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Stanisławska-Kubiak M, Majewska KA, Krasińska A, Wais P, Majewski D, Mojs E, Kȩdzia A. Brain functional and structural changes in diabetic children. How can intellectual development be optimized in type 1 diabetes? Ther Adv Chronic Dis 2024; 15:20406223241229855. [PMID: 38560719 PMCID: PMC10981223 DOI: 10.1177/20406223241229855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/11/2024] [Indexed: 04/04/2024] Open
Abstract
The neuropsychological functioning of people with type 1 diabetes (T1D) is of key importance to the effectiveness of the therapy, which, in its complexity, requires a great deal of knowledge, attention, and commitment. Intellectual limitations make it difficult to achieve the optimal metabolic balance, and a lack of this alignment can contribute to the further deterioration of cognitive functions. The aim of this study was to provide a narrative review of the current state of knowledge regarding the influence of diabetes on brain structure and functions during childhood and also to present possible actions to optimize intellectual development in children with T1D. Scopus, PubMed, and Web of Science databases were searched for relevant literature using selected keywords. The results were summarized using a narrative synthesis. Disturbances in glucose metabolism during childhood may have a lasting negative effect on the development of the brain and related cognitive functions. To optimize intellectual development in children with diabetes, it is essential to prevent disorders of the central nervous system by maintaining peri-normal glycemic levels. Based on the performed literature review, it seems necessary to take additional actions, including repeated neuropsychological evaluation with early detection of any cognitive dysfunctions, followed by the development of individual management strategies and the training of appropriate skills, together with complex, multidirectional environmental support.
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Affiliation(s)
- Maia Stanisławska-Kubiak
- Department of Clinical Psychology, Poznan University of Medical Sciences, ul. Bukowska 70, Poznan 60-812, Poland
| | - Katarzyna Anna Majewska
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Krasińska
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Paulina Wais
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - Dominik Majewski
- Department of Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Kȩdzia
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznan, Poland
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Stanisławska-Kubiak M, Stelcer B, Wojciechowska J, Kułacz K, Szybowicz U, Mojs E. Psychosomatic symptoms associated with traumatic events experienced in medical students. Int J Occup Med Environ Health 2023; 36:606-617. [PMID: 37865933 DOI: 10.13075/ijomeh.1896.02078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVES Many facts indicate the important role of psychosomatic symptoms that occur due to traumatic events. This study is an analysis of the coexistence of psychosomatic symptoms and traumatic events. Though not every person taking part in these events develops a fully symptomatic post-traumatic stress disorder (PTSD), psychosomatic symptoms with a strong psychological component are observed in many. This study focuses on a comparison of the intensity of somatization, anxiety, depression, and distress of medical university students, who encountered a traumatic event and those who have not experienced trauma. MATERIAL AND METHODS The data was collected from 594 students of different academic majors at the Poznan University of Medical Sciences, Poland. The participants were asked if they had experienced situations that caused psychological trauma as well as about the intensity of their psychosomatic symptoms. The data was collected with 2 questionnaires: Post-traumatic Stress Diagnostic Scale and Four-Dimensional Symptom Questionnaire. RESULTS The study reveals that 78% of students experienced a traumatic event, in 15% moderate and severe symptoms of PTSD are observed, 45% presents average and high stress levels, 23% experiences symptoms of depression, whereas 30% has anxiety and 26% somatic symptoms. CONCLUSIONS Studies show that experiencing traumatic events in life is linked to the higher intensity of an/the entire range of psychosomatic symptoms. Int J Occup Med Environ Health. 2023;36(5):606-17.
