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Psychiatria polska [journal]
- [Jerusalem syndrome - a case report]. [Case Reports, English Abstract, Journal Article]
- Psychiatr Pol 2013 Mar-Apr; 47(2):353-60.
The aim of the paper was to present the case of a patient who developed acute psychotic symptoms on her visit to Jerusalem.The analysis of the clinical case and medical history.The presented 62-year-old women with a history of previous psychiatric disorder arrived with her husband to Jerusalem as a part of organised touristic group. She developed acute psychotic reaction through some stages characteristic for the third type of Jerusalem syndrome. Symptoms resolved completely soon after returning to Poland and admission to the hospital where an antipsychotic treatment was performed.Despite the rare occurrence of this phenomenon, it is worth noting that we can divide Jerusalem syndrome into three types depending on its clinical course, patient's history of previous psychiatric disorders and this division has some clinical implications. This syndrome can be also considered in the context of some factors connected with travelling in general which may be responsible for psychiatric disturbances occurring among travelers. The course of psychiatric disturbances in the presented patient resembled the third type of Jerusalem syndrome despite her past psychiatric history and probably travelling caused her decompensations. In clinical practice we have to remember that in case of the patients with a known psychiatric history, clinical evaluation may be useful before travelling. In previously healthy patients developing the third type of the Jerusalem syndrome early intervention and separation from Jerusalem and its holy places and their contact with family are crucial for soon recovery.
- [Dual diagnosis in psychoactive substance abusing or dependent persons]. [Comparative Study, English Abstract, Journal Article]
- Psychiatr Pol 2013 Mar-Apr; 47(2):335-52.
There has been noticed a systematic growth of using psychoactive substance (SP) in last years. The co-occurrence of mental and physical disorders related to substance abuse of treated patients is more often a serious problem to medical services. Dual diagnosis (DD) is a clinical term referring to co-morbidity or the co-occurrence in the same individual of a psychoactive substance use disorder and another psychiatric disorder. The aim of the study is to investigate the prevalence of dual diagnosis in patients with diagnosis of substance use disorder hospitalized in years 1994-2005, to assess the kind of co-morbid mental disorders and the course of treatment in three groups: patients with DD, with diagnosis of mental disorder without substance use and with diagnosis related to substance use.The retrospective study of 4 349 case records of patients hospitalized in the department of psychiatry in years 1994-2005. Out of this number two groups of patients were separated: persons abusing or dependent on SP (n = 825) and patients with dual diagnosis (n = 362). The control group (n = 200) was created among patients with mental disorders and without SP abuse. Socio-demographic factors, number and the length of hospitalizations, aggressive behaviours, suicide attempts, discharges from hospital on demand were analyzed. In the DD group there was an attempt to evaluate the relation between substance use disorders and co-occuring mental disorders performed.The frequency of DD among all patients hospitalized in the studied period of time was 8.3%, whereas among patients abusing SP was 30.5%. This study demonstrates that patients with the DD are statistically longer hospitalized, discharged from hospitals at their own request and more often need treatment in hospitals, statistically more often try to commit suicide and perform aggressive behavior. Mental disorders were substantially often secondary to substance related disorders in the DD group. There was proved that patients mainly abused alcohol and the most frequent mental disorder were mood (affective) disorders.
- [Impulsivity and decision making in alcohol-addicted individuals]. [English Abstract, Journal Article, Review]
- Psychiatr Pol 2013 Mar-Apr; 47(2):325-34.
Decision making processes are the research problem, that has been increasingly undertaken. Alcohol addiction is a disease associated with unfavorable decision making, in spite of its negative consequences. Impulsivity plays an important role in alcoholics' decision making. It can be understood in terms of behavioral and/or cognitive flexibility disorders, that manifest in cognitive function disorders, making it difficult or even impossible to quickly and adequately assess the situation and to adjust behavior according to its requirements.. Neurobiological and genetic research indicate the existing relationship between impulsivity and certain genetic predisposition. In alcohol addicts, impulsivity can be understood also in terms of specific personality traits, e.g. novelty seeking according to the theory of Cloninger. Although the concept of impulsivity itself has been the main topic of many studies, not many of them concern also decision making processes. In studies concerning alcoholics' decision making, the relationship between this processes and behavioral impulsivity defined in many different ways, has been noticed. Some of these works define unfavorable decision making processes itself as a feature of impulsivity. Based on the results of theoretical works and research studies, it seems that it would be worth to define more precisely the concept of impulsivity, in order to determine its effect on decision making. The assessment of whether - and to what extent - the two variables (impulsivity and decision making) can be considered as separate should also be taken into account.
