Relationship of autistic traits and the severity of fear of the COVID-19 pandemic in the general population

Background

The aim of the study was to investigate the level of fear of the COVID-19 pandemic and to detect a possible correlation between the autistic traits and the level of fear and to learn about other factors that may affect the level of fear.

Methods

The study utilised a questionnaire and was conducted online in the period from 16.02.2021 to 11.06.2021. The test group consisted of 214 respondents with an average age of 23.78 years (95%CI: 22.48 - 25.08; max: 61, min: 14) from the general population. The study used The Autism-Spectrum Quotient (AQ) questionnaire to assess the degree of autistic traits in the general population and The Fear of COVID-19 Scale, which was used to assess the level of fear of COVID-19.

Results

Among the respondents, 9 people scored ≥32 on the AQ test and were considered to have a high degree of autistic traits. In multiple regression (R2 = 0.1, p<0.0001), a positive relationship between the severity of fear of COVID-19 and the autistic traits (p=0.01) and age (p<0.001) was obtained. Additionally, a second multiple regression (R2 = 0.1, p<0.000001) including the subscales of AQ was performed and a positive relationship between the severity of fear of COVID-19 and the difficulties in attention switching (p=0.0004) and age (p=0.00001) was obtained.

Conclusion

People with higher autistic traits present greater fear of the COVID-19 pandemic. We suggest that it might be caused by cognitive stiffness and disorders in emotions regulation, according to the literature. The elderly also present higher levels of fear. The other variables did not affect the level of fear of the COVID-19 pandemic.

The clinical picture of bipolar affective disorders in children and adolescents hospitalized at the psychiatric ward in Sosnowiec

OBJECTIVES

To determine the clinical picture of bipolar affective disorders (BD) in children and adolescents hospitalized at the Clinical Ward of Developmental Age Psychiatry and Psychotherapy (DAPP) in Sosnowiec, Poland.

METHODS

Documentation analysis of 288 BD patients below 18 years of age. Detailed clinical and demographic data were collected and symptoms present during hospitalization were assessed.

RESULTS

The mean age of illness onset was 13.6 ± 1.7 years. A total of 86.5% of the studied individuals received a first diagnosis different from BD/mania, and the average time until the proper diagnosis was 16.9 months. In 45.5% the first episode was depression with varied severity, in 29.2% a mixed episode and in 25.3% mania/hypomania. In 48.6% comorbid disorders were present. The most frequent reason for hospitalization was a mixed episode (47.6%). Among the symptoms, irritability was observed in over 80% of patients with mania or mixed episodes, but also in 60% of patients with depression. Suicidal thoughts were experienced by almost all the depression patients, 84.7% in the mixed episode and also 52.6% in mania/hypomania episode. Anxiety was mostly present in depression (40.7%) and mixed episode (22.6%), while moodcongruent delusions in depression and mania (around 20% of cases). Aggressive behaviours were manifested in around half of patients with mania and a mixed episode.

CONCLUSIONS

In the studied population of children and adolescents, BD usually started with a depression episode accompanied by a high rate of comorbid disorders and in most cases there was an original misdiagnosis. Study results also point to a significant frequency of some pathological symptoms in this population.

Coping methods among Polish students during Covid-19 pandemic

OBJECTIVES

The Covid-19 pandemic changed daily routines and forced people to develop various coping methods. University students were a social group that suffered due to a drastic change in their daily routine. The analysis of adaptation to chronic stress may help in developing more individualized care for people affected by it.

METHODS

The examination of coping methods and aggression level was conducted using Brief COPE and STAXI-2 questionnaires on a group of 283 participants, extracted from the initial group of 906 tested students. The study was conducted between the second and the third wave of pandemic in Poland.

RESULTS

The positive coping methods were dominant among the examined group. The most used were active coping, use of informational support and planning. The negative coping methods were inextricably linked to a higher aggression level, and were more prevailing in the female students.

CONCLUSIONS

The first symptoms of maladaptive behaviors may be hidden in presumably usual activities and attitudes. It is important to be aware of them in order to provide support for students and other social groups affected by chronic stress.

Evaluation of Peripheral Blood Concentrations of Phoenixin, Spexin, Nesfatin-1 and Kisspeptin as Potential Biomarkers of Bipolar Disorder in the Pediatric Population

There are some initial suggestions in the literature that phoenixin, spexin, nesfatin-1 and kisspeptin may play a role in the pathogenesis of affective disorders. Therefore, they may also be cautiously considered as potential diagnostic or predictive biomarkers of BD. This study aimed to evaluate the levels of the aforementioned neuropeptides in the peripheral blood of children and adolescents with bipolar. This study included 122 individuals: 67 persons with diagnosed bipolar disorder types I and II constituted the study group, and 55 healthy persons were included in the control group. Statistically significant differences in the concentrations of neuropeptides between the control and study groups were noted in relation to nesfatin-1 and spexin (although spexin lost statistical significance after introducing the Bonferroni correction). In a logistic regression analysis, an increased risk of bipolar disorder was noted for a decrease in nesfatin-1 concentration. Lower levels of nesfatin-1 seemed to be a significant risk factor for the development of bipolar disorder types I and II. Furthermore, the occurrence of bipolar disorder was associated with significantly elevated levels of spexin. None of the analyzed neuropeptides was significantly correlated with the number of symptoms of bipolar disorder.

Association of OXTR, AVPR1a, LNPEP, and CD38 Genes' Expression with the Clinical Presentation of Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that affects social interactions, communication, and behavior. Although the predominant genetic predisposition to ASD seems beyond doubt, its exact nature remains unclear. In the context of social cognition disorders and the basis of ASD, the oxytocinergic and vasopresynergic systems arouse great interest among researchers. The aim of the present study was to analyze gene expression levels for oxytocin and vasopressin receptors, as well as CD38 protein and oxytocinase, in the context of the clinical picture of autism spectrum disorders. The study included 90 people, of whom 63 were diagnosed with ASD based on anamnesis, mental status testing, and the ADOS-2 protocol. The results obtained in the presented study indicate that the balance between the levels of expression of the CD38 gene and the oxytocinase gene plays a key role in the risk and clinical presentation of ASD. In a hypothetical scenario, an imbalance in the expression of CD38 and LNPEP could potentially lead to alterations in the concentrations of oxytocin and vasopressin. At the same time, the most frequently studied genes-AVPR1a and OXTR-seem to be at best of marginal importance for the risk of ASD.

The role of selected polymorphisms in regulation of gene CD38 expression and their effect on the clinical picture of autism spectrum disorders - preliminary study

OBJECTIVES

Clinical effects observed in cases of oxytocin deficiency can also manifest themselves in disorders of mechanisms responsible, for example, for its secretion. For oxytocin, this function is played by - among others - the cluster of differentiation antigen 38 (CD38). Existing literature along with the correlation between protein CD38 and oxytocin secretion raise interest in the context of their possible relation to the clinical picture and development of the autism spectrum disorders (ASD). The aim of the study was to analyze the correlations between polymorphisms rs3796863 and rs6449197 in gene CD38, the level of gene expression and the clinical picture and the risk of ASD diagnosis.

