[Medical malpractice stress syndrome in theory and practice - a narrative review]

Accusations of medical malpractice, increasingly common among healthcare professionals, are a massive source of stress which can lead to the development of medical malpractice stress syndrome (MMSS). The symptoms of this syndrome are often compared to those in post-traumatic stress syndrome (PTSD), and the doctors are referred to as "second victims" of medical mistakes. The aim of the publication is to highlight MMSS, its symptoms, its similarity to PTSD, its consequences, and methods of prevention and management. In addition, attention was paid to the number of medical malpractice lawsuits among medical specialties mostly affected by this problem to illustrate the scale of the phenomenon. The publication is a narrative review. Medical databases (PubMed, ResearchGate, Biblioteka Nauki), termedia and Jurnals.viamedica service from the years 1988-2023 were reviewed. The MMSS manifests itself with symptoms such as anger, frustration, anxiety, guilt, sleeping disorders, loss of self-confidence, and depression. Later, somatic symptoms, such as cardiovascular, also appear. The MMSS may lead to unnecessary ordered examinations, delayed therapeutic processes, or premature retirement from the profession. Recently, patients have become more aware of their rights, resulting in an increase in malpractice lawsuits, particularly in specialties such as gynecology and obstetrics, neurosurgery, and radiology. Concerns about the legal consequences of medical errors may affect future specialization choices. Graduates tend to avoid specialties with a high risk of medical malpractice. Coping with MMSS requires social support and cooperation between doctors and lawyers or psychiatrists. Prevention of MMSS includes awareness of stress reactions and procedures decreasing the risk of committing medical malpractice. The prevalence of MMSS among physicians and the impact of the risk of medical malpractice lawsuits on the choice of medical specialty in Poland require further examinations. Med Pr Work Health Saf. 2023;74(6):513-26.

Assessment of knowledge and beliefs concerning mental disorders among medical students - preliminary report

OBJECTIVES

The aim of the study was to assess attitudes towards people with mental disorders.

METHODS

The survey was carried out in a group of 93 students of the fifth year of medical studies (medical faculty) including 59 women and 34 men, aged 24.34 ± 1.28 years.

RESULTS

In the conducted research, personal contact with a psychiatrist due to problems with their own mental health was declared by 23% of respondents. The choice of psychiatry as a field of specialization was declared by 19% of students. In the analysis of the questionnaire on beliefs, as many as 83% of respondents considered that mental illness is a cause for shame. Analyzing the attitude of the respondents to treatment, it was shown that as many as 80% of people believed that compulsory hospitalization is a right procedure. It should be emphasized that only 31% of the surveyed students believed that people with mental disorders should decide to have offspring, and 36% of people thought that mentally disturbed people would not be good as parents. As many as 30% of respondents believed that people with mental disorders more often commit crimes than healthy people, and 42% of students showed a lack of determination in this aspect.

CONCLUSIONS

The results of the research suggest the necessity of expanding knowledge and shaping appropriate attitudes towards people with mental disorders among future doctors.

Cognitive functions and sense of coherence in patients with carotid artery stenosis-Preliminary report

Background

There is scarcely any data in the available literature on the relationship between sense of coherence (SOC) and cognitive functioning, and no information on the relationship between SOC and cognitive parameters in patients with carotid atherosclerosis.

Aim

The aim of this paper was to determine the relationship of SOC measured prior to carotid artery stenting (CAS) with neurocognitive functioning in patients with carotid atherosclerosis 12 months after CAS.

Methods

A total of 35 patients with carotid atherosclerosis completed the SOC-29 Orientation to Life Questionnaire (SOC-29) and completed a cognitive test battery twice, i.e., before (baseline-T1) and 12 months after stent implantation (follow-up-T2). Selected cognitive functions such as memory, attention, perception, visuospatial and executive functions and non-verbal fluency were assessed.

Results

One year after the procedure, patients with a higher SOC and sense of manageability present better performance in visual memory. Higher SOC and sense of meaningfulness are positively related to the speed of understanding the changing rules of card sorting (WCST).

Conclusion

Higher overall SOC and a component of sense of meaningfulness and manageability may be related to better cognitive functioning 1 year after the procedure.

Evaluation of selected factors influencing sleep disorders in paramedics during the COVID-19 pandemic

Introduction

Sleep disorders can develop as a result of exposure to stressors. The outbreak of the COVID-19 pandemic was an additional source of stress for paramedics, due to the fear of the unknown nature of the new pathogen. The main aim of this study was to identify factors influencing the development of sleep disorders among paramedics working during the COVID-19 pandemic.

Material and methods

This was a cross-sectional, anonymous, voluntary, online survey conducted on social networks among paramedics working during the COVID-19 pandemic in Poland from 10/11/2020 to 14/01/2021. The survey included 387 participants, the majority of whom were men (72.35%). A proprietary questionnaire and standardized scales were used to identify risk factors: Athens Insomnia Scale (AIS) and Epworth Sleepiness Scale.

Results

Among all participants, there were 107 (27.65%) women and 280 (72.35%) men. Significantly higher scores of the analyzed scales were observed in the female gender. Based on the AIS scale, mild sleep disorders were found in 3.6% of women and 2.9% of men. Excessive sleepiness on the Epworth scale was assessed in more than 70% of women and 58.8% of men working in Emergency Medical Teams (EMTs).

Conclusions

The main factors influencing the development of sleep disorders were female gender, use of sleep aids and not having a life partner. In contrast, older age and longer job tenure, being married, and having good relationships with family members had a protective effect.

Meditation and psychosis. The comparison of the current knowledge in the light of scientific evidence and the experience of an Eastern meditation teacher

The aim of the study was to compare the current knowledge on the relationship between the use of meditation techniques and the occurrence of psychosis with the experience of an Eastern meditation teacher, Osho Rajneesh. While searching the PubMed database using the keywords "meditation AND psychosis" 72 research articles were obtained, of which only 17 fully corresponded to the assumptions of the work. They included the case reports of the patients, as well as meta-analyses, and review articles related to both the positive and negative influence of meditation practices on mental health. Additionally, the information contained in 3 books was used. The etiology of meditation-induced psychotic episodes is not clear given the frequent presence of many coexisting factors including fasting, sleep deprivation, or a positive psychiatric history, as well as the limitation of the methodology. In the analyzed studies, only patients who did not meditate in clinical conditions were reported. The analysis of these cases indicates that the risk of a psychotic episode was associated with excessively long practice and lack of adequate supervision. The comparison of current scientific knowledge with the experience of the Eastern meditation teacher made it possible to draw attention to rarely described in literature risk factors of the development of psychosis, which include "specific traits" of the practitioner's attitude. One of its fundamental elements is an incorrect understanding of meditation as a task to perform, instead of an open, passive, and accepting attitude of observing the external and internal world.

How Do Women React to the COVID-19 Pandemic Period? Relationship Between Ego-Resiliency, Anxiety, Alcohol Consumption and Aggression Among Polish Women

Purpose

There are many reports in the literature on the impact of the COVID-19 pandemic on mental health, including the condition of women. Most of these studies refer to a single time point, while there is a lack of studies controlling for selected parameters during different periods of the pandemic. This work aimed to determine the role of ego-resiliency in women's adaptation to the COVID-19 pandemic.

