[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.

[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 depressiveness of women patients diagnosed with ovarian cancer treated with surgery and after previous adjuvant therapy]

In the present study undertaken to assess the quality of life and depression of women patients diagnosed with ovarian cancer. The aim of the study was to assess quality of life and severity of depression of women diagnosed with ovarian cancer treated with surgery, and then underwent adjuvant radio or chemotherapy treatment.

MATERIAL AND METHODS

The principle of study was to included on random selection 42 women diagnosed with ovarian cancer who were treated surgically, and then subjected to adjuvant therapy. Quality of life was based on patient self-assessment using the EORTC QLQ C-30 form. The severity of depression was assessed by the Beck Depression Scale.

RESULTS

Our results showed that in the vast majority the quality of life of women with ovarian cancer who develop depression, evaluate their own quality of life at a low level. In contrast patients who did not get depressed in most cases evaluated their own quality of life at the average level. In studies it has been shown that patients manifesting symptoms of depression compared to women not having these symptoms differ in a statistically significant way, in terms of quality of life.

CONCLUSIONS

The results indicate that women diagnosed with ovarian cancer who have demonstrated the co-existence of depression presented a lower quality of life. The study indicates that in the majority of cases the severity of depression of patients diagnosed with ovarian cancer were mild.

[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.

[Creutzfeldt-Jakob disease in the psychiatric practice--case reports of the ataxic and Heidenhain variant]

OBJECTIVES

Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare fatal neurodegenerative brain disorder of variable clinical manifestation. Making the right diagnosis still remains challenging. First symptoms are vague and differ between clinical subtypes of the disease. This is to present the symptoms variability and diagnostic difficulties in sCJD based on case reports of two female patients examined at time of the disease duration by psychiatrists.

METHODS

Data of our patients were collected from hospital medical records.

RESULTS

The case of patient A. P.' ataxic sCJD is an example of clinical picture suggesting neurological background of the disease almost from the symptoms' onset and being referred by psychiatrist to the neurological ward, where the right diagnosis of probable sCJD was established. In the opposite is the case of patient I. W.' Heidenhain variant of sCJD, misdiagnosed with dissociative disorder delivering huge diagnostic difficulties, even to neurologists. In both patients the certain diagnosis was confirmed at autopsy.

CONCLUSIONS

In patients with visual disturbances of unknown etiology, even if the ophthalmological and neurological background is excluded, sCJD should be taken into consideration in the differential diagnosis.

[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.

[The prevalence of suicide attempts among children and adolescents]

Suicide is the act of a fatal outcome. People who think about suicide perceive death as a way to avoid problems. Suicide attempts by children and young people likely to arise from the fact that the identified single or co-occurring mental disorders.

THE AIM OF STUDY

was to illustrate the suicide problem, which is increasingly frequent attempts to take their own life for children and youth. Its main objective is to determine the prevalence and determinants of suicide attempts made by young people.

MATERIAL AND METHODS

The study group consisted of patients Babinski Hospital in Lodz. The study included 18 patients, 9 boys and 9 girls. Research methodology is based on the stories of young patients diseases. In order to verify the prevalence of trial and / or thoughts, suicidal tendencies among children and adolescents, was used as a research,tool - a survey of its own design. The survey consists of 21 questions about basic information on the state of social, physical and mental patients.

RESULTS

Subjective verification made disseminate ideas, trends and / or suicide attempts among children and adolescents in most reflects the actual collection of information gathered by various authors.

CONCLUSIONS

Children coming from families reconstructed and largely incomplete exhibit suicidal behavior. The main risk factors indicating the attempt on his own life are mental disorders: depression and behavioral disorders. Family situation of young people: conflicts between the father and the mother, violence, physical / mental, has a significant effect on the risk of an attempt on his own life. Superficial self-mutilation, is the main way to make a suicide bombing.

[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.

