Coping with stress, control of emotions and biochemical markers as a common protective element in the inflammatory response to stress

OBJECTIVES

Based on a comprehensive approach to the problem of stress, we have decided to evaluate all components of a stress response - immunological (IL-1, IL-2, IL-6, IL-10, CRP, TNF-alpha) and hormonal one (CRH, ACTH), as well as to evaluate the psychological indicators of stress, coping with stress, and controlling emotional reactions as psychological markers that predispose to the most beneficial adaption in relation to stressors affecting flight personnel taking part in peace missions abroad.

METHODS

The research studies being the subject matter of the project were conducted among 113 antiterrorists and 123 representatives of aircrew (236 respondents in total) who participated in peace missions outside Poland. The study was conducted both before departure and during the missions. The study included a biochemical evaluation (IL-1, IL-2, IL-6, IL-10, CRP, TNF-alpha, CRH, ACTH) as well as a psychological assessment based on the Perceived Stress Scale by S. Cohen (PSS-10) and the Courtauld Emotional Control Scale (CECS) by M. Watson and S. Greer, and the COPE Inventory by J. Corver.

RESULTS

Based on a statistical analysis of the variables, a relationship between the level of perceived stress and the methods of coping with it as well as between the selected methods of emotion control and inflammatory response indicators, was found.

CONCLUSIONS

In difficult situations, accompanied by an increase in the variables responsible for the biochemical inflammatory response of an organism, the effective model of coping with difficult situations and emotioncontrol increases, while the subjective level of perceived stress drops.

[A mistake in forensic psychiatric evaluation or abuse of psychiatry for non-medical purposes - a case report]

In this study we attempted to visualize certain irregularities that took place in the evaluation of a patient with personality disorders performed by psychiatrist expert witness, which resulted in an incorrect diagnosis, leading to wrong ruling of the court and a referral of the patient to clinical therapy lasting six years. The psychiatric and psychological expert opinions submitted to the court and first-hand psychiatric and psychological examination of the patient were analyzed. Efforts were made to show that the failure to comply with the diagnostic criteria in the process of diagnosis and not taking into account the previously issued five forensic psychiatric opinions issued by independent and experienced teams of psychiatrist expert witnesses, as well as not taking into account the nature of the offense committed have led to a number of irregularities in the assessment of the mental state of the patient. Above mentioned shortcomings have caused unjustified legal classification of the offense and six years long detention of the patient in closed psychiatric institutions, in our regard unnecessary. The described case could be regarded as an abuse of psychiatry for the non-medical purposes and thus should have be punish. Based on the presented case it has been demonstrated that insufficient experience in forensic psychiatry and failure to comply with diagnostic criteria of psychiatrists and psychologists expert witnesses had led to a series of blatant offense of civil rights and liberties, and thus unnecessary detention of the patient for six years.

[Emotional and psychosomatic disorder among female patients undergoing breast cancer diagnosis]

Basics of psychoneuroimmunology indicate factors such as emotions, behaviour, personality and cognitive functions to have impact on weakening of immunological system and worsening the risk to develop medical conditions, including breast cancer.

AIM

The aim of research was to attempt a coping of emotional and psychosomatic disorders among women undergoing breast tumor diagnostic process.

MATERIALS AND METHODS

145 female patients were included in the the research, among which 99 belonged to the research group (RG) and 46 belonged to the control group (CG). The average age in GB 49, 67 (± 9,47) i GK 46,43 (± 11,2). The research group members were undergoing diagnosis process for suspected breast cancer. The subjects filled out a survey and Symptom Questionnaire S-II, and were subject to mammographic and ultrasound examination, as well as aspiration biopsy was performed on them. 99 individual subjects were positively diagnosed with breast cancer, and 46 were negatively diagnosed.

RESULTS

One in three women belonging to RG displayed emotional disorders. In CG only one in ten displayed symptoms of such disorders. Anxiety was the most common disorder mentioned by both RG and CG. There is however statistically relevant difference in anxiety intensity between the two groups. A statistically relevant corelation has been observed among members of the research group between certain psychosomatic disorders and a number of sociodemographic and medical variables' levels.

CONCLUSIONS

Stress-related and formed psychophysiological and psychosomatic reactions are likely to play the role of psychosomatic and emotional factors leading to breast cancer development.

[Causes of suicide attempts in patients undergoing psychiatric hospitalization--a preliminary study]

Suicide is difficult and dramatic act of deliberately taking one's own life. The causes of suicidal behavior are complex and include both sociological as well as psychological and neurobiological factors associated with the dysfunction of the central nervous system.

AIM

The aim of study was to analyse tha causes of suicidal behavior.

MATERIALS AND METHODS

The study comprised of 76 individuals. The study group included 48 patients hospitalized in the Babiński Memorial Hospital in Łódź, Poland who have attempted suicide act recently or in the past. Each patient completed psychological tests: Basic Hope Inventory (BHI-12), in evaluating Evaluation Crisis Questionnaire (KKW), The Beliefs about Pain Control Questionnaire (BPCQ).

RESULTS

Statistical analysis revealed personality disorders and affective disorders to be the most frequent psychiatric diagnosis among patients, who attempted suicide. Patients from the study group had specific psychological characteristics. The most common suicide method was drug intoxication.

CONCLUSIONS

Suicide prevention should include somatic and psychiatric morbidity and a thorough analysis of psychological functioning. This would help to better understand the mechanisms underlying suicide and extract a group of people with a significantly increased risk of suicidal behavior so that we could apply adequate prevention methods.

[Quality of life, acceptance of illness and a sense of health control in patients with chronic musculoskeletal disorders during the rehabilitation process]

In medical science it is accepted that in order to determine the state of physical, mental as well as the progress of treatment, the concept of quality of life is applicable. However, the most popular use of the term is in the case of chronic diseases and particularly in the lives of those who are sick. Examples of such diseases are diseases of the musculoskeletal system and especially osteoarthritis of the knee and hip. The level of quality of life in chronic disease are also affected by psychological factors that can significantly help people in the healing process as well as acceptance of existing disease.

AIM

The aim of study was to evaluate the association between quality of life, acceptance of illness and sense of control over own health in patients with chronic motor disability during the rehabilitation course.

MATERIALS AND METHODS

The study included 105 patients (76 women and 29 men) with osteoarthritis of the hip and knee, undergoing rehabilitation at the Municipal Clinic "Lecznica" in Lodz. The study used a questionnaire in the development of their own - specifying the basic socio-demographic data subjects, the SF-36 questionnaire - evaluating the quality of life of patients, Acceptance of Illness Scale (AIS BJ Felton, TA Revenson, Hinrichsen GA) in the adaptation of the Z. Juczyński and Multidimensional Scale Health Locus of Control MHLC (KA wallstone, BS wallstone, R. DeVellis) in adaptation of Z. Juczyński.

RESULTS

The distribution of respondents by type of disease is as follows: diseases of the knee -63.81%, hip - 23.81% and knee and hip disorders - 12.38%. A similar breakdown occurs in women and men. The average level of quality of life in this population of patients was 88.63, which is not too high. Evaluation of the results of health locus of control scale laid the equal distribution of respondents, taking into account all the studied rocks. Thanks to the use of Pearson's correlation coefficient allowed the conclusion that the level of quality of life correlates positively with the acceptance of the disease and internal locus of control pain in patients.

