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Abstrakty Psychiatrii Polskiej 1997
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wydany: 1997-01-01


Kantorska-Janiec M. Kiejna A. Katedry i Kliniki Psychiatrii AM we Wroclawiu. [The development of epidemiologic research in psychiatry].Psychiatria Polska. 31(6):645-54, 1997. The article reviews the history of psychiatric epidemiology: five generations of American studies and future directions are described. There is also information on European studies and a brief history of classifications of mental disorders.


Piekarska A. Jakubik A. Wiejskiego Osrodka Zdrowia w Zadusznikach. [Prime-MD as a method for the diagnosis of mental disorders in primary healthcare].Psychiatria Polska. 31(6):655-65, 1997. A random sample of 150 people has been assessed. Prime-MD appears to be a useful tool for rapid diagnosing of mental disorders in primary care health and epidemiological research.


Miller K. Klopotowski T. Rosciszewska D. II Katedry i Kliniki Neurologii S1.AM w Zabrzu. [Suicide attempts in epileptic patients during the years 1990. -92. Analysis ofpatients in the Regional Poison Control Center in Sosnowiec].Psychiatria Polska. 31(6):667-75, 1997. During the years 1990. -92 in the Regional Poisons Control Center in Sosnowiec 42 epileptics (20 females and 22 males) were hospitalized because of suicide attempt. It amounted to 9% of all attempters, treated there in this period. The majority of patients were males of age range from 21 to 62 years. In 23 patients the suicide attempts were performed for the first time. the main reason for suicide was the family conflicted situation. Additionally, in 14 patients the poisoning attempts have been done during alcohol abuse. In the suicide attempts the antiepileptic drugs were most frequently used, mainly carbamazepine (23 cases).


Bomba J. Jaklewicz H. Kliniki Psychiatrii Dzieci i Mlodziezy Katedry Psychiatrii CM UJ. [Depression in children: prospective studies].Psychiatria Polska. 31(6):677-89, 1997. Prospective longitudinal observation of children socially and emotionally immature and depressive at entering school was carried on till their early adolescence. The study's aim was to describe: 1. childhood depression dynamics, 2. developmental changes in depression, 3. factors related to the depression course, 4. relation of childhood depression to adolescence depression. A screening study of representative population of school entering children led to identification of a risk group followed-up 3 and 6 years later. The Krakow Depression Inventory (AO "B1" and IO "B1") was used to diagnose, and for analysis of depression. Results of the study revealed a tendency to chronic course of depression in the studied group. Data collected at the first and the second stage showed coincidence of the depression chronicity and a set of nonspecific factors of "biological vulnerability" on the one hand, and dysfunctional family on the other. The latter was characterized by unclear family boundaries and difficult relational individuation. Data collected at the third stage of the study showed persistence of depression in the same individuals. Entering adolescence seemed to have no impact on depression prevalence in the studied group. It was, however, evident that cognitive and general activity disturbances increased among those studied who were not diagnosed depressive in the second and third stage. This finding requires further studies.


Kostecka M. Zardecka M. I Kliniki Psychiatrycznej AM w Warzawie. [The use of the restraint in Warsaw psychiatric hospitals before and afterthe introduction of the Mental Health Act].Psychiatria Polska. 31(6):691-701, 1997. The goal of the research was evaluation how, and to what degree the use of restraint in psychiatric hospitals was changed between 1989.  and 1996. Two month observations of the 11 psychiatric wards of Warsaw psychiatric hospitals were conducted. Researchers used special questionnaire to account for all of the cases of restraint. The first research of this sort was performed in 1989. , the second--in 1996. Each of the observed wards was described in terms of its conditions, equipment, personnel, the local customs and population of patients (T. Stanczak's questionnaire was used here); global level of pathology was described with the shortened version of Kellam's form. The most important difference between the characteristics of using restraint in 1996.  and 1989.  is the average time of remaining in restraint: it became distinctly shorter. The percentage of restraint grew after the act was issued but less patients were restrained. More often than in 1989.  aggressive behaviour was the reason for restraining patients. The research clearly states that the practice of restraint was evidently modified and the freedom of its use limited. The main causes are probably the introduction of the Mental Health Act and the changes in the observed wards.


Chlebowski M. Wojewodzkiego Szpitala Specjalistycznego dla Nerwowo i Psychicznie Chorych wCiborzu. [Forensic detention as a preventive measure on the basis of the analysis ofdocumentation of patients at the Ciborz Psychiatric Hospital during1958-1993. ].Psychiatria Polska. 31(6):703-11, 1997. The aim of this work was efficiency estimation of forensic detention, according to kinds of psychiatric disorders. The research included also the form and intensity of treatment. The study was made in Ciborz Mental Hospital and covered 262 internee patients during 35 years. The argument that efficiency in the psychotic group was higher was not confirmed. The correlation between complexity and efficiency was not found. The dependence between non-biological treatment and efficiency of detention was confirmed.


