Malkiewicz-Borkowska M. Namyslowska I. Siewierska A. Puzynska E. Sredniawa H. Zechowski C. Iwanek A. Ruszkowska E. Kliniki Psychiatrii Dzieci i Mlodziezy IPiN w Warszawie. [Family characteristics, organic risk factors, psychopathological picture andpremorbid adjustment of hospitalized adolescent patients].Psychiatria Polska. 30(6):889-905, 1996. The relation of some family characteristics such as cohesion and adaptability with organic risk factors, developmental psychopathology, clinical picture and premorbid adjustment was assessed in the group of 100 hospitalized adolescent patients and families. We found correlation between: some of organic risk factors (pathology of neonatal period, pathology of early childhood), some of indicators of developmental psychopathology (eating disorders, conduct disorders), some of clinical signs (mannerism, grandiosity, hostility, suspciousness, disturbances of content of thinking), premorbid adjustment, and variables related to families, described before. We think that biological variables characterizing child (pathology of neonatal period, pathology of early childhood) have an influence on some family characteristics as independent variable. General system theory and circular thinking support these conclusions. In order to verify them, it is necessary to undertake further investigations, based on other methodology, using this results as preliminary findings.

Wasieczko A. Wasieczko Z. Katedry i Kliniki Psychiatrii Doroslych CM UJ w Krakowie. [Sulpiride: an atypical neuroleptic with a wide spectrum of therapeuticclaims].[23]Psychiatria Polska. 30(6):1009-16, 1996.

Rybakowski J. Jaracz J. Klinika Psychiatrii Doroslych AM w Poznaniu. [Desipramine (Petilil) in the treatment of depression].[30]Psychiatria Polska. 30(6):993-1002, 1996.

Myszka DM. I Kliniki Psychiatrycznej AM w Warszawie. [Clomipramine in the treatment of depressive syndrome: the results from theopen study of Hydiphen].Psychiatria Polska. 30(6):1003-8, 1996.

Namyslowska I. Kliniki Psychiatrii Dzieci i Mlodziezy IPiN w Warszawie. [Research on siblings of mentally ill and retarded persons. Review ofliterature].[29]Psychiatria Polska. 30(6):907-18, 1996. Author describes the developmental tasks of the siblingship from the family life cycle perspective. Next, research on physical and mental health eg. psychopathological symptoms of siblings of mentally ill and retarded persons as well as research on their difficulties, perception of the brother's or sister's illness and its significance for their development is presented. In the last part of the paper research conducted by D. Reiss from the University of G. Washington is discussed. The main goal is the assessment of the relationship of shared and nonshared environmental factors in the development of adolescents. Research on siblings is of special significance for the understanding of the relation between genetic and environmental factors in the development of the person, as well as for the theory of mental disorders, especially the role of the family. [29]

Gmitrowicz A. Kaszynska B. II Kliniki Psychiatrycznej Katedry Psychiatrii AM w Lodzi. [Psychoeducation of families of adolescent patients].Psychiatria Polska. 30(6):919-27, 1996. The paper presents the preliminary observations concerning the attitudes manifested by the families of adolescents diagnosed as psychotic and admitted to psychoeducation group. The above group was characterized by the high level of expressed emotion and, what is even more important, by the attempt to deny the presence of the illness and by the fear of stigmatization. The last two factors proved particularly relevant for realization of the therapeutic programme, and were often instrumental in individual decisions to leave the group. In the course of psychoeducation of adolescents' families the therapeutic programme should be geared to the actual needs of the group.

Motak E. II Kliniki Chorob Psychicznych AM w Gdansku. [The family's emotional environment and social skill level in schizophrenia].Psychiatria Polska. 30(6):929-38, 1996. This paper describes the influence of family environment of schizophrenic patients upon their social skills. Patients from different families exhibit deficits in different kinds of interactions with other people. The family emotional environment in the study was described with Expressed Emotion Index. The index was evaluated quantitatively and qualitatively. The determination of dependence of specific social skills upon the characteristics of the family emotional environment made explicit therapeutic programs for the patients and their families possible.

Kasperowicz-Dabrowiecka A. Popek L. Jaskolska D. Mikolajczyk-Kant B. Banach-Wawrzyniak H. Rybakowski J. Katedry i Kliniki Psychiatrii AM w Bydgoszczy. [Anorexia nervosa in monozygotic twins: case report].Psychiatria Polska. 30(6):939-52, 1996. The case of monozygotic female twins simultaneously concordant for anorexia nervosa is reported. The mechanisms of interaction between psychological factors and genetic predisposition playing a role in the onset and the course of disease in twin sisters are discussed.