Patients and Methods

The survey was conducted in two stages - all via online forms. A total of 762 Polish women took part in the overall project. The scales used in the study were the Ego-resiliency scale (ER89-R12), Generalized Anxiety Disorder 7 Scale (GAD-7), Alcohol Use Disorders Identification Test (AUDIT), and Buss-Perry Aggression Questionnaire (BPAQ). Statistical analysis was performed using Statistica 13.3.

Results

Women participating in the second study had significantly lower scores on ego-resilience and its components compared to the first study. In the first research, ego-resiliency and optimal regulation were statistically significantly correlated with anxiety, alcohol consumption, generalised aggression, verbal aggression and hostility, while openness to life experiences was correlated with alcohol consumption and hostility. The second part of the project highlighted new significant correlations between ego-resiliency and optimal regulation and physical aggression and anger, but a non-significant correlation of these variables with alcohol consumption. The effect of openness to life experiences on alcohol consumption and anxiety, evident in the first study, was no longer present in the second part of the study.

Conclusion

The lack of a significant effect of openness to life experience on alcohol consumption, lower ego-resiliency and optimal regulation scores are observed in the second part of the research, which might be an expression of adaptation to the COVID-19 pandemic. Ego-resiliency is a protective factor against aggression, while optimal regulation against anxiety among Polish women.

How COVID-19 pandemic period influences on the selected mental health parameters of Polish respondents?

Introduction

There are many different articles about COVID-19 pandemic period and its influence on people and their behavior. Nevertheless, there is little research on the slightly later period of the pandemic, that is, the time when specific adaptation mechanisms in society should start to take place.

Methods

Our research was conducted by means of an online survey. Four hundred and eighty five adults participated, including 349 (71.96%) women and 136 (28.04%) men. The Buss-Perry aggression scale, Alcohol Use Disorders Identification Test and Generalized Anxiety Disorder 7 scale were used. The results were statistically processed using Statistica 13.3 software.

Results

Within the study population, positive correlations were noted between anxiety and generalized aggression, anger, hostility, physical and psychological aggression. In the female group, anxiety correlates positively with generalized aggression, anger, hostility, verbal and physical aggression. Among male subjects, anxiety correlates positively with aggression, anger, and hostility. Alcohol consumption has a significant association with verbal aggression. Statistically, more women experience anxiety, more men have inflated scores on the AUDIT scale and on verbal and physical aggression. Younger people are more likely than older people to experience anxiety and have inflated scores on hostility. Those with secondary education scored significantly higher on the GAD-7 scale and the aggression scale (and all subscales except anger) compared to respondents with higher education.

Discussion

As a result of adaptation to the COVID-19 pandemic, anxiety is no longer a factor in increased evels of alcohol consumption. The pandemic has not affected differences in alcohol consumption between men and women. The presence of a positive correlation between anxiety and aggression and the sociodemographic structure of those characterized by increased aggression are also unchanged. Anxiety directly influences aggressive behavior in a relatively strong way. Appropriate health-promoting measures should be implemented to protect the public from the negative effects of the COVID-19 pandemic.

Olfactory Obsessions: A Study of Prevalence and Phenomenology in the Course of Obsessive-Compulsive Disorder

Olfactory obsessions (OOs) are rarely described in the medical literature. The features of OOs appear consistent with characteristics of a typical obsession, but since they do not involve the realm of thought, it is questionable to term them obsessions per se. Olfactory Reference Syndrome (ORS) presents OOs inconsistently and is a distinctive diagnostic category related to OCD. Therefore, the primary objectives of our study were not only to assess the prevalence of OOs in OCD patients, but also to demonstrate their phenomenological consistency with other OCD symptoms. The study group consisted of 75 patients already diagnosed and treated for OCD. Hence, a comparison was made between OCD patients with and without OOs in terms of: symptom severity, level of insight and comorbidities. Olfactory obsessions (OOs) were found in 21.33% (n = 16). OOs induced compulsive behavior in more than 93% of subjects. The presence of OOs did not significantly differentiate the studied groups in terms of OCD severity (p = 0.876), level of insight (p = 0.680), depression (p = 0.746), mania (p = 0.525) and OCDP traits (p = 0.624). However, a comparison of the two groups showed that OOs patients presented higher levels of hostility (p = 0.036), cognitive impulsivity (p = 0.039), magic-type obsession (75% vs. 35.59%), and contamination obsession (87.50% vs. 67.80%). Conclusions: OOs frequently occur in the course of OCD, and their phenomenology is typical of this disorder. OOs are not a symptom of thought content disorders and are sensory in nature, which is not included in the definition of obsession. The presence of OOs in OCD provokes hostility and cognitive impulsivity. It can be assumed that the Olfactory Obsessions Questionnaire accurately identifies olfactory obsessions.

Influence of Selected Sociodemographic and Cultural Factors on the Age of Sexual Initiation of Students from Polish Universities

Sexuality is the one of the most important parts of human life. The aim of our study was to identify the factors influencing the onset and age of sexual initiation in students and drawing attention to the need to improve access to sexual education in Polish schools at a sufficiently high level. An original questionnaire with 31 questions was used for the study. Data were collected using the Google Forms tool. A total of 7528 students participated in the study and 5824 underwent sexual initiation. The mean age at sexual initiation was 18.1 years. Logistic regression analysis was performed to show factors influencing the onset of sexual activity, while linear regression analysis was used for factors influencing the age of sexual initiation. Religion, drug use, smoking, alcohol consumption, type of housing, and conversations with parents about contraception or sex affect the onset of sexual activity. The age of sexual initiation is affected by religion, the age of the first viewing of pornography, quality of life, the size of the city of residence, smoking and drug use.

Medications for the Treatment of Alcohol Dependence-Current State of Knowledge and Future Perspectives from a Public Health Perspective

No single effective therapy for alcohol abuse has been found, despite it being a serious sociological and economic problem for hundreds of years. It seems difficult to find a single drug as a panacea for the alcohol problem due to the complexity of the pathophysiology of alcohol dependence. The purpose of this narrative review is to review existing and potentially future pharmaceuticals for the treatment of alcohol dependence in the most affordable way possible. Psychotherapy is the mainstay of treatment for alcoholism, while few drugs approved by legislators are available in the augmentation of this treatment, such as acamprosate, disulfiram, and naltrexone, approved by the FDA, and nalmefene by the EMA. There are recent reports in the literature on the possibility of using baclofen, topiramate, varenicline, and gabapentin in the treatment of alcohol dependence. Moreover, the results of recent clinical trials using psychoactive substances such as psilocybin and MDMA appear to be a breakthrough in the modern treatment of alcohol abuse. Despite this initial optimism, a lot of scientific effort is still needed before new pharmacological methods supporting the treatment of alcohol dependence syndrome will be widely available.

Sexual disorders in the men treated in a psychiatric ward

OBJECTIVES

An attempt to assess the impact of dual diagnosis - mental illness and addiction on the occurrence of sexual dysfunctions, and evaluation of problems with sexual functioning in men treated in a psychiatric ward.

METHODS

140 psychiatrically hospitalized men (mean age 40.4 ± 12.7 years) with the diagnosis of schizophrenia, affective disorders, anxiety disorders, addiction and double diagnosis (schizophrenia and addiction) took part in the study. The Sexological Questionnaire, developed by Professor Andrzej Kokoszka, and the International Index of Erectile Function IIEF-5 were used in the study.