Tomaszewicz-Libudzic C. Jagielska G. Komender J. Bober-Olesinska K. Retka W. Kliniki Psychiatrii Wieku Rozwojowego AM w Warszawie. [Life threatening metabolic and pathophysiological complication in anorexianervosa patients].Psychiatria Polska. 31(6):713-21, 1997. Medical records of 210 adolescents hospitalised because of anorexia nervosa (1978-1995. ) were analysed. 8 patients have demonstrated life threatening metabolic and pathophysiologic complications. These complications were seen in cachectic patients or when their body mass index decreased in a very short time. They were parenterally fed. When physical state permitted, family and individual psychotherapy was introduced.


Rabe-Jablonska J. Dunajska A. II Kliniki Psychiatrycznej Katedry Psychiatrii AM w Lodzi. [Opinions regarding the importance of body image disorders in the developmentand in the course of eating disorders].[59]Psychiatria Polska. 31(6):723-38, 1997. The article presents a review of most important research results as well as opinions about the role and importance of body image disturbances in the development and the course of eating disorders. It also contains a review of definitions of body image, and techniques used in the evaluation of this type of disorders. [59]


Kokoszka A. Golec S. Curylo A. II Kliniki Psychiatrii AM w Warszawie. [Psychotherapy and pharmacotherapy: alternative or complimentary methods oftreatment?].[15]Psychiatria Polska. 31(6):739-44, 1997. Controversial arguments of proponents and opponents of combining psychotherapy and pharmacotherapy are discussed. The authors argue that in some circumstances the combined treatment is optimal. However, its application requires high skills and knowledge of the therapists. [15]


Malyszczak K. Kiejna A. Katedry i Kliniki Psychiatrii AM we Wroclawiu. [The influence of alprazolam on the symptoms of anxiety and depression].Psychiatria Polska. 31(6):745-52, 1997. The work describes the analysis of influence of alprazolam on anxiety psychic and somatic symptoms. Subscales were distinguished using the factorial analysis method.


Kiejna A. Kantorska-Janiec M. Malyszczak K. Katedry i Kliniki Psychiatrii AM we Wroclawiu. [The use of chlorazepate dipotassium (Tranxene) in the states of restlessnessand agitation].Psychiatria Polska. 31(6):753-60, 1997. Clorazepate dipotassium (Tranxene), benzodiazepine of retarded anxiety-relieving, sedative and sleep-inducing action was used in an open sample of 36 patients for fast control of anxiety and aggression in the course of schizophrenia, schizoaffective psychosis and other psychotic disorders. The intensity of aggressive behaviors was assessed as 6-7 items on the CGI scale. After intramuscular injection of clorazepate complementing the so-called basic treatment in the mean daily dose of 150 mg, several hours lasting sedative effect was achieved. No unfavourable interactions between the applied clorazepate (Tranxene) and the other medicines applied simultaneously (mostly neuroleptics and antidepressant drugs) were observed. Clorazepate (Tranxene) is an effective and safe drug giving fast and long-lasting sedation of the patients with low risk of interaction with other drugs or of side-effects.


Pisula E. Katedra Psychologii Wyzszej Szkoly Pedagogiki Specjalnej w Warszawie. [Early detection of autism in children. Review of literature].[26]Psychiatria Polska. 31(4):389-96, 1997. The difficulties with early detection of autistic disorder in children are discussed. DSM-IV diagnostic criteria are presented. Usefulness of clinical interview and clinical experiment in diagnosing autistic disorder are analyzed. [26]


Scheffel A. Oddzial Gerontopsychiatrii Rheinische Landesklinik Bedburg-Hau, Niemcy. [Aggression in elderly persons with psychiatric disorders].[23]Psychiatria Polska. 31(1):111-20, 1997. In recent years aggression among elderly patients with psychiatric disorders has become an area of scientific research. A review of 19 reports, mostly from the USA, shows that a great part of these people demonstrate aggression of varied intensity. It is often a very serious problem for family members and a reason for psychiatric admissions. The aggression-index in this population varies depending on the place of living from 14% in the community, 12%-48% in adult homes to more than 60% in psychiatric hospitals. Nearly half of demented patients show aggressive behaviour in different situations, often of extreme intensity. Some reports suggest aggression to be more common among men, but perhaps only in association with dementia. [23]


Rossa G. Wojewodzki Szpital Specjalistyczny o dla Nerwowo i Psychicznie Chorych wCiborzu. [The prevalence of Alzheimer's type dementia and vascular dementia in thedistrict of Swiebodzin].Psychiatria Polska. 31(1):121-34, 1997. In the study the prevalence of Alzheimer's type dementia and vascular dementia in the town of Swiebodzin and its surroundings was assessed. Also, the frequency of risk factors of vascular diseases for both types of dementia was evaluated. The study group comprised 7417 persons (45 years old and above). This population was divided into two groups. The younger subgroup (45-64 y) and the older one (65 y and above). The results obtained for indices of prevalence of both main types of dementia are comparable with the results that can be found in literature. The prevalence of Alzheimer's type dementia, in this study, is greater in women, while in men higher indices are referred to vascular dementia. The risk factors of cerebrovascular diseases are more frequent in the group of men. It could explain higher risk of vascular dementia in this group.


