ARCHIVES OF PSYCHIATRY AND PSYCHOTHERAPY 4/2003

Stefan Leder In search of Ariadna's thread      5 Summary This article was originally presented in Polish at the opening of the 40th Jubilee Conference of Polish Psychiatrists on "Integration in Psychiatry" held in 2001. The author reviews some of the changes that have occurred in psychiatry in recent years, and describes the current developmental tendencies in the field. These tendencies and changes cover an entire spectrum beginning with a favourable manner of perceiving and treating psychiatric patients by professionals in their environment. The article also addresses the strengthening of patients' position and control over their rights, formalised by appropriate legal regulations. Finally, the unfavourable and undesirable conditions, which endanger further advances in psychiatric treatment reforms, are also discussed with some forecast for what the future climate may hold.
Filip Rybakowski, Magdalena Kosmowska, Anna Leszczyńska-Rodziewicz, Agnieszka Kałwa, Marzena Zakrzewska, Joanna Hauser Temperament and Character Inventory in patients with bipolar disorder: influence of depressive symptoms       13 Summary Background: Specific personality traits may differ between bipolar affective disorder patients and controls. However, depressive symptomatology may influence the dimensions of the personality in individuals with affective disorders. Methods: Temperament and Character Inventory was used in 44 bipolar disorder patients and 50 sex- and age-matched healthy controls. The severity of depressive symptoms was assessed with self-assessment and clinician-rated instruments. Results: In whole group of bipolar patients the level of harm-avoidance was higher than in controls. This personality dimension score was significantly correlated with depression severity. In euthymic bipolar patients (n=25) patients score significantly lower than controls in the temperamental dimension of persistence. Discussion: The low persistence may be a psychological marker for bipolar affective disorders. The relevance of this construct to the ethiopathogenesis of the manic-depressive illness requires further study.
	Maciej Żerdziński Anancastic power or mediocrity in health: dilemmas of patients with obsessive-compulsive disorder in the process of treatment. Case report.       21 Summary Basing his observations on two patients suffering from deep obsessive-compulsive disorder, the author discusses the therapeutic difficulties related to their subjectively different concepts of illness and health, the level of therapeutic intervention accepted by them, and tries to explain the term anancastic power' and its relation to the dynamics discussed.
Krzysztof Rutkowski Posttraumatic dreams from an analytical perspective      29 Summary In the article, the specific character of nightmares, which occur as a direct reaction to trauma, has been described. These nightmares occur in the course of posttraumatic disorders, especially during posttraumatic stress disorder. Analytical perspective has been most widely used, as it considers the importance of nightmares for the dynamics of psychical disorders in the highest degree. Classic interpretations of the origin of specific posttraumatic stress disorder or traumatic neurosis symptoms by S. Freud and C. G. Jung have been described. One can conclude that posttraumatic dreams are distinguished by the following: 1) content - directly reproducing the trauma, 2) recurring character, 3) bringing out negative emotional reactions, most frequently - anxiety.
	Grażyna Adamiak, Zygfryd Juczyński Strategies of coping with stress in caregivers of patients with Alzheimer's disease      39 Summary Caregivers of the patients suffering from Alzheimer's disease are exposed to chronic stress of an intensity higher than in the general population. An investigation was carried out into the levels of stress and coping strategies of 60 caregivers of patients with Alzheimer's disease. This showed that emotion-oriented coping strategies were preferred in comparison with task - oriented coping and that the crucial resource for coping well was strong social support, both from family members and also medical staff and self-support groups. Education of caregivers giving the essence of the disease and its progress are also judged to be important.
Ewa Pisula Parents of children with autism - review of current research      51 Summary The parents of children with autism have become objects of many controversial studies and theories. This is a review of the studies that have been conducted in the nineties with this group of parents. The studies are combined into three categories: works on the broader phenotype, studies on the parental stress and the perception of the child, and finally, parents as therapists of their children. Although the idea of genetic determination of the cognitive, social and communication deficits has been widely spread, it still has not been sufficiently proved. The research shows that parents of children with autism experience profound stress. This stress response has a specific profile - the most difficult for parents are handicaps related with atypical child behaviors, and the lack of knowledge about real development limitation and child problems. But even though, the parents supported by professionals may become good teachers and therapists for their children. The partnership between parents and professionals is one of the conditions of the parent's success in these roles.
	Richard D. Chessick An unfinished experimental didactic novel. Chapter 8: Troy      65