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Abstrakty Psychiatrii Polskiej 1993
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wydany: 1993-01-01


Stanczakowa T. Instytutu Psychiatrii i Neurologii, Warszawie. [The course of affective disorders in different periods of life].Psychiatria Polska. 27(6):655-66, 1993. The aim of the following research was to estimate the dependence of the course of affective disorders on sex and age. The material used in this study came from 760 medical records of 100 patients with affective disorders. The proportions of depressive and mania phases were estimated both for men and women in 4 groups of age: I to 29 years; II--30-44; III--45-59; IV--60 years and over. It was found that the proportion of episodes of mania decreased from 71.8% in group I to 26.0% in group III and increased to 28.9% in the oldest group. The proportional changes of depressive episodes where noted. In the first group there were episodes of mania prevalent both in male and female patients. In group II depressive episodes dominated (60.6%) among women and there were 53.9% manias among men. In group III depressive episodes were prevalent among both sexes. In group IV depressive phases constituted the majority (75.2%) among women and 59.5% among men. Analyzing the clinical picture of depression it was found that men from group I and III more often mentioned suicidal thoughts and demonstrated fear and suicidal attempts. In group IV women more often then men exhibited fear, suicidal thoughts and attempts. In the mania phase men from group I exhibited more symptoms then women. In group II the clinical picture of mania were similar for both sexes. In group III women with mania were more seriously ill then men--they exhibited flight of ideas, aggression, dysphoria, they abused alcohol and took part in criminal activity. In the oldest group the clinical picture of mania was similar, only women exhibited flight of ideas and aggression more often then men.


Gierowski JK. Heitzman J. Zaklad Patologii Spolecznej Katedry Psychiatrii Collegium MedicumUniwersytetu Jagiellonskiego. [Was forensic psychiatry in Poland abused for political reasons?].Psychiatria Polska. 27(6):693-701, 1993. With the aim of answering the question whether Polish forensic psychiatry was misused for political purposes the authors formulate several discussion question and try to describe the conditions protecting human rights of the person who is of interest to psychiatry and the law. The difficulties with formulating the concepts which define "misuse" are a result of the lack of more in-depth empirical research into this issue, the danger of using judgmental arguments and the need to retain an emotional distance in relation to the problem. While avoiding an unequivocal answer to this question several specific questions were selected, which may be helpful in formulating a more general assessment. The complexity and the polymorphous nature of the conditions which must be fulfilled before one may speak of the realization of the guarantee of human rights within the field of forensic psychiatry makes it possible to accept the notion that simply the existence of exterior laws regulating this legal issue is not enough to guard against the misuse of psychiatry. Nevertheless, the moral standards of psychiatrists, the legal functioning of the country and the adequacy of current laws in relation to medical knowledge are no less important. Final and unequivocal assessment of the role played by forensic psychiatry in the socio-political life of Poland in the past several decades may not be conducted without unbiased and scientific empirical research.


Szymura-Oleksiak J. Wasieczko A. Wyska E. Zieba A. Zakladu Farmakokinetyki i Farmacji Fizycznej Collegium Medicum UJ, Krakowie. [Clinical pharmacokinetics of tricyclic antidepressants. Part I.Pharmacokinetic properties].[26]Psychiatria Polska. 27(6):683-91, 1993. Pharmacokinetic properties of tricyclic antidepressants (TCA) and factors changing pharmacokinetics of these drugs were presented. The following factors were discussed: age, genetically determined rate of metabolism and TCA interaction with co-administered drugs. As a consequence of these factors alterations mainly in elimination of TCA are observed. It leads to large interindividual variation in TCA plasma concentrations and lack of correlation between TCA concentration and dosage. [26]


Puzynski S. Koszewska I. Kalinowski A. Bogdanowicz E. Swiecicki L. II Kliniki Psychiatrycznej Instytutu Psychiatrii i Neurologii, Warszawie. [Drug resistance in endogenous depression. Part I. Refractoriness toantidepressants in patients with depression admitted to a psychiatric clinicfor the first time].Psychiatria Polska. 27(6):673-82, 1993. The efficacy of antidepressive treatment (mainly pharmacotherapy) was evaluated among 284 patients, admitted for the first time to the hospital with the diagnosis of endogenous depression. The first antidepressant therapy was found effective in 58% of the patients. Furthermore treatment with other antidepressants in the patients not responding to the initial therapy was successful in 57% of the cases. Drug resistance (defined as no therapeutical effect after 2 adequate courses of antidepressant treatment) was established in 7% of this sample. It was established that the drug resistance is more frequent after the 45th year of life. No relation between the drug resistance and sex, type of affective disorder, life events or somatic disorders were found.


Swiecicki L. II Kliniki Psychiatrycznej Instytutu Psychiatrii i Neurologii, Warszawie. [Phototherapy for winter depression: report of three cases].Psychiatria Polska. 27(6):667-72, 1993. Phototherapy was administered to three female outpatients with seasonal affective disorder (winter depression), according to the DSM III-R criteria. The intensity of light was about 2.500 lux in two, and 1.500 lux in one cases at the eyes level. The treatment has shown to be very effective. Antidepressant response was observed after about one week of treatment. A short-lasting switch into hypomania was observed in one case.