Working memory impairment as a common component in recurrent depressive disorder and certain somatic diseases

OBJECTIVES

Deterioration of the working memory is regarded as one of the most important deficits in a number of somatic diseases. The purpose of the present study was to compare the effectiveness of working memory in 4 groups of patients: 1) diagnosed with recurrent depressive disorder (rDD), 2) with diabetes type 1 (DM1), 3) with diabetes type 2 (DM2), 4) with arterial hypertension (HA) and in healthy controls (HC).

METHODS

The study comprised 300 subjects: rDD (n=99), DM1 (n=31), DM2 (n=31), HA (n=30) and HC (n=109).Cognitive function assessment was based on Trail Making Test (TMT) and the Stroop test.

RESULTS

Analysis of variance (ANOVA) indicated statistically significant differences of the mean values among particular groups for each of the analysed results of the Stroop Test and TMT (p<0.0001). Patients with DM1 performed better in both TMT and Stroop tests, when compared to those diagnosed with HA. Patients with HA obtained better results than patients with DM2. Patients with rDD performed significantly worse than those with DM1 in both parts of TMT (A/time: p=0.022, B/time: p<0.001) and in the Stroop test (RCNb/time: p<0.001; NCWd/time: p=0.001; NCWd/errors: p=0.443). They also obtained worse results than patients with DM2 and HA, however, the differences were not statistically significant.

CONCLUSIONS

1) Our study has confirmed previous results showing association between depressive disorder and cognitive impairment. 2) Patients with rDD had worse performance on working memory tasks than the patients with DM type 1, DM type 2 and HA. 3) Further investigation is needed to clarify the role of inflammatory and oxidative and nitrosative stress (O&NS) processes in neurocognitive dysfunctions occurring in recurrent depression and somatic disease.

[Are there any differences in the working memory of men and women?]

The aim of the study was to compare the implementation of the Stroop test among women and men and to answer the question of the existence of differences in verbal working memory performance and efficiency of attention between representatives of both sexes.

MATERIAL AND METHODS

A sample of 348 persons aged 20-68 years (mean age: M = 42.16 years) participated in the study: 187 women (53.73%) and 161 men (42.26%). Patients who took part in the investigation were divided into several groups: depressive disorders (DD, n = 146), diabetes type 1 (DM1, n = 31), diabetes type 2 (DM2, n = 31), patients with hypertension (HA, n = 30) and healthy controls (HC, n=110). Cognitive functions were evaluated by the Stroop test.

RESULTS

There were no significant differences between men and women in making the first (p = 0.831) and the second part of the Stroop test (p = 0.055). However, it should be noted that the difference between men and 'omen in the speed of the second part of the test is close to significance. Women performed the test faster than men, while men have committed in other parts of the test less errors (p = 0.441).

CONCLUSIONS

In the present study there was no statistically significant differences between men and women in the implementation of both parts of the Stroop test. Women performed both part of the Stroop test faster than men do but the latter make fewer mistakes.

[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.

[Influence of antidepressant pharmacotherapy on the course of cancer]

The coexistence of two or more diseases in one patient, especially in old age, is a common situation. The problem of drug effects, specifically speaking, their interaction and impact on the second condition still remains not fully explored and thus is very interesting. At the same time, it is commonly known that depression and cancer are some of the most frequently met disorders and following the WHO forecasts, their prevalence will constantly increase. In addition, it is worth noting that both the psychological and physical health of the patient suffering from cancer, are essential for proper co-operation, especially when it comes to adoption of recommended drugs. The case is aggravated by the fact that no standards of conduct in case of coexistence of the two diseases have been established and the results of research are very often contradictory. Therefore the issue discussed in this study seems to be very important and still valid. In this monograph the problem of the influence of antidepressant pharmacotherapy on the course of disease will be presented.

[A catamnestic study of psychiatric consultations of patients with somatic diseases]

The aim of the study was to analyse diagnoses made during psychiatric consultations in somatic wards of the multi-profile hospital, as well as the catamnestic analysis of their causes and determinants. The authors intended to estimate the needs for psychiatric consultations in a multi-profile hospital, to analyse a growth or decrease in demand for psychiatric consultations within two years, the analysis of psychiatric diagnoses made in the course of consultations qualifying a patient for transfer to the psychiatric clinic.