CONCLUSIONS

Quality of life of the patients in the general dimension is in significant correlation with the acceptance of the disease and with a sense of control over their own health internally. Patients who have a high sense of control health by others or by accident is characterized by a lower level of acceptance of his illness. Acceptance of the disease and a sense of control over their own health may be important factors for health behaviors.

[The effect of selected physical procedures on mobility in women with rheumatoid arthritis]

Electrotherapy, including iontophoresis and magnetic field, is one of the most commonly used physical procedures in the treatment of rheumatoid arthritis (RS).

THE AIM OF THE PAPER

To evaluate the effect of iontophoresis and magnetic field procedures on the intensity and frequency of pain sensation, administration of analgesics, limitation of knee joint mobility and comparative evaluation of analgesic effect s of the applied procedures.

MATERIAL AND METHODS

The study included a group of 60 female patients affected by RS with knee joint pain. Patients were randomly assigned to 3 equally-numbered groups. Group I was subjected to 20 iontophoresis procedures. Group II underwent 20 procedures with magnetic field. Group III was treated with 20 procedures combining both iontophoresis and magnetic field. Each iontophoresis procedure lasted 20 minutes, whereas the magnetic field procedure took 30 minutes. All study participants were evaluated in relation to pain sensation after and before the treatment with VAS (Visual Analogue Scale) and Latinen scale.

RESULTS

After a 4-week therapy in all the three groups there was a statistically significant decrease in pain perception with VAS scale and with all domains of Laitinen scale excluding the limitation of physical activity criterion. The comparative evaluation of statistically important differences after the therapy between the groups revealed marked decrease of pain perception in groups I and II comparing to group II. There were no significant differences between groups I and III.

CONCLUSIONS

Iontophoresis and magnetic field treatments demonstrate effective analgesic property in female patients with rheumatoid arthritis. The conducted studies showed the highest analgesic effects for both treatments used.

[Quality of life and depressive symptoms in patients diagnosed with uterus cancer]

In the present study quality of life and depressive symptoms as well as the influence of illness on emotional state in patients with diagnosis of uterus cancer was evaluated. The aim of the study was to evaluate quality of life and depressive symptoms in women diagnosed with uterus cancer who underwent surgical treatment and complementary therapy.

MATERIAL AND METHODS

The study has been conducted on randomly chosen group of 100 patients diagnosed with uterus cancer who underwent surgical treatment and adjunctive therapy. Surveys has been conducted 6 months after completed therapy when no recurrence of carcinomatous disease was confirmed. Quality of life was evaluated using quality of life questionnaire EORTC QLQ-C30 and depressive symptoms were measured by means of Beck's depression self-rating scale.

RESULTS

In the conducted study in most cases patients with diagnosis of uterus cancer didn't show symptoms of depression and in 40% of patients there were mild symptoms of depressive disorder. The results show that patients without depressive symptoms had better quality of life compared to those with concomitant depressive symptoms and it was statistically significant.

CONCLUSIONS

Patients with diagnosed uterus cancer in whom no symptoms of depression were detected presented with better quality of life compared to patients with depressive symptoms. Emotional state of patients with uterus cancer can be an important factor influencing their quality of life.

[Selected problems in the forensic-psychiatric evaluation of persons posing a likelihood of repeating a criminal act]

In the current penal code, compared to previous regulations, there have been alterations concerning medical security measures. These amendments have been prompted by socio-politic circumstances in Poland as well as implementation of Mental Health Act. According to the current law the court, on the request of expert psychiatrists, can pronounce a sentence of obligatory stay in psychiatric institution for perpetrator of criminal act who has been deemed not sane due to 31 subsection 1 of penal code and who is predictably able of recidivism. In legal-medical practice those less experienced expert psychiatrists may encounter difficulties producing expertise for the court, especially evaluating probability of recurrence of committing a criminal act and resulting request for psychiatric detention. In order to make this issue more acquainted we present a review of literature concerning it.

[Suicide attempts in patients with borderline personality--preliminary report]

Suicide is an act involving intentional taking his own life, which always raises a lot of emotion and controversy. In Poland, the suicide rate in the past few years has averaged about 15/100000 population, but in 2012 the number of suicides was fatal in 4177 cases. Over the years, there are certain fixed patterns in the epidemiology of suicide in Poland. Women often try to commit suicide but men often carry it out. Women usually choose less lethal methods. The highest rate of suicides committed in those states is between 50 and 59 years old. The aim of the study is to determine the prevalence of suicide attempts in patients with personality disorders of emotionally unstable personality type borderline and analysis of the underlying data and epidemiological determinants of suicide attempts.

MATERIALS AND METHODS

The study included 12 patients with a diagnosis of personality disorder with borderline type. Mean age of patients was 33 years. 83% were women. There have been a random analysis of hospitalized psychiatric patients. The obtained data were statistically analyzed.

RESULTS

41.67% declared a suicide attempt, more than one 25%, and without suicide attempts was 33.33 % of the respondents. Popular method of choice was drugs (41.67%), followed by hanging (16.67%), and jump out of the window (8.33%). The most common cause was heartbreak, then the stress of job loss and social conflict. 41.67% of patients had no comorbidities.

CONCLUSION

Emotionally unstable personality borderline type carries a high risk of suicide attempts. The majority of suicide attempts was by the method of low or moderate lethality. Suicide attempts occurred in patients with the same personality disorder, to a lesser extent in patients with concomitant other disorders. Females more predisposed to committing suicide.

[The epidemiology of suicide in bipolar disorder in the manic episode--preliminary reports]

Suicide is among ten leading causes of death in each country and the third most common cause of death in the age group 16-35. The presence of mental illness is the most important risk factor for suicide. Affective disorders contribute to 15-25% of deaths due to suicide attempts. Depression is the most likely cause of the patients attempt on his life. Contrary to popular opinion, manic episode can also increase the risk of suicide, especially if the patient dominates by productive symptoms in the form of delusions. The aim of study was to determine the frequency of suicide attempts and their determinants in an episode of mania in bipolar disorder.

MATERIALS AND METHODS

The study included 16 people with a diagnosed bipolar disorder, hospitalized with manic episode at the age of 28-76. Patients hospitalized in the Department of Adult Psychiatry were selected randomly. The number of suicide attempts, comorbid conditions, and basic epidemiological data were estimated.

RESULTS

Five patients declared suicide attempt, one of which wanted to make more than one attempt at suicide. 3 people took it during an episode of depression, two in an episode of mania. The methods of suicide were associated with an overdose of medication and this was accompanied by a greater amount of alcohol intake. 11 persons did not declare any willingness to attempt suicide.

CONCLUSIONS

A mania episode did not increase the risk of suicide in bipolar disorder compared to an episode of depression in the study conducted. The importance of somatic illness in patients with bipolar disorder is increased if the suicide attempt occurs in an episode of depression. Alcohol abuse showed no negative effects on suicidal behavior of patients. During abuse was the most common way of commit suicide.