METHODS

The study included 59 individuals with the mean age of 15.05 years with IQ > 90. The participants were divided into two groups: the studied group consisting of 37 persons with confirmed ASD diagnoses and the control group including 22 neurotypical individuals. Diagnosis verification was carried out via the ADOS-2 protocol.

RESULTS

The comparative analysis with the standardized population based on the 1000Genomes database with the presence of clinically significant intensification of ASD traits showed the correlation of alleles "T" of polymorphisms rs3796863 and rs6449197, which are more frequent in the general population and are treated as "wild". In the inter-group analysis, this type of dependency was weaker, and the genotype of the control group was somehow intermediate between the studied group and the standardized population. In the ΔΔCt analysis, the normalized value of the relative expression level of gene CD38 showed that in the studied group the expression level was around 1.1-1.2 times higher than in the control group.

CONCLUSIONS

The obtained results show that a significant correlation with the severity of autism spectrum disorder traits is mainly observed in the carriers of wild variants of the studied polymorphisms, in which the related increase in the expression level of gene CD38 is also observed.

Letter to Editor. Position of the Polish Psychiatric Association on the use of benzodiazepine derivatives and drugs with a similar mechanism of action in the treatment of mental disorders

no summary.

Patterns of Food Selectivity among Children with Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a heterogeneous group of neurodevelopmental disorders characterized by food selectivity in a significant portion of the population. The nature of this selectivity remains unclear, with hypotheses suggesting associations with sensory disorders or stereotypical and repetitive patterns of activity and interests. This study aimed to determine the prevalence and nature of food selectivity traits in individuals with ASD compared with the neurotypical population. This study involved 219 participants, with 115 diagnosed with autism and 92 without. Twelve children undergoing diagnosis were excluded from the analyses. The findings revealed that food selectivity traits are more common in individuals with ASD, with differences in preferences mainly involving structure, color, taste, and serving method. Children with ASD had more food selectivity traits than those without, and the intake of certain food characteristics could be altered as they grow. Selectivity occurred for both sensory and stereotypical reasons, but stereotypical features significantly differentiated neurotypical individuals from those with ASD.

Polymorphisms in Oxytocin and Vasopressin Receptor Genes as a Factor Shaping the Clinical Picture and the Risk of ASD in Males

Autism spectrum disorders (ASD) are a heterogeneous group of disorders affecting virtually every population, regardless of their ethnic or socioeconomic background. Their pathogenesis is multifactorial, based on interactions between genetic and environmental factors. The key symptom of ASD are deficits in social communication, which are the basis of many difficulties in everyday functioning. The aim of the presented study was to analyze the clinical picture of social cognition deficits in boys with autism spectrum disorders and to relate its elements with the frequency of alleles of selected polymorphisms within the oxytocin receptor (OXTR) and vasopressin receptor 1A (AVPR1A) genes. The study included 58 boys with IQ > 90, who were divided into two groups based on a confirmed or excluded ASD diagnosis based on the DSM-5 and ICD-10 criteria and then using the ADOS-2 protocol. The results indicated that polymorphism rs10877969 (T) within the AVPR1a gene was the only one to show a statistically significant association with a higher risk of autism spectrum disorders and has an impact on clinical presentation in the ADOS-2 study, primarily in terms of the social affect subscale. Polymorphisms in the OXTR gene showed no significant association with ASD risk and severity of autistic traits in the ADOS-2 study. In the group of people with ASD and those who are neurotypical, the rs53572 (A) genotype in the OXTR gene significantly increased the severity of the clinical picture of social cognition disorders in reading mind in the eyes test (RMiE) and empathy quotient (EQ) studies.

Predictive efficiency of phoenixin, spexin and kisspeptin neuropeptides concentration levels in diagnosis of bipolar disorder in paediatric population

Cel pracy

Celem badania była ocena stężeń wybranych neuropeptydów : feniksyny, speksyny oraz kisspeptyny w surowicy krwi żylnej dzieci i młodzieży z choroba afektywną dwubiegunową, a tym samym ich skuteczności predykcyjnej w tym zaburzeniu.

Metoda

Materiał i metoda. Badanie objęło 75 osób w wieku średnio 15,26 lat (95%CI: 14.86-15.67 ), z czego grupę badaną stanowiło 57 osób z diagnozą choroby afektywnej dwubiegunowej, a grupę kontrolną - 18 osób bez diagnozy psychiatrycznej i nieleczonych farmakologicznie. Feniksynę, speksynę i kisspeptynę oznaczano w surowicy krwi z żyły obwodowej. Pomiary stężeń neuropeptydów wykonano metodą immunoenzymatyczną ELISA.

Wyniki

Średnie stężenie feniksyny w grupie badanej wynosiło 1,57 ng/ml (95%CI: 1,35-1,79), natomiast w grupie kontrolnej – 2,69 ng/ml (95%CI: 2,38-3; U Mann-Whitney test p-value<0,05). W przypadku speksyny wyniki te wynosiły odpowiednio: 639,65 pg/ml (95%CI: 558,86-720,44) w grupie badanej oraz 354,28 pg/ml (95%CI: 310,33-398,22; U Mann-Whitney test p-value<0,05) w grupie kontrolnej. Obserwowane różnice były istotne statystycznie. W zakresie poziomu kisspeptyny średnie stężenie w grupie badanej wynosiło 126,02 pg/ml (95%CI: 39,82-212,23; mediana: 59,85), zaś w grupie kontrolnej - 54,83 pg/ml (95%CI: 39,23-70,43; mediana: 51,3; U Mann-Whitney test p-value=0,29), a obserwowana różnica nie była istotna statystycznie.

Wnioski

Występowanie objawów choroby afektywnej dwubiegunowej jest w istotny statystycznie sposób powiązane z obniżonym stężeniem PNX oraz w niewielkim stopniu z podwyższonym stężeniem speksyny w surowicy krwi chorych. Nie wykazuje natomiast związku ze stężeniem kisspeptyny.

Polish Psychiatric Association diagnostic and therapeutic management guidelines for patients with early-onset schizophrenia

Early onset of schizophrenia (before the age of 18 years) is associated with a higher risk of delayed or missed diagnosis, more severe course of the disease, and an increased susceptibility to adverse reactions to antipsychotic drugs. The objective of this paper is to present the recommendations for the diagnostic and therapeutic management of patients with early-onset schizophrenia, developed on the basis of a literature review and a consensus of a group of experts working with schizophrenia therapy. The formal criteria that must be met to diagnose schizophrenia are the same for children and adults. Early-onset schizophrenia must be thoroughly differentiated from uni - or bipolar affective disorder, autism-spectrum disorders (ASDs) and anxiety disorder. Diagnostic assessment for psychotic disorders is also necessary in the case of abnormal, destructive or aggressive behaviour, or self-harm. The mainstay of schizophrenia treatment is pharmacological therapy, which is used in the treatment of acute episodes and in maintenance treatment - prevention of relapses. However, the use of pharmacological interventions in children and adolescents only to reduce the risk of psychosis development is not justified. Antipsychotic agents significantly differ by their tolerance profile and clinical efficacy. Second-generation antipsychotic agents approved for the treatment of early-onset schizophrenia - aripiprazole, lurasidone and paliperidone - enable its effective and safe treatment. The necessary complement to pharmacological therapy is non-pharmacological interventions that should be adapted to the patient's age, cognitive abilities, disease stage and the needs of the whole family.