Radziwillowicz W. Magiera P. Smoczynski S. Instytutu Psychologii Uniwersytetu Gdanskiego. [Psychosocial and biological aspects of transsexualism].[30]Psychiatria Polska. 30(6):953-62, 1996. This study is an attempt at approximating the question of transsexualism as a psycho-biological and socio-legal problem. The authors point out the role of genetic factors in sex determination and sexual features' differentiation. Social and educational environment plays a great role in forming of a psychical sex. However, the subjective feeling of sex is most probably biologically conditioned. Recognition of the problems connected with transsexualism may contribute to an improvement in quality of life of individuals suffering from disorders of sexual identification. [30]

Wielosz M. Katedry i Zakladu Farmakologii AM w Lublinie. [The role of serotonergic system in the mechanism of action of antidepressantagents].[32]Psychiatria Polska. 30(6):963-72, 1996. Thirty eight years after the successful clinical introduction of antidepressant agents, there has been an important progress in the knowledge and changes in thinking about the role of central serotonergic system in depression and in the mechanism of their therapeutic efficacy. Although it is not clear whether an increase or decrease in serotoninergic function is more important in antidepressant action of agents, there is increasing evidence that almost all antidepressant drugs can induce changes in the sensitivity of somotodendritic 5-HT1A autoreceptors and postsynaptic 5-HT2 receptors in spite of very different pharmacological profiles after a single administration. The question arises as to the causal nature of the relationship between these effects and beneficial clinical action. Further studies are still required to dispel these doubts. [32]

Kiejna A. Malyszczak K. Rzewuska M. Sobucka K. Florkowski A. Rajewski A. Rajewska J. Wojtanowska M. Dabkowski M. Brzezinski R. Rybakowski J. Sep-Kowalikowa B. Galuszko P. Nowicki Z. Katedry i Kliniki Psychiatrii AM we Wroclawiu. [Alprazolam in the treatment of anxiety disorders and mixed anxiety anddepressive disorders. Results of multicenter clinical trial].Psychiatria Polska. 30(6):973-92, 1996. Alprazolam is one of the most commonly prescribed psychotropics drug all over the world. This suggests that alprazolam is very effective and safe. A multicentre clinical trial was carried out for assessing its efficacy and side effects. 130 patients suffering from anxiety disorders, mixed anxiety and depressive disorders and dysthtymia were involved in the trial. During 6 weeks they used to take from 1.5 to 2.5 mg. of alprazolam daily. Mental state has been assessed with Hamilton rating scales of anxiety and depression, Montgomery Asberg scale of depression and CGI scales. At the endpoint good recovery was found in 75% of the patients, mild recovery in 19%, and 6% got worse. The effect of treatment depends on individual patients' traits rather than on initial mental state. Adverse events were noted in a half of patients, were not severe and were going down during the treatment. 4.6% of patients dropped out because of adverse events, the others tolerated alprazolam well.

Bilikiewicz A. Puzynski S. [Professor Wlodzimierz Strzyzewski: physician, scientist, academician].Psychiatria Polska. 30(5):847-69, 1996.

Hauser J. Kliniki Psychiatrii Doroslych AM w Poznaniu. [Typological analysis in male alcoholics: one-year-long follow-up study].Psychiatria Polska. 30(5):835-46, 1996. The aim of our study was to estimate the correlation between typological division of male alcoholics and intensity of psychopathological symptoms in one year follow-up study. The studies at the Department of Psychiatry in Poznan included 82 men hospitalized after the period of drinking and examined one year after the treatment. The typological division of male alcoholics was the subject of another study and the patients included in this examination belonged to that investigative group. Two typological groups were isolated. The first group included the patients who-were characterized by late age of the disease onset, light load of alcoholic problems in a family, slight intensity of addiction profoundness, rare occurrence of psychiatric disorders and somatic diseases. The second group was characterized by an early age of the disease onset, profound addition, load of alcoholic problems in a family, frequent occurrence of somatic diseases and psychiatric disorders. The psychometric estimation was conducted on the basis of the results of the HDA, STAI XI, X2 scales. It was found out that the attachment to a typological group was not connected with maintaining of abstinence in one-glow follow-up study. In one year follow-up study the patients who belonged to the second typological group were characterized by higher intensity of depressive symptoms.

Rajewski A. Talarczyk-Wieckowska M. Katedry i Kliniki Psychiatrii Dzieci i Mlodziezy AM w Poznaniu. [Intelligence quotient levels, aspiration and self-acceptance in patientswith restricting and binge-eating type of anorexia nervosa].Psychiatria Polska. 30(5):811-20, 1996. A group of 50 patients aged from 12 to 20 with anorexia nervosa was examined: 40 persons with a diagnosis of restricting type and 10 with binge-eating type according to DSM IV. The level of intelligence quotient (IQ) was estimated by using Wechsler Test, selfacceptation by SQ and aspiration by TAT and test of unfinished sentences. In the majority of patients IQ was stated on the average level. Independently of intellectual level all patients presented a high aspiration degree. In their own estimation the emotional motivation sphere was significantly more important in the patients with binge-eating type and intellectual in the patients with restricting type of anorexia nervosa.