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Affiliation(s)
| | - Bogusław Stelcer
- Poznan University of Medical Sciences, Poznań, Poland (Department of Clinical Psychology)
| | - Julita Wojciechowska
- Adam Mickiewicz University in Poznan, Poznań, Poland (Department of Cognitive Psychology)
| | - Klaudia Kułacz
- Poznan University of Medical Sciences, Poznań, Poland (Department of Clinical Psychology)
| | | | - Ewa Mojs
- Poznan University of Medical Sciences, Poznań, Poland (Department of Clinical Psychology)
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Stanisławska-Kubiak M, Wiecheć K, Majewska KA, Teusz G, Mojs E, Kędzia A. Neuropsychological Aspects of Children's Somatic Disorders in Chronic Diseases: Diabetes and Short Stature in the Developmental Period. Biomedicines 2023; 11:3089. [PMID: 38002089 PMCID: PMC10669873 DOI: 10.3390/biomedicines11113089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Intellectual functioning studies carried out amongst children indicate that chronic diseases like type 1 diabetes and growth hormone deficiency (GHD), may, but do not necessarily, result in intellectual loss. Cognitive functions may decline as a child becomes older, as a disease persists over time and/or due to non-compliance with treatment recommendations or high stress levels. This study aimed to assess the cognitive functioning of children and youths with T1D and GHD-related short stature compared to healthy children. METHODS The study was carried out on 88 children with type 1 diabetes, 38 children suffering from short stature caused by (GHD), as well as a control group comprising 40 healthy children. Weschler's tests were applied to measure intellectual and cognitive functions. RESULTS The results suggest that for children suffering from type 1 diabetes and short stature, their chronic childhood diseases per se do not impair cognitive development. It was observed that the higher the age of chronically ill children and the longer the disease persists, the lower their scores in individual cognitive subtests. For healthy children, age is correlated with the acquisition of particular skills and higher scores in specific subtests. CONCLUSIONS On the basis of qualitative analysis of the cognitive functions subject to the study and close clinical observation of chronically ill children, we have been able to conclude that chronic diseases may alter cognitive functioning.
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Affiliation(s)
- Maia Stanisławska-Kubiak
- Department of Clinical Psychology, Poznań University of Medical Sciences, 61-701 Poznan, Poland; (K.W.); (E.M.)
| | - Katarzyna Wiecheć
- Department of Clinical Psychology, Poznań University of Medical Sciences, 61-701 Poznan, Poland; (K.W.); (E.M.)
- Center for Trauma, Crisis Add Growth, SWPS University of Social Sciences and Humanities, 61-701 Poznan, Poland
| | - Katarzyna Anna Majewska
- Department of Pediatric Diabetes, Auxology and Obesity, Poznań University of Medical Sciences, 60-572 Poznan, Poland (A.K.)
| | - Grażyna Teusz
- Faculty of Educational Studies, Adam Mickiewicz University, 60-568 Poznan, Poland;
| | - Ewa Mojs
- Department of Clinical Psychology, Poznań University of Medical Sciences, 61-701 Poznan, Poland; (K.W.); (E.M.)
| | - Andrzej Kędzia
- Department of Pediatric Diabetes, Auxology and Obesity, Poznań University of Medical Sciences, 60-572 Poznan, Poland (A.K.)
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Majewska KA, Stanisławska-Kubiak M, Wiecheć K, Naskręcka M, Kędzia A, Mojs E. Maternal anxiety in relation to growth failure and growth hormone treatment in children. Medicine (Baltimore) 2020; 99:e22147. [PMID: 32925771 PMCID: PMC7489751 DOI: 10.1097/md.0000000000022147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Health disorders in mothers and their children are subject to mutual influences arising from the nature of mother-child relationship. The aim of the study was to analyze the issue of anxiety amongst mothers of short children in aspect of growth hormone (GH) therapy in Poland.The study was based on a group of 101 mothers of originally short-stature children: 70 with GH deficiency treated with recombinant human GH and 31 undergoing the diagnostic process, without any treatment. Collected medical data included the child's gender, height and weight, chronological age, bone age delay, and GH therapy duration. For all children the height SDS (standard deviation score of height) and BMI SDS (standard deviation score of body mass index) were calculated. The Spielberger State-Trait Anxiety Inventory (STAI) was used to evaluate anxiety levels among the recruited mothers. Obtained results revealed low trait anxiety levels in all mothers, with no statistically significant differences between the groups. State anxiety levels were significantly higher in mothers of children without diagnosis and treatment than in mothers of children receiving appropriate therapy. Significantly lower levels of maternal state anxiety were observed during the first stage of the GH therapy, and they were further reduced in mothers of children treated for more than 4 years.Growth failure in Polish children is not associated with high maternal anxiety as a personality trait, but lack of diagnosis and lack of appropriate treatment seem to generate high levels of anxiety as a transient state in mothers. The initiation of GH therapy induces a substantial reduction of maternal state anxiety, and the duration of this treatment causes its further decrease. Mothers of short children undergoing diagnostic process could benefit from psychological support, but it seems to be unnecessary when their children are treated with GH.