Sterna W. Psychiatryczno-Wielospecjalistyczny ZZOZ w Gorzowie Wlkp. [A case of total pseudoamnesia].Psychiatria Polska. 31(1):135-8, 1997. In our article we present a case of a 44-year old man, who was admitted to Psychiatry Ward with suspicion of total amnesy after trauma of head. In time of hospitalisation patient was showing symptoms of total loss of memory, loss of identity without losing general knowledge. During hospitalisation it appeared that due to the same problem (trauma of head) the patients was hospitalized twice in time of one month in Surgical Word with diagnosis of subarachnoid haemorrhage, which was not found in the second hospitalization. The patient spontaneously, in time of a few days, recalled all dates. On the basis of clinical picture and laboratory findings we diagnosed this case as: "Simulation of mental disorders. Status after trauma of head". This case is a very good example of using medical care for one's own purpose not connected with treatment.


Jarema M. Choma M. Poniatowska R. Krawczyk R. Kozlowski P. Zaklad Neuroradiologii IPiN w Warszawie. [Improvement criteria after neuroleptic treatment and clinical andneuroradiological factors in schizophrenic psychoses. Preliminary studies].Psychiatria Polska. 31(1):21-32, 1997. In 40 schizophrenic patients, various criteria of clinical improvement after neuroleptic treatment were compared in order to establish correlations between improvement after treatment and some clinical and MRI parameters. Three ways of evaluation of clinical improvement (CGI scale, PANSS index, percentage of improvement) correlated strongly with one another. Only the distribution of numbers of patients with different clinical improvement evaluated by the use of PANSS index was not statistically significant. Clinical improvement, evaluated with all three methods, significantly correlated with basal PANSS score as well as with the severity of positive symptoms and affective blunting, but not with the severity of schizophrenia negative symptoms. Only clinical improvement with the use of CGI demonstrated significantly better improvement in patients who had good previous response to neuroleptics. This particular method of clinical improvement evaluation, in contrast to other two methods, failed to reveal better response to neuroleptics among patients with no cortical atrophy found in MRI. Among patients with different improvement after treatment, evaluated with the use of all three methods, selected MRI parameters did not show significant differences with the exception of CGI improvement which correlated positively with the intensity of signal in T2-weighted image of gray matter in left medial frontal gyrus.


Jarema M. Choma M. Krawczyk R. Poniatowska E. Kozlowski P. III Klinika Psychiatryczna IPiN, Warszawa. [Selected parameters of magnetic resonance imaging of the brain, clinicalpicture and recovery after treatment in schizophrenia. Preliminary report].Psychiatria Polska. 31(1):33-46, 1997. In forty schizophrenic (or schizophreniform disorder) patients diagnosed according to DSM-IV, the magnetic resonance imaging was performed. The T2 relaxation time was measured in selected brain regions from the dorsolateral prefrontal cortex as well as in amygdala. These results were compared with clinical parameters regarding severity of psychopathology and improvement after neuroleptic treatment. The mean T2 values of grey matter of right inferior frontal gyrus were significantly higher in patients with schizophreniform disorders (those patients were clinically diagnosed as suffering from cycloid psychoses) than in other types of schizophrenia. The T2 values of this region correlated inversely with the severity of negative symptoms before treatment. The T2 values of gray matter of left inferior frontal gyrus correlated positively with the severity of schizophrenic symptoms before treatment. Mean T2 values of left amygdala were significantly higher in patients showing less favorable improvement after neuroleptic treatment in comparison to those who improved better. No correlation was found between the presence of brain atrophy and T2 values in brain regions studied. The results allow to suggest that the measurement of T2 relaxation time might reveal interesting relations between clinical picture and neuroradiologic findings in schizophrenia, however clinical significance of such parameters still requires further elaboration.


Olajossy M. Katedra i Klinika Psychiatrii AM w Lublinie. [Electroconvulsive therapy in schizophrenia].[32]Psychiatria Polska. 31(1):47-54, 1997. The author presents the actual state of knowledge about the mechanism of action of ECT with schizophrenia. An analysis of literature indicates that controversy about the role of ECT in the treatment of schizophrenia doesn't stop. [32]


Rostworowska M. Opoczynska M. Cwiklinski Z. [The diagnostic and therapeutic process in patients with a first episode ofpsychotic disorder at the inpatients department].[25]Psychiatria Polska. 31(1):5-20, 1997. The paper presents the tradition of work on our inpatient ward, the specific character of diagnosis and treatment and their goals in relation to the first psychotic episode. Finally, some controversial issues concerning this subject are discussed. [25]


