all full-text, English language articles being included in the study. This paper aims to present the recent findings on CTS treatment while also suggesting a direction for further clinical trials.

Views: The search in PubMed and Google Scholar Databases revealed 229 articles of which 71 met the research criteria. The evi- dence regarding standard treatment methods of conservative CTS treatment is presented. CTS is a relatively common condition, which affects women more often than men. It is a multifactorial disease, and its clinical presentation mostly consists of symptoms distal to the entrapment site, including numbness, tingling, weakness and pain. Electrodiagnostic studies are considered to be the gold standard in CTS diagnosis. The conservative treatment methods reviewed are acupuncture, extracorporeal shock wave the- rapy, hydrodissection, kinesiotaping, corticosteroid injection, low level laser therapy, splints, platelet-rich plasma injection, manual therapy, ultrasound and phonophoresis.

Conclusions: Based on the current body of knowledge, we conclude that the conservative CTS treatment is very safe, but the effec- tiveness of reviewed methods differs. The first promising results presented by various studies motivate the need for further research on novel treatment methods.

Purpose: The aim of this article is to outline the impact of COVID-19 on the frequency of occurrence, course of stroke treatment, and to highlight the cause-effect relationship between SARS-CoV-2 infection and stroke on the basis of a literature overview.

Views: Since the end of 2019, the whole world has been struggling with the effects of the pandemic caused by the coronavirus SARS-CoV-2. The virus induces a wide spectrum of symptoms, ranging from mild or serious ones, which may lead to a severe multiorgan failure. Acute ischaemic stroke (AIS) might be associated with COVID-19 as a potentially fatal complication, while hemorrhagic stroke is less frequent. In most cases, stroke is caused by large artery occlusion. One of its reasons is hypercoagulation with a complex mechanism, which has not been fully explained. Research has shown that during COVID-19 pandemic, the number of patients admitted to hospitals due to AIS decreased. During the first pandemic wave there was no change regarding the proportion of patients with cerebral vessel obstruction who received endovascular treatment.

Conclusions: In the COVID-19 pandemic era, rapid intravenous administration of tissue plasminogen activator remains the main treatment for acute ischaemic stroke. Patients often fail to report to hospital for the fear of SARS-CoV-2 infection. It is of the utmost importance to raise society's awareness of the necessity to report to hospital when experiencing serious symptoms, including stroke.

Purpose: The present study aimed to assess the depression symptoms and predictors of depression in Polish young adults during online learning in the COVID-19 pandemic.

Methods: The online questionnaire, including the Kutcher Adolescent Depression Scale, was distributed to young Poles through school principals. The final sample consisted of 1,500 students between the ages of 18 and 23 attending secondary schools. Multivariable logistic regression assessed the relationships between sociodemographic factors, pandemic stressors, coping behaviours and depressive symptoms.

Results: 56% of young Polish adults are experiencing significant depressive symptoms (95% CI: 1.82-13.96). Social isolation was recognized as the main stressor. Many significant predictors of depression were captured. Being female, living in the countryside, talking to parents, and participating in sports and hobbies are found to be protective factors. The following sociodemographic factors are important predictors of depression in young adults: being male, attending a secondary school, living in a large city. Experiencing stress due to pandemic and online learning is one of the risk factors for depression.

Conclusions: The majority of young Poles met the criteria for depressive disorders. The initial findings of the presented study not only highlight the need to address mental health consequences for young people during online learning, but also provide the grounds for the development of post-pandemic interventions.

Purpose: The article is an application report. It focuses on the mental health difficulties currently experienced by university students in relation to the COVID-19 pandemic, which may have a significant impact on the study process. The work also presents examples of support implemented at higher education institutions during the pandemic, aimed at maintaining and strengthening students' mental health.