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Affiliation(s)
| | | | - Katarzyna Wiecheć
- Department of Clinical Psychology, Poznan University of Medical Sciences
| | - Monika Naskręcka
- Department of Mathematical Economics, Poznan University of Economics and Business, Poznań, Poland
| | | | - Ewa Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences
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Stanisławska-Kubiak M, Majewska KA, Kędzia A, Samborski W, Ruchala M, Mojs EH. Changes in cognitive functions in a girl with severe acquired hypothyroidism in comparison to the healthy twin sister. Endokrynol Pol 2020; 71:365-366. [PMID: 32716045 DOI: 10.5603/ep.a2020.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 05/06/2020] [Indexed: 11/25/2022]
Abstract
Not required for Clinical Vignette.
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Affiliation(s)
| | - Katarzyna A Majewska
- Department of Auxology and Paediatric Nursing, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Kędzia
- Department of Auxology and Paediatric Nursing, Poznan University of Medical Sciences, Poznan, Poland
| | - Wlodzimierz Samborski
- Department and Clinic of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Ruchala
- Chair of the Department of Endocrinology, Metabolism, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa H Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznan, Poland.
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Stanisławska-Kubiak M, Mojs E, Wójciak RW, Piasecki B, Matecka M, Sokalski J, Kopczyński P, Fichna P. An analysis of cognitive functioning of children and youth with type 1 diabetes (T1DM) in the context of glycemic control. Eur Rev Med Pharmacol Sci 2019; 22:3453-3460. [PMID: 29917198 DOI: 10.26355/eurrev_201806_15170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the cognitive functioning of children and youth with type 1 diabetes (T1DM). PATIENTS AND METHODS The study included 68 children with type 1 diabetes, aged 6-17 years, divided into 3 groups according to the level of glycated hemoglobin (HbA1c): group 1: HbA1c ≤ 6.0-7.5%; group 2: HbA1c 7.6-8.5%; group 3: HbA1c over 8.6%. Wechsler's intelligence scale (WISC-R), the Trail of 10 words and Brickenkamp's and Zillmer's d2 Test of Attention were used to assess cognitive functioning. RESULTS The research demonstrated a significant influence of low, medium or high glycaemic control on lowering the general level of functioning in verbal intelligence, and in WISC-R subtests: information, vocabulary, comprehension, number sequencing and block design. CONCLUSIONS Children with type 1 diabetes mellitus can experience difficulties in cognitive functioning, as a consequence of high HbA1c. Additional research, involving a larger group of patients and a wider age range when the disease was diagnosed, will enable further findings on the occurrence of cognitive impairment in T1DM.
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Affiliation(s)
- M Stanisławska-Kubiak
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznan, Poland.
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Stanisławska-Kubiak M, Warchoł-Biedermann K, Skommer M, Mojs E, Wójciak RW. The role of intra- and interpersonal relations in the process of diagnosis and treatment. JMS 2019. [DOI: 10.20883/jms.323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
There is an increasing tendency to adopt biopsychosocial approach to teaching how to care for patients. Participation in Balint’s groups is used to train students in communication and building relations with patients. Aim: To identify positive and negative aspects of participation in Balint’s groups, which are a part of compulsory training for students.Methods: 70 medical students, who took part in the study, filled in a questionnaire specifically developed for students participating in Balint’s group. The questionnaire consisted of three open questions. The answers were collected and then analyzed by way of qualitative analysis of text and factorial analysis Results: The results suggest that Balint’s method can be difficult for medical students because they have not practiced building therapeutic relations with patients. Nevertheless, most students benefit from training in terms of personal development, awareness of mechanisms influencing patients – doctor communication and satisfaction with participation in classes. Conclusion: Balint’s Workshops is a useful method of teaching which influences medical student’s self – reflection because they become aware of the necessity of personality development.