RESULTS

The occurrence of sexual dysfunctions in the study group was reported in 83.6% of patients. The most common was reduction in sexual needs (53.6%) and orgasm delay (40%). Depending on the research tool used, erectile dysfunction appeared in 38.6% of respondents (according to Kokoszka's Questionnaire) and 61.4% of patients (IIEF-5). Severe erectile dysfunction was more common in the group of patients without a partner (12.4% vs. 0; p = 0.000) compared to people in relationships and in the group with anxiety disorders (p = 0.028) compared to groups with other mental disorders. In the group of people with dual diagnosis (DD), sexual dysfunctions were observed more frequently in comparison to patients with schizophrenia (p = 0.034). Treatment lasting over 5 years was more often associated with sexual dysfunctions (p = 0.007). In the DD group, lack of orgasm and excessive sexual needs were more frequent in comparison to people with one diagnosis (p = 0.0145; p = 0.035).

CONCLUSIONS

Sexual dysfunctions are more common in patients with DD in comparison to patients diagnosed with schizophrenia. Lack of a partner and the duration of psychiatric treatment over 5 years is associated with more frequent occurrence of sexual dysfunctions.

Symptoms of Anxiety and Depression and Sense of Coherence in Patients Undergoing Carotid Artery Stenting

BACKGROUND

The sense of coherence is lower in patients with somatic diseases and psychiatric disorders.

PURPOSE

The purpose of this study was to evaluate the intensity of depression and anxiety symptoms and their relationship with the sense of coherence and to try to determine the relationship between the strength of sense of coherence and symptoms of depression and anxiety with the presence of symptoms of carotid atherosclerosis in a group of patients undergoing carotid artery stenting.

METHODS

35 patients, including 13 with symptomatic atherosclerosis in the carotid arteries, completed self-report tests: Hospital Scale of Depression and Anxiety (HADS) and the SOC-29 Life Orientation Questionnaire (SOC-29), 22 of whom also rated their subjective feelings of anxiety and depression on a scale included in the author's questionnaire.

RESULTS

Both symptomatic and asymptomatic patients did not differ significantly in the severity of depression, but they differed in anxiety levels as assessed by the HADS scale. There were no differences in the overall strength of sense of coherence and its individual components. Nearly 12% of those undergoing carotid artery stenting have pronounced anxiety symptoms, and just over 14% have pronounced depression symptoms. A higher overall sense of coherence and its components are associated with lower severity of depression symptoms. Lower severity of anxiety correlates negatively with a higher sense of understanding, meaningfulness, and holistic Sense of Coherence (SOC). Manageability appeared higher in men.

CONCLUSIONS

SOC is an important health-promoting factor that is preferably related to mental health parameters of patients with carotid atherosclerosis.

Depressive and Anxiety Symptoms and Their Relationships with Ego-Resiliency and Life Satisfaction among Well-Educated, Young Polish Citizens during the COVID-19 Pandemic

Ego-resiliency is a set of traits that promotes positive adaptation to life's vicissitudes. High ego-resiliency helps in upholding one's personality system when facing adversity and in adjusting it to new environmental demands. Our study aimed at evaluating the connections between ego-resiliency, the severity of anxiety and depressive symptoms as well as life satisfaction during the COVID-19 pandemic in Poland. A total of 604 Polish citizens aged 16 to 69 years participated in the online survey. Ego-resiliency was measured with the Ego Resiliency Scale (ER89-R12), anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and life satisfaction with the Satisfaction with Life Scale (SWLS). Statistical analyses were performed using the Spearman rank correlation coefficient. The results revealed correlations between the intensity of depressive and anxiety symptoms, life satisfaction, and the intensity of ego-resiliency. Individuals with a high level of ego-resiliency tended to experience a lower intensity of anxiety and depressive symptoms during the COVID-19 pandemic. Moreover, individuals with a high level of ego-resiliency exhibited a higher level of life satisfaction. Our conclusions might assist in better understanding the close link between levels of ego-resiliency, the occurrence of depressive and anxiety symptoms, and satisfaction with life among Polish individuals experiencing crises.

The Influence of Sociodemographic Factors on Symptoms of Anxiety, the Level of Aggression and Alcohol Consumption in the Time of the COVID-19 Pandemic among Polish Respondents

The COVID-19 pandemic has had a significant impact on the mental health of most of the world's population. The authors of this study decided to identify differences in the intensity of anxiety, aggression and alcohol consumption within the study population. The study was conducted via an Internet survey. It uses Polish adaptations of international scales to assess anxiety (GAD-7), aggression (Buss and Perry Aggression Scale) and alcohol consumption (AUDIT test). A total of 538 people were examined. The surveyed group of respondents does not reflect the structure of Polish society. The group of surveyed women scored higher than men in terms of anxiety, as well as anger and hostility. The examined men were characterized by higher results of alcohol consumption and physical aggression. People between 18 and 49 years of age consumed significantly more alcohol than people aged 50 and over. People aged 18-29 obtained statistically significantly higher scores in generalized aggression and hostility. The relationships between the studied parameters do not differ significantly from those presented in other studies. People under the age of 50 are the group most exposed to the harmful effects of alcohol. Women between the ages of 30 and 49 are most vulnerable to the negative mental health effects of the COVID-19 pandemic. There is a need for further research studies in which the studied group will obtain a greater degree of compliance with the structure of Polish society.

Belief in false information regarding the COVID-19 pandemic and a tendency to conspiracy thinking as factors that may exacerbate symptoms of anxiety and depression among Polish citizens

Introduction

The COVID-19 pandemic has become the subject of intense discussion on social media platforms. Fake news and conspiracy theories about the SARS-CoV-2 virus, in particular its origin, spread, impact on health and prevention, have become especially popular. The social crisis triggered by the COVID-19 pandemic is associated with a growing tendency to believe in conspiracy theories, which in turn may contribute to an increase in anxiety tension and thus deteriorate the psychological health of citizens.

Objectives

The aim of the study was to determine the relationships between the tendency to believe in false information about the COVID-19 pandemic and the severity of symptoms of anxiety and depression among the surveyed Polish citizens.

Methods

The study included 700 Polish people aged 24.7±6.34 years. We used questionnaires such as: COVID-19 Conspiratorial Beliefs Scale to measure the level of belief in false information regarding the COVID-19 pandemic, Generic Conspiracist Beliefs Scale to measure tendencies to believe in conspiracy theories, and Hospital Anxiety and Depression Scale.

Results

Belief in false information about the COVID-19 pandemic may be associated with a slight increase in the severity of both anxiety symptoms (b=0.044; p=0.021) and depression (b=0.048; p=0.004). A factor known as belief in the criminal activity of government organizations may also contribute to predicting the increase in the severity of symptoms of anxiety (b=0.172; p=0.001) and depression (b=0.169; p=0.000) during the COVID-19 pandemic.

Conclusions

Belief in false information about the COVID-19 pandemic, as well as belief in general conspiracy theories, can contribute to the psychological deterioration of citizens during the COVID-19 pandemic.

Disclosure

No significant relationships.