Komorowska-Pietrzykowska R. Rajewski A. Wiktorowicz K. Sluzewska A. Kliniki Psychiatrii Dzieci i Mlodziezy AM w Poznaniu. [Immunological system activity in anorexia nervosa].Psychiatria Polska. 30(5):801-10, 1996. The immunological system of patients with anorexia nervosa seems to react in a non typical and, up to now, obscure way. We do not observe greater ability to catch infectious diseases while damage due to other reasons leads as a rule to breakdown of resistance mechanisms thus giving increased receptivity to infections. The works concerning the immunological functions in anorexia nervosa are not heterogeneous and concern small groups of patients. The research was made upon 29 female patients aged 12 to 20 with the diagnosis of anorexia nervosa due to DSM-IV criteria. The research was made before starting the treatment and 6 weeks after the withdrawal of all anorexia nervosa symptoms. The research results showed that in the female patients there were no essential disturbances in the scope of electrophoresis of serum protein. Testing the protein of acute phase CRP as well as the estimation of their main microheterogeneity did not show significant deviation from the norm, which shows any features of early and later activation of the immunological system. However, a slight decrease of CD3 and low coefficient CD 4/8 during the disease were observed. After the symptoms retreated the coefficient became normal. Summing up we can state that the immunological system in patients with anorexia nervosa, in spite of great cachexia, did not show significant changes. The stated specific dysfunctions may be connected with a subtype of disease and other neurotransmitter mechanisms, which still requires to be confirmed in further research.

Wojtanowska M. Rybakowski J. Kliniki Psychiatrii Doroslych AM w Poznaniu. [Changes of humoral and cellular immunity in schizophrenia].[83]Psychiatria Polska. 30(5):783-99, 1996. The paper is a review of the literature on cellular and humoral immunity in schizophrenic patients. The reports have revealed that there are manifestations of autoimmunological process in a subgroup of schizophrenics (among others: increased serum level of specific and non-specific autoantibodies, decreased lymphocyte interleukin-2 production, increased soluble IL-2 receptor concentration, increased serum IL-6 level, presence of lymphocyte abnormalities and association with HLA antigens. It is suggested that virus infection may provoke the appearance of autoimmunological reaction, while genetic factors might increase some predisposition to this reaction. The reports have also revealed that autoimmunity may play a role in pathogenesis of schizophrenia in a subgroup of schizophrenic patients who have immunological abnormalities. [83]

Slluzewka, A. Rybakowski J. Sobieska M. Kliniki Psychiatrii Doroslych AM w Poznaniu. [Immune activation in endogenous depression].Psychiatria Polska. 30(5):771-82, 1996. Serum concentration of three positive acute phase proteins: C-reactive protein (CRP), alpha-1-acid glycoprotein (AGP), alpha-1-antychymotrypsin (ACT) were measured in 81 patients with endogenous depression during acute episode and in 20 matched controls. Determination was also made of glycosylation types of AGP and ACT as well as of the concentration of interleukin-6 (IL-6) and its soluble receptor (sIL-6R). In patients with depression, the mean values of all parameters studied except for AGP glycosylation were significantly elevated compared with the group of control healthy persons, what may suggest an excessive immune activation in these patients in the form of acute phase response. Particularly intense were the indies of the immune activation in the subgroup of patients (1/3 of population studied) having pathologically elevated coefficient of AGP glycosylation (Type I glycosylation). Patients with Type I glycosylation had longer duration of illness and were characterized by recent depressive episode of greater severity and chronicity as well as refractoriness to pharmacological treatment. The results obtained corroborate the existence of excessive immune activation during acute depressive episode and suggest the possible role of this phenomenon in the pathogenesis and course of affective illnesses.

Jaracz J. Rajewski A. Junik R. Sowinski J. Gembicki M. Kliniki Psychiatrii Doroslych AM im. K. Marcinkowskiego w Poznaniu. [The assessment of regional cerebral blood flow using HMPAO-SPECT duringdepressive episode and in remission].Psychiatria Polska. 30(5):757-69, 1996. Twenty patients who met the DSM-IV criteria for major depressive disorder were investigated at rest using Single Photon Emission Computed Tomography (SPECT). Participation in the study required a minimum score of 18 points on the 17-item Hamilton Rating Scale. All patients were drug free for at least one week before the SPECT scan. Assessments were made twice during depression and after recovery. Regional tracer uptake was measured by a semiquantitative method. The reference region was delineated on the cerebellum. In remission a significant increase of 99m Tc-uptake in almost all regions of interest was observed what may point on the improvement of regional blood flow after recovery from depression. For most regions except right frontal and left parietooccipital there were no significant differences of tracer uptake between patients with bipolar and unipolar depression. The negative correlation between regional cerebral blood flow and Hamilton score was found in temporal areas and left temporo-parietal region. We did not find the influence of age on regional cerebral blood flow. In conclusion, during depression global reduction of brain metabolism was observed, which may point on the role of subcortical nuclei with diffuse cortical projection in pathogenesis of depression.

Twardowska K. Rybakowski J. Kliniki Psychiatrii Doroslych w Poznaniu. [Limbic-hypothalamic-pituitary-adrenal axis in depression: literaturereview].[46]Psychiatria Polska. 30(5):741-55, 1996. A review of the literature has been presented concerning pathogenetic role of limbic-hypothalamic-pituitary-adrenal axis (LHPA) in depression and the therapeutic possibility obtained by influencing this axis. Increased cortisol concentration has until now been the best documented biochemical abnormality in depression. Pathological results of the Dexamethasone Suppression Test pointing to hyperactivity of LHPA axis are found in about half of depressive patients. According to most recent research, primary disturbance of LHPA axis concerns hypothalamus (excessive secretion of corticotropin releasing factory) and limbic system (insufficiency of glucocorticoid receptor). An association was found between disturbances of LHPA axis in depression and immune system abnormalities in this illness. Disturbances of serotonergic and noradrenergic neurotransmission in depression may also partially result from LHPA axis dysfunction. In recent years, the attempts have been made to use drugs acting on LHPA axis for therapeutic purposes in depression, such as ketoconazole, within the framework of antiglucocorticoid strategy. Influencing LHPA axis may underlie the mechanism of new antidepressant drug, tianeptine. Recently, it was found that classical tricyclic antidepressant drugs as well as electroconvulsive may also act on LHPA in regulatory way. [46]