Siewierska A. Niedzielska A. Witkowska-Ulatowska H. Kliniki Psychiatrii Dzieci i Mlodziezy Instytutu Psychiatrii i Neurologii,Warszawie. [Personality assessment of primary school children (VIII grade) withdepressive features (preliminary description)].Psychiatria Polska. 27(6):643-54, 1993. 235 primary school children (VIII grade) aged about 14 years, meeting the criteria for depressive syndrome were assessed by the IPAT High School Personality Questionnaire of R.B. Cattell (14 factors version). Results show that the personality of adolescents with depressive syndrome is characterized by a tendency to isolation and conflictual relations with peers. The results point also to the difference between depressive girls and boys. Girls' personality has more features similar to adult depressive personality such as introversion, schizothymia, isolation and irritability. In boys only the scale of isolation was alleviated. It is planned to compare these results with the results of a control group of normal adolescents.


Magiera P. Jurec A. Katedry i I Kliniki Chorob Psychicznych AM, Gdansku. [Comments on contemporary concepts of hypnosis and its application inpsychiatry].Psychiatria Polska. 27(6):633-41, 1993. This paper is an overview of the concepts of hypnosis from the first descriptive accounts until the present, from a phenomenological and practical perspective. The authors described this phenomenon as a specific state of consciousness, which is engendered by a therapist. It is very important to note the difference among hypnosis, sleeping and wakefulness. This paper discusses the basic hypothesis of the origins of hypnosis e.g. "suggestive acting", theories of neodissociation, psychoanalytical, multidimensional and behavioural. The authors emphasizes the meaning of reducing the sphere of the consciousness in this state and it's limitation in case of suggestions, which are contradictory to the ethics and instinct of self-preservation represented by the patient. The essence of hypnosis is a specific state of rapport between the therapist and the passive patient. The authors remove from hypnosis any hint of mystery emphasising the methodological difficulties in reliable researches on this subject. Hypnosis is an useful instrument in the hands of a qualified and experienced therapist. It is particularly valuable in the therapy of drug dependences, some kinds of neurotic states, an anxiety and phobias, as in treating disturbances of personality.


Guzinska K. II Kliniki Chorob Psychicznych AM, Gdansku. [Estimation of the levels of anxiety, emotional endurance and placement ofcontrol of female patients hospitalized with coronary disease].Psychiatria Polska. 27(6):623-31, 1993. Spielberger's State--Trait Anxiety Inventory, Z. Bizon's Questionnaire of Neurotic Symptoms as the indicator of emotional endurance and Rotter's Internal-External Control Scale were used for the analysis of a problem concerning the mechanisms of psychological functioning of female patients hospitalized with coronary disease. 35 women suffering from coronary disease were examined, a control group consisting of 35 healthy women was also assessed. The results indicate significantly higher levels of anxiety both as a state and as a trait, lower level of endurance, and more externally placed control in the patients group in comparison with the control group. Additionally, patients strongly predisposed to anxiety tended to have an external sense of control, high level of anxiety, and low level of emotional resilience.


Swiatecka G. II Kliniki Chorob Serca Akademii Medycznej, Gdansku. [Twenty-five years of telephonic emergency service in Poland: the aim androle of the Telephone Helpline in the prevention of social pathology].Psychiatria Polska. 27(6):613-21, 1993. In 1992.  Polish Telephonic Emergency Service celebrated its 25th anniversary. The first two posts of "Telefon Zaufania" (Confidence Telephone) started simultaneously but independently in Wroclaw and Gdansk in 1967. Both sought to serve people in psychological crisis. The Gdansk post became known as "Anonymous Friend" and it was run on a voluntary basis. In Wroclaw "Telefon Zaufania" was strictly professional, it was organized in the Psychiatric Clinical of the Medical Academy and manned only by psychiatrists. Today in Poland there are such telephone posts almost in all cities and larger towns. Since 1973 the Polish telephone posts belong to IFOTES (International Federation of Telephonic Emergency Service) and they follow the norms of IFOTES: anonymity, unselfishness, confidence and befriending callers. In 1990.  their was organized the Polish Association of Telephone Service in order first of all to improve the quality and efficiency of their service, to coordinate their work and to co-operate with Polish and international centers. The major problems of callers in crisis are the same in all types of post: family conflicts, marital troubles, peer group problems, the lack of the sense life, suicidal thoughts, drink and/or drug addiction. In the prevention of social pathology "Telefon Zaufania" proves the first, often the only rescue line to people in psychological crisis.


Bialyszewski A. IV Kliniki Psychiatrycznej Instytutu Psychiatrii i Neurologii, Warszawie. [The chronic fatigue syndrome].Psychiatria Polska. 27(6):601-11, 1993. The chronic fatigue syndrome (CFS) including myalgic encephalomyelitis and the postviral syndrome is a term used today to describe a not fully recognized disease characterized primarily by chronic or recurrent debilitating fatigue and various combinations of neuromuscular and neuropsychological symptoms. The term CFS has been introduced and defined by the Centers for Disease Control (CDC) in Atlanta. Fatigue is one of the most common symptoms in medicine, but CFS as defined by CDC has appeared to be quite rare in the general population. Researchers have suggested that the syndrome is a heterogenous immunologic disorder that follows viral infection, but despite numerous studies on the subject the etiologic factor of the syndrome is unknown. CFS is a controversial diagnosis. In a very high percentage of patients with the CFS depression, phobias or anxiety disorders have frequently preceded the onset of the chronic fatigue. There are many overlapping symptoms between CFS and major depression. Some clinicians suggest that it is not obvious that CFS can be distinguished from neurasthenia.