Impact of Venlafaxine on Platelet Count and Activity—Case Report and Narrative Review

Venlafaxine (VEN) is considered to be one of the most effective antidepressants. It belongs to the group of serotonin (5-HT) and noradrenaline (NA) reuptake inhibitors (SNRIs). NA and 5-HT have receptors on the surface of platelets and are involved in platelet aggregation. In this case study, we present the case of a patient treated for one of the types of myeloproliferative neoplasm (MPN), essential thrombocythemia (ET), in whom VEN was added to pharmacotherapy during the treatment of a severe episode of depression with psychotic symptoms. We observed a gradual reduction in platelet count when increasing the dose of VEN. We also present a narrative review of literature about the effect of VEN on platelet counts and activity. We conclude that, in the group of patients taking VEN, attention should be paid to the rare adverse effect of a decrease in the number of platelets.

Analysis of Factors Influencing Polish Students' Opinions on Euthanasia

Due to the continuous development of palliative care and methods of pain relief in the last moments of patients’ lives, we are faced with the question of how long we should take measures to delay inevitable death for, without providing prolonged therapy against the patient’s will. For terminally ill and people experiencing unimaginable suffering, euthanasia is considered as one of the possible options for a dignified farewell. The aim of the study was to determine the views on euthanasia in a group of students from Polish universities. Questionnaire responses were analyzed for 9686 students (79.9% of women and 20.1% of men) aged 18−35 years. Respondents were asked to complete their own questionnaire on demographic data and attitudes toward euthanasia in the case of severe terminal illness or paralysis preventing independent living. Euthanasia was significantly more acceptable among women (85% vs. 75%, p < 0.0001; 69% vs. 62%, p < 0.0001) and non-believers [98% vs. 97% (denominations other than Christian), 84% (other forms of Christianity), 69% (Roman Catholic); p < 0.0001] in every case considered. Religious affiliation was the factor that most influenced attitudes toward euthanasia. Among the other elements influencing attitudes toward euthanasia, residence and field of study were distinguished. Considering the large sample size and specific conclusions, the article should be an important argument in the discussion on euthanasia.

[Minority stress and selected mental disorders in people with gender dysphoria and gender incongruence - a narrative review]

between experienced and assigned gender that does not have to be associated with discomfort or suffering. However, the aspect of suffering is emphasized in the understanding of the diagnostic unit of gender dysphoria according to the DSM-5 of the American Psychiatric Association. People with gender incongruence are exposed to misunderstanding, persecution and stigmatization, often related to experienced minority stress. The aim of this study was to analyze the available literature in terms of the relationship between gender dysphoria and some mental disorders and minority stress, and to draw attention to the suffering of these people in the context of social confrontation with the phenomenon of gender transposition. The unfavorable image of a person with gender dysphoria created by some media, persecution and, as a result, bans on gender reassignment in some countries mean that a steady increase in mental disorders in these patients can be expected. The main psychiatric problems in people with gender dysphoria, accompanied by minority stress for most of their lives so far, concern the coexistence of depressive and anxiety disorders, self-destructive behaviors and the tendency to addiction. An important aspect of the functioning of people with gender dysphoria are also difficulties in taking up and maintaining employment, fear of losing income due to attempting to live in accordance with the perceived gender. The authors of the presented review wanted to emphasize the importance of minority stress in the lives of these people and the need for social education and a change in the approach to the concept of "employee," excluding the record gender from it, which - according to the authors - could help people with gender incompatibility in their working life by reducing minority stress. Med Pr. 2022;73(2).

Conspiratorial Beliefs About COVID-19 Pandemic - Can They Pose a Mental Health Risk? The Relationship Between Conspiracy Thinking and the Symptoms of Anxiety and Depression Among Adult Poles

The aim of the study was to describe the relationship between the tendency to believe in false information about the COVID-19 pandemic, tendency to believe in conspiracy theories and the severity of anxiety and depression symptoms among the surveyed Poles. The study was conducted via the Internet in a group of 700 people aged 24.8 ± 6.3 years (mean ± SD). 585 females and 110 males were involved. Scales such as Generic Conspiracist Beliefs Scale (GCBS), Hospital Anxiety and Depression Scale (HADS) and the original questionnaire COVID-19 Conspiratorial Beliefs Scale (COVID-19 CBS) designed to measure the tendency to believe in false information about COVID-19 pandemic were used. A positive correlation was observed between the tendency to believe in false information about the COVID-19 pandemic (COVID-19 CBS) and the tendency to believe in general conspiracy theories (GCBS) (r = 0.768; p < 0.001). Moreover, both COVID-19 CBS and GCBS positively correlated with the severity of anxiety and depression symptoms in the study group. For COVID-19 CBS, the correlation coefficients were 0.087 (p < 0.021) and.108 (p < 0.004) for depressive and anxiety symptoms, respectively, while for GCBS the coefficients were 0.132 (p < 0.001) and 0.147 (p < 0.001). Regression analysis showed that the increased tendency to believe in false beliefs about the COVID-19 pandemic may be associated with an increase in the severity of anxiety (b = 0.04; p = 0.021) and depression (b = 0.06; p < 0.001) symptoms. It can be hypothesized that the tendency to believe in false information regarding the COVID-19 pandemic is positively associated with the tendency to general belief in conspiracy theories. False beliefs about the COVID-19 pandemic may, at least to some extent, influence the development of anxiety and depression symptoms.

Sense of happiness and other aspects of quality of life in patients with obsessive-compulsive disorder

INTRODUCTION

Quality of life (QoL) is the intellectual and emotional wellbeing of an individual, which is determined by many factors. The most measurable are the sense of happiness, occupational satisfaction, quality of interpersonal relationships and sex life. Obsessive-compulsive disorder (OCD) is a chronic mental disorder diagnosed by the presence of obsessions and compulsions that disrupt normal psychosocial functioning. Despite early onset, treatment is delayed (OCD-DTI) and unsatisfactory.

OBJECTIVES

The primary objective of this study is to assess selected correlates of the sense of happiness among patients with OCD. The secondary objective is to compare the sense of happiness with healthy people.

METHODS

Seventyfive OCD patients and equal number of healthy subjects were compared using a Polish adaptation of the Oxford Happiness Questionnaire (OHQ-23).

RESULTS

We found a significant negative correlation between sense of happiness and the severity of OCD (r = -0.479), the number of obsessive-compulsive personality traits (r = -0.323), the number of other comorbid mental disorders (r = -0.272), the level of aggression (r = -0.448), impulsivity (r = -0.301), depressiveness (r = -0.357), and the sexual dysfunctions (r = -0.279). The latter were much more common in individuals with OCD compared to healthy subjects (66.67 vs. 12%). The level of loneliness was over two times higher in the study group compared to controls (27 vs. 12%). The mean delay in treatment onset was 13 years. Conclusions. Assessment of aspects of QoL should be an integral part of the diagnostic and therapeutic process in OCD.