Project Extension for Community Health Outcomes (ECHO) Autism: A Successful Model to Increase Capacity in Community-Based Care

Individuals with autism spectrum disorder (ASD) struggle to access high-quality health care due to the shortage of trained providers. ECHO (Extension for Community Healthcare Outcomes) Autism is a unique educational program that allows ASD experts to provide knowledge and skills to professionals in local communities to deliver evidence-based care to children with ASD and their families. The model teaches clinicians how to screen and diagnose ASD, as well as manage common co-occurring medical and mental health issues. ECHO Autism is particularly useful for addressing the complex needs of children with ASD and reducing disparities often present in rural and underserved communities. The model can be disseminated globally due to its flexibility in accommodating local and regional differences in social norms and constructs. This article provides an overview of the format of the ECHO Autism model, data supporting the model’s efficacy, and discusses future research directions.

The position statement of the Working Group of the Polish Psychiatric Association on the use of D2/D3 dopamine receptor partial agonists in the treatment of mental disorders

Aripiprazole, cariprazine and brexpiprazole are antipsychotic drugs (APD) whose action is associated with partial agonism at the dopamine D2/D3 receptors. They are increasingly more widely used in clinical practice, also off-label. The aim of this article is to present the current state of knowledge on the use of these drugs in the treatment of mental disorders. The position statement was developed by the panel of experts appointedby the Executive Board of the Polish Psychiatric Association, consisting of individuals with many years of experience in treating patients with mental disorders. The evaluation included the analysis of literature databases (Medline, Embase, Cochrane) and information obtained from metaanalyses and summaries of product characteristics. A key property of D2/D3 partial agonists is that they display diverse effects on dopamine pathways: (a) blockade of mesolimbic signalling that is overactive in the acute phase of schizophrenia and mania, (b) stimulation of mesocortical pathways with an improvement (or at least with no deterioration) of cognitive functions and negative symptoms, (c) no blockade of the tuberoinfundibular pathway and, consequently, low risk of increased prolactin secretion, (d) no blockade of nigrostriatal pathway and, consequently, low risk of extrapyramidal symptoms. Selective profile of action and intrinsic activity at dopamine D2 (aripiprazole > brexpiprazole) and D3 (cariprazine) receptors in combination with the lack of antihistamine and anticholinergic properties make aripiprazole, brexpiprazole and cariprazine different form other APD in terms of their safety and tolerability. This is the reason for the increasing use of these drugs in the treatment of schizophrenia and mood disorders, and in the case of aripiprazole also in obsessive-compulsive, autism-spectrum and tic disorders.

The position statement of the Working Group of the Polish Psychiatric Association on the use of D2/D3 dopamine receptor partial agonists in special populations

D2/D3 dopamine receptor partial agonists (aripiprazole, brexpiprazole, cariprazine) are increasingly often used in the treatment of mental disorders due to a more favourable tolerability profile as compared to other antipsychotics. The article presents the position statement on the use of these drugs in the treatment of special populations: people with comorbid somatic diseases, people over 65 years of age, including those with dementia, children and adolescents, pregnant and breastfeeding women. The position statement was developed by the panel of experts appointedby the Executive Board of the Polish Psychiatric Association consisting of people experienced in the treatment of patients with mental disorders. The evaluation included the analysis of literature databases and information obtained from summaries of product characteristics, as well as reports and registers on the safety of the three evaluated drugs. D2/D3 dopamine receptor partial agonists can be used in the treatment of people who must be provided with the highest safety standards of the therapy. It results from their low risk of producing side effects, such as weight gain, metabolic disorders, akathisia, extrapyramidal symptoms, increased prolactin levels, prolongation of QTinterval in ECG, sedation and anticholinergic effects. Since dopamine receptor partial agonists are available for arelatively short time, there is less information on their use in pregnant women than for other antipsychotics.

Orthorexia - current approach. A review

The aim of the study was to define orthorexia nervosa (ON) based on the latest scientific findings regarding incidence, groups and risk factors as well as relationships between ON and other clinical entities. The paper is based on the review of the MEDLINE/PubMed databases. Publications published between 2009 and 2019 were analyzed in terms of epidemiology, risk factors and formulation of the ON concept. ON is a clinical entity of an unclear origin and various authors have continued their discussion on the relation between ON and other groups of disorders (AN, BN, OCD, ASD). Epidemiological data vary and depending on a population present extreme values from anywhere between 1% and 90%. Risk factors are alternatively identified in various groups and authors are not unanimous as for the effect of determinants such as anthropometric and sociodemographic variables on the presence of ON symptoms. Presented findings are affected by the fact that there is a relatively small number of studied groups, they are not fully representative and applied tools are different: BOT, ORTO-15, EHQ, DOS. Since the nosological status of ON remains unclear and there are no standard and operationalized diagnostic criteria and reliable assessment tools, ON requires further study. Similarly, because it is still not known how to best treat ON - which is caused by ambiguities in the concept of the phenomenon itself - prevention and therapy programs, which are non-existent, should be developed (in risk groups in particular).

Association between single nucleotide polymorphisms in oxytocin and vasopressin receptor genes and symptom severity of autism spectrum disorder– preliminary study

Introduction

One of the defining features of autism spectrum disorder (ASD) are deficits in social interaction and communication. Although their etiology is poorly understood, several lines of evidence from studies on humans and rodents suggest that two nonapeptides – oxytocin and vasopressin – might play a pivotal role in their development.

Objectives

To evaluate if single nucleotide polimorphisms in OXTR and AVPR1A genes are linked to the severity of symptoms in autism spectrum disorder.

Methods

The study was conducted on the group of 40 Caucasian males with average age of 14,22 (SD: 1,71) years. ADOS-2 examination was utilized for confirmation of ASD diagnosis as well as evaluation of symptoms severity in each patient. The genotyping of preselected SNPs for each gene (rs10877969; rs7294536; rs2254298; rs53576) was conducted.

Results

“CC” genotype at rs7294536 (p=0,033) was significantly associated with higher outcomes of ADOS-2 especially in terms of social affect. In case of oxytocin receptor gene, frequency of “AA”/”AG” genotype at rs2254298 equaled 100% and of “AA”/”AG” genotype at rs53576 equaled 85% of the study group (expected “A” allele frequency in neurotypical European population was respectively 11% and 35% according to 1000Genomes database). For rs10877969 prevalence of “CC”/”CT” genotype equaled 95% while expected frequency of “C” allele in neurotypical European population was 13%.