Jodzio K. Katedry i Zakladu Rehabilitacji Akademii Medycznej, Gdansku. [Personality changes of neurotic patients as outcome of the treatment].Psychiatria Polska. 27(6):593-600, 1993. The present article attempted to assess the importance of outcomes which appeared during the treatment of 30 neurotic patients. This study specially concentrates on measures of emotional empathy, self-confidence and introspection. There were two surveys in the clinical group: before and after the treatment was completed. Data were compared with a control group, also consisting of 30 persons (15 male and 15 female) matched for age and education. All patients attending group psychotherapy were also treated by pharmacotherapy. As it appeared from the analysis before treatment high empathy in patients was found, but this declined after therapy, however it was still significantly higher than in the control group. The first survey revealed also that patients demonstrated lower levels of self-confidence and introspection. After treatment there were no important differences between the groups. Relationships between the studied qualities were not statistically significant.


Kwiatkowska L. [The psychiatric hospital in Wart in 1908-1988. ].Psychiatria Polska. 27(5 Suppl):1-38,1993.


Kiejna A. Janska-Skomorowska M. Baranowski P. Katedry i Kliniki Psychiatrii AM, Wroclawiu. [Medical procedure with aggressive patients: experiences of psychiatricclinic in Wroclaw].Psychiatria Polska. 27(5):501-13, 1993. In retrospective research--frequency of aggression among the patients admitted to the Department of Psychiatry in Wroclaw in 1992.  was estimated about 8.2% from all the patients. Aggressive events were more frequent among the female patients. The most common group of drugs used in order to settle down the patients was benzodiazepines regardless of origin of aggression. In terms of type of disorder aggression was more likely to occur in schizophrenia, then Clopixol-acuphase was used as the most effective drug. Restraining was one of the unavoidable method in several cases but as the only one method it was used in 13% of cases.


Turczynski J. II Kliniki Chorob Psychicznych Akademii Medycznej, Gdansku. [Diagnostic difficulties and efficacy of electroconvulsive therapy in thetreatment of lethal catatonia].Psychiatria Polska. 27(5):535-43, 1993. This publication presents a case of 38-year old woman suffering from schizophrenia, whose body temperature reached 41 degrees C after she had taken 1250 mg of levomepromazine during a suicide attempt. Initially, the dominant symptoms were quantitative and qualitative disturbances of consciousness and periodically increased psychomotor activity, negativism, hallucinations, delusions, schizophrenic disturbances of affect became prominent. When the patient was hospitalized on the internal diseases ward, only symptomatic treatment was conducted, while the cause of the patient's high temperature was still investigated. Only when acute lethal catatonia was diagnosed and ECT was used, did the patient recover. In the event of rapid onset of high temperature in a patient with a mental disorder, a possibility of acute lethal catatonia must be always considered. A differential diagnosis of this disorder with neuroleptic malignant syndrome is very important, as the treatment is quite different. Many M.D.s aren't aware that high body temperature may be a symptom of a mental disease.


Habrat E. Walecka W. Kalinowski A. II Kliniki Psychiatrycznej Instytutu Psychiatrii i Neurologii, Warszawie. [Personality as a predictor of therapy effectiveness in endogenousdepression].Psychiatria Polska. 27(5):473-82, 1993. On the basis of personality assessment (MMPI, MPI) patients with endogenous depression were shown to react differently to treatment. Women who obtained low scores on the Lie (L), Depression (D) and Repression (R) scales as well as high scores on the Psychopathic deviate (Pd) and Alcoholism (Mac) scales had better therapy outcomes. On the other hand from among men with endogenous depression those reacting better to treatment were those who obtained low scores on the Depression (D) and high scores on the Mania (Ma) scales.


Guzinska K. II Kliniki Chorob Psychicznych AM, Gdansku. [Influence of personality traits of female patients hospitalized withcoronary disease upon their susceptibility to iatrogenic psychical trauma].Psychiatria Polska. 27(5):483-91, 1993. The analysed problem dealt with personality determinants of susceptibility to iatrogenic psychical trauma. A group of 35 female patients with coronary disease and another group consisting of 35 healthy women were tested with C.D. Spielberger's State-Trait Anxiety Inventory, Z. Bizon's Questionnaire of Neurotic Symptoms, J.B. Rotter's I-E Scale, and the author's own method for the determination of susceptibility to iatrogenic psychical trauma. In comparison with healthy women, the patients displayed significantly higher level of anxiety both as a state and as a trait, lower level of psychical endurance, more external sense of control and higher susceptibility to iatrogenic trauma. More over, the patients with lower psychical endurance and external sense of control displayed high susceptibility to iatrogenic psychical trauma.