Mercy Procedure or a Nightmare? Attitude towards Pregnancy Termination among Polish University Students

Worldwide, there are about 121 million unintended pregnancies per year. The aim of the study was to assess the attitudes in different groups of students from 40 Polish universities towards pregnancy termination. In total, 9686 university students (20.1% male and 79.9% female) took part in our research. Questions about attitudes towards abortion in all possible circumstances were involved in the survey, which also included a socio-demographic questionnaire. Overall, 94.5% of women and 90.7% of men consider that abortion should be legal in the situation of a threat to the mother's life, while only 52% of women and 38.7% of men accept it in the case of a hard financial situation for the mother. Most students stand for abortion in the situation of a threat to the mother's life, in the case of rape, or in the case of a mortal fetus defect. Less than half of the students interviewed consider that abortion should be legal in the case of a hard financial situation for the mother or on the mother's demand. People who declare a religious affiliation more often disagree with abortion, even in the hardest cases such as a danger to the mother's life or a mortal fetus defect. The factor that influences the strongest on attitudes towards abortion is being an active Roman Catholic. The majority of students have a pro-choice attitude in respect of pregnancy termination.

Cognitive Functions in Patients after Carotid Artery Revascularization-A Narrative Review

Carotid revascularization may lead to improved cognitive function beyond stroke prevention. This article summarizes the conclusions from available studies on the effects of carotid reperfusion procedures on cognitive function. The papers cited used different neuropsychological tests for cognitive assessment, resulting in different methodologies and the results obtained were not always convergent. However, most studies reported an improvement in neurocognitive abilities after both vascular interventions, but a more precise assessment of the specific benefits is still awaited. Clinical determinants to predict the effects of these treatments on cognitive function are still being sought, but results are not yet satisfactory. In view of these studies, carotid stenosis seems to be an independent risk factor for cognitive deterioration, and the main mechanisms responsible are embolism and cerebral hypoperfusion. The aim of this study is to order the knowledge about the effects of carotid artery stenting (CAS) and endarterectomy (CEA) on neurocognitive functions and to verify the usefulness of using these treatments.

Relationship between the Severity of Anxiety Symptoms, Aggression and Alcohol Consumption during the COVID-19 Pandemic Period

Background and objectives: There have been many reports of mental health in the pandemic period. The research conducted so far has indicated an increase in the severity of anxiety and aggression and an escalation of alcohol consumption during the COVID-19 pandemic. The aim of this study was to determine the relationship between the severity of anxiety, the amount of alcohol consumed and the severity of aggression. Materials and Methods: A total of 538 Polish residents—413 women (76.77%) and 125 men (23.23%)—participated in the study via an online survey. It included socio-demographic parameters and psychological scales: AUDIT—to determine the model of alcohol consumption, GAD-7—to measure the severity of anxiety and the Buss–Perry Aggression Questionnaire. Results: There was a correlation between the severity of anxiety and generalized aggression, and its two components—anger and hostility—in the entire study group. Moreover, relations were found between the intensity of alcohol consumption and generalized aggression and its components—anger and verbal and physical aggression. Those relationships turned out to be gender specific. The increased anxiety intensity affected the pattern of alcohol consumption and the severity of aggression. Conclusions: Psychotherapeutic and psychoeducational interactions and some elements of psychiatric treatment should aim at reducing the severity of anxiety in society, and thus minimizing the health and social consequences—aggressive behaviour and excessive alcohol consumption.

Lysergic Acid Diethylamide, Psilocybin and Dimethyltryptamine in Depression Treatment: A Systematic Review

Despite many different kinds of substances available for depression treatment, depression itself still appears to be a clinical challenge. Recently, formerly illicit substances came to scientists' attention, including lysergic acid diethylamide (LSD), psilocybin and dimethyltryptamine (DMT). Some studies suggest that these substances might be effective in depression treatment. The aim of this study was to evaluate the efficiency of LSD, psilocybin and DMT in depression treatment in the light of current medical literature. The authors followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for this systematic review. The authors searched the PubMed and Cochrane Library databases to identify relevant publications. Finally, 10 papers were included. Most of the selected studies showed significant correlation between psilocybin and DMT use and reduction in depression symptom intensity. By analyzing qualified studies, it can be concluded that psilocybin and DMT could be useful in depression treatment, but further observations are still required.

Persistent genital arousal disorder – the present knowledge

Persistent genital arousal disorder (PGAD) is a relatively recently described sexual disorder, characterized by symptoms of spontaneous genital arousal which persist in the absence of sexual desire and may affect women and men. Epidemiological studies conducted so far indicate that the prevalence of PGAD in the population may reach 1-4%. The etiology of PGAD remains unclear and complex, hypothesized causes include vascular, neurological, hormonal, psychological, pharmacologic, dietary, mechanical factors or a combination of these factors. Proposed methods of treatment include pharmacotherapy, psychotherapy, electroconvulsive therapy, hypnotherapy, injection of botulinum toxin, pelvic floor physical therapy, application of anesthetizing agents, reduction of identifiable factors exacerbating the symptoms, and transcutaneous electrical nerve stimulation. There is no standardized treatment algorithm for PGAD due to lack of clinical trials (evidence-based medicine). The classification of PGAD is under discussion: it could be classified as a separate sexual disorder, a subtype of vulvodynia or a disorder with pathogenesis similar to overactive bladder (OAB) and restless legs syndrome (RLS). Due to specificity of symptoms, patients may feel shame and discomfort during the examination or even delay reporting symptoms to the specialist. Thus, it is crucial to spread knowledge about this disorder, which would allow doctors to diagnose and help PGAD patients sooner.

Uncompleted extended suicide – discussion on the boundaries of psychosis based on a case study

The article describes the case of a 40-year-old woman who attempted suicide and killed two of her own children and was examined by three teams of forensic psychiatrists and psychologists for the purpose of judiciary. This women was somatically healthy, did not use psychiatric or psychological help. The authors were the third team of experts and, after conducting double psychiatric and psychological examinations and analysis of documents from the case files, which include the course of forensic-psychiatric observation, recognized the symptoms of dependant personality disorders and acute stress reaction, which resulted in a complete loss of the ability to recognize the meaning of the act and to manage proceeding. The paper discusses the diagnostic process as well as the analysis of psychotic disorders in relation to specific clinical diagnoses in accordance with the current classification of mental illnesses and disorders. Attention was paid to the problem of differentiating individual disorders and the way of defining psychotic disorders. The existence of difficulties in drawing the line between psychotic and non-psychotic disorders in the context of forensic psychiatric evaluation is emphasized.

The Dark Triad of Personality's Relationship with Compliance towards COVID-19 Pandemic Recommendations along with Anxiety and Depressive Symptoms in Polish Citizens

The outbreak of the COVID-19 pandemic forced everyone to comply with rules of a sanitary regime and social distancing on a daily basis. The aim of our research was to assess the differences in the levels of Dark Triad traits between people who obeyed and disobeyed the pandemic restrictions. Additionally, we considered the possible correlation between the Dark Triad and the intensity of symptoms of depression and anxiety. A total of 604 Polish participants, whose average age was 28.95 ± 11.27 years, completed an online survey which measured Dark Triad traits using the Polish version of the Dirty Dozen test. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). The results revealed a possible relationship between personality traits and compliance with pandemic restrictions. Individuals with higher levels of psychopathy tended to disobey newly introduced rules. On the other hand, a higher level of subclinical narcissism might have contributed to a better civil compliance. The results showed a significant positive correlation between the intensity of the Dark Triad and the occurrence of depressive symptoms. Furthermore, narcissism was linked to anxiety symptoms. These results can contribute to a better understanding of behavioural patterns during the COVID-19 pandemic within the group of individuals who exhibit the Dark Triad traits. Our conclusions might help to identify individuals who are particularly vulnerable to mental health problems.