[Evaluate the influence of psychosocial factors on sexuality soldiers participating in the Polish Military Contingent in Afghanistan]

Sexual health problems of stabilization missions soldiers, contrary to other specific populations, have not been fully studied. However, effects of being in a war zone have been thoroughly investigated. Modern warfare soldier experiences stress related not only to life and health threat but also to separation from loved ones. Anxiety and depression as adaptive disorders, rarer posttraumatic disorder were diagnosed in participants of stabilization missions. These disorders as well as not diagnosed dysfunctions may have impact on sexual health.

THE AIM OF STUDY

To assess the selected psychosocial factors on sexuality of veterans of Polish Military Contingent (PMC) in Afghanistan.

MATERIAL AND METHODS

The study was carried out on 68 soldiers, participants of stabilization mission in Afghanistan. The following diagnostic tools were used: sexual history related to military service specificity was taken, IIEF questionnaire, Mell-Krat Scale for Men, scale of sexual pathology in men, questionnaire: 'Self-esteem on relationship with a partner'.

RESULTS

According to the investigated individuals, taking part in a military mission did not increase present or trigger new problems in sex life. The examined soldiers were satisfied with their sexual activity, assessed themselves as good lovers and claimed to be perceived so by their partners.

CONCLUSIONS

The results of the study show that taking part in Polish Military Contingent seems to have had no negative effect on veterans sex life. Majority of the investigated veterans assessed well the relationship with a wife/partner as well as satisfaction from sexual activity and were aware of being well assessed by a wife/partner with reference to sexual activity.

[Assessment of the relationship of depressive disorders in men with lumbosacral pain syndrome]

Coincidence of pain in various somatic diseases of depression was confirmed in many epidemiological studies. Lumbosacral pain can be classified as one of the most aggravating National Health budget.

THE AIM OF THIS STUDY

To assess the relationship between the presence of pain, depression, and emotional functioning of male patients.

MATERIAL AND METHODS

56 men with lumbosecral pain syndrome took part in this study. Some of them were diagnosed as depressive disorders patients. In this study we used scales to measure the degree of pain and depression and Emotional Control Questionnaire to determine subjects emotional functioning.

RESULTS

This paper presents the relationship between the occurrence of lumbosacral pain syndrome and depressive disorders. The results confirm the existence of a relationship between the severity of pain and depression and emotional disorders.

CONCLUSIONS

The study shows that there is a correlation between the intensity of lumbosacral pain in male patients and the incidence of depressive and emotional disorders. Men with back pain syndrome and depressive disorders during pain increase period have less emotional excitability and rationally motivated behavior. Men with back pain syndrome without depressive disorders during pain increase period have a greater control of emotional expression, and less control of the situation emotiogenic situation.

[Subjective evaluation of symptoms and effects of treatment and the intensity of the stress and anxiety levels among patients with selected diseases of the skin and gastrointestinal tract]

AIM

Aim of this study was to evaluate the relationship between subjective evaluation of disease (the intensity of symptoms, complaints and nuisance effects of treatment) in selected skin diseases and digestive system and investigated psychological factors: the level of stress and severity of state anxiety and trait anxiety.

METHOD

Verification of the research hypothesis was made using the following test methods: medical survey prepared by the authors and standardized psychological tests, such as Medical Questionnaire, Perceived Stress Scale (PSS) by S. Cohen, State-Trait Anxiety Inventory (STAI) by C.D. Spielberger. The study was conducted among 120 patients, including patients with psoriasis, rosacea, gastroesophageal reflux disease and irritable bowel syndrome.

RESULTS

Patients received average results in the level of stress and anxiety. The highest degree of severity of the disease and its nuisance reported patients with gastrointestinal disease. All invited to the study patients evaluated effects of treatment of their disease as relatively low. In patients with psoriasissignificant relationships conserned the largest number of tested variables, as compared to other groups.

CONCLUSIONS

In all groups of patients partial correlation between the examined determinants of psychological and subjective assessment of symptoms and effects of its treatment was shown. The higher rating of the variables was most associated with a higher intensity of stress and anxiety.

[Correlations between working memory effectiveness and depression levels after pharmacological therapy]

AIM

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.

METHODS

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.

CONCLUSIONS

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.

[Psychopathological and psychosocial aspects of military crimes]

Crimes in the military, as well as criminal behaviors in the civilian community are determined by multiple factors. However, in case of military crimes committed by soldiers on active duty, an important part of forensic psychiatric opinion, is to assess whether occurring mental disorder resulted in inability to perform military duties.

THE AIM OF THE STUDY

was to investigate the psychopathological and psychosocial determinants of criminal behavior in soldiers who committed military crime.

MATERIAL AND METHODS

The study included 122 soldiers who committed military crime. Material for this study consisted of forensic psychiatric opinions formed on the order of military prosecutor and the military judicial authorities.

RESULTS

The results indicate that military crimes are determined by multiple factors. In most cases, the criminal behavior was associated with personality disorder (70%), alcohol problems (43%) and psychoactive substance use (30%). Psychosocial factors analysis revealed more frequent behavioral problems during childhood and adolescence (51%), history of parental alcohol problem (31%) and previous criminal record (29%).

CONCLUSION

Forensic psychiatric examinations revealed that military crimes are more frequent in soldiers on compulsory military service, and in those with personality disorder or/and alcohol problems.

[The use of RHLB battery for the evaluation of the lingual and social skills among psychiatric patients--case study]

Prosody plays an important role in the process of verbal communication, complementing and emphasising the linguistic and emotional aspects of language. Disturbances of speech prosody are rarely recognised, although aprosodia occurs frequently in patients with schizophrenia. Prosodic disturbance of speech can significantly impair verbal communication and social functioning of patients with schizophrenia. Right-hemisphere is connected with emotional prosody deficits and left-hemisphere with linguistic prosody. The aim of the study is to describe. The Right Hemisphere Language Battery by Karen L. Bryan in the examination of patients with schizophrenia.

[Assessment of psychosocial attitudes among homosexual men]

Homosexuality, though more than 20 years no longer exists in the classification of diseases as a deviation, it is still by many people seen as such behavior. The aim of the study was to assess the situation and psychosocial attitudes in the group of homosexual men.

MATERIAL AND METHODS

The study involved a group of 187 men aged 20-54 years. The study population was characterized by hiding homosexual orientation, lack of a permanent partner for more than half of them and the tendency to avoid safe sex and taking a passive role in intimate contact. In the study a questionnaire prepared by the authors was used.

RESULTS AND CONCLUSIONS

Most respondents hid his homosexuality from others, and over half of them do not have a permanent partner. Representatives of the study group, in most cases do not prefer safe sex and in intimate contact acted as passive.

[Results of the MMPI-2 test among patients suffer from depressive disorders and organic depressive disorders]

The Minnesota Multiphasic Personality Inventory (MMPI) is a psychological tool used in the diagnosis of various disorders and a helpful tool in determining the direction of the planned psychotherapeutic interactions. Is considered as a gold standard for diagnosis. The aim of the study was to compare the MMPI-2 test in patients with depressive disorders and organic depressive disorders.