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Piasecki B, Stanisławska-Kubiak M, Strzelecki W, Mojs E. Attention and memory impairments in pediatric patients with cystic fibrosis and inflammatory bowel disease in comparison to healthy controls. J Investig Med 2017; 65:1062-1067. [DOI: 10.1136/jim-2017-000486] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 11/04/2022]
Abstract
The main aim of the study was to analyze and compare attention and memory performance in pediatric patients with cystic fibrosis (CF), inflammatory bowel disease (IBD) and in healthy controls. 28 patients with CF, 30 patients with IBD and 30 healthy subjects took part in the study (all in age range of 7–17). All subjects were in intellectual norm. To analyze the functioning of attention, the d2 Test of Attention by Brickenkamp (d2 test) was applied. Memory performance was assessed using the Benton Visual Retention Test (BVRT) and the Trial of 10 words. The CF and IBD groups committed significantly more errors in the d2 test than the healthy controls. The CF group also had significantly higher fluctuation rates and received significantly lower scores in overall concentration performance than the control group. Patients with CF made more mistakes and had fewer correct memory projections in BVRT than the healthy controls. Patients with IBD committed significantly more errors in BVRT than the control group. Patients with CF and IBD also got significantly lower scores in the Trial of 10 words than the control group. Pediatric patients with CF and IBD performed more poorly than the healthy controls on attention and memory tests. More distinct cognitive impairments were observed in the CF group. Further research is needed to find the underlying mechanisms and clinical and/or functional significance of observed cognitive deficits.
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Marcinek K, Wójciak RW, Krejpcio Z, Stanisławska-Kubiak M. An Assessment of the Consumption of Energy and Selected Minerals and Their Content in the Hair of Children Aged 1-4 Years. Biol Trace Elem Res 2016; 170:255-63. [PMID: 26289087 PMCID: PMC4791474 DOI: 10.1007/s12011-015-0469-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 08/04/2015] [Indexed: 12/03/2022]
Abstract
The aim of this study was to assess the consumption of energy and selected minerals (Ca, Mg, Fe, Zn, Cu) and their content in the hair of children aged 1-4 years. Seventy-five children were divided into three age subgroups: 12-24-month-olds, 25-36-month-olds and 37-48-month-olds. The data on energy intake and consumption of nutrients were obtained by means of a nutritional interview. The content of elements in the hair was measured by means of flame atomic absorption spectrometry (AAS) with an AAS-3 spectrophotometer (Zeiss). The daily food rations of children aged 12-36 months were characterised by adequate energy value, but the values of Ca and K were too low, whereas the content of Mg, Zn and Cu was high. On the other hand, the daily food rations of children aged 37-48 months provided sufficient amounts of Mg and Zn, but the value of Cu was too high, whereas energy, Ca, K and Fe were too low. About 42.7% of the children under study were characterised by an abnormal state of nutrition. An inadequately balanced diet needs to be corrected by educating parents or guardians in appropriate nutrition. There are significant correlations (r > 0.9) between the supply of Ca in the diet of children aged 1-4 years and the content of this element in their hair.
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Affiliation(s)
- Katarzyna Marcinek
- />Department of Human Nutrition and Hygiene, Poznań University of Life Sciences, Poznań, Poland
| | - Rafał Wojciech Wójciak
- />Department of Human Nutrition and Hygiene, Poznań University of Life Sciences, Poznań, Poland
- />Department of Clinical Psychology, Poznań University of Medical Sciences, Poznań, Poland
| | - Zbigniew Krejpcio
- />Department of Human Nutrition and Hygiene, Poznań University of Life Sciences, Poznań, Poland
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Mojs E, Stanisławska-Kubiak M, Skommer M, Wójciak R. [Smoking from the perspective of positive psychology]. Przegl Lek 2009; 66:765-767. [PMID: 20301932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Cigarette smoking remains a significant problem on a global scale. Positive psychology is blazing new trails in researching the mutual relation between health and disease, stressing the promotion of positive factors supporting health. The crucial point in this perspective is examining the factors, that assists healthy behaviours. The paper is an introduction to the research on the sense of happiness and emotionality in the currently cigarette addicted, never-smokers and past smokers. Studies clearly show that in people who threw smoking level of happiness and awareness of owns emotions are the highest compared to those never smokers and smokers.
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Affiliation(s)
- Ewa Mojs
- Zakład Psychologii Klinicznej, Uniwersytet Medyczny, im. Karola Marcinkowskiego, Poznań.
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