Conclusions

Overrepresentation of minor alleles at rs2254298, rs53576 and rs10877969 in patients with ASD might indicate their link to development of ASD. Furthermore, significant association between minor allele at rs7294536 and symptoms severity suggest potential role of arginine-vasopressin receptor deficiency in clinical picture of ASD.

Disclosure

No significant relationships.

Systematic Review of Literature on Eating Disorders During Pregnancy-Risk and Consequences for Mother and Child

Background: Eating disorders (ED) are a diagnostic category that includes several nosological units such as anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED). This category most often concerns women, while the peak incidence falls on the reproductive age. Therefore the issue of ED during pregnancy is an interesting topic. Due to the creation of unrealistic ideal of "desired," slim figure both by the mass media and social media even during and right after gestation, more and more pregnant women introduce behaviours aimed at maintaining the "perfect" appearance. However in some cases it may have serious consequences for the health of both mother and child leading to the creation of the term "pregorexia" by the media to describe this issue. Aim: The aim of this paper was to conduct a systematic review of the literature dealing with eating disorders in pregnant women, with particular emphasis on pregorexia. Method: A systematic review of literature published within the last 5 years (2016-2021) in English or Polish and available through MEDLINE / PubMed, Google Scholar and Cochrane Library databases was conducted based on the previously assumed inclusion and exclusion criteria. Results: Initially, 634 publications were obtained during the review, of which 55 papers were selected in the course of the title analysis. After further evaluation of abstracts, 28 papers were qualified for full text analysis. Ultimately, 10 papers were selected for the final analysis. Conclusions: The issue of ED in pregnant women is a broad topic covering a heterogeneous group of women-both those with a previous history and those with the onset during pregnancy. The occurrence of ED symptoms during this period is associated with a high likelihood of negative consequences for both the mother and the child. The course of pregnancies and deliveries in these patients is more complicated. Therefore, it seems reasonable to develop a multidisciplinary screening strategy and standards of management and supervision over this group of patients.

Vitamin D deficiency and depressive symptoms: meta-analysis of studies

AIM

The aim of this study was the identification and summary of studies examining the relationship between vitamin D levels and the risk of depression and depressive symptoms severity, published between January 2008 and January 2019.

MATERIAL AND METHODS

A systematic review of literature published within the last 10 years and accessible in PubMed database was conducted by each author separately based on predetermined inclusion criteria.

RESULTS

Out of the 823 studies qualified to the initial abstract analysis, 24 were included into the full-text review and 18 into the meta-analysis. Statistically significant odds ratio was obtained for risk of depression in the course of vitamin D deficiency (OR = 1.51; 95% CI: 1.4-1.62; p < 0.01).

CONCLUSIONS

The analysis of available literature seems to indicate that there is an association between risk of depression and vitamin D deficiency. However, current literature does not give the possibility to state explicitly what is the exact mechanism and direction of this dependency.

Analysis of psychiatric services provided to children and youth in 2010-2016 based on the National Health Fund data

OBJECTIVES

In Poland, there is no systematic epidemiological research on mental disorders of children and adolescents in the general population, as well as a register dedicated to mental disorders. The aim of the presented study is to analyze psychiatric services reported to the National Health Fund that were provided to children and adolescents in the years 2010-2016.

METHODS

The starting point of this study was report entitled Maps of health needs in mental disorders published by the Ministry of Health. The analysis concerns all mental health services provided to children and adolescents in the years 2010-2016. The analysis covers seven largest, in terms of the number of patients, groups of mental disorders according to ICD-10 in children and adolescents.

RESULTS

In the years 2010-2016, both the number of psychiatric service users under the age of 18 years and the total number of healthcare services have increased in almost all of analyzed areas. Unusually high increase in the number of services provided in the ad hoc mode in A&E department was registered, with a very small share of services provided in home environment. In almost all analyzed groups of mental disorders, there was a greater number of boys, as well as residents of a town/city. Only in the group of neurotic disorders associated with stress and in the somatic form a slightly higher number of girls was noticed.

CONCLUSIONS

In the years 2010-2016, an increase in the number of registered cases in the population of children and adolescents and the number of services in almost all of the analyzed areas was observed. High increase in services provided in the ad hoc mode in A&E department and a small share of services provided in the home environment indicates significant discrepancy between the needs and the availability of resources.

Organisational units providing psychiatric services for adults - an analysis based on National Health Fund data for 2010-2016

OBJECTIVES

The aim of this publication is to analyze the organizational units of mental healthcare for adults based on the data on the services reported to the National Health Fund in 2010-2016.

METHODS

The following organizational forms of care were analyzed: mental health outpatient clinics, general psychiatric wards, general day care psychiatric wards, community mental health teams, and psychiatric emergency rooms. These organizational units were analyzed in terms of their number, utilization and accessibility. In addition, a preliminary simulation of the expected Mental Health Centers was carried out.

RESULTS

In Poland, in 2010-2016, the number of mental health service providers under contracts with the National Health Fund increased by 5%. The most robust growth was observed for community mental health teams, whose number increased by 282%. However, this organizational form was used by a marginal (1.9%) percentage of patients. The highest rate of admission to general psychiatric wards was observed in districts where a general psychiatric ward and a mental health clinic were available with no day care psychiatric wards or community mental health teams. Asmall number of entities providing comprehensive care was in operation in 2016. The preliminary simulation has shown that in 2016 a total of 156 MentalHealth Centers should have been in operation, assuming that each of them would have provided care for 200,000 inhabitants.

CONCLUSIONS

It would be advisable to analyze the exact geographic distribution of units, human resources in individual organizational units, and to take financial outlays for mental healthcare in their various forms into consideration.

Nesfatin-1 in the neurochemistry of eating disorders

The vast majority of new neuropeptides feature unique biochemical properties as well as awide spectrum of physiological activity applied in numerous neuronal pathways, including hypothalamus and the limbic system. Special interest should be paid to nesfatin-1 - the relatively recently discovered and still intensively studied regulatory factor and a potential modulator of eating behaviors. New information about it now allows to consider this neuropeptide as a potentially important factor involved in the pathogenesis of many different mental disorders. The considered pharmacomodulation of nesfatinergic signaling may be potentially helpful in the future treatment of some neuropsychiatric and metabolic disorders including anorexia nervosa. Although the results of some basic and clinical tests seem to be promising, all possible applications of the aforementioned neuropeptides, together with their agonists and antagonists still remain in the area of speculation. The intensive search of selective modulators of their known receptors may facilitate the opening of a promising chapter in the eating disorders therapy. This paper provides a review of recent scientific reports regarding the hypothetical role of nesfatin-1 in the neuronal pathways related to pathophysiology of anorexia nervosa.

Are suicidal thoughts in adolescents dependent on substance abuse?

Substance abuse is common issue in youth and may influence youth's suicide thoughts or actions. It can lead to social isolation, low self-esteem, loss of work or school, estrangement from family and friends – all these may create a core of stresses that may lead to suicidal tendencies.

Analysis addictive factors correlating with occurrence of suicidal thoughts and behaviours among adolescents at the age of 18–20.