MATERIAL AND METHODS

The study involved 79 people (41 women, 38 men), hospitalized in the Department of Adult Psychiatry Medical University of Łódź. The subjects were divided into two groups: patients with depressive disorders (DD, n = 53) and patients with organic depressive disorders (ODD, n = 26). The study used MMPI-2 test.

RESULTS

There were no statistically significant differences between the two groups in MMPI-2 test. Patients with DD have obtained higher scores on scales forming 'neurotic triad' (hypochondria, depression, hysteria), on a scale of psychopathy, psychasthenia and each of the five subscales of depression scale.

CONCLUSIONS

Patients with depressive disorders achieved higher results than patients with depressive disorders in hypochondria, depression, hysteria, psychopathy, psychasthenia, social introversion scale and each of the five subscales of depression scale. Patients with organic depressive disorders in the test MMPI-2 tend to aggravation (unconscious exaggeration of symptoms), and elevated results on a scale of paranoia, schizophrenia, mania and masculinity-femininity.

The MMPI-2 neurotic triad subscales and depression levels after pharmacological treatment in patients with depressive disorders - clinical study

BACKGROUND

Affective disorders provide for one third of the main causes of psychiatric inpatient care, both in male and female subjects. An early diagnosis of the disease with precise identification of the character of its particular symptoms are key important factors for the efficacy of treatment. The goal of the study was an identification of possible associations between scores of the neurotic triad in the MMPI-2 test (hypochondria - Hs, depression - D, hysteria - Hy), evaluated at initial hospitalization period with remission degree assessed by the Hamilton Depression Rating Scale (HDRS), following eight weeks of treatment with SSRI.

SUBJECTS AND METHODS

A group of 50 subjects took part in the study. The MMPI-2 test and HDRS were used in the study. The HDRS was performed at the therapy onset and reapplied after 8 weeks of its continuation. The MMPI-2 test was applied at the beginning of treatment.

RESULTS

Higher scores in Hs (p=0.007), D (p=0.021) and Hy scales (p=0.001) are associated with the higher degree of depression, measured by the HDRS at the therapy onset. The highest performance in Hs scale (p=0.003) and Hy scale (p=0.001) evaluated on admission, was associated with the highest depression level after pharmacological treatment.

CONCLUSION

The higher the degree of hypochondria and hysteria symptoms, measured by the MMPI-2 test at the onset of therapy in patients with depressive disorders, the higher severity of depression is being found after 8 weeks of therapy with SSRI agents, measured by the HDRS scale.

[Self-aggressive behavior in prisons]

In the literature devoted to the phenomenon of self-harm among engaged imprisonment, meets the different views the causes of such behavior and the risk of their occurrence. Views prevail, according to which aggression is considered common phenomenon among people in prisons. Social isolation and lack of close intimate relationships may foster this type of behavior. The aim of this study is to assess the prevalence of self-aggressive behavior among prisoners.

MATERIAL AND METHODS

We analyzed 133 cases of self-harm and 151 cases of suicide made a fatal persons deprived of their liberty.

THE RESULTS

Among those detained in prisons showing self-aggressive behavior are high rates of mental dysfunction.

CONCLUSIONS

In carrying out self-aggressive states embedded high rates of mental dysfunction, mainly disorders Personality and alcohol dependence and/or psychoactive substances. Among those who made a successful suicide bombing found a high rate of personality disorders and disorders depressive. Causes and determinants of self-harm and suicides by persons residing in institutions prisons are in many respects similar. Those embedded in prisons having mental disorders pose a high risk of autoimmunity, and therefore require special supervision and care of individual psycho-psychological one.

[Results of the Benton Visual Retention Test and the Bender Visual--Motor Gestalt Test among patients suffer from depressive disorders and organic depressive disorders]

AIM

The comorbidity of depression and dementia has been extensively studied. Four main hypotheses have been suggested to explain the relationship between depression and dementia: 1. depression may be a psychological reaction to perceived cognitive decline, 2. depression may be an early symptom of dementia, 3. depression may be an etiologic risk factor for the onset of dementia, and 4. dementia and depression share common risk factors. The objective of this study was to examine the differences between depressive disorders and organic depressive disorders by using two neuropsychological tests.

METHOD

A sample of 61 persons aged 23-62 years participated in the study. Patients who took part in the investigation were divided into two groups: depressive disorders (DD, n = 30), organic depressive disorders (ODD, n = 31). Cognitive functions were evaluated by the Benton Visual Retention Test (BVRT) and Bender Visual-Motor Gestalt Test (BVMGT).

RESULTS

Relevant statistical differences among examined group were observed: in BVRT correct answers (p = 0.006), errors (p < 0.001); in BVMGT: (p < 0.001). DD patients achieved higher results in psychological test than ODD patients. DD group (average) in BVRT: correct answers (-1.33), errors (2.31); BVMGT (average): (50.37). ODD group (average) in BVRT: correct answers (-2.71), errors (5.81); BVMGT (average): (72.01).

CONCLUSIONS

Patients with organic depressive disorders achieved significantly lower results than patients with depressive disorders in BVRT and BVMGT.

[The role of the right hemisphere in the aetiology of the depressive disorders]

Many differences between the hemispheres have been observed, from the gross anatomical level to differences in dendritic structure or neurotransmitter distribution. Analytic reasoning and language functions such as grammar and vocabulary are often lateralized to the left hemisphere of the brain. The right cerebral hemisphere plays a special role in tasks involving the direction of spatial attention, recognition of faces, perception, possibly generation of affect and affective prosody. Depression is associated with many different cognitive impairments e.g. in the domains of working memory and executive functions as well as interpersonal and social cognition problems. Little is known about the relationship between cognitive and affective deficits in depression. Researchers have hypothesised that the laterality of brain damage may facilitate the expression of emotional or affective disturbances. The aim of the study is to describe the role of the right hemisphere in the aetiology of depressive disorders.

[Auditory-verbal learning test by Łuria in the examination of psychiatric patients]

The aim of the study was an evaluation of memory process course efficacy in healthy subjects (n = 37), patients with schizophrenia (n = 44), patients with depressive disorders (n = 58) and patients with organic mood disorder (n = 33).

MATERIAL AND METHODS

A sample of 172 persons aged 18-55 years participated in the study. Cognitive functions were evaluated by the auditory-verbal learning test by Łuria (AVLT).

RESULTS

The best results in the first trail (M = 5,84, SD = 1,38) and after 30 minutes (M = 8,92, SD = 1,23), were obtained by healthy subjects, while the lowest scores were noted for the subjects with organic mood disorder (M = 4,67, SD = 1,24 and M = 5,85, SD = 2,56). Patients suffering from depressive disorders: M = 5,01 (SD = 1,39) and M = 6,68, (SD = 2,21). Patients suffering from schizophrenia: M = 4,84 (SD = 1,52) and M = 6,18 (SD = 2,16). Relevant statistical differences among healthy subjects and mentally ill patients and lack of any relevant differences among mentally ill patients were observed. Sten norms of AVTL were developed for general population.