MATERIAL AND METHODS

Personal experience from work as a consultant psychiatrist as well as data from the literature were used in the study. The collected research material in the form of psychiatric consultations concerned the case histories of the Archive of the 10 Military Clinical Hospital with Polyclinic in Bydgoszcz from 2006-2007. A total of 735 consultations in 630 patients were carried out.

RESULTS

The results of the study indicated that in a multi-profile hospital there is a great demand for psychiatric consultations. The most frequent cause of reporting the need for consultation by doctors in somatic wards were depressive disorders. The results obtained also showed that the fact of alcohol intoxication at admission is an important factor which can potentially have an effect on the need for a psychiatric consultation as well as a later decision to transfer the patient to other hospital departments. Additional psychological consultations commissioned in patients moved to psychiatric clinic were carried out in an amount higher than average, and the largest number of them were carried out among those refusing the transfer.

CONCLUSIONS

The most often diagnoses made during consultations were: dysphoria and affective disorders secondary to organic changes, adaptive disorders and delirium.

[Trazodone in the treatment of addiction]

The problem of addiction to psychoactive substances (SPA) is an important aspect of modem psychiatric treatment. This is due to the increasing number of addicts, and reducing their increasing age. It is estimated that in the United States in 2006, people aged over 12 years of meeting criteria for dependence on SPA was 20-25 million. Other statistics report that in the same age group over the last year contact with these substances were 8-10 percent of the U.S. population. Therefore, it becomes an important issue the appropriate therapeutic treatment of addicts. The result of the search of drugs that help people to alcoholism treatment program, were studies involving trazodone. Counted among the SARI (serotonin reuptake inhibitor and antagonist), shows antagonism to serotonergic receptors (5-HT2 receptors), while an inhibitor of serotonin reuptake. Its performance was analyzed in individuals dependent on alcohol, benzodiazepines and opiates, as well as mixed addictions. Also raised the problem of influence of trazodone on the experience of pain, which maybe helpful in relieving withdrawal symptoms. The data show a positive effect of trazodone in individuals addicted to the SPA, although the mechanism by which trazodone works in the body is very complex and not yet fully understood. Its advantage is the relatively small panel of side effects. Although many of the analyzed studies were not placebo-controlled, the results are so promising that you can recommend on the basis of trazodone therapy in individuals addicted to the SPA.

[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.

[Characteristic and treatment of sexual dysfunctions in depression (part I)]

Sexual dysfunction in patients diagnosed with depressive disorders affect all phases of sexual response: a decline in libido, erectile dysfunction, ejaculation disorders in men and orgasm and menstruation in women. It is estimated that are present in approximately 70% of patients, affecting 23-50% of men suffering from depression and 33-90% of women. The most common symptoms include disorders of sexual arousal in women (usually in the form of excessive vaginal dryness), erectile dysfunction in men and affects both sexes abnormal orgasm (anorgasmia or delayed). Sexual dysfunction is treated as a potential side effect of antidepressant therapy. These drugs can exacerbate the symptoms of primary sexual dysfunction, and induce it in those patients who were not present before treatment. Symptoms of sexual dysfunction reduces quality of life, self-esteem, mood, and negatively affect the relationship with your partner. Most currently used antidepressants in the world leads to the occurrence of sexual dysfunction. These include monoamine oxidase inhibitors, tricyclic antidepressants, serotonin reuptake inhibitors, serotonin reuptake inhibitors and norepinephrine, and a new generation of antidepressants. SSRIs are considered to be preparations for the largest iatrogenic effect. Sexual dysfunction resulting from treatment with antidepressant among the most serious reasons for discontinuation by the patients.

[Evaluation of the influence of tianeptine on the psychosomatic status of patients with ulcerative colitis in remission]

In order to maintain ulcerative colitis (UC) in remission, chronic use of aminosalicylates is recommended. All patients have a fear of the recurrence of symptoms, which makes their mental state and quality of life worse. Because of this a number of patients are recommended to use different sorts of anxiolytic drugs and antidepressants.