Demographic and health characteristics of 3,4-methylenedioxymethamphetamine users (MDMA, ecstasy)

OBJECTIVES

MDMA is one of the most commonly used drugs in the world. Clinical studies are currently being conducted around the world on the use of this substance in the treatment of PTSD and alcoholism. However, little demographic information is available on users who use the substance for recreational purposes. The aim was to determine basic demographic and helath characteristics with validated tools.

METHODS

The authors prepared an original questionnaire on the demography of MDMA users and combined it with the General Health Questionnaire-28 (GHQ-28) and the Hospital Anxiety and Depression Scale (HADS). The survey was sent to Polish MDMA users via the Internet.

RESULTS

304 responses were received from people over 18 years of age. MDMA is widespread among young adults, in many different places of residence and regardless of gender. The users take MDMA in both pill and crystal form and very rarely test drugs bought from a dealer. Most users feel that MDMA has had a good impact on their lives.

CONCLUSIONS

MDMA is rarely used as the only psychoactive substance. MDMA users rate their health higher than people using other psychoactive substances.

Is it good to be resilient during the COVID‑19 period? The role of ego-resiliency in the intensity of symptoms of anxiety, alcohol use and aggression among Polish people

OBJECTIVES

The SARS-CoV-2 pandemic has affected the development of negative phenomena such as anxiety symptoms, a tendency to use alcohol and aggressive behaviors. It is postulated to investigate the factors limiting the development of the indicated adverse effects. One of the psychological resources that may have a significant, pro-health character in relation to mental functioning is ego-resiliency (ER). It is described as a personality trait associated with a high ability to adequately regulate self-control, depending on the conditions. There are studies providing information about the prohealth, adaptive nature of ER during the COVID‑19 period. The aim of the study was to assess the relationships between ER and anxiety, the tendency to use alcohol and aggression in the group of Polish people in the initial lockdown period in Poland.

MATERIAL AND METHODS

Overall, 538 adult Polish people participated in the study. The Ego-Resiliency Scale referred to as ER89-R12, according to Block's concept, was used to measure ER. The other scales used were the General Anxiety Disorder Scale, the Alcohol Use Disorder Identification Test, and the Buss-Perry Aggression Questionnaire. Statistical analyses were performed using Spearman's rank correlation coefficient, the multiple regression procedure, the Mann-Whitney U test and the Kruskal-Wallis rank ANOVA. Cronbach's α coefficients were also assessed.

RESULTS

Statistically significant negative relationships between ER and the severity of anxiety symptoms and generalized aggression were found. There was a weak positive relationship between ER and the tendency to use alcohol. Among the surveyed Polish people, higher ER was characteristic of the older respondents (aged >29 years) and people with higher education.

CONCLUSIONS

Ego-resiliency in the times of the SARS-CoV-2 pandemic can counteract the development of anxiety and aggression. Optimal regulation seems to play an important role in this relationship. The relationship between resiliency and the tendency to use alcohol requires further observation. Int J Occup Med Environ Health. 2021;34(2):289-300.

Physical, Cognitive and Social Rehabilitation in Relation to Sleep Quality and Cognitive Functions in the Elderly

The aim of the study was to assess cognitive functions and sleep quality after a 3-month holistic intervention including physical, social and cognitive rehabilitation in patients 65+. Twenty-nine people participated in the study. The study was divided into two stages. In the first stage, a self-administered questionnaire consisting of sociodemographic questions was used, and cognitive functions were assessed using the Rey-Osterrieth complex figure test, Addenbrooke's Cognitive Examination III (ACE III) test, Montreal Cognitive Function Assessment Scale (MoCA) and digit repetition test. All patients were also assessed for sleep quality using the Athens Insomnia Scale (AIS). After three months, the patients were assessed for cognitive functions and sleep quality, which was the second stage of the study. Analysis of the results obtained by patients in the study showed a statistically significant improvement in sleep quality and cognitive function. Rehabilitation activities, including physical training, cognitive exercises and occupational therapy, reduce the severity of mild cognitive disorders and reduce insomnia.

Will MDMA-assisted psychotherapy become a breakthrough in treatment-resistant post-traumatic stress disorder? Critical narrative review

Post-traumatic stress disorder (PTSD) is a common mental health condition that begins after exposure to a traumatic event. Despite recommended various therapeutic approaches, including both pharmacotherapy and psychotherapy, treatment is not as effective as expected. Over recent years the pharmaceutical industry has not been able to offer a new approach, founded on multiple mechanisms of action. That is why a part of researchers focused on psychoactive substances synthesized years ago and then banned. These days MDMA-assisted psychotherapy for the treatment of PTSD clinical trials are conducted, and due to previous results, the Food and Drug Administration (FDA) granted a breakthrough therapy designation. In this article, we present the mechanism of actions, the therapeutic rationale, applied psychotherapeutic methods, and potential dangers. If ongoing phase 3 studies are completed and clinical efficacy criteria are achieved, the FDA could approve the treatment as early as 2022.

Long-term psychoeducation in limiting body mass gain in patients treated with atypical antipsychotics

OBJECTIVES

The aim of the study was to assess efficacy of psychoeducation in limiting body mass gain in patients with schizophrenia undergoing atypical antipsychotics monotherapy treatment.

METHODS

Education program Caring for Health and Silhouette, commissioned by Moneo Pharma Group, was implemented for patients with schizophrenia. The aim of the program was providing patients with information regarding lifestyle and nutrition.

RESULTS

The one-year follow-up was completed by 7,541 patients. The mean BMI (body mass index) gain in one-year follow-up was 0.56 and the difference between men (0.52) and women (0.60) was statistically significant (p < 0.001). The mean one-year body mass gain was 1.63 kg, whilst the mean one-year increase in waist circumference was 1.25 cm. There were no statistically significant differences between sexes. The subjective evaluation of patient compliance increased systematically with every visit, both for men and women. High-compliance patients less frequently experienced body mass gain (p < 0.001), while obese patients experienced the greatest decrease in BMI.

CONCLUSIONS

Education program resulted in a decrease of body mass gain in obese patients treated with atypical antipsychotics. Patients with BMI ≥30 more often than other patients experienced the reduction of body mass during education program. The quality of cooperation during the first and second visit has a predictive value for the estimation of body mass changes during education program. This method of education is easy to implement in clinical practice.

Cardiac syndrome X - the present knowledge

The aim of this work was to define the notion of cardiac syndrome X based on latest research, determine its connection with mental disturbances and present the current therapeutic directions. Cardiac syndrome X was distinguished in 1973 to describe a group of patients with coronary syndrome symptoms despite normalcoronary vessels in coronarography. Many years have passed since then, but the syndrome definition and the diagnostic criteria still arouse controversy. It is estimated that 10 to 20% of persons who undergo coronarography suffer from cardiac syndrome X, a vast majority of them being perimenopausal women. That patient population suffers from anxiety disorders, depressive symptoms and sleep disturbances much more frequently than does general population. Treatment includes a range of medicines with various mechanisms of action, but their effectiveness is limited; non-pharmacological actions are a significant part of the therapy. The patient group with cardiac syndrome X requires periodic follow-ups because prospective observation has shown that it is a risk group concerning development of atherosclerosis and acute coronary syndrome.