CONCLUSIONS

Healthy subject achieved higher results in AVLT than patients suffering from schizophrenia, depressive disorders and organic mood disorders. Any relevant differences among mentally ill patients were observed. Sten norms of AVTL were developed for general population.

[Psychiatric and psychological complications in obstructive sleep apnea syndrome]

It is estimated, that symptoms of obstructive sleep apnea syndrome (OSAS) affect 2 to 4% of the middle-aged population and their prevalence increases with age (over 50% people aged 65 and older suffer from OSAS). Among risk factors of OSAS we can distinguish: the male sex, race, overweight and obesity, thyroid hypofunction, age and alcohol abuse. Obstructive sleep apnea results in the absence (apnea) or reduction (hypopnea) of airflow lasting at least 10 s despite normal respiratory exertion. The apnea and hypopnea result in decreased oxygen saturation levels in the blood (hypoxemia). A number of consequences of OSAS can appear including: disruption of the sleep cycle, fragmentation of the sleep cycle, sleepiness, fatigue, headaches, cognitive impairments, irritability and mood disturbance, the higher risk of accidents at work and car accidents, the decrease of the quality of life and the higher risk of cardiovascular diseases. Besides various psychiatric and psychological complications presented in this review can occur in obstructive sleep apnea syndrome.

Psychiatryczne i Psychologiczne Powikłania Zespołu Obturacyjnego Bezdechu Sennego

Objawy obturacyjnego bezdechu sennego (OSAS) dotyczą 2-24% populacji w średnim wieku, a częstość ich występowania wzrasta wraz z wiekiem (ponad 50% osób po 65. rż. wykazuje symptomy OBS). Do czynników ryzyka obturacyjnego bezdechu sennego należą: płeć męska, rasa, nadwaga i otyłość, niedoczynność tarczycy, wiek, nadużywanie alkoholu. U chorych z OBS mamy do czynienia z fragmentacją snu spowodowaną przez liczne, powtarzające się epizody całkowitej lub częściowej obturacji dróg oddechowych, trwające przynajmniej 10 sekund. Dochodzi wówczas do niewystarczającego lub zupełnego braku przepływu powietrza przez drogi oddechowe. W konsekwencji pojawiają się: zaburzenia rytmu snu i zaburzeń architektury snu, nadmierna senność w ciągu dnia i uczucie zmęczenia, bóle głowy, osłabienie procesów poznawczych, drażliwość i wahania nastroju, zwiększone ryzyko wypadków przy pracy, wypadków komunikacyjnych, obniżenie jakości życia oraz ryzyko chorób układu sercowo-naczyniowego. Ponadto, w przebiegu zespołu OBS mogą się pojawić różnorodne psychiatryczne i psychologiczne zaburzenia, które przedstawiono w niniejszej pracy.

[The MoCA scale in diagnosis of the amnestic syndrome--case report]

AIM

Among main symptoms of the amnestic syndrome we can distinguish: short-term and long-term memory deterioration, deficiency of the effectiveness of learning, the anterograde amnesia and the retrograde amnesia, lack of the orientation in the place and in the time and confabulations. The aim of the study is to introduce the unknown tool of cognitive assessment named Montreal Assessment Cognitive (MoCA). The authors want to indicate the diagnostic accuracy of the scale in the examination of the amnestic patient.

METHOD

In the neuropsychological examination of the amnestic patient, the Montreal Cognitive Assessment scale was used.

RESULTS

The patient correctly performed the tasks which estimated effectiveness of the visual-motor coordination, language abilities (naming, repeating of the sentences) and effectiveness of the short-term memory. Difficulties in the remaining tasks indicate at deficiency of the effectiveness of the learning ability, long-term memory (recognition), abstractive thinking and the orientation in the place and time. Deterioration of the working memory and executive functions is also noticeable.

CONCLUSIONS

Montreal Cognitive Assessment scale is a useful tool for the evaluation of the cognitive functions among amnestic patients.

Normalization of the Verbal Fluency Test on the basis of results for healthy subjects, patients with schizophrenia, patients with organic lesions of the chronic nervous system and patients with type 1 and 2 diabetes

INTRODUCTION

Verbal fluency is the ability to form and express words compatible with required criteria. Verbal fluency is necessary for optimal communication and for normal social and occupational functioning. The Verbal Fluency Test is a good indicator of frontal lobe dysfunction, particularly of the left frontal cortex.

MATERIAL AND METHODS

The aim of the study was to compare verbal fluency in healthy subjects (n = 50), patients with paranoid schizophrenia (n = 36), patients with organic lesions of the central nervous system (CNS) (n = 33), and patients with diabetes (n = 62) - type 1 diabetes (n = 31) and type 2 diabetes (n = 31).

RESULTS

Healthy subjects and patients with diabetes achieved the highest results in all categories of the Verbal Fluency Test. Patients with paranoid schizophrenia achieved significantly lower results. Sten norms of the Verbal Fluency Test were developed for the general population. Using these norms it was found that subjects with schizophrenia or with organic lesions of the CNS had very poor results more often and very high results less frequently compared to healthy subjects and also to patients with diabetes.

CONCLUSIONS

This observation is consistent with the neurodevelopmental hypothesis of schizophrenia, in which cognitive functions of the frontal lobe (e.g. verbal fluency) play a major role in the psychopathological picture. We have also demonstrated that in patients with type 1 and 2 diabetes verbal fluency is comparable with healthy subjects.

[Differences in the course of depressive disorders among women and men measured by MMPI-2]

AIM

The aim of the study is to assess the differences between clinical scales of MMPI-2 among women and men suffering from depressive disorders.

METHOD

36 patients were examined (aged 23-62 years, average age = 51.27, SD = 8.84): 19 women (52.77%, aged 23-59, average age = 51.16, SD = 4.74) and 17 men (47.23%, aged: 23-61, average age = 51.41, SD = 12.07). All patients were hospitalised in the Clinic of Adult Psychiatry Medical University of Łódź. The Minnesota Multiphasic Personality Inventory (MMPI-2, adapted by T. Kucharski) and Hamilton Depression Rating Scale (HDRS, consisting of 21-items) were used. MMPI-2 is used in psychological diagnostic and HDRS is used to assess the intensity of depressive disorders.

RESULTS

Relevant statistical differences between women and men in the several clinical scales of MMPI-2 were observed. There were no relevant statistical differences between the examined groups in the HDRS.

CONCLUSIONS

(1). The characteristic symptoms of depressive disorders for women are: the excessive concentration on physical health, numerous complaints about physical disabilities, lack of energy, insomnia, diminishing of attention concentration and low self-esteem, diffidence and pessimism (2). Examined men achieved statistically lower results than women in the following scales: hypochondria, hysteria and D1, D3, D4 subscales of the depression scale. (3). MMPI-2 is one of the psychological methods which allow for a specific diagnosis of depressive disorders symptoms among women and men.