AIM OF THE STUDY

Evaluation of the influence of tianeptine (selective serotonin reuptake enhancer) on the mental and somatic status in the group of patients.

MATERIAL AND METHOD

The research was conducted in two groups of thirty patients, with benign form of ulcerative colitis in remission, aged 24-46 years. Patients, during a period of 12 months, were given aminosalicylates in a daily doses 2 x 1.0 g and tianeptine in a doses 3 x 12.5 mg (group I) or placebo (group II). During the treatment every three months anxiety (Hamilton Anxiety Rating Scale-HARS), depression (Back Depression Inventory-BDI), The Mayo Clinic Disease Activity Index (MCDAI), hemoglobin and C-reactive protein (CRP) level were evaluated.

RESULTS

After 12 months in a group of patients who took tianeptine decrease in anxiety (from 20.35 +/- 4.03 to 12.65 +/- 3.78 points) and depression (from 19.95 +/- 4.49 points to 9.60 +/- 2.76 points) was obtained; difference compared with placebo was statistically significant (p < 0.01). At the same time significant decrease compared with placebo (p < 0.05) of disease activity index (respectively 3.05 +/- 1.36 and 4.65 +/- 1.69), insignificantly lower level of CRP (7.00 5.65 and 9.41 +/- 10.12) and higher level of hemoglobin (11.93 +/- 0.83 and 11.0 +/- 0.70) was observed.

CONCLUSIONS

Tianeptine has a positive influence on mental and somatic status of patients with UC. Results give the support for tianeptine apllication in UC as adjuvant drug.

[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.

[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.

Association between inducible and neuronal nitric oxide synthase polymorphisms and recurrent depressive disorder

BACKGROUND

Major depression is characterised by increased nitric oxide (NO) levels. Inhibition of the NO synthesizing enzymes, neuronal nitric oxide synthase (nNOS) and inducible nitric oxide synthase (iNOS), results in antidepressant-like effects, whereas the expression of iNOS and nNOS is increased in depression. Recent studies have indicated that NOS participates in the mechanisms of antidepressants. The aim of this study was to examine whether a single nucleotide polymorphism (SNP) present in the genes encoding iNOS and nNOS can contribute to the risk of developing recurrent depressive disorder (rDD).

METHODS

The study was carried out in a group of 181 depressive patients and 149 control subjects of Polish origin. SNPs were assessed using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analyses.

RESULTS

The genotype distributions of the polymorphisms in exon 22 of the NOS2A gene and in exon 29 of the nNOS gene were significantly different between rDD patients and controls. The results showed that the G/A SNP of the gene encoding iNOS was associated with an increased susceptibility to rDD, whereas A/A homozygous carriers had a decreased risk of developing rDD. There was also a significant association between the C/T SNP of the gene encoding nNOS; the presence of the CC homozygous genotype decreased the risk of rDD, whereas the T allele and T/T homozygous genotype increased the vulnerability to rDD.

CONCLUSIONS

Our results suggest that polymorphisms in the iNOS and nNOS genes confer an increased susceptibility or resistance to rDD. Future research should examine genetic variants and their associations to the expression of NOSs and NO level in depressive patients.

Cardiovascular side effects, QT interval in patients treated with some selected antypsychotics. preliminary results

Introduction

Treatment with antypsychotics is associated with cardiovascular side effects. This results from mechanism of action of antypsychotics. Arrhythmias are the serious side effects. Treatment with antipsychotics may prolong QTc and increase the risk of dangerous supraventricular and ventricular arrhythmias.

Objectives

The main aims of the research are the following: If Any antypsychotics agents may prolong QT interval? If monotherapy with olanzapine, zyprasidone, arypiprazole and politherapy with perphenazine and olanzapine may induce any arrhythmias?

Methods

Data for this study were collected from 65 patients hospitalized in the Department of Adult Psychiatry and treated with olanzapine and perphenazine (n = 10) and with olanzapine (n = 20), aripiprazole (n = 20), ziprasidone (n = 15). All patients had 12 leads ECG two times: before admitting the drugs and during the treatment. All ECG were assessed on the presence of any abnormalities and QTc was calculated manually by using Bazzet formula.