Szafranski T. Jarema M. Bialek J. Buksowicz M. Marciniak E. Choma ME. Ruzikowska A. Milej M. III Klinika Psychiatrii IPiN w Warszawie. [Therapeutic effect of zuclopenthixol acetate on positive and negativesymptoms in schizophrenia].Psychiatria Polska. 31(1):55-69, 1997. Fifty schizophrenic in-patients (DSM-IV) were treated in an open study with zuclopenthixol acetate. Mental status, improvement and side-effects were measured before administration of the drug as well as after the 1st, 2nd and 3rd injection. Positive and negative symptoms were evaluated with the use of PANSS. 60% of patients received three injections. Usually the intervals between injections lasted 48 hours. The improvement after the 3rd injection of zuclopenthixol acetate was found in 80% of patients. All positive symptoms improved after the treatment (p < 0.001), among them excitement (54% reduction vs. baseline), hostility (49%) suspiciousness/persecution (45%). The study revealed that parallel to the decrease of positive symptoms, the severity of negative symptoms also decreased, in particular: difficulty in thinking (28%) and stereotyped thinking (27%) (p < 0.001). Passive/apathetic social withdrawal and lack of spontaneity as well as flow of conversation only slightly improved (p < 0.05). 50% of patients experienced side-effects--usually extrapyramidal reactions.


Wciorka J. Anczewska M. Charazinski M. Golebiewska M. Nurowska K. Skowronska J. Stanikowska I. I Klinika Psychiatryczna IPiN w Warszawie. [The evaluation of reliability and validity of a preliminary version of theClinical Assessment of Schizophrenic Syndrome (CASS)].Psychiatria Polska. 31(1):71-86, 1997. Basic indices of reliability and validity of a preliminary version of the new tool for "Clinical Assessment of Schizophrenic Syndrome" (CASS) was evaluated. Six experienced psychiatrists working in two teams examined the mental state of 49 patients with clinical diagnosis of schizophrenia, in the majority of them confirmed by the criteria of DSM-IV and ICD-10 (one of the teams examined 25 patients, the other-24). Each diagnostician rated the patients' mental state independently, by means of three-level rating permitted by the CASS-CASS-G (global), CASS-D (dimensions), and CASS-S (symptoms)--as well as by means of BPRS and PANSS scale included in the study as international standard scales for validity testing. Statistical analysis of the results confirmed that the scales under study allow to obtain results which could be characterized, with few minor exceptions, by high concordance coefficients (Kendall's W) high internal consistence coefficients (Cronbach's alpha) and high correlations (as measured both by Pearson's and Kendall's rank correlation coefficients taub) with internationally appreciated standard scales. It suggests reliability and validity of the CASS to the degree which could be considered as encouraging to continue the study on this instrument.


Jarema M. Szafranski T. Waszkiewicz-Bialek E. Marciniak A. Roslaniec D. III Klinika Psychiatryczna IPiN w Warszawie. [The evaluation of well-being of schizophrenic or depressed patients withBradley's questionnaire: a pilot study].Psychiatria Polska. 31(1):87-96, 1997. Well-being of 65 in-patients with the diagnosis of schizophrenia or major depression was evaluated with the use of Bradley's well-being questionnaire. The severity of psychopathology as well as clinical improvement after pharmacotherapy were evaluated by doctors using CGI scale. Patients with the diagnosis of depression estimated their well-being lower in comparison to schizophrenics. The groups did not differ in the subscales of depression and energy. Female patients revealed more anxiety than male ones, regardless diagnosis. Physicians' evaluation of disease severity did not correlate with patients' well-being judgement using Bradley's questionnaire. After pharmacotherapy correlation between clinical improvement and several questions from Bradley's questionnaire was found.


Lamot G. Grzywa A. Katedra i Klinika Psychiatrii AM w Lublinie. [Insight and psychotic illness].[30]Psychiatria Polska. 31(1):97-110, 1997. This paper reviews the literature concerning the meaning of insight in clinical psychiatry. A number of studies indicate that insight is a complex and multidimensional phenomenon, consisting of at least several partly independent components (awareness of psychotic illness, the ability to recognize psychotic symptoms as pathological, the acceptance of treatment). It is suggested that good insight plays an important role in the course and treatment of psychotic disorders, and of schizophrenia in particular. [30]


Heitzman J. Rutkowski K. Zaklad Patologii Spolecznej Katedry Psychiatrii Collegium Medicum UJ. [Mental disturbances in persons persecuted for political reasons in Poland inthe years 1944-1955].Psychiatria Polska. 31(2):153-64, 1997. The paper presents the results of studies on the present state of mental health in persons persecuted for political reasons in Poland in the years 1944-1955. Symptoms of mental disturbances were detected in nearly all examined group. PTSD criteria were applied in the diagnosis.