- [Prospective memory - concepts, methods of assessment, neuroanatomical bases and its deficits in mental disorders]. [English Abstract, Journal Article, Review]
- Psychiatr Pol 2013 Mar-Apr; 47(2):313-24.
In the last two decades of the last century there has been a shift in the studies on memory. In psychology of memory the criticism of the laboratory approach resulted in development of the ecological approach. One of the effects of this change was to initiate researches on memory that includes plans for the future, which has resulted in the distinction of the concept of prospective memory. Prospective memory is used in many aspects of everyday life. It deals with remembering intentions and plans, it is connected with remembering about specific task or activity in the future. There are three types of PM: event-based prospective memory, time-based prospective memory and activity-based prospective memory. Current research in this field have already established its own paradigm and tools measuring PM and there is still increasing scientific interest in this issue. Prospective memory assessment may be carried out in various ways. Among them, the most frequently used are: a) questionnaires, b) psychological tests, c) experimental procedures. Within the latter, the additional distinction can be introduced for: the experiments conducted under natural conditions and the laboratory procedures. In Polish literature, there are only a few articles on PM. The aim of this work is to review studies on assessment methods of PM. Its neuroanatomical bases and its functioning in different mental disorders are analyzed. The work is aimed to focus clinicians attention on prospective memory as an area which is important for complex diagnosis of cognitive processes.
- [Sleep disturbances in children and adolescents with psychiatric disorders - affective and anxiety disorders]. [English Abstract, Journal Article, Review]
- Psychiatr Pol 2013 Mar-Apr; 47(2):303-12.
Sleep disorders are common in children and adolescents, their incidence is estimated to be within 25-40%. Among children with psychiatric disorders, sleep problems often arise. Sleep disorders are a symptom of many mental illnesses, they have a major impact on the severity of other symptoms of the disease and the treatment is often difficult. Epidemiological and clinical studies have shown that children in this group often suffer from chronic insomnia, but also relatively frequently are seen in them primary sleep disorders such as restless legs syndrome or obstructive sleep apnea. On the other hand, there is evidence that primary insomnia may be a risk factor for many psychiatric diseases especially depression and anxiety disturbances, and may even produce symptoms of mental illness. Researches regarding pharmacotherapy in pediatric sleep disorders are limited. As a first-line treatment nonpharmacologic strategies are usually recommended.
- [Will new diagnostic criteria facilitate the diagnostic process of ADHD in adults?]. [English Abstract, Journal Article, Review]
- Psychiatr Pol 2013 Mar-Apr; 47(2):293-302.
ADHD is traditionally described as a pediatric disorder. According to contemporary knowledge in around 60% of children suffering from ADHD symptoms of the disorder persist into adulthood. The epidemiological data show the 2-5% prevalence ofADHD in adults. The consequences of the disorder are serious and may cause other health problems and impairments in occupational and individual functioning. The diagnosis ofADHD in adult is based on diagnostic criteria which were created for children. As a result, many difficulties and doubts appear during diagnostic process, and it may also lead to underdiagnosis ofADHD in adults. The paper presents disadvantages of the current diagnostic criteria of ADHD in adults in both DSM-IV and ICD-10. Suggestions of authorities concerning the changes, which may facilitate the diagnosis of ADHD were discussed. The most important proposals are: with reference to symptoms - the inclusion of additional symptoms describing the specificity of hyperactivity in adults and the reduction of number of symptoms, which should be fulfilled to set the diagnosis; with reference to age-onset criterion - the increase of age level (symptoms should begin before 12).
- [Self-esteem of boys with attention deficit hyperactivity disorder - pilot study]. [Comparative Study, English Abstract, Journal Article]
- Psychiatr Pol 2013 Mar-Apr; 47(2):281-91.
To compare the self concept of boys with ADHD and health subjects; to determine which symptoms ofADHD, oppositional defiant disorder (ODD) or conduct disorder (CD) have the greatest impact on self-concept.Polish version of The Harter Self-Esteem Questionnaire (HSEQ) was filled by boys with ADHD and control group. In addition, a diagnosis of ODD and CD was made in ADHD group.A significant difference was observed between boys with ADHD and control group on the following scales of HSEQ: Global Self-Esteem Subscale, Social Acceptance Subscale and Scholastic Performance Subscale. No significant influence of the quantity and intensity of ADHD and ODD symptoms on self-esteem was found. A significant correlation was indicated between all scales of HSEQ and quantity and intensity of symptoms ofADHD.Boys with ADHD have lower self-esteem than their healthy peers and their global self-esteem, social acceptance and school skills are most affected. The presence of conduct disorder (CD) had the greatest impact on the decrease of self esteem in ADHD group.
- [Cognitive behavioral therapy for chronic insomnia]. [Comparative Study, English Abstract, Journal Article]
- Psychiatr Pol 2013 Mar-Apr; 47(2):269-79.