Results

Among treated patients no QTc prolongation was observed. There was no prolonged QTc over 450 ms in Male and 470 ms in female patients treated with antypsychotics in mono and politherapy. Potassium level in all patients was within the norm. Bradykardia (< 50/min) and tachykardia (>100/min) was not observed among participants.

Conclusions

Atypical antypsychotics such as olanzapine, arypiprazole, zyiprasidon are cardiovascular safe drugs. They did not induce dangerous for life arrhythmias especially ventricular arrhythmia (known as torsades de pointes), which can progress to ventricular fibrillation and sudden death. Politherapy with olanzapine and first generation agents perphenazine is a safe combination and did not induce any cardiovascular side effects.

Psychotic disturbances in adult female patient with congenital hypopituitarism due to mutation in PROP1 gene

INTRODUCTION

Untreated congenital hypopituitarism in adult patient is - nowadays - a very rare observation.

CASE

A 52 years old female patient, was referred to the Department of Psychiatry for psychotic symptoms, manifested as auditory pseudohallucinations with delusional interpretation, significant psychomotor agitation, anosognosia, attempts of symptom dissimulation and negativism. At admission, attention was drawn to her short stature and low body weight. Because of general weakness, she was hardly moving, her skin was pale, dry, cold, little elastic and desquamating. Neither axillary nor pubic hair could be traced. Basic studies revealed anaemia, significant hyponatraemia and hypercholesterolaemia. Hormonal tests confirmed diagnosis of hypopituitarism. Genetics studies revealed mutations (150delA and 296_297delAG) in PROP1 gene. Combined somatic and neuroleptic treatment considerably improved the physical and psychic status of the patient, as well as strengthened her social functioning.

CONCLUSIONS

An exogenous, psychotic episode identified in the patient was induced by multihormonal hypopituitarism and disappeared after hormonal replacement therapy.

[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.

Functional polymorphism of cyclooxygenase-2 gene (G-765C) in depressive patients

BACKGROUND

Depressive disorder (DD) is characterized by an inflammatory process and oxidative stress. Cyclooxygenase-2 (COX-2), the expression of which increases in depression, is an enzyme involved in inflammation and free radical processes. The aim of our study was to assess the correlation between single nucleotide polymorphism G-765C of the COX-2 gene and recurrent DD.

METHODS

The study was carried out in a group of 181 patients treated for recurrent DD, and in 149 healthy subjects of the control group (CG). Polymerase chain reaction/restriction fragment length polymorphism was used for genotyping.

RESULTS

A statistically significant difference in genotype distribution was observed as a result of the comparison between the CG and the patients with DD. We demonstrated that the presence of the -765G allele in the COX-2 gene increased 2.1-fold the risk of DD development, whereas the presence of a homozygote (G-765G) in the analyzed gene increased the risk of DD development 2.5-fold.

CONCLUSION

According to the obtained results, it may be proposed with some caution that the presence of both the -765G allele and the G-765G genotype in the COX-2 gene may confer a susceptibility to an increased risk of recurrent DD in the Polish population.

Functional polymorphism of the myeloperoxidase gene (G-463A) in depressive patients

Gałecki P, Florkowski A, Bobińska K, Śmigielski J, Bieńkiewicz M, Szemraj J. Functional polymorphism of the myeloperoxidase gene (G-463A) in depressive patients.

OBJECTIVE

Myeloperoxidase (MPO) is an enzyme involved in the production of hypochloric acid as well as other reactive oxygen species. This enzyme plays a significant role in inflammatory processes. In view of the observed associations between depression and such inflammatory processes, as well as of the reports that confirm the presence of oxidative stress in depression, this study was designed to assess the correlation, if any, between the single nucleotide polymorphism G-463A of the MPO gene and the risk of recurrent depressive disorders (DD).