Sidorowicz S. Klinika Psychiatryczna AM we Wroclawiu. [Psychopathology of violent behavior in mental disorders].Psychiatria Polska. 31(2):165-75, 1997. The frequency of violent behaviour in mental hospitals has been increasing in recent years. A number of factors may be responsible. Violent and dangerous patients are sent to hospitals, quite often against their will. This may lead to conflicts and assaults against the staff members. There are many factors, both in present situation and in biography, conductive to violent behaviour: unfavourable experiences in childhood (neglect, cruelty, sexual exploitation), psychopathic structure of premorbid personality, frustrations, and eventually deformations of world perception caused by psychotic symptoms. Various mental disorders may lead to the violent behaviour, but it is most frequently observed in exacerbation of paranoid schizophrenia, in young males, particularly in cases with systemized delusions, emotional turmoil and anger. Introduction of a person (nurse, physician, family member, other patient) into psychotic world may also lead to the attack. In particular cases it is difficult to foresee violent behaviour, but some indicators are known. There are very few investigations on the role of the staff in violent behaviour of patients. The danger may be brought by criticism, refusal and rejection, compulsory drug administration, undue limitations of the patient's liberty, or the opposite--no reaction to violations of institutional regulations. Psychopathology of the staff may also encourage the violent behaviour: inability to solve the transference and countertransference, reaction formation and denial are the most important. Fear exaggerates the feeling of danger and induces the staff members to avoid the patient, diminishing the possibility of influence and control of the patient's disturbed behaviour. Recurrent violent behaviour may be connected with brain pathology, so the modern diagnostic procedures may be indicated in such cases.


Sterna W. Psychiatryczno-Wielospecjalistyczny ZZOZ w Gorzowie Wielkopolskim. [Treatment by judicial obligation of alcohol dependent persons].Psychiatria Polska. 31(2):177-82, 1997. Treatment without consent of alcohol dependent persons has persisted for years in Poland. Only judicature determines obligation to treatment, which can be realized in ambulatory treatment or psychiatric ward. There are positive and negative aspects of such treatment. This article shows most of them, proposing a discussion of this problem again.


Lukaszewicz A. Markowski T. Pawlak D. Klinika Chorob Psychicznych AM w Bialymstoku. [The comparison of concentration of endogenous ethanol blood serum inalcoholics and in non-alcoholics at different stages of abstinence].Psychiatria Polska. 31(2):183-7, 1997. In this report the concentration of endogenous ethanol in blood serum in alcoholics at different stages of abstinence and in non-alcoholics was studied. 36 people--26 alcoholics and 10 non-alcoholics were examined and gas chromatography was used. It was revealed that the longer the period of abstinence in alcoholics, the lower the concentration of endogenous ethanol in blood serum. Moreover, the alcoholics showed a higher concentration of endogenous ethanol in blood serum as compared to non-alcoholics.


Wolanczyk T. Wojnar M. Cedro A. Klinika Psychiatrii Wieku Rozwojowego AM w Warszawie. [Carbamazepine in the treatment of alcohol withdrawal].[43]Psychiatria Polska. 31(2):189-96, 1997. The authors present a review of literature on the initial rationale and efficacy in clinical trials of carbamazepine (CBZ) in the treatment of alcohol withdrawal, and the pharmacokinetics of carbamazepine in alcoholics as well. Neurophysiological and clinical studies support the kindling hypothesis in the pathophysiology of alcohol withdrawal. The exact physiological action mechanism of CBZ has not been entirely examined. However, the "antikindling effects" are of particular importance in epilepsy and other neurological and psychiatric conditions. Numerous controlled studies were able to demonstrate the effectiveness of carbamazepine in the treatment of alcohol withdrawal symptoms and have compared its properties to other drugs such as clomethiazole and benzodiazepines. Carbamazepine could be a useful alternative to conventional therapeutic approaches, especially in the treatment of mild and moderate alcohol withdrawal symptoms, and alcohol withdrawal with generalized tonic-clonic seizures. [43]


Nasierowski T. Matsumoto H. I Klinika Psychiatryczna AM w Warszawie. [HIV follow-up. New data on pathophysiology and treatment of psychiatricdisturbances in the course of AIDS].Psychiatria Polska. 31(2):197-209, 1997. In the article summarized here, the authors present the most important achievements in the research on pathogenesis and treatment of AIDS, with particular consideration of psychiatric disturbances occurring in the course of infection by AIDS. Since the 1 st of January 1993. , a new definition of AIDS has been obligatory. This definition is based on immunological criteria (HIV seropositivity and number of limphocytes CD4 < 200/microliter). There is a considerable progress in the scope of laboratory diagnostics of the infection by HIV (a method of polimerase chain reaction has been introduced) and in the laboratory and clinical appraisal of the development of AIDS. An astonishing capability of HIV to mutation has been proved. Asymptomatic HIV carriers show about 10(6) genetically different variants of HIV, and subjects showing symptoms of AIDS may prove over 10(8) HIV variants. This extreme dynamics of HIV causes that even the subjects who are not pharmacologically treated (but who are HIV seropositive) indicate the formation of mutants resistant to medicines applied in the treatment of AIDS. The only one and relatively efficient means of treatment of AIDS is combined therapy applied from the first weeks of the infection by HIV. Professor Luc Montanier, a co-discoverer of HIV virus suggests that the most efficient therapy is that by a medicine known as 3TC, in combination with DDI or DDC and with one of the drugs named anti-proteases. This method of treatment inhibits the activity of virus protease--one of 3 enzymes indispensable for replication of HIV. Recently (at the turn of the years 1995. /1996. ) three medicines from the anti-protease group: saquinavir, ritonavir and indinavir have been admitted to be used for treatment of AIDS by the American agency for the control of drugs and foods. FDA, in the exceptionally short time. In the article there is also a description of a concept represented by R. Price, concerning the origin of psychiatric disturbances in the course of AIDS, as well as some results of recent clinical studies on psychiatric disturbances in the course of AIDS.