[Neuropsychological examination among patients suffering from transient global amnesia]

Transient global amnesia (TGA) is a temporary disease with an unexplained aetiology. The clinical picture of TGA is characterised by retrograde amnesia (spanning from several days to several years), anterograde amnesia (from few to several hours, most often from 4 to 8), significant disorientation with respect to time (about 50% of the patients) and place (above 90% patients), preserved auto-orientation and preserved ability to recognise other people. The onset of transient global amnesia is sudden and unpredictable. Memory impairments in TGA are unspecific and they are not limited to one single sense or to one given type of material. In TGA there is a lack of comorbid neurological symptoms. Among 10-20% patients after one TGA episode there is a possibility of a next one. Among the risk factors of transient global amnesia we can distinguish biological and psychological variables. The aim of the study is to present symptoms and aetiology of TGA and to show several neuropsychological methods which can be used in differential diagnosis.

Rola Zmiennych Psychologicznych w Powstawaniu i Przebiegu Astmy Oskrzelowej oraz Funkcjonowanie Poznawcze Pacjentów

Przewlekłe choroby układu oddechowego stają się coraz poważniejszym problemem zdrowia publicznego na całym świecie. Do grupy najczęściej występujących należą choroby obturacyjne płuc, w tym astma oskrzelowa. Na chorobę tę cierpi kilkanaście procent populacji krajów cywilizowanych, a dotyka ona ludzi z różnych grup wiekowych i różnych warstw społecznych. Mimo niewątpliwych postępów diagnostycznych i terapeutycznych, astma wpływa niekorzystnie na jakość życia pacjentów i utrudnia adaptację do wymagań stawianych przez otoczenie. Jej przewlekły charakter sprawia, że w znacznym stopniu ogranicza funkcjonowanie pacjentów w aspekcie fizycznym, emocjonalnym i społecznym. Od wielu lat poszukuje się psychologicznych uwarunkowań wystąpienia i rozwoju astmy oskrzelowej. Niewiele jest jednak doniesień naukowych, przede wszystkim z polskich ośrodków, dotyczących wpływu astmy oskrzelowej na funkcjonowanie poznawcze pacjentów. Celem pracy jest przedstawienie wpływu czynników psychologicznych na powstawanie i rozwój astmy oskrzelowej oraz analiza funkcjonowania poznawczego pacjentów.

Quality of life and emotional functioning in selected cardiovascular diseases

BACKGROUND

Numerous psychosomatic diseases, especially cardiovascular, are regarded as diseases of modern civilization. Psychological factors play a dominant role in these diseases. Among these factors we can distinguish several different types of emotional functioning and subjective estimation of patients' quality of life (QoL).

AIM

To assess the level of QoL and types of emotional functioning among patients suffering from ischaemic heart disease (IHD) and hypertension.

METHODS

A group of 160 male patients was subjected to examinations. They were divided into two groups: IHD with hypertension (120 patients) and a control group (40 healthy patients). In the examination the Emotional Control Questionnaire by Brzeziński (KKE) was applied together with Life Quality Test SF-36 and with a personal questionnaire.

RESULTS

Approximately 25% of patients had low QoL. The mean QoL was lower than in healthy subjects (p < 0.05). Also parameters of emotional functioning were significantly lower in patients than in controls (p < 0.05). Significant correlations were found between level of QoL and several types of emotional functioning (p < 0.05, p < 0.01 and p < 0.001).

CONCLUSIONS

1. Quality of life level among psychosomatic patients is significantly lower than in healthy individuals. 2. Quality of life level is closely related to emotional functioning of the studied individuals. 3. Among psychosomatic patients lower level of QoL is accompanied by higher intensity of negative emotional functioning schemes.

[The psychologist's responsibilities--legislative issues]

An act of psychological profession and psychologists' self-governing council on June 8th 2001 has been in effect since January 1st 2006. It cannot be forgotten, that the psychologists have not only entitlement but also responsibilities. Among above-mentioned we can number: duty of patient's agreement obtaining, duty of official secret, duty of period of special training, duty of information about going out of psychological profession, duty of professional training and duty of membership in professional autonomy.

Oxidative stress parameters after combined fluoxetine and acetylsalicylic acid therapy in depressive patients

OBJECTIVE

There are numerous reports indicating disturbed equilibrium between oxidative processes and antioxidative defense in patients with depression. Moreover, depressive patients are characterized by the presence of elements of an inflammatory process, which is one of the sources of reactive oxygen species (ROS). In view of the above, it was decided to study both the effect of fluoxetine monotherapy and that of fluoxetine co-administered with acetylsalicylic acid on lipid peroxidation and antioxidative defense in patients with the first depressive episode in their life.

METHOD

Seventy seven patients with major depressive disorder (MDD), divided into two groups were included in the study. The first group, consisting of 52 patients, received fluoxetine 20 mg, and the second one, in addition to fluoxetine 20 mg, received 150 mg of acetylsalicylic acid. The activity of antioxidative enzymes, copper-zinc superoxide dismutase (CuZnSOD, SOD1), catalase (CAT), glutathione peroxidase (GPSH-x) and the concentration of malonyldialdehyde (MDA) was determined in erythrocytes, whereas the total antioxidant status (TAS) was determined in the plasma. All parameters were measured before and after three month therapy.

RESULTS

The obtained results indicate a significant decrease in the activity of SOD1, CAT and GSHP-x, as well as in MDA concentration after the combined therapy. Also a significant TAS increase was observed after the combined therapy. The study demonstrated that combined therapy with fluoxetine and ASA is characterized by the same efficacy and clinical safety as fluoxetine monotherapy, resulting additionally in improvement of oxidative stress parameters in the patients treated for depression.

The prevalence of computer and Internet addiction among pupils

INTRODUCTION

Media have an influence on the human psyche similar to the addictive actions of psychoactive substances or gambling. Computer overuse is claimed to be a cause of psychiatric disturbances such as computer and Internet addiction. It has not yet been recognized as a disease, but it evokes increasing controversy and results in mental disorders commonly defined as computer and Internet addiction.

MATERIAL/METHODS

This study was based on a diagnostic survey in which 120 subjects participated. The participants were pupils of three kinds of schools: primary, middle, and secondary school (high school). Information for this study was obtained from a questionnaire prepared by the authors as well as the State-Trait Anxiety Inventory (STAI) and the Psychological Inventory of Aggression Syndrome (IPSA-II).

RESULTS

he results confirmed that every fourth pupil was addicted to the Internet. Internet addiction was very common among the youngest users of computers and the Internet, especially those who had no brothers and sisters or came from families with some kind of problems. Moreover, more frequent use of the computer and the Internet was connected with higher levels of aggression and anxiety.

DISCUSSION

Because computer and Internet addiction already constitute a real danger, it is worth considering preventive activities to treat this phenomenon. It is also necessary to make the youth and their parents aware of the dangers of uncontrolled Internet use and pay attention to behavior connected with Internet addiction.