METHODS

The study was carried out in a group of 149 patients with recurrent DD and 149 healthy control subjects. Genotyping was performed by PCR/restriction fragment length polymorphism.

RESULTS

A comparison between healthy controls and depressive patients showed a statistically significant difference in genotype distribution and allele frequency in the studied groups. Genotype distribution and allele frequency did not correlate with clinical variables of the patients.

CONCLUSION

The obtained results of the study allow us to draw a cautious conclusion about the role of the analysed G-463A MPO polymorphism in recurrent DD development, which, however, requires eventual confirmation in further studies.

Analysis of two polymorphisms of the manganese superoxide dismutase gene (Ile-58Thr and Ala-9Val) in patients with recurrent depressive disorder

Reactive oxygen species (ROS) may contribute to the pathogenesis of depressive disorder (DD). Functional genetic polymorphisms of manganese superoxide dismutase (MnSOD) are candidates for DD susceptibility. The study examined the relationship between MnSOD gene polymorphisms (Ala-9Val, Ile-58Thr) and DD in the Polish population. The association study was conducted in a case-control design in DD patients (n=149) and healthy controls (CG; n=149) by genotyping. Assessment of Ala-9Val genotype distribution and disease odds ratio demonstrated a statistically significant difference between the compared groups only in the female subgroup. The obtained results suggest a role of the MnSOD polymorphism in the development and course of depression.

[The risk of death following the consumption of ethanol based on forensic research material]

The number of abusers in Poland is estimated at about 2.8-3.5 million, including about 600-900 thousands dependent. In this group a variety of somatic disorders and mental health are diagnosed. Mortality among persons with alcohol dependence is several times higher than among those abstainers. Alcohol dependence increases the risk to attempt suicide. Health damage caused by alcohol depends on: the frequency and quantity of drinking of alcohol, age, gender, duration of addiction. THE AIM OF THIS STUDY was to analyze the causes of death in the aftermath of alcohol consumption based on sectional material.

MATERIALS AND METHODS

We analyzed 336 autopsy protocols. In order to analyze the collected material was used a questionnaire created for this study. Deaths have been divided into two groups: violent deaths, resulting from trauma and natural deaths.

RESULTS

It was observed significant relationship between alcohol consumption and the nature of death.

CONCLUSIONS

Most of the deaths associated with alcohol consumption is a sudden deaths, not due to natural causes. Among the sudden deaths domination of ethyl alcohol poisoning, traffic accidents, murder, hanging and drowning.

[The shaken baby syndrome as a kind of domestic abuse]

In the recent decades research on child abuse has grown impressively. Four types of child abuse: physical, psychological (emotional), sexual, and neglect have been clinically observed and defined. In 1972, John Caffey, a pediatric radiologist, published an article on the theory and practice of the abusive shaking of infants. This was followed, in 1974, with a second article on the whiplash shaken baby syndrome (SBS). Shaken baby syndrome, is caused by the violent shaking of a child with or without contact between the child's head and a hard surface. Such contact may result in head trauma, including subdural hematoma, diffuse axonal injury and retinal hemorrhage. The annual estimated rate of inflicted traumatic brain injury is 30 cases per 100,000 children aged 1 year of younger. Shaken baby syndrome often occurs after shaking in response to crying bouts. In 2001, an estimated 903,000 children were victims of SBS. Additionally, 1300 children were fatally injured from SBS the same year. The ability to detect SBS is difficult secondary to under reporting and misdiagnosis. There is no established set of symptoms that indicate SBS.

[Effectiveness of trazodone in the treatment of sexual dysfunctions]

Sexual dysfunctions may be main cause of social disability. The knowledge of the rates of occurrence of sexual dysfunctions in the general population and the primary risk factors for these conditions is very important to assist in assessing the risk and planning treatment. Sexual dysfunctions are highly prevalent in our society worldwide, and that the occurrence of sexual dysfunctions increases directly with age for both men and women. Specific medical conditions and health behaviors represent major risk factors for sexual disorders. Trazodone is sedative antidepressant drug, which is effective, safe, fast acting, with a few side effects, with proved efficiency in the treatment of sexual dysfunction.