Nasierowski T. Kaminska-Kopicz E. I Klinika Psychiatryczna AM w Warszawie. [Psychiatric disorders and sensory deprivation in AIDS. Case report].Psychiatria Polska. 31(2):211-4, 1997. In AIDS there are several opportunistic infections that may occur. Some of them can lead to blindness (for example toxoplasmosis, CMV). It is known that psychiatric disorders can also occur in AIDS. Both situations can take place at the same time. In that case we face the diagnostic problem: Are psychiatric disorders a result of the sensoric deprivation connected with sudden blindness or organic changes in the brain caused by HIV? In our article we described the case of a 37 years old woman who had that kind of symptoms.


Nasierowski T. Piotrowski T. I Klinika Psychiatryczna AM w Warszawie. [Mental disorders in the course of scleroderma: case reports].Psychiatria Polska. 31(2):215-21, 1997. In our paper current knowledge about mental disorders in the course of autoimmunologic diseases is presented. Two such cases (catatonic syndrome and major depressive episode) are described.


Hermanowska-Szpakowicz T. Pancewicz S. Szulc A. Poplawska R. Klinika Chorob Pasozytniczych i Neuroinfekcji AM w Bialymstoku. [Mental disorders in patients after tick-borne encephalitis (TBE)].Psychiatria Polska. 31(2):223-30, 1997. There were 58 patients (aged 17 to 72) analyzed in our study: 34 women and 24 men one year after TBE. Psychic state was estimated with the use of psycho-pathologic scales CPRS, Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale, Mini Mental State and our own questionnaire. It was assumed that 22 patients required psychiatric treatment because of dementia, personality change, depressive disorder and anxiety disorder. It seems that so many syndromes stated in this group of patients were caused by TBE reaction increase of intellectual-mnestic functions as well as social and professional status.


Garlicki A. Dereszak-Kozanecka E. Pietruszewski K. Krukowiecki J. Katedra i Klinika Chorob Zakaznych Collegium Medicum UJ. [Diagnostic difficulties in encephalitis: two case reports].Psychiatria Polska. 31(2):231-5, 1997. The differential diagnosis of psychiatric symptoms in encephalitis, especially in the early phase of the disease may be very difficult. It is particularly hard to distinguish it from the classic psychosis. The diagnostic problems have been presented on the basis of analysis of two case reports of the acute encephalitis in young persons. The presence of fever and pathological changes in the CSF were the most important indicators that helped to establish the diagnosis of encephalitis during the phase of acute psychopathological disorders.


Bembenek A. Schaeffer E. Wciorka J. I Klinika Psychiatryczna IPiN w Warszawie. [Assessment and self-assessment of patients' attitudes toward their psychoticdisorders].Psychiatria Polska. 31(3):249-55, 1997. The aim of the study was the evaluation of concordance between rating and self-rating of attitudes toward psychotic disorders in one hundred patients (72 of them with diagnosis of schizophrenia). At discharge from the hospital patients were examined by two scales: Experience of Illness Scale (for rating) and My Experience of Illness Scale (for self-rating). Moderate concordance of results of rating and self-rating of the overall patients' attitude was noted. The higher concordance was found on dimension of evaluation of the illness experience, lower on dimension of reflectiveness to disease experience, and the lowest one on dimension of identification of the disease with self. Two different scales, simultaneously used, seem very beneficial because they reflected attitudes from two different perspectives, creating more complete a picture.


Mroziak B. Czabala J. Wojtowicz S. Zaklad Psychologii Klinicznej IPiN w Warszawie. [A sense of coherence and mental disorders].Psychiatria Polska. 31(3):257-68, 1997. Sense of coherence, a health-promoting life orientation, i.e. perceiving the world as comprehensible, manageable and meaningful, was compared in three groups: of healthy controls (37 males and 45 females), neurotic patients (31 males and 54 females), and hospitalized patients with depressive syndrome defined according to DSM-IV criteria (13 females). Two self-report questionnaires were used in the study: Antonovsky's SOC-29 scale measuring the sense of coherence, and SCL-90-R by Derogatis, measuring psychopathological symptoms intensity. As hypothesized, psychopathology level in the groups under study was significantly differentiated, being most marked in patients with depression. Sense of coherence and all its constituents turned out to be significantly lower in both clinical groups as compared to controls; the lowest SOC level was noted in depressive patients. Moreover, in the latter group, in contradistinction to the other two, significant correlations between sense of coherence (SOC) and general self-rated health (positive correlations), and between SOC and symptoms intensity (negative correlations) have disappeared. Due to the small size of the depressive group it was possible only to suggest a hypothesis explaining the findings, namely, that the SOC protective function disappears in persons situated far away from the "health" pole of the health-disease continuum.