Koscielska M. Katedry Psychologii Klinicznej przy Wydziale Psychologii, UniwersytetuWarszawskiego. [The psychological meaning of abnormal behavior in mental retardation]. [9]Psychiatria Polska. 27(5):493-500, 1993. The aim of the article is to encourage psychiatrists to follow the psychopathological approach to mental retardation. According to the author's opinion it is impossible to explain mental retardation only by using neurological and genetic categories. Mental retardation belongs to the group of psychological disorders like the psychoses and the neuroses. This disorder is characterized by pathological organisation of personality, that inhibits the development of the cognitive functions. The author presents the conditions of life in social care homes (where the basic needs concerning dignity, love and freedom are absent) as an example of the factors pathologizing the personality. She explains the psychological meaning of some abnormal behaviours by persons with mental retardation living in such conditions. [9]


Rzewuska M. Sobucka K. Samodzielnej Pracowni Farmakoterapii, Instytutu Psychiatrii i Neurologii,Warszawie. [Buspirone in the treatment of Generalized Anxiety Disorders].Psychiatria Polska. 27(5):545-61, 1993. A group of 86 patients, diagnosed with GAD, were treated with doses of 25 mg of Buspirone or 20 mg of Diazepam in a blind study. Comparative efficacy of both drugs and placebo was conducted on 40 patients (archival data). Greater efficacy of Diazepam and Buspirone in states of chronic anxiety was indicated. There were no differences in the intensity of efficacy of both drugs. The effects of Buspirone were equally strong but more general on psychic and somatic anxiety, with the exception of sleep disturbance, in comparison with Diazepam. The efficacy of Buspirone increased after 2 weeks of application. No serious or intensified adverse effects were observed. The incidence of adverse effects was slightly higher in the Buspirone group, and included dizziness, weakness and disturbance of sleep. There were no significant changes in physical examination or laboratory measures.


Kiejna A. Borys J. Hein-Antonik K. Baranowski P. Katedry i Kliniki Psychiatrii AM, Wroclawiu. [Clinical evaluation of Clozapol in the treatment of schizophrenia].Psychiatria Polska. 27(5):563-74, 1993. The clinical research on Klozapol included 28 patients (17 female and 11 male) diagnosed as suffering from schizophrenia. The drug was tested in open trial without comparison with original medication. This research revealed a high therapeutic effectiveness of Klozapol in roughly 2/3 of the cases. The side effects which have been observed were slight, and occurred with similar frequency as Leponex. The hematological complications such as granulocytopenia and agranulocytosis were not observed. The range of the doses was quite wide between 50 and 900 mg per day.


Kokoszka A. [Controversy regarding private practice in psychiatry and psychotherapy:notes from panel discussion].Psychiatria Polska. 27(5):577-8, 1993.


Parnowski T. Gabryelewicz T. Matuszewska E. Jarkiewicz J. Kliniki Psychiatrycznej Instytutu Psychiatrii i Neurologii, Warszawie. [Prevalence of the dementia syndrome among elderly people in an urban area. Apilot study].Psychiatria Polska. 27(5):515-20, 1993. Data was collected from a group of 100 randomly selected subjects from a city population above the age of 65 years. The aim of the research was to prove the reliability and validity of the research tools: the Folstein's MMSE and the Blessed's IMC. Thirty subjects were eliminated from the sample the remaining 70 were grouped according to gender for further analysis. The intergroup correlation indicated a high reliability of both tests. The hypothesis about the normal distribution of both groups was supported. In eleven subjects the results indicated the existence of a dementia syndrome f not great severity.


Rydzynski Z. Gruszczynski W. Instytutu Higieny Psychicznej Wojskowej Akademii Medycznej, Lodzi. [Problems concerning the use of alcohol and other dependence including drugsused by children and adolescents of the region of Lodz in the years 1980-1992. in the light of epidemiological studies by the Institute of Mental Hygiene ofthe Military Academy of Medicine].Psychiatria Polska. 27(5):521-34, 1993. In the years 1980-1992.  the authors with the cooperation of persons quoted in the References, investigated children from elementary and secondary schools, among them particularly children of unemployed parents, recruits, students of high schools and juvenile alcoholics and drug addicts. They found a decrease in the age of initiation of the use of alcohol and drugs in the last years, significant increase in the use of alcohol in all investigated groups and described the common reasons and mechanisms of development of dependency among children and youth.


Puzynska E. Witkowska-Ulatowska H. Iwanek A. Namyslowska I. Kliniki Psychiatrii Dzieci i Mlodziezy, Instytutu Psychiatrii i Neurologii,Warszawie. [Organic risk factors and developmental psychopathology in a group of 100hospitalized adolescents].Psychiatria Polska. 27(4):443-52, 1993. In the Psychiatric Clinic for Children and Adolescents, a group of 100 hospitalized adolescents were assessed with respect to organic risk factors and developmental psychology, using original questionnaires drawn up by the clinic. Pathology during infancy, early childhood and the results of psychological tests assessing changes in the C.N.S. differentiated 4 diagnostic subgroups: psychoses, neuroses, anorexia and conduct and personality disorders. Organic risk factor indicators were most frequent in the subgroup of conduct and personality disorders. Some indicators of developmental pathology such as speech impediments, eating disorders and conduct disorders, correlated highly with psychiatric diagnosis during adolescence.