To evaluate the efficacy of cognitive behavioral therapy (CBT-I) in chronic insomnia treatment.236 patients with ICD- 10 nonorganic insomnia were assigned to group CBT-I (6 sessions, 6-10 patients). From this pool, 72 participants with no history of other psychiatric or sleep disorders conditions were selected. Eventually, 51 patients (40 female, mean age: 54.6+/-13.9y, mean insomnia duration: 7+/-6.3y) and 51 matched healthy controls (mean age: 55.4+/-14.3y) completed the study. Outcomes in the insomnia group at baseline and post-treatment were compared to control group. Subjects underwent sleep diary, the Athens Insomnia Scale (AIS), the Beck Depression Inventory (BDI), the Ford Insomnia Response to Stress Test (FIRST), the SF-36 questionnaire and the State-Trait Anxiety Inventory (STAI).At baseline, groups differed significantly in most dependent variables. At posttreatment, a substantial improvement in all sleep parameters was observed in insomnia group: sleep latency, number ofawakenings, wake time after sleep onset, sleep time, sleep efficiency, sleep quality and frequency of hypnotic use. These outcomes were accompanied by lower AIS and FIRST scores, reductions of depression and anxiety symptoms, and improved energy and social functioning ratings. All changes were maintained during the 3-month follow-up. Only 10/51 patients had no clinically meaningful improvement at any post-treatment time points. After the therapy, patients did not differ significantly from good sleepers in number of awakenings, sleep quality, feeling in the morning, depression and anxiety symptoms, and quality of life related to mental health.The CBT-I produced a sustained, clinically meaningful improvement in nocturnal sleep and daytime functioning.
- [Correlations between working memory effectiveness and depression levels after pharmacological therapy]. [Comparative Study, English Abstract, Journal Article]
- Psychiatr Pol 2013 Mar-Apr; 47(2):255-67.
The goal of the study was to identify possible associations between spatio-visual performance and verbal working memory, evaluated on admission, with the remission degree, assessed by the HDRS after 8-week pharmacotherapy with SSRI in a group of patients with depression.141 subjects were examined (patients with depressive disorders, DD: n = 86, healthy subjects, CG: n = 55). TMT and the Stroop Test were used. Results. CG obtained higher results vs. DD-I patients (the evaluation started on the therapy onset) in the Stroop Test, RCNb/time (p < 0.001), NCWd/time (p < 0.001), NCWd/errors (p < 0.001), TMT B/time (p = 0.009). CG demonstrated higher results than DD-II patients (following eight weeks of pharmacological treatment) in the Stroop Test, RCNb/time and NCWd/time (p < 0.001). Compared to DD-I group, DD-II group achieved better results in the Stroop Test, NCWd/time (p = 0.03), NCWd/errors (p < 0.001), TMT, A (p < 0.001), B (p <0.001). The lowest performance levels in the Stroop Test, NCWd/time (p = 0.02), NCWd/errors (p = 0.04) and in TMT, A/time (p = 0.01), may have been related to the highest depression levels after pharmacological treatment.1. Depressive disorders are associated with deteriorated efficiency of visual and verbal working memory. 2. Antidepressant treatment resulted in improved of visual and verbal working memory. 3. The better performance in the Stroop Test and in TMT on the first day of treatment may have influenced the noted reduction in severity of depressive symptoms after treatment with SSRI.
- [Cognitive functioning in depression and the course of bipolar affective disorder]. [English Abstract, Journal Article]
- Psychiatr Pol 2013 Mar-Apr; 47(2):239-53.
The study aims were to demonstrate the relationship between neuropsychological functioning in depressed bipolar patients and clinical variables: intensity of depressive symptoms, age at onset, duration of illness, total number of episodes, number of maniac episodes, number of depressive episodes and number of hospitalizations.Cognitive functions were examined in 30 depressed bipolar patients aged 18-68 (M=45.6, SD= 12.6; 18 women and 12 men) who fulfilled ICD-10 criteria for depressive episode (Hamilton Depression Rating Scale score > 11). A neuropsychological battery assessed executive functions and working memory. Demographic and clinical variables were assessed with questionnaire.The results do not indicate relationship between the neuropsychological functioning and intensity of depressive symptoms. Number of hospitalizations seems to be related to severity ofneuropsychological dysfunction. Longer duration of illness and earlier onset turned out to be connected with better neurocognitive functions. Total number of episodes, number of maniac and depressive episodes are not related to neuropsychological functioning.Neuropsychological impairment in bipolar disorder seems to be stable trait, independent from intensity of depressive symptoms and they progress with course of illness measured by number of hospitalizations.