Spila B. Grzywa A. Karakula H. Kosinska U. Makara M. Katedra i Klinika Psychiatrii AM w Lublinie. [The comparison of self-concept and self-acceptance in patients with paranoidschizophrenia and neurotic disorder].Psychiatria Polska. 31(3):269-83, 1997. Self-acceptance as a correlation between real and ideal self-concept distinguishes neurotic patients from paranoid schizophrenic patients. This fact may support the hypothesis that these groups of patients are characteristic of different personality traits.


Motak E. II Klinika Chorob Psychicznych AM w Gdansku. [The determination of social skills in schizophrenia].[28]Psychiatria Polska. 31(3):285-93, 1997. The author describes a review of research concerning connection between the social skills in schizophrenia and each of the above factors. The problem of the influence of various factors upon the social skills in schizophrenia seems to be very important as far as therapeutic possibilities are concerned. Social skills are a "tool", used in all sorts of contact with other people. They are used both to achieve specific goals, and to satisfy various emotional and social needs. Schizophrenic patients have significantly worse level of social skills than non-schizophrenic patients and healthy people. Deficits in social skills are present in all their aspects: in the topographical features, in the problem solving skills, etc. According to the model of social skills developed in The Clinical Research Center for Schizophrenia and Psychiatric Rehabilitation those skills consist of social schemata, interpersonal problem solving skills, social competence and self-efficacy. Social skills are determined by the cognitive processes, family environment and factors specific to schizophrenia, like premorbid functioning and psychopathological symptoms. [28]


Motak E. II Klinika Chorob Psychicznych AM w Gdansku. [The features of family environment and social skills in schizophrenia]. [26]Psychiatria Polska. 31(3):295-303, 1997. The influence of environmental factors upon the social skills in schizophrenia is beyond doubt. The family environment of schizophrenic patients has been extensively described. Some research revealed those features of emotional context of the family, which influence the exacerbation of schizophrenia. Those features are called the Expressed Emotion Index (EE). The Expressed Emotion Index has great prognostic value and it seems interesting to examine the influence of the family environment as described by EE, upon the social skills. This paper contains both a characterization of the family environment described by various aspects of EE and an analysis of its influence on the social skills. Possible connections of EE with premorbid functioning of schizophrenic patients, and with psychopathological symptoms, as well as cognitive processes are also described. In the analysis of interrelation of EE and the social skills it is very important to consider both qualitative and quantitative aspects of Expressed Emotion Index. Various aspects of the family environment seem to be connected with specific cognitive dysfunctions and various psychopathological symptoms. In a similar way, various social skills seem to be determined by different internal and external factors. [26]


Sawicka M. Kolaczek A. Bednarek A. Meder J. Zaklad Rehabilitacji Psychiatrycznej IPiN w Warszawie. [Teaching schizophrenic patients self-care skills].Psychiatria Polska. 31(3):305-12, 1997. The level of knowledge and skills on self-care abilities has been examined among the group of 30 long-term patients suffering from schizophrenia. The research has been made four times during the period of 18 months after the training session had been completed. The final results show that three months duration of the training session exerts influence on the progress in learning and change of the view point. However, little change is observed as regards the daily functioning of patients.


Glowczak M. Kasperek B. Meder J. Spiridonow K. I Klinika Psychiatryczna AM w Warszawie. [The preliminary evaluation of quality of life in patients with chronicschizophrenia].Psychiatria Polska. 31(3):313-21, 1997. The aim of our work was to check out the usefulness of the questionnaire "Quality of Life". Thirty patients from day hospitals in Warsaw took part in the research. 3/4 of the patients had indifferent attitude towards their clothes, environment, health and their lives generally. Everyday functioning is of some difficulty for the patients, and their families help them in everyday duties. Most of the patients can rely on their families in solving their problems. The higher was the patients' subjective level of functioning, the better was their quality of life. Estimation of everyday functioning made by patients themselves depends on the intensity of psychopathological symptoms. There is not such dependence concerning the patients' quality of life. Convergence between our data and data collected from the literature suggests usefulness of the questionnaire in the research on the quality of life of patients with mental illness.


Konieczynska Z. Jarema M. Cikowska G. III Klinika Psychiatryczna IPiN w Warszawie. [Evaluation of health-related quality of life in hospitalizedschizophrenics].Psychiatria Polska. 31(3):323-31, 1997. Health related quality of life was evaluated in 40 schizophrenics from day hospital at admission, during the treatment and after 8 weeks. In contrast to the psychopathology which significantly decreased after 4 weeks already, the improvement of quality of life was found to be significant only at the discharge from day hospital. The quality of life did not correlate with the severity of schizophrenic symptoms. The older and more frequently hospitalized patients were, the less favorably they evaluated the quality of life. Patients professionally disabled were also less pleased with their quality of life. All quality of life domains improved after treatment with the exception of physical functioning and reported health transition. Physical functioning, role-physical, general health and mental health correlated inversely with severity of schizophrenia after treatment. There was no correlation between clinical improvement after treatment and quality of life domains. The higher was the patients' educational level the better they evaluated their vitality, social functioning and reported health transition.