Chimiak-Drozdzowska E. Lasek W. Boron Z. Rybakowski J. Katedry i Kliniki Psychiatrii AM, Bydgoszczy. [Computer tomography of the brain in psychiatric patients. Comparison withother indices of organic changes].Psychiatria Polska. 27(4):431-41, 1993. A group of 80 psychiatric patients--40 males and 40 females--aged 13 to 72--were examined in order to compare the results of computer tomography (CT) of the brain with indicators of organic changes obtained from EEG, psychological and neurological tests. The most frequent organic pathology present in the computer tomography was brain atrophy, displayed in 40 patients (50% of the examined) and constituting the only change in 29 patients (36% of the examined, including 19 males and 10 females). The comparison of 29 patients with brain atrophy with those with normal CT revealed that the former produced pathological EEG more frequently. However, it did not indicate any predominance of pathological results of psychological and neurological examination, neither did it show one of defined psychopathological image. Within the group of "other organic pathology", the most frequent abnormality was hyperostosis frontalis interna. It was present in 6 persons, including 5 females, and was usually associated with brain atrophy and pathological results of psychopathological tests. Other abnormalities found in the "other group of organic changes" included celebral tumours, hydromas, ischenic foci and inherited defects of the brain. No explicit relationship between the CT and the indicators of organic changes was found in this group.


Kubiszewski M. Hein-Antonik K. Maciejowski A. Kiejna A. Sobieszczanska-Lampika M. Katedry i Kliniki Psychiatrii AM, Wroclawiu. [Brain evoked potential in schizophrenic patients].[58]Psychiatria Polska. 27(4):407-22, 1993. The authors reviewed the literature on evoked potentials in mentally ill patients, with particular emphasis on schizphreniacs. The commonly observed abnormalities were as follows: 1) higher SEPs amplitudes with less waveshape variability during first 100 ms in non-depressed chronic, paranoid or undifferentiated patients with florid psychotic symptoms; normal SEPs amplitudes in acute or latent schizophrenics and in chronic depressed schizophrenics but without florid psychotic symptoms; 2) reduced SEPs and VEPs amplitude recovery and faster latency recovery; 3) reduced AEPs amplitude and latency; 4) greater VEPs waveshape variability and tendency to be "reducers" in hallucinating patients; reduced amplitude and latency recovery; prolonged latencies in patients with positive family history (schizophrenia or affective disorders in close relatives); prolonged N2 latency in motor responses to "easy" and "difficult" stimuli; reduced activity of "late potentials"; 5) greater waveshape variability in all modalities in chronic schizophrenics, abnormal P300 (reduced amplitude, lack of P300 or negative "effect of uncertainty") and abnormal CNV (less "readiness" potential, prolonged negativity with motor responses). [58]


Wciorka J. I Kliniki Psychiatrycznej Instytutu Psychiatrii i Neurologii, Warszawie. [Prognosis in delusional psychoses: comparison of prognostic value ofschizophrenia by six diagnostic criteria].Psychiatria Polska. 27(4):399-406, 1993. A group of 107 patients with diagnosis of syndromological dilusional psychosis underwent a catamnestic examination after 11.2 years from contracting the disease (8.7 years after the first hospitalization). During the first hospitalization with application of different criteria, the dependence of the early (clinical improvement after the first hospitalization) and late stages of the disease, qualified on the basis of catamnesis (intensification of the residual complex, life functioning, hospitalization intensity) on nosological qualification of disorders (schizophrenia vs no-schizophrenia) was analysed. It was concluded that the prognostisity of the course of illness depended in negligible degree on the kind of applied criteria. Of greater prognostic value, however, were the criteria in case of which diagnosis of schizophrenia depended, from the very beginning, on meeting the conditions formulated either directly (DSM-III-R) or indirectly (AS, VRC) of illness chronisity.


Wciorka J. Anczewska M. Chojnowska A. Stanikowska I. I Kliniki Psychiatrycznej Instytutu Psychiatrii i Neurologii, Warszawie. [Delusional psychoses during first hospitalization: age of onset anddiagnosis of schizophrenia by six diagnostic criteria].Psychiatria Polska. 27(4):385-99, 1993. The histories of illness of 167 patients with syndromological diagnosis of delusional psychosis were analysed with respect to their nosological qualification based on clinical diagnostics and 5 selected, operationalised criteria of schizophrenia. Its purpose was to establish dependence between diagnostics of schizophrenia and morbidity age (early, middle and late). A conclusion was that with application of clinical criteria, diagnosis of schizophrenia was a prevailing nosological qualification within the examined group (67%). Such diagnosis was less frequent in the group of late morbidity psychoses. It was also concluded that the dependence on morbidity age was displayed by these criteria which were strongly premised on a defined diagnostic approach. The Schneider's primary symptoms allowed more often for diagnosis of schizophrenia in later age. The Bleuler's (axial) symptoms more often facilitated diagnosis of schizophrenia in earlier age. Mediating criteria, belonging to the DSM-III-R or ICD-IO classification, did not display dependence on morbidity age.