Rybakowski J. Chlopocka-Wozniak M. Kliniki Psychiatrii Doroslych AM w Poznaniu. [Long-term administration of lithium carbonate: experience based on a case of25-year-long treatment with lithium].Psychiatria Polska. 30(5):731-40, 1996. In the beginning of 1960s, initial reports appeared pointing to a possibility of preventing depressive and manic recurrences in affective illness by means of long-term administration of lithium salts. Subsequent several years of controlled studies confirmed such prophylactic effect of lithium in affective illness beyond any doubt. Some patients in whom lithium administration was started in the beginning of 1970s may, by now, have received lithium for more than twenty years. The patient reported in the present paper, had began lithium treatment on April 1, 1971, after her third depressive episode since 1965. During 25 years of uninterrupted lithium carbonate administration in daily dose 1000 mg (for 5 years-750 mg) and with mean serum lithium concentration 0.6 mmol/l, the recurrences have not been observed, mental status was normal and professional (physician-ophthalmologist) and family functioning was good. Either somatic or mental side-effects have not occurred. Twenty five years of the patient's lithium treatment, was paralleled by important events for lithium therapy such as, i.a., autobiographies of prominent persons receiving lithium for porphylactic purposes, definition of a new category of psychotropic drugs (normothymic) with lithium as a prototype, establishing some mechanism of lithium action on intracellular transmission, discovery of antiviral and immunomodulatory effect of lithium as well as finding of decreased mortality of patients receiving long-term lithium therapy.

Suwalska A. Rybakowski J. Kliniki Psychiatrii Doroslych AM w Poznaniu. [Biological mechanisms of drug-resistant depression].[56]Psychiatria Polska. 30(5):713-29, 1996. The authors review recent findings concerning biological mechanisms of drug-resistant depression. Treatment-resistant depression may result from the inability of antidepressants to normalize serotonergic transmission. Efficacy of therapeutic strategies enhancing serotonergic function such as potentiation of tricyclic antidepressants with lithium or fluoxetine as well as effectiveness of selective serotonin reuptake inhibitors in drug-resistant depression may support this hypothesis. Limbic-hypothalamic-pituitary-adrenal axis hyperactivity may be also an important factor of the persistence of depression, and so treatment with inhibitors of steroid biosynthesis may bring about readjustment of this axis and remission of depression in some cases of drug-resistant depression with hypercortisolemia. Another subtype of drug-resistant depression may be related to a dysfunction of hypothyroidism. Some evidence suggests also a relationship between drug resistance in depression and changes in the immune system. Research on biological mechanisms of drug-resistant depression may help clinicians to decide on the most appropriate treatment strategy in resistant depression as well as to shed light on the pathomechanism of depression. [56]

Rybakowski J. Ainiyet J. Szajnerman Z. Zakrzewska M. Kliniki Psychiatrii Doroslych AM w Poznaniu. [The study of the relationship between cholesterol and lipid concentrationand suicidal behavior in patients with schizophrenia affective illness].Psychiatria Polska. 30(5):699-712, 1996. In 143 patients (63 male, 80 female), admitted to the Department of Adult Psychiatry, University of Medical Sciences in Poznan, throughout the period from 1 October 95-31 March 96, with the diagnosis of schizophrenia (46 patients), endogenous depression (79 patients) or mania (18 patients), serum concentration of total cholesterol, LDL and HDL cholesterol, triglycerides and total lipids was estimated during the first days of admission. The occurrence of suicidal behaviors (thoughts, tendencies or acts) in these patients during the period of 3 months preceding the admission was also determined. The occurrence of suicidal behavior was found in 74 patients (30 male, 44 female). The persons revealing suicidal behaviors had significantly lower concentrations of total cholesterol, LDL cholesterol, triglycerides and total lipids compared with patients without such behaviors. This relationship was observed in all diagnostic groups as well as in both younger (below 32 years) and older (over 40 years) groups of patients. The results obtained confirm previous reports on the association between low cholesterol concentration and an increased risk of suicidal behavior in patients with psychiatric disorders. Authors discuss possible mechanisms and also clinical implications of this finding.