Study was based on authorial, previously validated questionnaire, included 16 questions about suicidal thoughts. Questionnaires were filled by adolescents (age 18–20) of 21 Secondary Schools in Katowice.

From the group of 965 adolescents, 28.8% had suicidal thoughts. From all respondents: 31.3% smoked, 92.7% drunk alcohol, 16.0% used legal hights and 30.9% – drugs; 35.8% of smoking adolescents had suicidal thoughts. In group of non-smoked adolescents – 25.6%. There was statistical significant difference (P = 0.0012) between these groups. Among adolescents who drunk alcohol, 28.8% had suicidal thoughts. In the group of non –drinking alcohol adolescents – 27.9%. There was no statistical significant differences (P = 0.88233) between these groups. There were 43.7% adolescents with suicidal thoughts who used legal hights. In the group of non-users of legal hights, 26.0% adolescents had suicidal thoughts.

Adolescents that are using examined stimulants are in the group risk of suicidal thoughts and autodestructive behaviours. Results show the need of psychiatric and psychotherapeutic support that is aiming to prevent suicides and autodestructive behaviours in this group. Screening questionnaires that are assessing the problem of addiction within the adolescent may help to identity persons with suicidal tendencies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

An analysis of psychiatric services provided to adults in 2010-2014 based on the National Health Fund data

OBJECTIVES

Analyzing the indices that allow to improve population health by, for example, improving the quality of healthcare services and increasing accessibility to these services is among the priorities of the World Health Organization (WHO). This is of particular importance in Poland, as the psychiatric care reform is being carried out in accordance with the National Mental Healthcare Program guidelines. The aim of the study is to analyze mental health services provided to adults and reported to the National Health Fund in 2010-2014.

METHODS

In the present study, we expanded the information included in the second part of the maps of health needs. In addition to the evaluation of services provided to adults in 2014, we presented an analysis of services in 2010-2014. According to these data, there was a continuous increase both in thenumber of individuals provided with services for psychiatric disorders and in the total number of provided services. There was an increase in the number of patients treated for mood disorders, neurotic disorders, stress-related and somatic disorders, as well as addictions.

RESULTS

The increase in the total number of services was mainly seen for outpatient types of care. The reasons why in 2014 there was a resurgence in psychiatric hospitalizations and in the hospitalization rate per 100 thousand adults remains unclear.

CONCLUSIONS

Our results indicate the need for further support of the development of psychiatric care using multidirectional efforts within an integrated model for solving health problems. An overall analysis of services provided in psychiatric care requires access to information on services funded from non-public sources and expanding the reported information.

Longitudinal study on novel neuropeptides phoenixin, spexin and kisspeptin in adolescent inpatients with anorexia nervosa - association with psychiatric symptoms

OBJECTIVES

It is hypothesized that novel neuropeptides such as phoenixin (PNX), spexin (SPX), and kisspeptin (KISS) are involved in the pathogenesis of eating disorders. The study presented here analyzed neuropeptide concentrations during the course of anorexia nervosa (AN) and aimed to correlate those values with anthropometric and psychometric measurements.

METHODS

A longitudinal study was carried outin 30 AN adolescent patients and 15 age-matched healthy female controls. Selected neuroprotein serum levels were analyzed in malnourished patients (accAN) and following partial weight recovery (norAN), and these values were compared with the control group.

RESULTS

In accAN patients, decreased serum PNX levels were detected while SPX serum concentrations were lower in the accAN and norAN patients. No differences were observed in KISS concentrations in all studied groups.

CONCLUSIONS

In malnourished adolescent inpatients with AN, serum PNX and SPX level were decreased. The partial weight recovery normalized PNX concentrations but failed to normalize SPX levels. Therefore these two neuropeptides might be crucial for the etiology and course of the AN. The KISS levels did not change in the course of AN. The PNX levels were associated with some symptoms of eating disorders which may indicate its potential contribution in the regulation of emotions and behaviors in AN.

Differences in oxytocin and vasopressin levels in individuals suffering from the autism spectrum disorders vs general population - a systematic review

INTRODUCTION

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interactions, communication, and the presence of stereotyped, repetitive behaviors. Oxytocin (OXT) and arginine-vasopressin are neuropeptides produced in hypothalamus and they are related to processing emotions and social behavior. In the light of a growing number of scientific reports related to this issue, the two neurohormones started to be linked with the basis of neurodevelopmental disorders, including the ASD. The aim of this study was a systematic review of previous studies regarding the differences in OXT and vasopressin levels in ASD and neurotypical persons.

MATERIALS AND METHODS

Literature review focused on publications in the last 10 years located via the MEDLINE/PubMed database as well as the Google Scholar browser. Selection was made by assumptive criteria of inclusion and exclusion.

RESULTS

From the 487 studies qualified to the initial abstract analysis, 12 met the six inclusion criteria and were included in the full-text review.

CONCLUSION

Currently, available study reports still do not provide unequivocal answers as to the differences in concentrations of those neuropeptides between children with ASD and neurotypical control. Therefore, it is necessary to continue the research taking into account necessity of proper homogenization of study groups, utilization of objective and quantifiable tools for ASD diagnosis and broadening the range of biochemical and molecular factors analyzed.

Risk Factors for Noncompliance with Antipsychotic Medication in Long-Term Treated Chronic Schizophrenia Patients

BACKGROUND

The attitudes of schizophrenic patients toward medications directly impact the treatment compliance. Although noncompliance represents a serious concern in long-term schizophrenia treatment, a detailed information on the factors that impair compliance is still limited. The present study aims to assess the factors related to noncompliance with antipsychotics agents, in long-term treated chronic paranoid schizophrenia patients.

SUBJECTS AND METHODS

Two groups of such patients (total number n=162) were analyzed and compared: 1). patients with symptomatic remission on haloperidol (n=32), clozapine (n=40) or olanzapine (n=45), and 2). drug resistant patients (n=45). The mean duration of the disease was 19.3 years.

RESULTS

Altogether, in our patient sample, a better drug attitude was found in the olanzapine and clozapine groups. Our findings have also revealed that worse attitude toward antipsychotics correlated with an earlier onset of schizophrenia, younger patient age, shorter duration of the disease, higher burden of symptoms, treatment with a typical antipsychotics, and higher severity of akathisia.

CONCLUSION

Our results suggest that detecting factors that influence the patient's attitude toward medications might be helpful for designing targeted educational strategies in chronic schizophrenia patients (particularly those with the high risk of noncompliance), and further trials are warranted to explore this topic.

The Relation Between Emotional Intelligence and Internet Addiction in Katowice High School Students

BACKGROUND

Emotional intelligence (EI) is described as the capacity to be aware of, control, and express one's emotions, and to handle interpersonal relationships judiciously and empathetically. It is considered as one of the most important predictors of success, quality of relationships, and overall happiness. Dynamically changing environment of the youth and young adults in recent years may influence their EI development, affecting their lives significantly. The purpose of this study was to analyse the way how the Internet is used by high school students, to determine the amount of time they spend on the Internet, identify the level of EI and to explore if there is any correlation between those factors.