Analysis of High-Risk Sexual Behavior among Polish University Students

High-risk sexual behavior consists of activities and habits that put a person at increased risk of sexually transmitted infections (STIs) or unplanned pregnancy. Poland is currently experiencing a problem with increased STI rates, largely due to poor sexual education. Our exploratory study aims to evaluate the sexual behavior of students attending universities across Poland. The study covered 7678 students from 50 different faculties and universities across the country. The authors created an original questionnaire which consists of 31 questions which, among others, included demographic factors, sexual initiation, high-risk sexual behavior, STI's and religious beliefs. 78% of students have participated in sexual activity, among them 19% of students had 'casual sex' consisting of intercourse without the use of a condom, 27% had participated in sexual intercourse after the consumption of alcohol. Our study found that students who are influenced by religious belief tend to engage in sexual activity into their later years. The groups most exposed to the consequences of risky sexual behavior are mostly homosexual men, bisexual women, art students, and military students. Alcohol consumption is a strong factor contributing to risky sexual behavior. Sexual education in Poland should be improved.

EMOTIONAL PROBLEMS AND SLEEP DISTURBANCES IN PARAMEDICS IN THE ERA OF THE COVID-19 PANDEMIC

Infectious diseases have accompanied mankind for centuries, and the effects of their dramatic course are felt on many levels of everyday life. The COVID-19 pandemic caused by SARS-CoV-2 virus infection carries a tremendous psychological burden for both those infected and health care workers. Particularly vulnerable to psychological strain are paramedics who have direct contact with and caring for patients infected with coronavirus. From a review of the literature, it is known that Emergency Medical Team members, as a result of the stress experienced during a pandemic, manifest symptoms such as depression, anxiety, and sleep disturbances. In order to limit the adverse impact of the pandemic on the mental condition of this professional group, it is necessary to create appropriate conditions for solitary rest, relaxation and satisfaction of basic needs such as: food, sleep and protective clothing. An important role is also played by unrestricted access to psychological support in the broad sense of the word and often also to psychiatric care.

MODERN ENDOVASCULAR TREATMENT METHODS FOR ERECTILE DYSFUNCTION: A CRITICAL ANALYSIS

OBJECTIVE

75% of men with coronary artery disease confirmed by coronarography have erectile dysfunction in history, while 75% of patients with a vascular etiology of ED have significant stenoses in penile arterial vascularization. Patients with coronary artery disease have shown a relationship between the range of the lesions in the coronary vessels and erectile dysfunction intensity. This paper aims at attempting to systematize the knowledge of the benefits and drawbacks of nonsurgical endovascular treatment methods for erectile dysfunction with confirmed vascular causes. It analyzes seven studies which assess the results of erectile dysfunction treatment with percutaneous angioplasty. It also mentions the limitations of the cited works and formulates relevant conclusions.

CONCLUSION

Conclusions: The analysis shows that endovascular procedures in erection-related arteries are safe in a specially selected group of men. It is necessary to conduct further studies to define an appropriate group of patients who have a chance of benefiting optimally from the endovascular treatment of erectile dysfunction in a long-term follow-up.

SEXUAL DISORDERS AFTER HEART TRANSPLANT

OBJECTIVE

The aim: To systematize and bring the reader closer to knowledge about the occurrence of sexual disorders in people after heart transplantation based on available bibliography.

PATIENTS AND METHODS

Material and methods: A review of the literature on this topic from the last 30 years made with using the PubMed database, using a total of 17 articles.

CONCLUSION

Conclusions: The incidence of sexual dysfunction (SD) is higher in heart recipients than in the general population and erectile dysfunction is the most common. When the symptoms of dysfunction occur before the transplant - they do not improve, rather they get worse, which reduces the improvement in the quality of life of these patients compared to patients without sexual dysfunction. Improvement in quality of life is observed in patients with SD after heart transplantation, but not as pronounced as in subjects without sexual dysfunction. Some patients notice an increase in libido, with the genital response being insufficient or completely disappearing, which results in a decrease in the quality of relationships between partners and a deterioration in the quality of life. The cause of SD in heart recipients is unclear, but it is associated with the type of immunosuppression used, the level of sexual activity and the state of health of patients prior to transplantation. Nowadays patients after ortotrophic heart transplant live longer and their quality of life improves, but not in sexual terms. The articles concerned almost exclusively men, that is why the topic requires exploration in subsequent research.

Impact of dual diagnosis in patients with schizophrenia and affective disorders during hospital treatment on the course of illness and outcomes of treatment - a preliminary report

OBJECTIVES

Comparison of the course of illness and functioning as well as occurrence of somatic diseases between patients with dual diagnosis, alcohol or drug addiction without mental disorders and patients with schizophrenia or affective disorders; drawing attention to the problems of people with dual diagnosis and importance of longer psychiatric inpatient treatment of this group of patients.

METHODS

108 persons were examined during inpatient psychiatric treatment. Injuries, occurrence of somatic diseases, aggressive behaviors, suicidal attempts, and discharges from hospital on patients' request against medical advice were evaluated. Sociodemographic data and data associated with the course and treatment of an illness were compared between dual diagnosis group (n = 30), group of patients with mental illness (n = 41) and patients with alcohol or drug addiction (n = 37) using questionnaires designed by the authors.

RESULTS

In the dual diagnosis (DD) group, patients more often tried to commit suicide, started to use drugs or alcohol in younger age. In this group significantly more people were before marriage or after divorce. In the DD group and the group of patients with mental disorders (C), there were significantly more patients treated in hospitals longer than 180 days during their life. No statistically significant differences were found between groups when comparing incidence of somatic diseases, injuries, discharges from hospitals on patients' request or aggressive behaviors.

CONCLUSIONS

Due to non-compliance, frequent interruption of treatment, higher suicidal risk in the dual diagnosis group, there is a need of longer inpatient treatment in order to improve mental status, regular pharmacological treatment, provide social support, motivation, and prepare patients for psychotherapy of addiction. It is essential to take actions to create therapeutic standards of treatment and adjust financial funding for this group of patients in Poland.

[Insomnia in shift workers of a zinc smelter]

BACKGROUND

The aim of this study was to assess the prevalence of insomnia among the employees of a zinc smelter in Miasteczko Śląskie using the <i>Athens Insomnia Scale</i>.

MATERIAL AND METHODS

The examined group of plant employees and the control group were asked to fill in a questionnaire composed of the AIS and questions relating to the place and nature of their work, accidents over the last year, medications, diseases and conditions, sleep, naps and sleepiness during the day.

RESULTS

The result leading to a diagnosis of insomnia as indicated by the AIS was found in significantly more instances in the test group than in the control group (29.5% vs. 8.4%). While comparing the test subgroup, which was not employed in shift-work, with the control group did not result in a statistically significant difference, slightly more respondents from the day-work test subgroup obtained the result of ≥ 8 pts.

CONCLUSIONS

The prevalence of insomnia assessed by means of the AIS in the group of employees of a zinc smelter is significantly higher than in the control group. Based on the AIS, the highest percentage of individuals with insomnia occurred in the subgroup employed in shift-work. Med Pr. 2019;70(5):611-6.