Hauser J. Zakrzewska M. Kliniki Psychiatrii Doroslych AM w Poznaniu. [The typological analysis of males with alcohol dependence disorder].Psychiatria Polska. 30(5):821-33, 1996. The aim of our study was the typological analysis of male alcoholics that was conducted on the basis of the K-means cluster analysis. 296 hospitalized men were examined after a duration of drinking. The results of the statistical analysis let us isolate two and then three types of alcoholics. When dividing the examined into two clusters it appeared that those who belonged to the 1st type had shorter history of addiction, became dependent later and in their case coexistence of psychiatric disorders, somatic diseases and the genetic loading for alcoholism were found less frequently than those from the 2nd type. Thus, early age of dependence onset was connected with the family alcoholism and worse clinical course-i.e.-co-occurrence of psychiatric disorders and somatic diseases. When dividing the patients into three clusters the following variables that differentiate the examined from three types of alcoholics were found: (a)-1st type: late age of dependence onset, rare load of family alcoholism, psychiatric disorders, somatic diseases; (b)-2nd and 3rd type: early age of dependence onset, the load of family-alcoholism, co-occurrence of psychiatric disorders and somatic diseases; (c)-3rd type: patients from the 3rd type were dependent longer than those from the 2nd type. Longer duration of the disease was connected with more frequent occurrence of psychiatric disorders and somatic diseases.

Wygledowska-Kania M. Bogdanowski T. I Katedry i Kliniki Dermatologii SAM w Katowicach. [Psychic factors in case histories of patients with alopeciaareata--preliminary report].Psychiatria Polska. 30(4):669-76, 1996. We tested the significance of psychic factors in the etiopathogenesis of alopecia areata. We analysed the patient on the basis of a detailed examination based on the case history, including important events in his/her life, personality traits, serious events and the loss of emotional attachment. General important events happened to 80% of the patients, personality traits able to cause the disease were present in 73%, serious events in 62% and the loss of emotional attachment was also found in 62% of the patients. We tested 60 patients (31 women and 29 men). The evidence obtained from the detailed examination based on case histories indicated significantly frequent occurrence of the psychic factors preceding the occurrence of alopecia areata.

Karakula H. Grzywa A. Spila B. Baszak J. Gieroba A. Kosikowski W. Jedrych M. Katedry i Kliniki Psychiatrii AM w Lublinie. [Use of Hospital Anxiety and Depression Scale in psychosomatic disorders].Psychiatria Polska. 30(4):653-67, 1996. Sixty-three psychosomatic patients were examined using three self-evaluation scales: Beck Depression Inventory-BDI, State-Trait Anxiety Inventory-STAI and Hospital Anxiety and Depression Scale-HADS in order to attain a description of the level of anxiety and depression in the group as well as to make an opinion on the reliability of HADS and to make a comparison from the results of the two scales: STAI and BDI. The final results indicated that HADS could perhaps stand-up to be a useful instrument for medical patients for screening and examining the disturbed emotion in groups of psychosomatic patients.

Wieczorek D. Jodzio K. Radziwillowicz W. Katedry i Zakladu Rehabilitacji AM w Gdansku. [Objective complaints and results of memory tests in depression and diffusebrain damage].Psychiatria Polska. 30(4):641-52, 1996. Memory complaints are a common symptom among hospitalized depressed and brain damaged patients. In present work we attempted to identify factors that affected the severity and character of these complaints. 21 hospitalized psychiatric patients with diagnosis of major depressive disorder, and 21 patients with diffuse brain damage, participated in the study. They completed self-reported memory questionnaire, mood questionnaire and performed on neuropsychological memory tests. There were lower performance results on several memory tests in results the brain damaged group but no between-groups difference was found the in self-reported memory questionnaire. The results suggest that different factors contributed to subjectively experienced memory problems in each group. Current mood state and immediate memory deficit were the most important predictors in the depressed group. In brain damaged patients, memory complaints the were associated with delayed story recall problems and learning deficit.

Habrat E. II Kliniki Psychiatrycznej IPiN w Warszawie. [Evaluation of selected temperamental traits in depression and in remission].Psychiatria Polska. 30(4):629-40, 1996. The aim of the study was to investigate differences in some temperamental traits during depressive phase and in remission. The group of 30 patients with endogenous depression was compared with 30 healthy controls. All subjects completed Formal Characteristic of Behaviour-Temperamental Questionnaire (FCZ-KT by Zawadzki-Strelau) and were investigated by computer exposed task from Wiener-Testsystem (WT). Alertness subscale from FCZ-KT differentiates affective patients (in depression and remission) from healthy persons. Improvement of results during remission in scales from FCZ-KT: Alertness, Perseveration and Activity was observed. WT was more a sensitive method to show differences between patients with affective disorders and healthy persons. Results in WT during remission have demonstrated that deficits in Alertness, Perseveration, Reaction Time, Decision Making Time tasks even after depressive phase are still present.

Zyss T. Krawczyk A. Katedry Psychiatrii Collegium Medicum UJ. [Magnetic brain stimulation in treatment of depression: the search foreffective parameters of stimulation].[28]Psychiatria Polska. 30(4):611-28, 1996. Transcranial magnetic stimulation seems to evoke an antidepressant effect similar to that of electroshocks. This effect, however, is not accompanied by convulsions. This technique may be regarded as an alternative method of treatment of depression. It may prove as effective as electroshock treatment, but induce no negative phenomena connected with electro-convulsive treatment. Effectiveness of magnetic stimulation depends on selection of physical parameters of the applied magnetic field. In our model the optimum parameters of transcranial stimulation are: magnetic field induction B < or = 2 T stimulation frequency f [symbol: see text]:50-100 Hz: time of single impulse twide [symbol: see text]:0,1-1 ms: time of impulse rise trise [symbol: see text]:(10)50-200 microseconds: time of impulse decline tdecline [symbol: see text]:(100)200-1000 microseconds: total stimulation time ttotal > or = 1 min repetition rate repetition rate = 8-12 [28]