SUBJECTS AND METHODS

1450 high school students from Katowice, at the age from 18 to 21 years took part in an anonymous survey consisting of three parts: The Trait Emotional Intelligence Questionnaire - Short Form (TEIQue-SF), Internet Addiction Test and authorial test giving information about the way of spending time online. The questionnaires were collected from May 2018 to January 2019.

RESULTS

1.03% of the respondents fulfilled the Internet addiction criteria. Students at risk for addiction (33.5%) turned out to be a larger group. A statistically significant correlation between TEIQue-SF and Internet Addiction Test score (P<0.0001, r=-0.3308) was observed. Another significant correlation was found between TEIQue-SF score and amount of time spend on the Internet (p<0.0001, r=-0.162).

CONCLUSION

A significant part of high school students used Internet excessively. Such behaviours were positively correlated with lower EI test results.

Girls and women with autism

Girls and women with autism are often undiagnosed, misdiagnosed or receive a diagnosis of autism at later age. This can result in adverse outcomes in their well-being, mental health, education, employment, and independence. The diagnosis of autism spectrum condition/disorder (hereinafter referred to as autism), with its current features linked with descriptions in the major diagnostic classification systems, is based primarily on observations and research on males. The term 'Autism Spectrum Condition' (ASC), used in this paper, has been coined by Simon Baron-Cohen and used in the professional literature for a decade to respect these individuals on the autism spectrum who feel that the term 'disorder'is stigmatizing, whereas ASC presents both the strengths of these people and difficulties they experience. The research shows that autism in females has unique symptomatology and manifests itself differently, more subtly, especially in high-functioning girls and women, i.e., those with fluent speech, average or above-average intelligence quotient. The research also shows diagnostic stereotypes and lack of required sensitivity to identify autistic females. Additionally they do not reflect the unique presentation of autism in females demonstrated by greater compensatory capacity and an ability to develop sophisticated methods of 'camouflaging'and masquerading. Furthermore, autism in females is associated with high comorbidity during adolescence including anxiety disorder, tic disorder, depression, high incidence of suicide, eating disorders, and high rates of other medical problems. Timely diagnosis, however, can reduce the difficulties that females with autism experience over their lifetime, allowing for the assessment of their needs regarding health, education, leisure, social relationships, and employment.

Systematic Review of Literature on Single-Nucleotide Polymorphisms Within the Oxytocin and Vasopressin Receptor Genes in the Development of Social Cognition Dysfunctions in Individuals Suffering From Autism Spectrum Disorder

Introduction: Autism spectrum disorder (ASD) is found in virtually all population groups regardless of ethnic or socioeconomic backgrounds. Among others, dominant symptoms of autism persistent throughout its course of development include, inter alia, qualitative disorders of social communication and social interactions. Numerous studies have been performed on animal models as well as groups of healthy individuals to assess the potential role of oxytocinergic and vasopresynergic systems in normal social functioning. These studies have also discussed their potential participation in the development of social cognition dysfunctions in the course of ASD. This literature review aimed to identify studies examining single-nucleotide polymorphisms of the oxytocin (OXT) and arginine vasopressin (AVP) receptor genes and their differential effects on social cognitive dysfunction in the development of ASD. Methods: A systematic review of literature published within the last 10 years and accessible in PubMed, Google Scholar, Cochrane Library, and APA PsycNET databases was conducted by each author separately. Inclusion criteria required that articles should 1) be published between January 2008 and August 2018; 2) be published in English or Polish; 3) be located in periodical publications; 4) focus on the role of polymorphisms within oxytocin and vasopressin receptor genes in autistic population; 5) provide a clear presentation of the applied methodology; and 6) apply proper methodology. Results: From the 491 studies qualified to the initial abstract analysis, 15 met the six inclusion criteria and were included in the full-text review. Conclusions: The analysis of available literature seems to indicate that there is an association between social cognition dysfunctions in the course of autism and selected alleles of polymorphisms within the OXT receptor AVP 1A receptor genes. However, previous studies neither specify the nature of this association in an unequivocal way nor select genotypes that are the basis for this association.

Telepsychiatry and Virtual Reality an the Teatment of Patients with Intellectual and Developmental Disabilities

BACKGROUND

Treatment and rehabilitation of people with intellectual and developmental disabilities is a multidisciplinary challenge, which require implementing new attitudes. The use of modern technology solutions like telepsychiatry or virtual reality may be a valuable addition to the traditional methods.

OBJECTIVE

The objective of this review was to explore the usability of new technological solutions in this special population of patients.

METHODS

The search in the PubMed was conducted using the following terms: (intellectual disability (Title/Abstract) OR developmental disability OR learning disorder (Title/Abstract)) AND virtual reality (Title/Abstract) OR telepsychiatry OR telemedicine OR e-mental health AND English (lang) AND (1995/01/01(PDAT): 2017/07/31(PDAT)).

RESULTS

Telepsychiatry may be a useful tool in situations, when the direct access to professional assistance is limited, in solving particular problems like e.g. managing challenging behavior, also to support patients' parents and for diagnostic and educational purposes. Virtual reality can be a safe and effective method of improving different skills, developing physical fitness, and enriching the ways of spending the leisure time.

CONCLUSIONS

Using modern technology is a relatively new and promising field in which new ideas may develop to support the already existing services for patients with intellectual and developmental disabilities.

The Role of Hormones and Inflammatory Markers in Cognitive Functioning of Schizophrenic Patients

BACKGROUND

In the literature we can find evidence that immunological processes are involved the alterations of cognition in schizophrenic patients. Another factor, which may have an impact on cognitive domains in this clinical group are hormones.

OBJECTIVE

The objective of this review was to explore studies, in which the role of both immunological and endocrine factors on cognitive functions in schizophrenia are analyzed.

METHODS

The search of papers covering this topic in PubMed and Google Scholar was performed.

RESULTS

The studies focusing on this co-relation are not numerous. The role such hormones like cortisol, insulin and sex hormones may be important in the immunomodulatory processes influencing cognition in schizophrenia.

CONCLUSIONS

More studies are necessary to confirm these possible co-relations.

Analysis of facial expressions in patients with schziophrenia, in comparison with a healthy control - case study

INTRODUCTION

Deficits in area of communication, crucial for maintaining proper social bonds, may have a prominent adverse impact on quality of life in patients with schizophrenia. Social exclusion, lack of employment and deterioration of family life, may be consequences of aggravated social competencies, caused by inability to properly exhibit and interpret facial expressions. Although this phenomenon is known since first clinical descriptions of schizophrenia, lack of proper methodology limited our knowledge in this area. Aim of our study was to compare facial expressivity of the patient with schizophrenia, and the healthy individual.

METHODS

47-years old patient suffering from schizophrenia, and 36-years old healthy individual were invited to participate in our study. They underwent the examination in Human Facial Modelling Lab in Polish-Japanese Institute of Information Technology in Bytom (Silesia, Katowice). Both participants were presented with two video materials, first one contained different facial expressions, which they had to imitate. Second one a part of comedy show, during which spontaneous reactions were recorded. Acquisition of facial expressions was conducted with marker-based technology of modelling. Obtained data was analyzed using Microsoft Excel.