[Cognitive functions and depression]

Affective disorders are one of the main causes of hospitalisation among women and men older than fifty years old. Yearly, about 100 million people all over the world disclose symptoms of depression. Although the most noticeable signs of this disease concern the emotional sphere, it can also significantly influence their cognitive functioning. Deterioration in cognitive functions among patients who suffer from depression could have a varied nature and intensity (from deficits which are selective, particular and gentle to those which are generalized and more powerful). The deterioration of cognitive functioning can be related to the various aspects: perception, attention, memory (short-term, long-term and working memory), thinking and studying, executive functions, verbal fluency, psycho-motor speed and visual-spatial coordination. Differentiating the symptoms of depression from the symptoms of dementia is an essential issue. Neuropsychological examinations among depressive patients have to be conducted before and after the treatment when the symptoms are resolved.

Relation between functional polymorphism of catalase gene (-262C>T) and recurrent depressive disorder

Numerous studies have provided information indicating the involvement of oxidative stress in the pathophysiology of depressive disorder (DD). The antioxidative system protects against the effects caused by reactive oxygen species (ROS). Catalase (CAT) is one of antioxidative enzymes observed to change their levels in the course of depression. The enzyme decomposes hydrogen peroxide (H(2)O(2)), whose overproduction is a result of many processes taking place in depression. Therefore, functional polymorphism of the CAT gene can be a candidate marker of the risk of depression. The presented study assessed the correlation between -262C>T polymorphism of the CAT gene, which influences the increase of CAT expression and activity, and the risk of depression development. The study, carried out on a homogeneous group recruited from the Polish population, enrolled 149 healthy subjects and 149 depressive patients. The groups were age-matched. The obtained results indicate no correlation between -262C>T polymorphism of the CAT gene (both with respect to genotype distribution and allele frequency) and the risk of depression. Nevertheless, further studies assessing the correlations between depression and polymorphism of the genes encoding antioxidative enzymes on larger groups of subjects should be undertaken.

[The impact of psychological variables on the presentation and progress of asthma and patient's cognitive functions]

Chronic respiratory system diseases become serious public health problem all over the world. The most prevalent are obstructive diseases (asthma and COPD). The prevalence of asthma is still high and concern patients representing wide range of age and socio-economic status. Despite progress in diagnostic and therapeutic options several studies showed that asthma has an impact on health-related quality of life and patients' coping. Asthma as chronic condition results in limitations of patients activity and social relations. Thus psychosocial variables, which may have an impact on asthma symptoms presentation and disease progress, should be considered. There are only few reports concerning cognitive functions in asthma. The aim of the study was to assess the potential impact of psychosocial factors on asthma symptoms presentation, and cognitive function in asthma patients.

[Socio-economic status, aggressive behaviours and coping with stress]

AIM

The authors define the term "satisfaction from life" as being able to achieve satisfying objectives, realize one's own needs and desires. Such a vision depends upon personal experience, knowledge, role models and value system. The objective of this study is to establish the styles of coping with stress, as well as kinds and intensity of aggressive behaviours that depend on the degree of life satisfaction. The degree of life satisfaction was assessed by the look at the socio-economic status.

METHODS

80 people were enrolled in the study. The authors used a personal data form, Coping Inventory for Stress Situations (CISS) by N. Endler and J. Parker and Psychological Inventory of Aggression Syndrome by Z. B. Gaś (IPSA-II).

RESULTS AND CONCLUSIONS

The level of life satisfaction (measured using the family situation and socio-economic status) of the participants is associated with the style of coping with stress and with tendency to aggressive behaviours. The higher the level of life satisfaction was, the lower the intensity of aggressive behaviours and more effective styles of coping with stress were observed.

[The burnout syndrome among doctors and nurses]

The burnout syndrome is a complex of symptoms which are related to psychological, behavioral and physiological man's functioning. Recently, the spread of a burnout syndrome significantly increases. As Polish examinations show it is a serious danger among nurses and doctors.

THE AIM OF THE STUDY

To estimate the presence and the level of the burnout syndrome intensity among nurses and doctors. The second aim was to confirm the connections between symptoms of a burnout syndrome and the internal locus of control. Material and methods. 55 doctors and 53 nurses who worked full-time in hospitals in tbdi and in Social Assistance House were examined. Questionnaire of burnout syndrome Ch. Maslach (MBI) and Questionnaire of Locus of control--I-E Scale W. Gliszczyńska were used.

RESULTS

Among doctors and nurses all three factors of burnout syndrome were presented: emotional exhaustion (WE), low level of personal satisfaction from work (ZA) and depersonalization (DP). Nurses in comparison to doctors have a higher level of the emotional exhaustion, a lower level of an involvement in work and a lower level of an internal locus of control.

CONCLUSIONS

Executed research supplied the proofs which confirmed a view that the burnout syndrome is most popular among nurses and doctors. Our results indicate that the burnout syndrome escalates among nurses in comparison to doctors and its influence of work functioning is essential.

[Depressive disorders in the elderly depending on life activity]

Depressive disorders in the elderly are an important medical and social problem. Age is one of the risk factors of depression, which, apart from dementia, is the most frequent mental disorder after the age of 65.

THE AIM OF THIS STUDY

To assess mood in respect of the presence of depressive disorders in the elderly depending on their life activity, for example participation in Third Age University classes. The authors also decided to assess general life-satisfaction of Third Age University students comparing to the control group.

MATERIAL AND METHODS

200 respondents (aged 60 to 85), living in tLdi were enrolled in the study. The study group was comprised of 100 students of the II Third Age University, aged 60 to 85. The control group was comprised of 100 not associated with Third Age University, randomly selected citizens of t6di. The following tools were used in the study: Beck Depression Inventory and Socio-demographic questionnaire.

RESULTS

Depressive symptoms were less frequent among Third Age University students comparing to the control group. Life satisfaction of Third Age University students was higher comparing to seniors of the control group. CONCLUSIONS. Third Age Universities as a form of activity for the elderly satisfy many needs of the elderly. They allow to find new environment and forget about loneliness, old age, and every form of activity in this age is the source of health, gratification and life satisfaction.

[Neuropeptide Y--structure, receptors, effect and its place in psychiatry]

Neuropeptide Y exists in the central nervous system as a co-transmitter, neuromodulator and neurohormone. It effects many processes dependent on the central nervous system. The paper reviews the latest knowledge on the structure and occurrance ofneuropeptide Y, its receptors, agonist and antagonist binding of these receptors. Taking into account its role in psychiatry, the authors concentrated on its part in the kindling mechanism in affective disorders as well as the neuroprotective function of neuropeptide Y in the excytotoxicity phenomena. NPY enhances the release of glutaminiane, which results in the anticonvulsing effect as well as in a neuroprotective one. The role of NPY in the stress mechanism, pathogenesis of depression, response to antidepressive treatment and the antianxiety profile of NPY in the brain structure has also been discussed. Taking into account its antidepressive and anticonvulsive profile, as well as neuroprotective properties, the searching for agonists and antagonists of its receptors seems to be interesting, as a possible way of influencing separate receptors and eventually controlling the physiological processes.

[Cognitive impairments among diabetic patients]

Diabetes is a metabolic condition of various aetiology. It is characterized by chronic hyperglycaemia with the disorder of metabolism of carbohydrates, fat and proteins as a result of giving off defects and/or working insulin. Cognitive functions are these psychological functions which the human needs in order to be knowledgeable about surroundings, to get the information about oneself and your body, to analyse the situations, to formulate conclusions, to take right decisions or to function. The aim of the study was to find the answer to the question about character of diabetes' influence on cognitive functions of patients and to examine cognitive differences between all diabetic patients and patients with brain damages.