Poprawska I. Jarosz M. Katedry i I Kliniki Psychiatrii AM, Lodzi. [Research into the formation of proportions of "insight vs lack of insight"in paranoid schizophrenia].Psychiatria Polska. 27(4):363-72, 1993. The relevant literature was reviewed, focusing on available evidence which emphasizes common occurrence of lack of insight among the sufferers of schizophrenia. The opinion has long been considered one-sided as it ignores occurrence of partial insight. Therefore, the purpose of this research was to attempt to find out to what extent the patient can afford to have insight and when he or she fails in doing so. A group of 100 paranoid schizophrenics were examined and both "insight and lack of insight" scales were applied. The results negate the hypothesis that insight does not take place in schizophrenia. A quarter of those examined displayed partial insight, with 16% of them showing pronounced insight indicating some awareness of changes in their psychic state due to "some" unidentified pathological factors. Different approaches and hypotheses were taken into consideration that would oscillate between the two extreme attitudes of insight and lack of insight. Contiguity between the examined phenomenon and that of coexistence of logically correct trains of thought with incorrect ones, as it occurs in hypomaniacal states, were indicated. An attempt to explain the so-called McEvoy's riddle was made. Final conclusion: It can be assumed that the interpenetration of the two antithetic trains of thought, where one displays partial lack of insight and the other partial insight, may be particularly characteristic of schizophrenia, more so than lack of insight.


Jarosz M. Pankiewicz Z. Buczek I. Poprawska I. Rojek J. Zaborowski A. Katedry i I Kliniki Psychiatrii AM, Lodzi. [Investigation into the formation of proportions of "realistic thinking vsmagical thinking" in paranoid schizophrenia].Psychiatria Polska. 27(4):353-61, 1993. Both magical thinking among healthy persons and magical and symbolic thinking in schizophrenia were discussed. The investigation covered 100 paranoid schizophrenics. They also underwent an examination in connection with the formation of the remaining 3 proportions. Both "realistic thinking and magical thinking" scales were used. An ability to think realistically was preserved, to a varying degree, in all patients, with 50% of those examined having shown an explicit or very explicit ability to follow realistic thinking. The above findings deviate from a simplified cognitive model within the discussed range. It was further confirmed that realistic thinking may coexist with magical thinking, and, in some cases, it concerns the same events. That type of disorders of the content of thinking are referred to as magical-realistic interpenetration. The results, and particularly high coefficient of negative correlation within the scales of the examined proportions, confirm the correctness of the assumption that the investigated modes of thinking form an antithetic bipolarity of proportions, aggregating antithetic values, therefore being also complementary.


Jarosz M. Katedry i I Kliniki Psychiatrii AM, Lodzi. [Formation of fundamental psychopathological proportions in autistic andsyntonic schizophrenias].Psychiatria Polska. 27(4):373-83, 1993. This paper recapitulates the research conducted in recent years, including the results of the first stage of research presented in 1988. The research is characterized by meticulous preparation of 8 scales which enables us to observe the formation of 4 fundamental proportions. Of vital importance for the interpretation of the results are correlations among the proportions and among scales. Explicit correlation (r = 0.69) between the syntonic-autistic proportion and that of "vitality and emotional adequacy--emotional dementia" was recorded. This observation is of great significance in isolating paranoid schizophrenia subgroups. Emotional dementia is also significant (r = 0.64) in cases characterized by profound autism. Thus, syntony is not only a quality which strongly correlates negatively with autism (r = 0.79) but above all there exists a high positive correlation between syntony and emotional vitality (r = 0.58). Not included here is a discussion on complex relationships between syntonic-autistic proportion and the one of "insight vs lack of insight". The obtained results confirm the correctness of earlier hypothesis and correlate with the results of the research on the formation of syntonic-autistic proportion. In other words, they verify a hypothesis which makes us isolate autistic and syntonic schizophrenias within paranoid schizophrenia.


Bidzan L. II Kliniki Chorob Psychicznych AM, Gdansku. [Relationship between normal aging and Alzheimer's dementias. Practicalapplications].Psychiatria Polska. 27(4):423-30, 1993. During the process of normal ageing significant loss of neural brain cells is known to take place. To a greater or lesser degree, all ageing persons undergo the process which does not deviate in a qualitative sense from the morphological changes observed in the dementias. It is therefore reasonable to assume that the following 3 relationships can occur between normal ageing and the dementias. Firstly, dementia may results directly from the ageing process of the C.N.S. alone. Secondly, a number of diverse factors either augments normal ageing deficits or accelerates the very process. Finally, normal ageing and dementias are assumed to be coincidental. There exists considerable evidence that most dementias are generated by an accelerating rate of ageing of the C.N.S. or by augmentation of the process by diverse factors. The acceptance of the above hypothesis may be beneficial not only from the theoretical point of view but could also produce new treatment techniques and, particularly, assist in preventing Alzheimer's and other dementias.