RESULTS AND CONCLUSIONS

An overall facial expression intensity, expressed as an average value of distances traveled by markers during shifts from neutral position was higher in case of a healthy participant during both part of the study. The difference was especially visible in case of an upper half of the face. Utilization of marker-based methods in analysis of human facial expressions seem to be reliable and remarkably accurate.

Validation of the Polish Version of the Washington 4-Digit Diagnostic Code for the Assessment of Fetal Alcohol Spectrum Disorders

OBJECTIVES

The aim of this paper is a quantitative assessment of FASD facial phenotype in the Polish population using the Polish version of the 4-Digit Diagnostic Code.

METHODS

The study covered 2 groups of children: 30 children aged 4-7 and 30 children aged 8-11 with a facial phenotype characteristic for the Fetal Alcohol Syndrome (FAS). The control group consisted of 60 children (4-11 years old) developing normally. We compared 3 facial features (small palpebral fissure lengths, smooth philtrum and thin upper lip). The repeatability, conformity and diagnostic accuracy of particular dysmorphic features of the study were assessed.

RESULTS

Obtained values for palpebral fissure were "poor", "good" and "very good", for philtrum "good" and "very good" and for upper lip "good" and "very good". As for conformity, values for palpebral fissure were "moderate" and 'good", for philtrum - "good" and for upper lip also "good". In the experimental group, the FAS diagnostic criteria were met by 13 subjects, partial FAS criteria were met by 37 subjects and the criteria of static encephalopathy with no FAS phenotype were met by 2 subjects. None of the subjects in the control group met these criteria.

CONCLUSIONS

The pictorial scale for the assessment of the facial dysmorphic features proved to be a useful tool in the clinical diagnostics of FAS in the Polish conditions. Due to the problems associated with the measurement of the palpebral fissure, it is necessary to verify the normal growth charts for the Polish population.

The role of genetic factors and pre- and perinatal influences in the etiology of autism spectrum disorders - indications for genetic referral

Autism spectrum disorders (ASD) are caused by disruptions in early stages of central nervous system development and are usually diagnosed in first years of life. Despite common features such as impairment of socio-communicative development and stereotypical behaviours, ASD are characterised by heterogeneous course and clinical picture. The most important aetiological factors comprise genetic and environmental influences acting at prenatal, perinatal and neonatal period. The role of rare variants with large effect i.e. copy number variants in genes regulating synapse formation and intrasynaptic connections is emphasised. Common variants with small effect may also be involved, i.e. polymorphisms in genes encoding prosocial peptides system - oxytocin and vasopressin. The environmental factors may include harmful effects acting during pregnancy and labour, however their specificity until now is not confirmed, and in some of them a primary genetic origin cannot be excluded. In several instances, especially with comorbid disorders - intellectual disability, epilepsy and dysmorphias - a detailed molecular diagnostics is warranted, which currently may elucidate the genetic background of disorder in about 20% of cases.

The assessment of orthorexia nervosa among 1899 Polish adolescents using the ORTO-15 questionnaire

OBJECTIVE

Orthorexia nervosa (ON) is considered an eating disorder (ED), with an excessive fixation on the consumption of healthy food and an obsession with its biological purity. Since the adolescent period poses a risk for EDs, the aim of this study was to assess the prevalence of ON in a population of Polish urban adolescents and some possible contributory factors.

METHOD

1899 high school students, 992 girls and 907 boys aged 15-21 years were studied. Demographic and clinical data were collected using a validated questionnaire including information on preferred living choices, in the context of pro- and antihealth activities. The Polish version of the ORTO-15 questionnaire was used.

RESULTS

The mean value of the ORTO-15 was 39.2 ± 3.6 points, with no sex difference. The main factors connected with orthorexia, according to the 'Orthorexia 33.35 and 40' definitions were excess weight, sporting activities, out-of-school activities, smoking status, working parents and a high family income.

CONCLUSIONS

This study, of a large number of adolescents, showed a prevalence of ON similar to that recorded in adult populations. Since factors predisposing to ON in adolescence differ from those for other eating disorders, it is not clear whether ON should be treated as a new form of ED.

Prevalence Of Orthorexia Nervosa Among Polish Adolescents – Assessment Made By The Orto-15 Questionnaire

Objective

Orthorexia nervosa (ON) is an excessive fixation on the consumption of healthy food and an obsession with its biological purity. The aim of this study was to assess the prevalence of ON in a population of Polish urban adolescents and some possible contributory factors.

Method

Validation and adaptation of the ORTO-15 Questionnaire was made in the group of 399 participants (15–21 years old). The validation procedure incorporated three basic methods to be applied in the reliability analysis. The reliability analysis of the ORTO-15 Questionnaire based on repeatability of the responses presents a very good (kappa: 0.81–1.00 for 5 items) and a good repeatability (kappa: 0.61–0.80 for 10 items). The reliability analysis based on the value of the Cronbach's α reached a satisfactory level (0.7–0.9). The ORTO-15 questionnaire was considered a reliable tool to identify the risk of ON in population studies in the group of urban youth aged 15–21. Assessment was made among 1899 high school students, 992 girls, and 907 boys, aged 15–21 years.

Results

The mean value of the ORTO-15 was 39.2 ± 3.6 points, with no sex difference. The main factors connected with orthorexia, according to the “Orthorexia 35” definition were excess weight, sporting activities, out-of-school activities, smoking status, working parents and a high family income.

Conclusions

This study, of a large number of adolescents, showed a prevalence of ON similar to that recorded in adult populations. This is a first assessment of orthorexia among adolescent population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

[Validation of ORTO-15 Questionnaire in the group of urban youth aged 15-21]

AIM

The aim of the study was the validation and adaptation of the ORTO-15 Questionnaire in the group of the Polish schoolgirls and schoolboys.

METHODS

The study included 399 participants (15-21 years old), all of them high school students in the city of Sosnowiec. The ORTO-15 is a tool created in Italy by L.M. Donini, comprising of 15 items describing intensification of orthorexia risk (population diagnosis). The validation procedure incorporated three basic methods to be applied in the reliability analysis - the comparison of double tests with the same method, the statistical properties analysis of test items as well as analysis of the relation of test items with the general test result. Moreover, the compliance of the ORTO-15 Questionnaire results with other questionnaire focused on eating habits (EAT-26) was studied.

RESULTS

The reliability analysis of the ORTO-15 Questionnaire based on repeatability of the responses presents a very good (kappa: 0.81 - 1.00 for 5 items) and a good repeatability (kappa: 0.61 - 0.80 for 10 items). The reliability analysis based on the value of the Cronbach's α reached a satisfactory level (0.7 - 0.9). A full agreement of in the occurrence of orthorexia risk and the risk of eating disorders concerned 47.2% (Kappa = 0.04; 95% CI: 0.004 - 0.09) for the Ortho-40 and 88.2% (Kappa = 0.32; 95% CI: 0.17 - 0.47) for the Ortho-35.