MATERIAL AND METHODS

The group of 95 people was individually examined. People who took part in the investigation (aged from 18 to 55) were divided into three groups: patients with type 1 diabetes (n=31), patients with type 2 diabetes (n=31) and patients with brain damage (n=33). In the research were used several neuropsychological methods.

RESULTS

Relevant statistical differences among examined group were observed.

CONCLUSIONS

All diabetic patients achieved higher results in psychological test than people with brain injury.

[Suicide attempts--possibility of psychoprofilactic]

Not all suicides can be prevented, however considering the risk of committing the suicide on its merits allows physician to undertake treatment of depression and at the same way decrease morbidity and mortality rate in population at suicidal risk. Every physician should pay special attention to patients with intense anxiety and psychomotor agitation or psychotic symptoms like imperative hallucinations or persecutory delusions. The important risk factors of committing suicide are hopelessness, social isolation, adaptation difficulties after loss, divorce, braking up, spouse death. The high suicidal risk group is made up of adolescents and advanced in years. In case of any doubts in estimating the suicidal risk the psychiatric consultation ought to be taken.

[Causes and consequences of frequent hospitalization among schizophrenic patients]

Schizophrenia is one of the most frequent mental diseases. The probability of being taken ill with this psychosis among the whole population is 1%. Frequent hospitalizations of schizophrenic patients prevent them from normal and effective functioning in a society.

AIM OF THE STUDY

Conducted research had an aim to isolate and define the risk factors of rehospitalization among schizophrenic patients.

MATERIAL AND METHODS

In the research, the authors used their own questionnaire which provided the demographic, social and medical data. The research was based on archival case histories of schizophrenic people who were the patients of a mental hospital. The research was conducted among 65 people (27 women, 38 men) who were hospitalized more than 15 times in the schizophrenic treatment.

RESULTS

Psychiatric rehospitalizations in schizophrenia are conditioned not only by medical factors connected with the disease itself, but also by demographic and social factors.

CONCLUSIONS

1. The decisive role in rehospitalization of schizophrenia patients plays a small availability of alternative psychiatric care in the patients' dwelling place as well as the lack of regularity in the continuation on treatment after leaving the mental hospital. 2. Patients' family status, relationship with family and friends and the level of acceptance and understanding of their disease decline the risk of rehospitalization. 3. The greatest risk of rehospitalization is among people from the lowest class--lonely, young men with primary or vocational secondary education, having no permanent employment.

Quality of life and emotional functioning in selected psychosomatic diseases

BACKGROUND

Disease and its treatment may affect a patient not only in the physical, but also in the psychological and social spheres. Quality of life (QOL) is a global concept which should include mental and social actions, physical activities, and the beneficial aspects of a good physical and mental condition as well as negative ones caused by disease and infirmity. The aim of this study was to assess the relationships between emotional functioning and QOL among people diagnosed with coronary disease, hypertension, or gastric and/or duodenal ulcer.

MATERIAL/METHODS

A group of 180 male patients hospitalized during 1999-2002 at the Military Medical Academy Hospital in Łódź was subjected to examinations. The Emotional Control Questionnaire by Brzeziński was applied together with the SF-36 Quality of Life Test. The psychometric techniques used in the examinations allowed determining statistically significant relationships between QOL level and emotional excitability, emotional expression control, and situation control.

RESULTS

1) The QOL level of the psychosomatic patients was essentially lower compared with that of healthy people. 2) QOL was strictly related to the emotional functioning of the subjects. 3) There was no essential diversity in the range of emotional functioning among the patients. 4) QOL of the patients suffering from gastric ulcer was on average a little higher than that of patients with coronary disease.

[Diagnostic and stating problems in delirium tremens cases]

THE AIM OF THE STUDY

To get to know the kinds and prevelence of diagnostic problems related to delirium tremens cases as well as their stating ramifications related to correctness of medical treatment.

MATERIAL AND METHODS

Twelve forensic psychiatric opinions of delirium tremens cases made in Adult Psychiatry Department of Medical University in Lodz in years 2002-2007 were assessed as far as correctness of medical treatment is concerned.

RESULTS AND CONCLUSIONS

In analyzed material of 12 delirium tremens patients no mistreatment cases were found. The most frequent reason of hospitalization was head trauma--7 cases (58%), among them 4 cases (33%) were the consequence of epileptic seizure. None of the patients was referred to psychiatric department and in most cases they were hospitalized in surgical wards--7 patients (58%) or neurological wards--4 patients (33%). During hospitalization in majority of patients--10 cases (83%) delirium tremens was observed on second day. 50% of patients were transferred to psychiatric wards. 11 (92%) of analised patients died. In all of the cases chronic alcoholism with delirium tremens accompanying as the one however indirect cause of death was revealed. The direct cause of death in all the cases was acute circulatory or circulatory and respiratory failure.

[Doctors' alcohol problems]

An overusing and an addiction to alcoholic drinks are important problems in a medical society. The studies made in the United States had documented that about 8-12% doctors were addicted to alcohol. In many cases the doctors are able to keep their problem as a secret and their activity is satisfied up to the moment when a decrease is noticed. Some factors--such as a high level of stress--predispose doctors to alcoholic problems especially surgeons. Alcohol problems should be identified as early as possible, and therapy ought to be given as well. There is no reason to hide the problem.

[The range of cooperation between psychiatrist and psychologist during the medical-military certification]

The aim of certification is to determine the ability to be in the Military Service and to determine the connection between disorders and military service. Military Medical Board that gives certification is obligated to consulate a psychiatrist or a psychologist about soldiers' physical connections. Nowadays the rules that are used in candidates' selection to the military service are not obligatory enough. Regarding the present conditions of health, some changes are needed to be made. It is postulated to estimate candidates' mental health by using a larger frame of psychological examination.

[Psychiatric and psychological problems of the court expertise in military crimes]

The responsibility for committing the military crime by an active service soldier is not always depending on the level of the accountability by the offender. The basis of the psychiatric and psychological court expertise in giving an opinion on military crimes have to be the motivation process. It is known that the motivation is creating by individualistic, biological and situational factors. Among soldiers the situational factors are connected with the decompensation of the personal accountability or with the adaptive disorders. Therefore, it is necessery and obligatory to appoint the psychologist for making court expertise.

[Salutogenesis--the extension of physician's capabilities]

Changes in medicine are not only technical but are also relating to people's awareness. The biomedical model is not sufficient to explain the various phenomena and processes of health and disease. Actually the most popular is the holistic approach. In the salutogenesis model, the essential issue is not the disease but the health. In this approach, among numerous variables, the most important is the sense of coherence (SOC) - the personal variability, the key to health. The psychological problems which are essential in Antonovsky's theory, refer to the physicians. Many of the contemporary researches refere to the medicine and psychology. The salutogenesis can be used in medicine as the extension of doctor's and patient's capabilities but not instead of medicine.