[Gender psychological of psychiatrically hospitalized persons with a history of suicide attempt]

Suicide is a major social problem. Annually as a result of suicide, almost one million people are killed and many more unsuccessful attempt to take his own life. Knowledge of risk factors is one of the first steps of prevention of this phenomenon.

THE AIM OF THE STUDY

To know the personality determinants of gender found in people after a suicide attempt.

MATERIAL AND METHODS

The study included 37 people after a suicide attempt, psychiatric hospital and a control group (healthy people) well-matched for age and education. Questionnaire method used to study selected personality variables.

RESULTS AND CONCLUSIONS

Psychological gender--masculinity dimension to significantly differentiate a person from the study group and controls. People after a suicide attempt is characterized by a higher level of anxiety (as a state and as a feature). In less able to cope effectively with stress.

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.

[Psychopathology service on ships]

The aim of this study was to describe the specific engineering services and suitability of candidates for the psychophysical performance. Navy ships are equipped with equipment and weapons are controlled by electronic devices ship and crew. Advanced technology puts high demands on operator. For the ship's staff are recruited soldiers of the psychophysical characteristics predisposing to this kind of action. The paper uses personal experience to work in military units of the Navy, and data from the literature. Terms of sailing ships off the summer season are defined as difficult. The crew during a combat mission felt the risks associated with movements of the ship in difficult meteorological conditions, and associated with the implementation of the task. The development of ship's technical equipment, working in isolated groups, functioning within a limited space, noise, vibration, electromagnetic waves heighten the emotional burden on crew members. Military service on Navy ships require high psycho-physical predisposition, resistance to stress. The crucial factor is proper selection among the candidates based on psychiatric and psychological counseling for military and medical jurisprudence. Also plays a significant role for training doctors and specialists in psychoprophylaxy of military units in the field of mental hygiene.

[Efficacy of trazodone in the treatment of insomnia]

Sleep disorders are among the most common in the general population. Insomnia is a serious clinical and social problems. The prevalence of insomnia in developed countries is estimated at 10-35% (40%). The effective treatment of insomnia, it is essential to proper diagnosis and treatment of the primary causes. When choosing an antidepressant for a patient with sleep disorders should be taken into account the effectiveness of antidepressant, sedative activity profile, good tolerability and possible administration evening dose. Trazodone is an sedative antidepressant, acting quickly, efficiently, safely, with a small number of adverse reactions and proven effective in the treatment of insomnia.

[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.

[Analysis of the causes and determinants of reaction to severe stress and adjustment disorder patients on mental health clinics]

In everyday life there are many obstacles that prevent the creation of many important needs. They require a skillful adaptation and may be the cause of stress. Stress of considerable intensity can receive the joy of life and even lead to a temporary mental disorder.

THE AIM OF THE STUDY

To present the main causes and frequency of disturbance determined according to the ICD-10 as a reaction to severe stress and adaptive disorders among patients in psychiatric and psychological counseling and to establish whether the causes of the disorder are dependent on factors such as age, sex or level of education.

MATERIAL AND METHODS

Analysis was done on a separate group of 754 persons from among patients seeking psychiatric counseling--Psychological Outpatient Mental Health in the 10th Military Clinical Hospital in Bydgoszcz, in 2005. This group were qualified person, who according to the criteria of ICD-10 were found to respond to severe stress and abnormal adaptation. In addition, during the interview determines whether they are long-term somatic illness. They have not been included in the study group. Also excluded persons who were found difficulties in operation prior to the stressful situation and those that have already been treated with psychiatric or psychological benefit from therapy. The collected data were statistically analyzed.