Views: Mental health is closely related to physical/somatic health, among other things, in terms of health behaviour and immuno-logical processes. Thus, any physical, life-threatening and therefore life-altering illness has a potentially negative impact on an individual's overall mental health. A pandemic such as COVID-19 in 2020 is a potential additional risk factor for mental health that is not yet well understood. Pandemic-related changes such as remote learning, reduced interpersonal contact, the uncertainty surrounding this pandemic of unknown magnitude, as well as its dynamic and often surprising course may have an impact on the functioning of young people and their daily activities, including studying.

Conclusions: It is essential to monitor mental health in different population groups, including students-young adults, specifically in relation to the threat of SARS-CoV-2 coronavirus infection, prevention activities and the treatment of COVID-19 patients. It is important to introduce parallel activities to support students' mental health, in line with the sanitary regime, e.g. by using new technologies.

Purpose: The purpose of this paper is to describe some aspects of the intra-cellular mechanism of action of neuroleptics, drugs widely used in psychiatry in treatment of psychotic and affective disorders. The ability of neuroleptics to influence and modify the metabolic, energetic and structural processes of neurons, as well as their apoptosis, probably influence their therapeutic potential. The direct and indirect mechanisms of antipsychotics are discussed on the basis of epigenetic, intra-cellular and post-transcription processes.

Views: Antipsychotic drugs facilitate chromatin remodeling, decreasing or increasing histone acetylation, and affect DNA methylation differently. Antipsychotics modulate the intracellular signaling cascades like the cyclic adenosine monophosphate (cAMP), AKT/glycogen synthase kinase-3 (GSK-3) pathway and mitogen-activated protein kinase (MAPK) in a variety of ways that contribute to their different clinical and side-effect profiles. Among the cellular processes involved in the activity of antipsychotics are energy and metabolism, protein synthesis and processing, cytoskeleton functions like microtubule dynamics, dendritic branching, and spine dynamics, as well as cell adhesion and synaptic activity. Finally, antipsychotics have the ability to modulate the expression of a large number of miRNAs, which is related to oxidative stress and metabolism.

Conclusions: Despite the efficacy of antipsychotics in treating schizophrenia and bipolar disorders over the last several decades, their molecular mechanisms of action turn out to be very complex and have not yet been fully elucidated. Recent thinking about a more personalized and endophenotype-specific diagnosing and treatment requires a more advanced genomic and proteomic approach and seems to be the next step in the treatment of mental disorders.

Purpose: This review discusses the assessment of psychotic disorders in prelingually deaf patients and the related challenges.

Views: Although prelingually deaf patients are often diagnosed with psychotic disorders, the clinical presentation of this group is complex and no clear guidelines regarding the assessment process can be formulated due to the lack of valid, reliable research. Sign language dynamics or language dysfluency may be falsely recognized as disorganized thinking. Some of the symptoms indicating disorganized thinking in the case of spoken languages may fulfill specific functions when used in sign language (for example object chaining). Furthermore, deaf individuals experience multiple stressors that may be considered as risk factors for developing delusions, especially for those growing up in hearing, non-signing families. Nevertheless, it is important to acknowledge that some seemingly delusional beliefs shared by prelingually deaf people may be associated with the lack of assisted learning, gullibility, low level of confidence in healthcare or deaf communities' social norms. The question concerning the sensory modality of hallucinations experienced by deaf individuals remains unresolved. Patients' accounts suggest that hallucinations described as auditory may be perceived as lip-reading without identifying the speaker's face, among others. However, for those who provide help it is far more important to recognize the function of hallucinations and to differentiate them from normative experience.

Conclusions: It is essential to expand our knowledge regarding the clinical presentation of psychotic disorders in deaf individuals in order to develop assessment guidelines and tools and, above all, increase the well-being of those suffering from psychotic disorders, as well as of those whose diagnosis remains unclear.

Purpose: To identify teachers' mental health predictors of stress, anxiety and depression within the sociodemographic, health-related, work-related and COVID-19-related factors.