Zyss T. Gorka Z. Kowalska M. Vetulani J. Katedry Psychiatrii Collegium Medicum UJ. [Behavioral and biochemical effects of magnetic brain stimulation andelectroshock in rats].Psychiatria Polska. 30(4):593-610, 1996. It was proposed that the repetitive rapid-rate transcranial magnetic stimulation (TMS) induces the functional and structural changes analogous to those which are evoked during the electroconvulsive treatment. Presently, we compared the effects of 8 daily treatments with TMS (t = 5 min, B = 0.1 T, trise = 200 microseconds, f = 50 Hz) and electroconvulsive shock (ECS) (t = 0.5 s, I = 150 mA, f = 50 Hz) on the behavior of rats in the forced swimming test (24 h after the last treatment), the exploratory activity test (0-10 min), the basal locomotor activity test (11-30 min), and the tail flick test (2 h after the last treatment). We also tested (24 h after the treatment) the reactivity of the cyclic AMP generating system in cerebral cortical slices. Statistical significance of the results was estimated by ANOVA and t-Student test. The immobility time in the forced swimming test was shortened after TMS and ECS to 86 and 75% of control values, respectively (p < 0.05 and p < 0.01). Both ECS and TMS depressed the basal locomotor activity (by 60 and 80%, resp.), and ECS, but not TMS, diminished also the exploratory activity by 70% (p < 0.01) only ECS induces analgesia, prolonging tail-flick latency by 90% (p < 0.01). ECS diminished the accumulation of the noradrenaline-stimulated cyclic AMP in the cortex slices (by 35%; p < 0.05). The effect after TMS was similar but statistically not significant (87% of control values). The data suggest that TMS produces in rats some responses that are regarded as predictive for the antidepressant activity, similar to those produced by ECS, but less side effects.

Beresewicz M. II Kliniki Psychiatrycznej IPiN w Warszawie. [Results of long-term (over 10 years) lithium therapy].Psychiatria Polska. 30(4):583-91, 1996. The effectiveness of long term lithium prophylaxis has been studied in thirty patients with bipolar affective disorder. The study covered only these patients receiving prophylactic lithium treatment for at least 10 years, who demonstrated positive response to lithium during the initial five years of the therapy. Standard medical documentation was analyzed for the time-course of the illness within the whole observation period (number, duration and character of remissions) as well as for the history of lithium therapy (serum lithium concentrations, regularity of medical checks, breaks in the lithium treatment). The effectiveness of lithium prophylaxis has been found to diminish with time in as many as 40% of patients subjected to the prolonged lithium therapy, as evidenced by an increased number of recurrences in this group. The explanation for this phenomenon is not clear, particularly that the change in the responsiveness to lithium has been found not to correlate with age, duration of illness, duration of lithium therapy, incidence of somatic diseases and history of lithium treatment (serum lithium concentrations, breaks in the treatment).

Jarema M. III Kliniki Psychiatrycznej IPiN w Warszawie. [A test for using meta-analysis to evaluate antidepressive effects offluoxetine].Psychiatria Polska. 30(4):569-81, 1996. The review of clinical antidepressive efficacy of fluoxetine was made on the basis of various authors' reports. The results showed that clinical efficacy of fluoxetine and of classical antidepressive drugs in the treatment of depression was comparable. The meta-analysis revealed effect-size of fluoxetine to be similar to tricyclics. Also the clinical effects of fluoxetine in the treatment of depressive disorders of different severity (mild, moderate, severe) were similar to the effects of classic tricyclic agents. The tolerability of therapeutic doses of fluoxetine in the daily range 20 to 40 mg is comparable while the dosage augmentation to 60 mg per day causes increase in the percentage of patients demonstrating side effects. In comparison with placebo fluoxetine showed significantly better clinical efficacy in the treatment of depression.

Falicki Z. Rutkiewicz W. Kliniki Chorob Psychicznych AM w Bialymstoku. [A discussion of problems in interpretation of the Mental Health Act].Psychiatria Polska. 30(4):561-7, 1996. On the basis of their experience as psychiatrists, and observations of Mental Health Act influence on mutual relationships between psychiatrists, their patients and patients family members, the authors analyze situations in which strict, appliance of the law may be harmful, or, for other reasons, ethically doubtful. They suggest that the Mental Health Act is too meticulous in regulating the procedures regarding mentally disturbed persons. According to the law indications, motives for treatment without consent are more often social or behavioral rather than strictly medical. It limits the ability to help a lot of people who really require psychiatric care. Authors indirectly suggest that it is impossible to replace ethics and doctors' conscience by the law.

Bilikiewicz A. II Kliniki Chorob Psychicznych AM w Gdansku. [Against abuse of methodology in psychiatry].Psychiatria Polska. 30(4):555-60, 1996. The author argues with methodological requirements of scientific research in psychiatry especially as far as the estimation of the value of new psychotropic drugs is concerned. Periodical withdrawal of the drugs and double blind placebo controlled challenge in endogenous depression and psychosis as well as in pediatric psychiatry and psychogeriatry are considered to be inadmissible. The author warns against the possibility of judicial claim in case of fatal complications in psychiatric patients. The abuse of methodology has been named "methodologization of psychiatry" as compared to the discredited term "politicalization of psychiatry".