RESULTS

The analysis identifies three main causes of adjustment disorder. The first group of reasons is related to difficulties in the workplace, which represents 59% of all patients with the disorder described. In this group identifies three major stressful situations: bullying, job loss, unemployment. Another reason relates to family problems. They are the reason for the emergence of abnormalities in 23% of patients analyzed group. Among these difficulties was divided into four main types of situation causing disorder presented. There are family conflicts, death of spouse, parent death, divorce. The last group of factors are stressful events or incidents which contributed to the disorder in 16% of patients in the group described. In this category were observed four major groups analyzed the causes of the disorder. This is due to the difficulty of adapting to the compulsory military service, traffic accidents, participation in missions abroad, the situation of rape. Making a detailed analysis by category of difficulty is shown that in this group of subjects, age, educational level and gender are significant factors in influencing the formation of these disorders.

CONCLUSION

The main causes of this disorder are closely related to everyday human activity and especially on employment. Harassment and bad relationships in the workplace, job loss, unemployment are the factors most often causing disorder in question. The analysis made also clear that the situations of family conflict is also a frequent cause of severe reactions to stress and adjustment disorder. Not without significance is the impact of factors such as level of education, age and sex. Analysis by specific categories of causes of reactions to stress and adjustment disorder indicates that these factors significantly correlate with the formation of these disorders in the group of people.

[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.

[Restless legs syndrome]

Restless legs syndrome (RLS) is characterised by daily dynamic sensorial and motor syndromes. It is a relatively little known syndrome among neurologists as well as psychiatrists. In spite of a growing number of researches on this issue, the problem seems to be underdiagnosed. Because of a subjective character of the symptoms and also their appearance in the evening hours, they are difficult to observe among outpatients. In the case of diagnosing the restless legs syndrome, therapists pay attention to sleep disorders, which usually remain as the only one being treated and others are omitted. Some are convinced of little harmfulness of this syndrome, however sleep disorders themselves worsen social functioning and those disorders lasting longer, increase the probability of other, not only psychiatric disorders appearing. A separate issue is the not yet established pathogenesis of the restlessness legs syndrome, especially its genetic background. It is important because of the possible ways of treatment. Undoubtedly RLS needs more research and promoting knowledge on this issue not only among doctors but also in the whole society.

[Münchausen syndrome by proxy]

Münchausen syndrome by proxy (MSBP), is a psychiatric disorder, a particular form of child abuse. An impaired emotional relationship exists mainly between the mother and her child. According to the variety of victims' symptoms, all medicine doctors may deal with this syndrome in every day clinical practice. Still insufficient knowledge about the syndrome and its' rare consideration in the differential diagnosis result in only severe, potentially lethal cases recognition. For many years the rest remains a source of a long-term physical and mental injuries in victims. About 30 years from the first attempt to precisely point the signalling symptoms for a proper diagnosis, we present the current knowledge on epidemiology, aetiology, diagnostic criteria, advised management and psychological portrait of the mother with the syndrome and her child, the syndrome's victim.

Single nucleotide polymorphism of the KIBRA gene in recurrent depressive disorders

OBJECTIVE

Depression is a disease of multifactor background. Episodic memory dysfunction is one of depression characterising disturbances, which may lead to its onset and development. Memory processes are controlled by a number of extra- and intracellular mechanisms. KIBRA, a newly discovered protein, belonging to signal transduction proteins, participates in the control of episodic memory. The presented study was designed to assess correlation between single nucleotide polymorphism (SNP) T/C (rs17070145) of the KIBRA gene and the risk of recurrent depressive disorder (DD).

METHODS

The study was carried out in a group of 181 patients with recurrent DD and 149 healthy control subjects. Genotyping was conducted by polymerase chain reaction (PCR)/restriction fragment length polymorphism (RLFP) method.

RESULTS

TThe obtained results have revealed no significant correlation between the studied polymorphism and recurrent DD. Obtained value of the disease odds ratio (ORdis) suggests that presence of T/T homozygote decreases risk of development of recurrent DD, but the result was not statistically significant.

CONCLUSIONS

Following the results, it may be concluded that the studied polymorphism does not influence either the onset mechanism or the course of recurrent DD. Even if T/C polymorphism of the KIBRA gene induces memory disturbances, they may be unspecific and unselective for recurrent DD. Further studies on the genes, which control characteristic processes of DD and influence their course, are demanded and mostly justified.