Methods: Between March 3 and April 11, 2021 the cross-sectional national online survey of Polish teachers of all educational levels was conducted. The semi-structured questionnaire used in the study included demographic data (place of residence, gender, age, marital status, education), exposure to people infected with COVID-19, critical life events and pandemic-related stressors, health variables, work-related characteristics (duration of remote teaching), as well as DASS-21.

Results: In 2,757 completed responses, 86% of the respondents were female and the mean age was 46.14 (SD = 9.35); 21.3% had been previously diagnosed with COVID-19; 38.8% of the respondents (n = 1,069) were employed in primary schools (grades 4-8) and 34% worked in the secondary level education. The mean years of work experience in the sample was 20.94 (SD = 10.60). At the moment of completing the survey, most of the respondents (n = 1,488; 54%) were working on-site, 24% were still working remotely and 22.1% were engaged in the hybrid model. Sociodemographic variables, mental and physical illness, fear of the negative consequences of COVID-19, and the deaths of a family member or friend due to COVID-19 were significant predictors of stress, anxiety, and depression. Stress and depression were also predicted by remote working methods and working in a very large city. The cases of COVID-19 in groups of co-workers or students predicted only stress. COVID-19 deaths of co-workers/students/parents of students and COVID-19 diagnosis predicted anxiety.

Conclusions: The most vulnerable group of teachers turned out to consist in young women, working in a big city, mostly teaching remotely. Sustainable support and care systems adapted to the teachers' needs should be developed. Also some essential predictors of mental health deterioration among teachers should be considered when designing long-term prevention strategies.

Purpose: This case reports on anomic aphasia related to COVID-19. Increasing knowledge about rare symptoms and complications may aid in the characterization of the disease, understand its pathophysiology, identify more quickly possible infected people and break the transmission chain.

Case description: This work reports on the case of a middle-aged man who presented to his assistant psychiatrist complaining about difficulty with naming objects in his daily routine surroundings, with ten weeks of duration and following a SARS-CoV-2 infection. The organic study, including brain magnetic resonance imaging, was unremarkable. The symptoms resolved spontaneously within fourteen weeks.

Comment: Neurological manifestations of COVID-19 may be related to the dysfunction of the blood-brain barrier, resulting in immune cell infiltration and neuroinflammation that can persist for weeks or months after the resolution of the infection. Weakened health after overcoming the infection acute phase is being reported increasingly and called post-COVID-syndrome. Rare disorders such anomic aphasia can occur in this syndrome.

Purpose: Some alcohol-dependence relapses occur soon after a concluded detoxification treatment. A popular agent used in that treatment is diazepam, which effectively relieves withdrawal symptoms due to its long half-life and affinity to the same receptors. It is hypothesized here that these attributes, after nominally completed detoxification, result in, respectively, persisting benzodiazepine (BZD) influence and a distorted (optimistic) clinical presentation. This could contribute to later reemergence of withdrawal symptoms caused by delayed final elimination of BZDs, as the evidence puts into doubt the concept of a gentle self-taper of a long-acting drug.

Methods: Serum-BZD concentration levels were measured with a radioimmunoassay at the end of routine treatment of moderately- intense alcohol withdrawal syndrome. These data were cross-referenced with individual diazepam administration schedules, including the maximal daily dose and the day of its administration, and the day of overall diazepam cessation.

Results: Most patients revealed clinically relevant serum-BZD levels. These correlated with the doses but also with the day of maximal- dose administration and the day of diazepam withdrawal.

Conclusions: The confrontation with actual abstinence comes after detoxification. Delayed elimination of diazepam may be a contributing factor in the re-emergence of symptoms and early post-detox relapses. The optimization of the procedure has been discussed in terms of concentration evolution and known treatment schedules. Maximal initial dosage compression and further decisive counteracting the tendencies of diazepam towards accumulation increase the patient's chance of going through the low-concentration crisis under medical assistance.