Dabrowski S. Instytutu Psychiatrii i Neurologii w Warszawie. [Decentralization of psychiatric health service].Psychiatria Polska. 30(4):547-53, 1996. The article discusses two stages of de-centralization of psychiatric hospitals: the first consists in further division into sub-districts, the second one includes successive establishment of psychiatric wards in general hospitals. With the growth of their number these wards are to take over more and more general psychiatric tasks from the specialized psychiatric hospitals. These wards will not substitute psychiatric hospitals completely. The hospitals, though decreasing in size and number, will be a necessary element of the de-centralized and versatile psychiatric care for a long time to come.

Koszewska I. Z II Kliniki Psychiatrycznej IPiN w Warszawie. [Pharmacotherapy of depression in patients with and without conversion fromdepression to mania in the course of bipolar affective disorder].Psychiatria Polska. 30(1):99-111, 1996. To answer the question whether the kind and duration of the applied antidepressant therapy is a risk factor for the occurrence of mania directly after depression, the treatment of depression relapses in 30 patients with switch from depression to mania in the course of bipolar disease, and the treatment of 30 (appropriately selected) patients without this change was compared. No differences in treatment procedures were stated in comparable relapses, apart from more frequent application of lithium carbonate and carbamazepine in the patients with the switch from depression to mania. It was shown that long-term application of antidepressant drugs is not connected with the increased risk of such change.

Koszewska I. Z II Kliniki Psychiatrycznej IPiN w Warszawie. [Pharmacotherapy in depression during conversion from depression to mania inpatients with bipolar affective disorder].Psychiatria Polska. 30(1):113-25, 1996. Frequency of occurrence of mania directly after depression during antidepressant treatment with drugs of different pharmacological characteristics was examined. 210 depressive episodes (in 118 patients) finished with switching from depression to mania were analyzed. It was found that this phenomenon occurs more frequently during therapy with classical tricyclic drugs (amitryptyline, imipramine) than with the second generation antidepressant drugs. A group of patients in whom the switch from depression to mania occurs independently of the kind of applied therapy, was observed.

Zyss T. Goscinski I. Z Katedry Psychiatrii Collegium Medicum UJ w Krakowie. [Can psychiatric examination be useful in early diagnosis of intracranialexpansion processes?].Psychiatria Polska. 30(1):151-8, 1996. The authors carried out pilot investigations of the role of basic psychiatric examination, paying special attention to psychiatric evaluation of anamnestic data in the early recognition of intracranial expansion processes (intracranial tumors). The investigations show that psychiatric diagnostic is not sufficiently effective in the case of intracranial tumors. Despite rich symptomatology of the advanced disease processes, the early symptoms are ambiguous and "litle alarming". What occurs earlier is the "strong" neurological symptoms that can be verified with the use of more and more accessible techniques (mainly neuropicturing).

Kasperksa E. Chaba P. Szelenberger W. Wilczak H. I Kliniki Psychiatrycznej AM w Warszawie. [Continuous attention in schizophrenic patients].Psychiatria Polska. 30(3):459-69, 1996. Continuous Attention Task (CAT) was applied in a group of schizophrenic patients (N = 35), patients with schizoaffective disorder (N = 17), major depressive episode (N = 14), chronic alcohol dependence (N = 16) and healthy volunteers (N = 31). Moreover, the patients were examined with the Positive and Negative Syndrome Scale (PANSS) and the intelligence test (DMI). The results of the CAT test were significantly better in the group of healthy subjects and depressive patients in comparison to the other groups. There were no differences in CAT test between the schizophrenic, schizoaffective and alcohol dependent patients. There were no differences in CAT between the depressive patients and the healthy subjects either. The differences in the CAT results could not be contributed to the PANSS scores. The depressive patients got higher scores on the logical multiplication scale (MN) and the analogy scale (AN) of intellectual ability test (DMI) as compared to the schizophrenic patients, and higher scores on the MN scale in comparison to the alcohol dependent subjects. It was concluded that the deficits in CAT scores could be connected with the deficits in intellectual functions.

Rybakowski J. [Comments from the conference "Understanding social phobia". Oslo, September15-16, 1995. ].Psychiatria Polska. 30(1):171, 1996.

Tyszkiewicz M. [International conference of mentally disordered workers. Liege (Belgium).August 28-September 8, 1995. ].Psychiatria Polska. 30(1):172, 1996.

Ostapowicz A. Kosmicki J. Solarz J. Horodnicki JM. Z Pomorskiej Akademii Medycznej w Szczecinie, Katedra i Klinika Psychiatrii. [Mianserin efficacy in the treatment of depression].Psychiatria Polska. 30(1):127-36, 1996. Fifty patients suffering from depression were treated wigh mianserin in monotherapy. ICD-9 and DSM-III criteria for depression were used. Patients were divided into four groups--with monopolar depression (28 patients), bipolar depression (8 patients), organic depression (10 patients), neurotic depression (4 patients). The intensity of psychopathological symptoms of depression was established using the Hamilton Depression Rating Scale (HDS) on the 7th, 14th and 28th day of the treatment. The antidepressant action of mainserin was evident already on the 14th day of treatment. Mianserin proved to be most effective in endogenous bipolar depression group and neurotic depression group (70% reduction in the score obtained on the HDRS). Mianserin was well tolerated by most patients. Most frequent side effects observed were: hypertension (8 patients), feeling of anxiety (10 patients), constipation (8 patients), tachycardia (6 patients), dry mouth (3 patients).