Krzyminska E. Rossa G. Krzyminski S. Wojewodzkiego Szpitala Specjalistycznego dla Nerwowo i Psychicznie Chorych wCiborzu. [The Global Deterioration Scale (GDS) and Functional Assessment Staging(FAST) in the diagnosis of Alzheimer type dementia].Psychiatria Polska. 27(2):129-38, 1993. Described are two scales for the diagnosis of dementia of the Alzheimer type and for identifying its following stages solely on the basis of social functioning and on daily activity level of the patient. The authors of the scale, Resiberg et al. based their findings on the conclusion that dementia of the Alzheimer type is a rare clinical syndrome with a characteristic onset and development which are identical in over 90% of patients. The GDS (Global Deterioration Scale) separates the course of dementia into 6 stages. The FAST (Functional Assessment Scale) separates deterioration into 16 stages. Both scales, especially allow for the systematic tracking of course of the uncomplicated Alzheimer's case. They also show the appearance of any additional somatic and psychopathological factors which cause the state of the patient to appear worst than could result from the current stage the patient is in. They ease the differentiation between dementia of the Alzheimer type and dementia of other aetiology. Apart from these scales, especially the FAST, allow to the estimation with significant accuracy how long the current stage, as well as the whole illness will last in a given patient. Similarly, predictions may be made as to the time and in what order particular life functions will be diminishing in specific patients until the terminal state.


Pawlowski L. [Sulpiride: a neuroleptic agent of new generation with unique pharmacologicalqualities and rather wide range of clinical applications].Psychiatria Polska. 27(2):199-205, 1993. Basing on the latest world literature the paper presents the profile of pharmacological and clinical effects of sulpiride, an atypical neuroleptic which has only recently become available in Poland. The author promotes the clinical application of sulpiride.


Jarosz M. Katedry i I Kliniki Psychiatrii, Akademii Medycznej w Lodzi. [The notion of psychopathological proportion and diagnostic progress inschizophrenia].Psychiatria Polska. 27(2):139-47, 1993. The concept of psychopathological proportions which has been described on the grounds of the analysis of the selectivity and bipolarity phenomenon, facilitates perceiving and describing clinical features of schizophrenia. The proportions make one pay closer attention to important features opposing the leading features of schizophrenia, that are not always being taken into consideration. The results of the research have verified the autistic and syntonic schizophrenia hypothesis. It may be possible that the serious and numerous differences in the results of studies on schizophrenia held by various authors are partly caused by not regarding the distinction between the syntonic and the autistic form of this psychosis.


Jarosz M. Pankiewicz Z. Bienkiewicz JW. Buczek I. Cichocki M. Czech-Sniady I. Furgo-Olszewska M. Juszczak E. Pisarski A. Poprawska I. et al.Katedry i I Kliniki Psychiatrii, Akademii Medycznej w Lodzi. [Scales for the assessment of developing primary proportions in paranoidschizophrenia].Psychiatria Polska. 27(2):149-64, 1993.


Rozewicka L. Marchlewicz M. Mikulska D. Piasecka M. Dominiak B. Katedry i Zakladu Histologii i Embriologii, PAM w Szczecinie. [Morphological and hormonal evaluation of the influence of sulpiride on therat's testis and epididymis].Psychiatria Polska. 27(2):189-98, 1993.


Badzio-Jagiello H. Magiera P. Katedry i I Kliniki Chorob Psychicznych, AM w Gdansku. [Selected aspects of practical pharmacotherapy of anxiety].[31]Psychiatria Polska. 27(2):181-8, 1993.


Rabe-Jablonska J. II Kliniki Psychiatrycznej, Akademii Medycznej w Lodzi. [Panic attacks and panic disorder. Diagnostic criteria, prevalence,etiopathogenesis, clinical presentation and treatment].[74]Psychiatria Polska. 27(2):165-79, 1993.


Magiera P. Smoczynski S. Jakitowicz J. Krupa-Wojciechowska B. Katedry i Kliniki Chorob Psychicznych, AM w Gdansku. [The application of hemodynamic examination in psychiatry].[22]Psychiatria Polska. 27(2):121-8, 1993. The authors discuss the most modern non-invasive methods for the examination of the circulatory system and consider the opportunity of their application in psychiatry. They refer to the results of their earlier studies on the some selected parameters of the circulatory system by means of radiocardiography i.e. Total Peripheral Resistance Index (TPRI), Heart Rate (HR), Arterial Blood Pressure (AP) and the Stroke Index (SI). It follows from the results that such examinations are appropriate mainly in patients with endogenous depression and may contribute to an increased safety factor in the treatment with tricyclic antidepressants. Among the methods which could contribute to the better evaluation of the state of the circulatory system (especially on contraction in the left ventricle of the heart and peripheral resistance) in depressive patients, phonocardiography, mechanocardiography and Doppler echo sounding cardiography are enumerated. Haemodynamic examinations turned out to be useful in predictions of the somatic tolerance of tricyclic antidepressants and to be helpful in understanding the reason for several complains involving the circulatory system in patients with endogenous depression. Two groups of patients: psychomotorically retarded and excited (with high intensity of anxiety) who differ from each other in the haemodynamic parameters are discriminated. This paper points out the necessity for the control of the circulatory system in these patients by means of modern non-invasive methods and is in agreement with the holistic attitude towards a patient. [22]


Rabe-Jablonska J. II Kliniki Psychiatrycznej, Akademii Medycznej w Lodzi. [A new draft of the mental disorders classification prepared by the AmericanPsychiatric Association: diagnostic and statistical manual of mentaldisorders-IV, Options Book].Psychiatria Polska. 27(2):109-19, 1993.