CONCLUSIONS

The ORTO-15 questionnaire is a reliable tool to identify the risk of ON in population studies in the group of urban youth aged 15 - 21.

Impact of pharmacological and psychological treatment methods of depressive and anxiety disorders on cognitive functioning

Anxiety and depressive disorders are characterized by a number of clinical symptoms like decreased mood, apathy, anhedonia and anxiety. An important element of the clinical picture is also neurocognitive impairment. The most common treatment methods for depression and anxiety are pharmacology, psychotherapy or a combination of both methods. The data from literature show that those treatment methods lead to an improvement of clinical symptoms, but they exert a possible impact on cognitive functions. However the study results referring both to the role of pharmacological treatment and psychotherapy in this domain are still inconsistent. There is an increasing number of accessible data confirming the positive effects of those clinical interventions on cognitive functioning of anxiety and depressive patients, but the interpretation is complicated because of differences in methodology as well as examined sample size and their characteristics. More studies are then needed to describe this phenomenon.

Effects of olanzapine and paroxetine on phospholipase D activity in the rat brain

BACKGROUND

Phospholipase D (PLD) plays a key role in a second messenger system producing phosphatidic acid, mediating, among others, serotonin 5-HT2 receptor activity. The aim of the study was to evaluate a possible effect of atypical antipsychotic drug, olanzapine (OLZ), and selective serotonin reuptake inhibitor (SSRI) antidepressant, paroxetine (PX), on oleate-activated PLD activity in plasma membranes isolated from rat brain cortex.

METHODS

PLD activity was determined using a fluorometric assay. Ritanserin was used to determine the 5-HT receptor mode of action.

RESULTS

A single dose of 10 mmol/kg OLZ produced no change in rat brain cortex PLD activity, 20 mmol/kg OLZ caused a nonsignificant decrease, and long-term (21 days) administration of OLZ resulted in a 41.9% decrease in PLD activity. Single doses of PX significantly decreased PLD activity: 10 mmol/kg - by 28.6%; 20 mmol/kg - by 31.5%, and long-term (21 days) administration of PX - by 39.5%.

CONCLUSION

The study indicates that the 5-HT2 receptor-mediated inhibition of oleate-activated PLD may be a common part of the mechanisms of action of OLZ and PX.

[Dysregulation of the mTOR signaling pathway in the pathogenesis of autism spectrum disorders]

Mammalian target of rapamycin (mTor) plays multiple role in central nervous system and is involved in regulation of cell viability, differentiation, transcription, translation, protein degradation, actin cytoskeletal organization and autophagy. Recent experimental and clinical studies reveal that disturbances of mTOR signaling are involved in the pathogenesis of autism spectrum disorders (ASD). This article reviews current data on the alteration in the mTOR transduction cascade, which may contribute to common neurobehavioral disorders typical for ASD. Moreover, the results of the latest experimental studies on the potential of mTOR inhibitors for the treatment of ASD are reviewed.

[Role of leptin in eating disorders--current concept]

Eating disorders constitute a dynamically developing group of diseases, in which only some have well-established diagnostic criteria, e.g. anorexia nervosa or bulimia nervosa. Many symptoms of eating disorders are hard to be qualified to any known disorder from that group, and quantity and diversity of symptoms connected to eating grow systematically. It makes the work of clinicians and psychotherapists more difficult, as well as hampers communication between specialists. It is also a challenge for scientists to create new qualifications based on known and theoretical pathomechanisms connected to disruptions in food intake regulation.

[Autoaggressive behaviour with patients suffering from type 1 diabetes treated at the Clinic for Psychiatry and Psychotherapy Developmental Age--description of cases]

AIM

The aim of this study was to observe autoagressive behaviour with patients suffering from type 1 diabetes hospitalized in The Child Psychiatry Department of The Paediatric Centre in Sosnowiec.

METHOD

Analysis of clinical cases, medical documentation and literature.

RESULTS

Patients suffered from type 1 diabetes. On account of mental disorders they required treatment in a psychiatric ward. In the course of their hospitalization the appearance of various autoagressive behaviour were observed--the sick deliberately gave a dose of insulin improperly, apply an inadequate diet, and also self-mutilated themselves.

CONCLUSIONS

Described patients by their own illness (type 1 diabetes) in a self-destructive way coped with negative emotions. Autoagressive behaviour were their way of coping with stress, communicating experienced problems to others, they also helped in reducing inner tension. Through autoagression patients express anger, guilt, shame, loneliness, inner emptiness, a lack of confidence or humiliation. The period of adolescence, female gender and the presence of chronic disease are the factors that could intensify the difficulties described.

Inferior performance on selected neuropsychological tests in abstinent schizophrenia patients who have used cannabis

Background

A substantial proportion of patients with schizophrenia have co-morbid psychoactive substance use, which can influence their cognitive functions. The aim of this study was to assess cognitive functioning in abstinent schizophrenia patients with various previous patterns of psychoactive substance use.

Material/Methods

The study was performed on a group of 80 schizophrenia patients (74 men, 6 women), aged 18–40 (mean 25) years, of whom in 40 a co-morbid psychoactive substance abuse was diagnosed. The latter group was subdivided, based on their predominant type of substance (opioid, amphetamine, or cannabis). All patients were examined during clinical improvement, and patients with comorbid substance use were also examined after a 6-week period of detoxification in a therapeutic community. A battery of neuropsychiatric tests was used, which included subtests of Trail Making test, Stroop test and Verbal Fluency test.

Results

No significant differences in clinical factors and cognitive functioning between the 2 examined groups were found. However, when the patients were divided according to their pattern of substance use, it turned out that the group of patients who used cannabis, despite the shortest duration of disease and that of addiction, and highest percentage of using atypical antipsychotics, performed worse on all cognitive tests, significantly so on Stroop and Fluency tests, compared to the groups with predominant opioid or amphetamine use.

Conclusions

Abstinent schizophrenic patients who previously used cannabis have worse cognitive functioning compared to other schizophrenic patients with comorbid substance use. The possible role of previous cannabis use or cannabis withdrawal in this phenomenon is discussed.

Bright light therapy in the treatment of childhood and adolescence depression, antepartum depression, and eating disorders

Circadian rhythm disorders represent an important component underlying the pathology of depression. One of the subtypes of depression, in which these disorders may play a crucial role, is the seasonal affective disorder (SAD). The bright light therapy (BLT) has been reported as a novel, promising treatment method for SAD since 1984, and most of the data revealing its efficacy has been referred to adult patients, without comorbid disorders. However, in the recent years, more and more reports have been presented, which confirm the usefulness of BLT in some specific subpopulations of patients, including children, adolescents and pregnant women. The present review summarizes the applications of BLT in antepartum depression, childhood and adolescence depression as well as in patients suffering from eating disorders. Although the body of evidence is still too small to recommend the use of BLT as the first line of treatment for the depression or eating disorders in these patient subpopulations; it appears that BLT may be a useful alternative or adjunctive therapy for these diseases. However, the specific clinical applications of BLT in these areas need further investigation.