Piasecki T. Z II Kliniki Chorob Psychicznych AM w Gdansku. [Therapeutic problems in the application of antiparkinsonian drugs inpsychiatry].[26]Psychiatria Polska. 30(1):137-50, 1996. This paper describes therapeutic problems concerning antiparkinsonian drugs in psychiatry. Particular attention was paid to problems like: 1. Possibility of making a therapeutic mistake of too prolonged and therefore harmful pharmacotherapy with antiparkinsonian drugs in the treatment of most common psychoses. 2. The importance of a careful selection of an optimal antiparkinsonian drug, especially in psyhogeriatric cases (for example Amantadinum). 3. The description of other indications for antiparkinsonian drugs: affective diseases or alcoholic withdrawal syndroms. [26]

Scheffel A. Z Oddzialu Gerontopsychiatrii, Rheinische Landesklinik, Bedburg-Hau, Niemcy. [Serum cholesterol, triglycerides, HDL and LDL in aggressive elderly patientswith dementia].Psychiatria Polska. 30(1):159-70, 1996. Associations were analysed between serum concentrations of cholesterol, triglycerides, HDL and LDL measured after hospital admission, and physical aggression in a sample of elderly patients with dementia (210 women and 160 men). A significant lower serum cholesterol and LDL concentration were found in aggressive patients of both sexes and a significant lower serum triglycerides only in aggressive women. In the subgroups of Alzheimer type dementia, women showed significant lower serum triglycerides, and aggressive men significant lower LDL concentration compared with non-aggressive controls. There were no significant differences in serum HDL between aggressive and non-aggressive patients.

Wciorka J. Muskat K. Z I Kliniki Psychiatrycznej IPiN w Warszawie. [Patients' attitudes toward their psychosis after its long-term duration].Psychiatria Polska. 30(1):17-29, 1996. The aim of the study was to analyze frequency of various types of patients' attitudes toward their illness and correlations between these attitudes and other clinical and social variables. Attitudes of 107 patients suffering from delusional psychoses (70% of them schizophrenic) were studied during follow-up examination ca. 8.7 years after their first hospitalization and 11.2 years after the onset of their illness. The attitudes were assessed by the "Experience of Illness" scale. Its results were correlated with several measures--indices of intensity of hospitalization during the follow-up period, as well as patients' clinical and social functioning at the end of this period. The isolating attitudes predominated over the undecided and integrating (7:4:1). Integrating attitudes correlated with earlier age of the onset of illness, and paranoid structure of delusional syndroms. They also correlated sligthly with better life functioning as well as with lower intensity of residual symptomatology. No relationships between attitudes and nosological position of the illness (schizophrenia versus non-schizophrenia) were stated. The implications of results for future treatment programs is briefly discussed.

Zaluska M. Bronowski P. [Non-governmental organizations for the social assistance to people withmental disorders].Psychiatria Polska. 30(1):175-7, 1996.

Anczewska M. Z I Kliniki Psychiatrii IPiN w Warszawie. [The frequency of occurrence of negative symptoms at the early stage ofschizophrenic psychosis].Psychiatria Polska. 30(1):31-41, 1996. 103 patients were admitted for the first time to the psychiatric hospital (Institute of Psychiatry and Neurology in Warsaw) between 1976-1983.  and received a research diagnosis of schizophrenia (in accordance with the ICD-9 criteria). The course and clinical pattern of the illness were analyzed at a follow-up in 65 patients--rehospitalized in the 5th year from their first admission. As regards the clinical pattern analysis, it was focused mostly on positive and negative symptoms occurrence, as assessed using the Andreasen Scales (SANS, SAPS). The data obtained from the case reports were statistically tested and the results were presented in the tables according to the research questions. The frequency of occurrence of at least one negative symptom was found to be high in the group under study (in 72% of patients during the first hospitalization and in 83% at the five-years' follow-up). The increment in the frequency of occurrence pertained also to all groups of negative symptoms, which is concordant with many authors, results.

Hunca-Bednarska A. Z Katedry i Kliniki Psychiatrii AM w Lublinie. [Frequency analysis of verbal associations obtained from schizophrenics andnormals. Formal study].Psychiatria Polska. 30(1):43-54, 1996. An association experiment was conducted in a group of schizophrenic people and in a group of sane ones. Words varied as to their emotional shade were given as the stimuli. There were 4 words emotionally neutral, 4 words with a positive emotional shade, 4 words with a negative one and 4 words with an aggressive one. The hierarchies obtained in the group of the insane people had a smaller range: the "frequent" responses were more rare here and the "rare" ones more frequent; the strength of the dominating response was also reduced. All these characteristics were clearer in the relation to the emotionally shaded stimuli, especially the aggressive ones. The views of Broen and Storms as well as Mednick and Osgood were corroborated here.