[Socio-demographic indicators of alcohol dependence in patients treated for addiction in a post-industrial city]

BACKGROUND

The aim of the study was to evaluate the influence of the place of living on the prevalence of the alcohol dependence syndrome (ADS) and to find its possible connections with socio-demographic data within a post-industrial city with a population > 100 000 inhabitants.

MATERIAL AND METHODS

The study was carried out in 2004-2012 on a group of 431 patients living in Bytom with diagnosed ADS treated either in psychiatric wards or in outpatient psychiatric clinics. The patients' gender, age, employment, marital status, level of education and the fact of living in a given town district were analysed. The majority of the demographic data was obtained from the City Office.

RESULTS

The study demonstrated the influence of the place of living, age, gender, level of education and employment on the prevalence of ADS in a post-industrial city.

CONCLUSIONS

Alcohol addicts who seek treatment are predominantly men > 40 years of age, with low education, mostly unemployed, living in the urbanized districts within the city center or the post-industrial area of the city, which are the areas with the highest risk of ADS. Living in a suburban neighborhood may protect against alcohol addiction due to the lower risk of exposure to environmental factors contributing to the prevalence of ADS. Additional protective factors include at least secondary education and paid employment prospects. The neighborhood of people with ADS has a particularly devastating effect on women, who are more likely to become addicted in such environments. Med Pr. 2019;70(2):221-8.

Sense of coherence in selected allergic diseases

According to "holistic" model of physician's approach to the patient, physical, psychological and social aspects should be taken into account when we assess disease and effects of diagnostics and treatment. Those attributes form health related quality of life. Patient's disposition to disease depends on many psychological factors, among them sense of coherence (SOC). Sense of coherence is a health-promoting life orientation, perceiving the world as comprehensible, manageable and meaningful. The prevalence of allergic diseases is dramatically increasing. This epidemy strongly influences comfort of patient's life. In our paper we try to present the current knowledge on sense of coherence as a factor potentially influencing the course of allergic diseases.

Analysis of psychiatric consultations in a multidisciplinary hospital patients

AIM : The aim of the research is the analysis of psychiatric consultations conducted in the multi-disciplinary hospital, establishing the cause of the consultations according to ICD-10 and the analysis of psychiatric consultations regarding their number on particular wards.

METHODS

Retrospective analysis of medical documentation concerning given consultations in the multidisciplinary hospital in Tarnowskie Góry in the years 2002-2010 has been conducted. In the statistics studies Shapiro-Wilk test, Kruskal-Wallis test, Mann-Whitney U test, Chi-square test of independence and the others have been used.

RESULTS

In the analyzed years, 3,672 consultations have been done, the mean age of the consulted patients has been 46.9 years. Taking into consideration the sex of the consulted patients, 41.99% of them were female and 58.01% were male. The main diagnoses of all consultations present as follows: F00-F09: 18.82%, F10-F19: 29.58%, F20-F29: 17.70%, F30-F39: 10.29%, F40-F48: 13.83%, F50-F59: 0.16%, F60-F69: 3.21%, F70-F79: 1.77%, F80-F89: 0%, F90-F98: 1.01%, other: 3.62%. The consultations most often have taken place on the following wards: Hospital Admitting Department (13.21%), Hospital Emergency Service (6.97%), Surgery Department (8.42%), Internal Medicine Department (6.51%), Neurology Department (4.82%).

CONCLUSIONS

The most frequent causes of consultation were addictions, the next were organic and psychotic disorders, neurotic and affective disorders. Consultations most often have taken place at the Hospital Admitting Department/Hospital Emergency Service, Surgery Department, Internal Medicine Department and Neurology Department.

[The sense of coherence in women undergoing coronary arteriography]

AIM

The examination referred to two groups of female patients: with and without significant coronary stenoses in coronarography. There were two stages of the examination: before and 6-9 months after coronarography. The factor dividing patients into two groups: without significant atheromatosis and with coronary atheromatosis, was the result of invasive diagnostics of coronary heart disease.

METHODS

The sense of coherence scale (SOC-29) and sociodemographic questionnaires were used to evaluate the condition of the two groups.

RESULTS

In group of patients with irrelevant coronary stenoses statistically lower values of sense of comprehension were noticed in the first and the second examination and also sta- tistically lower values of sense of manage were observed, comparing to the group of patients with significant stenoses. The initial value of general coherence was comparable in both groups and did not significantly change in 6-9 months after coronarography. The characteristic parameters: lack of social support, intensity of depressiveness and anxiety before getting information about necessity of coronarography and worse education were connected with lower sense of coherence.

CONCLUSIONS

The baseline strength of the total sense of coherence was not different between groups. Patients with no significant stenosis of coronary arteries demonstrate a lower sense of comprehensibility before and after the coronary arteriography and lower sense of manageability after the procedure compared to the group of patients with significant atherosclerotic lesions. No social support, tendency for depression and anxiety and lower level of education were associated with lower sense of coherence in both groups.

[Hypochondria yesterday and today]

The publication aims to discuss hypochondriacal disorders. This paper presents the history of the concept of hypochondria from antiquity to modern times, also includes brief information regarding etiopathogenesis, etiology, classification and treatment of hypochondria with particular emphasis on psychotherapy. Our goal was to make the subject hypochondriacal disorders, as a disease entity often encountered in everyday medical practice.

[Gender identity disorders or andromimetic behaviour in a victim of incest--a case study]

Nowadays, it is becoming increasingly difficult to clearly classify the issues associated with the phenomenon of gender dysphoria due to the fact that one identifies oneself in the context of increasingly fluid categories of gender identity-- an intrinsic sense of being a woman or a man. The authors present a woman whose internal problems connected with her sexuality and incomplete identification with the role attributed to her gender originate from her family history. Long-lasting, traumatic experiences of incestuous abuse and violence on the part of close relatives disturbed her development in many areas of personality and functioning. The aim of the study was to verify the hypothesis of the existence of gender identity disorder accompanied by depressive disorders. In addition to the medical history, the study of patient's problems included the following diagnostic tools: the Minnesota Multiphasic Personality Inventory (MMPI) and the Rorschach Inkblot Test in a CSR Exner system (TPA). The study revealed that as for sexual identification, the patient unambiguously identifies herself as a woman. Her behaviour to become like a man does not deny her sex, or even involve a temporary need of belonging to the opposite sex. It should be interpreted in the broader context of her traumatic experiences, not just sexual, but also concerning different aspects of a female gender role.

[The association of quality of life with mental status and sociodemographic data in schizophrenic patients]

AIM

The aim of this study was to assess the mental status and sociodemographic data as well as their influence on the quality of life in schizophrenic patients.

METHODS

SF-36, Soc-29, CDS, PANSS, AIS and sociodemographic questionnaire were given to a cohort of 64 subjects who participated in this study (28 female, 36 male), with age range of 21-58 (Mean 33.4 +/- 10.8). Questionnaires were administered to all patients in partly-remission or remission time.

RESULTS

Patients showed significant positive correlation of summary scales of PCS and MCS with SOC and AIS and negative correlation with depression symptoms estimated by CDS. There were no significant differences in MCS and sociodemographic factors. The values of the PCS were negatively associated with the number of hospitalisations, disease duration time and negative syndromes estimated by PANSS-N.

CONCLUSIONS

Sense of coherence, acceptance of illness and depressive syndromes influence quality of life.