Jarema A. Klinika Radioterapii PAM w Szczecinie. [Evaluation of quality of life in patients with cancer].Psychiatria Polska. 31(3):333-43, 1997. Subjective evaluation of health related quality of life was studied in 53 cancer patients. The Polish version of quality of life questionnaire SF-36 was distributed among the patients before radiotherapy and repeated after one year. Significantly higher quality of life was found in the control measurement after one year in comparison to the evaluation before radiotherapy started. The quality of life estimated by the patients was not correlated with physician's evaluation of patients made with the use of the Zubrod scale. Patients in more advanced disability due to the cancer (Zubrod scale) evaluated their social activity better than did subjects less severely disabled and bed-bound. Patients' sex as well as the localization of the cancer did not influence their opinion regarding their quality of life. The severity of pain and discomfort the patients experienced before radiotherapy correlated with the evaluation of quality of life. The severity of pain and discomfort the patients experienced before radiotherapy correlated with the evaluation of quality of life. After one year the intensity of pain and discomfort correlated only with the patients' general health evaluation and with physical fitness but not with their social and daily activity.


Hunca-Bednarska A. Katedra i Klinika Psychiatrii AM w Lublinie. [Associative meaning of emotionally neutral words in a group of healthy andschizophrenic patients: a comparative study].Psychiatria Polska. 31(3):345-55, 1997. Distributions of associational responses--to four emotionally neutral stimulus words--obtained from schizophrenic people and sane ones were compared. Significant differences in some content categories were discovered.


Biela J. Sklepinska E. Oddzial Obserwacji Sadowo-Psychiatrycznej Szpitala ZK nr 2 w Lodzi. [Paradoxical reaction in a 18-year-old defendant with a diagnosis of immaturepersonality with schizoid features: a case report].Psychiatria Polska. 31(3):357-61, 1997. We introduce a case of an 18 years old man suspected of murder attempt of his colleague. We made a diagnosis of immature personality with schizoid features; we also want to remind Edward Brzezicki's thoughts on paragnomen.


Bomba J. Kliniki Psychiatrii Dzieci i Mlodziezy Katedry Psychiatrii CM UJ. [Designing a mental health system for children and adolescents].Psychiatria Polska. 31(4):379-87, 1997. Mental Health Act indicates childhood and adolescence as the periods of life requiring a special prophylactic, therapeutic and rehabilitative care. Planning future organization of mental health care for children and adolescents can be based on patterns developed in countries of longer tradition, as well as on suggestions of international bodies interested in improving health care. Desirable status, however, will remain at the project stage if the reality is not taken into account. Assessment of the particular community can be done with epidemiological studies which require highly trained professionals and are costly. Thus, epidemiological data can be used rather for modification of well developed care systems. Early start of training in mental health problems of children, adolescents and their families in undergraduate training of physicians seems to be very important, taking into account that development of specialized services requires support and cooperation of other doctors, e.g. general practitioners, and forms a background for postgraduate training in child and adolescent psychiatry. Professional, or rather multiprofessional associations of child and adolescent mental health care givers aiming at improvement of care system have a very important role in lobbying for changes essential for realization of any design.


Rabe-Jablonska J. II Klinika Psychiatryczna Katedry Psychiatrii AM w Lodzi. [Body image disturbance in anorexia nervosa].Psychiatria Polska. 31(4):397-408, 1997. 30 girls aged 13-19, who met DSM-IV criteria for anorexia nervosa, and control group were investigated by using: 1. semistructured interview with subjects and their mothers about the pubertal status, history of marked overweight and the teasing about weight, the discrepancy between actual and ideal body weight, 2. a specially prepared questionnaire aimed to establish onset of body image disturbances, and the connection with above-mentioned symptoms and life events and lowered self-esteem, 3. Hamilton Anxiety Scale and 4. subscale from the Eating Disorders Inventory--Body Dissatisfaction Scale. Body image disturbances were characterized for anorectic persons with low global self-esteem and high level of anxiety, and developed during the change of the peer group or a change of the patient's position within the peer group.


Malkiewicz-Borkowska M. Zechowski C. Klinika Psychiatrii Dzieci i Mlodziezy IPiN w Warszawie. [Anorexia nervosa in a young man: a case report].Psychiatria Polska. 31(4):409-16, 1997. The paper describes a case of a young man with anorexia nervosa. We try to explain our difficulties in diagnosis and treatment of this patient. Most of them were connected with comorbidity of anorexia nervosa (depression, anxiety and obsessive-compulsive behaviour).


Brynska A. Klinika Psychiatrii Wieku Rozwojowego AM w Warszawie. [Obsessive-compulsive disorder in children and adolescents: literaturereview. Part I].[53]Psychiatria Polska. 31(4):417-28, 1997. The literature on obsessive-compulsive disorder (OCD) in children and adolescents is reviewed. The disorder is characterized by obsessions (recurrent troublesome thoughts) and compulsions (ritualized thoughts or behaviors performed repetitively in response to an irresistible urge). OCD is far more common among children and adolescents than was previously believed. Good epidemiological studies from different parts of the world are still needed to determine if prevalence is equally high. Boys seem to have an earlier age of onset of OCD than girls. Male female ratio changed with age of onset, with males predominating in early on