Bomba J. Katedra Psychiatrii Akademii Medycznej im. Mikolaja Kopernika w Krakowie. [Human values and respect of human rights in oppressive conditions]. [26]Psychiatria Polska. 27(3):225-38, 1993. Human rights, an issue of political debates in the last decades, listed in the United Nations Declaration of 1946 are rooted in the humanistic tradition of philosophy and religion. The UN declared their universal character and made state organizations responsible for their observation. Among all human rights that for freedom is usually perceived as crucial. Psychiatry developed in Europe primarily a caring function. The medical model developed in psychiatry through the 19th c. supplied the criteria for medical diagnosis of mental disturbance, and elaborated a system of treatment which included long term hospitalization. Medicalization of psychiatry (recently coming back) is a force which gives courage to those who suffer, to their families, and to professionals as well. This power however, can be easily abused, when a psychiatrist adopts a position of someone who knows better that which is good for his/her patient. Legal regulations of the circumstances of psychiatric treatment, especially treatment against the patient's will should prevent the abuse of the mentally disturbed person's right for freedom. The goal is usually achieved by clear description of clinical and other conditions under which a person can be committed, and by establishing the committed person's right to claim the decision to be unjust. Poland is a country without legal regulation in the area of mental health (there are only administrative acts). For more than sixty years several projects on mental health law have been worked on. The last one which came to the Sejm (parliament) in 1980 was withdrawn by the "Solidarity" Trade Union. At present, the membership of Poland in international organizations makes an introduction of mental health law an obligation. Having no legal regulation, Polish psychiatry has been a self-regulating system. It is worth to note that even in the hard Stalinist period (1947-1956) there was no abuse of psychiatry for political reasons. The main reason for Polish psychiatry staying free from political abuse is seen in the role of internalized norm of human dignity. But others should also be taken into account. It was a specificity of the political situation that the ruling powers did not insist that psychiatrists cooperate. On the other hand the integration of the Polish psychiatric community was helpful in observing the rule of non-collaboration. One of the most important factors is seen as the experience and memory of NAZI crimes in the field of psychiatry in Poland. Extermination of psychiatric patients had to leave the feeling of the importance of psychiatrist's own responsibility.(400 WORDS) [26]


Anonymous. [Panel discussion at the 37th Congress of Polish psychiatrists in Poznan inMay, 1992. ].Psychiatria Polska. 27(3):239-52, 1993.


Szyrynski W. Uniwersytetu Ottawskiego, Ottawa, Kanada. [Confrontation with frustration in psychiatric practice].Psychiatria Polska. 27(3):253-68, 1993. In the educational programs for psychiatrists one often meets emissions in the confrontation with difficult situations during the first steps in that specialty. In the background of frustrogenic cases, which trainees have in their first years of their practice, the author outlines an adequate program, which could improve this situation. A discussion about these themes would also be useful in postgraduate training.


Rabe-Jablonska J. II Kliniki Psychiatrycznej Katedry Psychiatrii AM w Lodzi. [Affective disorders in the fourth edition of the classification of mentaldisorders prepared by the American Psychiatric Association -- diagnostic andstatistical manual of mental disorders].Psychiatria Polska. 27(3):269-79, 1993.


Krzyzkowiak W. IV Kliniki Instytutu Psychiatrii i Neurologii w Warszawie. [Computer tomography in diagnosis of mental disorders].[11]Psychiatria Polska. 27(3):281-91, 1993. The article includes a review of literature discussing the results of CT (computed tomography) usage with psychiatric patients and a range of recommendations for using this diagnostic method in psychiatry. Recommended indications for ordering a CT scan for psychiatric patients have ranged from narrow guidelines (only patients with focal neurological findings) to a broad spectrum, including any of the following: confusion and/or dementia of unknown cause, a first episode of a psychosis of unknown etiology, a movement disorder of unknown etiology, a diagnosis of anorexia nervosa, prolonged catatonia, and a first episode of major affective disorder or personality change after 50. [11]


Jarosz M. Furgo-Olszewska M. Juszczak E. Pisarski A. Stasiak J. Wieclaw B. Katedry i I Kliniki Psychiatrii AM w Lodzi. [Further research into the formation of the "vitality and adequacy ofemotion-emotional blunting" relationship in paranoid schizophrenia].Psychiatria Polska. 27(3):303-10, 1993. A sample of 100 paranoidal schizophrenic patients were assessed. Scales of "vitality and the adequacy of emotion" and "emotional blunting" which are described in a separate paper were used. At the beginning attention was focused on the fact that several synonimous terms are used to describe the blunting of emotion (flatness of affect, blunted or inappropriate affect, presence of affect as opposed to flatness). The results indicate that in only a very few cases the intensity of both studied qualities was negligible, however in the majority of the cases it appeared that the quality of "vitality" and its opposite is present. In 62 patients the emotional blunting was moderate. Emotional vitality in these cases remained in the wide range from moderate to significant. Both factors may be considered to be additional factors on the basis of the size and type of correlation. The coefficient of both Scales is expressed by r = -0.77. The correlation between the studied proportion and the syntonic-autistic proportion is expressed by r = 0.69. The cases of emotional blunting which occurred at different levels of intensity were generally accompanied by relative vitality and adequate emotional reaction. The formation of the studied proportion and in particular the high correlation coefficient between this proportion and the syntonic-autistic proportion suggests that autistic schizophrenia and syntonic schizophrenia form two basic subgroups of paranoidal schizophrenia.