Psychiatria Polska 5/2002

Stefan Leder
W poszukiwaniu nici Ariadny  685
In search of Ariadna's thread  685
Summary
The article was presented on the opening of the jubilee 40th Polish Psychiatric Conference, where the main theme was "Integration in psychiatry" The author describes the present developmental tendencies in medicine and analyses the changes which took place in psychiatry in the recent years, beginning with a favourable manner of perceiving and treating psychiatric patients by their surroundings, through the strengthening of the patients' positions and control of their laws, formalised by appropriate legal regulations, all the way to unfavourable instances which formulate a barrier and endangerment of further advances in psychiatric treatment reforms.

Leszek Bidzan, Joanna Łapin, Krzysztof Sołtys, Jacek Turczyński
Strata osoby bliskiej a poziom funkcji poznawczych u osób z otępieniem typu Alzheimera  695
The loss of a close person and the cognitive functions of persons with Alzheimer type dementia  695
Summary
Aim: The aim of the present investigations was qualification of influence of loss of near and dear persons on cognitive functions in persons with Alzheimer's disease. Method: The initial population consisted of all the people who in the period from 1/02 to 30/10/2000 were treated at one of the following psychiatric treatment institutions: psychiatric ward of the hospital, psychiatric regional outpatient clinic, psychiatric department. The qualifying criteria were: - patient's consent to the examinations; - possibility of obtaining an objective interview; - no psychic diseases in the interview; - recognition of dementia syndrome on the basis of DSM IV criteria. 59 persons have been qualified for the examinations. After qualifying the patient basic examination was being conducted and consisted of the following elements: - Mini Mental Scale Examination (MMSE); - Alzheimer's Disease Assesment Scale: AMDP scale - inventory 3 - anamnesis was applied to obtain history data. Results: The investigations showed a possible relationship between stress factors and degree of cognitive function.

Małgorzata Chądzyńska, Beata Kasperek, Joanna Meder, Katarzyna Spiridonow
Jakość życia osób przewlekle chorych na schizofrenię w ocenie ich samych i ich rodzin  703
The quality of life of chronic schizophrenic patients in their and family's assessment  703
Summary
The aim of the research was to analyze the subjective quality of life of chronic, schizophrenic patients. The patients' quality of life was compared to the evaluation of their family. They evaluate the quality of life similarly. The differences concern the relationship between the quality of life and clinical characteristics.

Beata Kasperek, Katarzyna Spiridonow, Małgorzata Chądzyńska, Joanna Meder
Jakość życia chorych na schizofrenię a umiejętność rozwiązywania problemów związanych z chorobą - porównanie grup pacjentów uczestniczących w treningu behawioralnym i psychoedukacji  717
Quality of life of schizophrenia patients and health related problem solving skills - comparison between the group of patients participated in social skills training and psychoeducation group  717
Summary
Aim: The aim of this study was to obtain answers to the following questions: 1. Are there differences in the level of knowledge among the patients divided into two groups t. i. social skills training group (SSTG) and psychoeducation group (SG)? 2. Do the differences correlate with the level of subjective quality of life (SQOL)? 3. Does the participation at two groups influence SQOL and whether this correlates with two different methods of running of rehabilitation activities such as social skills training and psychoeducation? Method: The group of 47 patients diagnosed with schizophrenia by DSM-IV were tested. They were divided into two groups: SSTG (24 persons) and SG (23 persons). Results: The increase of knowledge in coping with schizophrenia symptoms was significant in the whole tested group but it was significantly higher in the training group. The SQOL and the level of knowledge in schizophrenia do not correlate. The level of SQOL decreased after taking part in social skills training. Conclusions: 1) The participation at any of tested rehabilitation activities causes an increase in the knowledge of coping with the problems resulting from schizophrenia. 2) The level of knowledge in schizophrenia does not directly influence SQOL. The level of SQOL significantly decreased in SSTG. It suggests that clinicians should concentrate on the stage just after the training cycle in order to support the patients by giving positive reinforcement.

Marek Nieznański
Przetwarzanie kontekstu i monitorowanie źródła informacji w schizofrenii  731
Processing of context and source of information monitoring in schizophrenia  731
Summary
Recent research has suggested that deficit in the processing of context could be responsible for various impairments in cognitive functioning observed in schizophrenia. Source monitoring, an ability closely related to memory for context, seems to be one of the most important correlates of positive symptoms, especially auditory hallucinations and delusions of alien control.

Marek Nieznański, Monika Czerwińska, Agnieszka Chojnowska, Sławomir Walczak, Witold Duński
Ocena efektywności treningu umiejętności poznawczych w schizofrenii  745
Effectiveness of cognitive skills training in schizophrenia  745
Summary
Aim: This study evaluated methods for improving cognitive skills of patients with schizophrenia. Method: Subjects in the experimental group received 12 sessions of practice with various cognitive tasks, while patients in the control group participated in sessions of psychoeducation. Results: Cognitive assessment before and after the study phase showed that patients in the experimental group had made significantly more improvement than the control group. Both groups improved on the insight scores, however reductions in the level of psychopathology were less tangible.

Mirosława Jawor, Aleksandra Szproch, Agata Dimter, Małgorzata Kuleta, Dominika Dudek
Poczucie koherencji, style radzenia sobie a adaptacja po zabiegu histerektomii  759
Sense of coherence, style of coping and adaptation after hysterectomy  759
Summary
Aim: This article is devoted to analysis of factors favourable for adaptation after hysterectomy procedure. The consequence of expressing the hysterectomy as a stress situation is laying a great emphasis on analysis of coping with yourself and the factors affecting this process We suggest the model where the sense of coherence affect indirectly through the styles of coping on the level of health. Method: Overall we examine 71 woman, 35 of them 10 days after the operation and 36 having this procedure 24-36 months earlier. The applied methods were: SOC-29, CISS, BDI, STAI and the Kuppermann Index. Results: We obtain results that confirm significant impact of the sense of coherence and the styles of coping to womans health. Conclusions: The results challenge proposed model as the only explanation. The sense of coherence influence the health not only through the styles of coping. Discrepancies that were obtained through the researches suggest the necessity of examining other possible relationships between those variables.

Piotr Radziwiłłowicz, Joanna Szeliga
W pułapce uzależnienia - refleksje na temat substytutu szczęścia  771
The trap of addiction - reflections on the substitute of happiness  771
Summary
This essay is a set of concepts concerning human nature with its intrinsic move towards happiness and positive balance of feelings. One of the methods of obtaining pleasure is the use of psychoactive substances. This infallible method becomes a trap. The aim of our work was to present the reader how significant the positive emotions and the ways of obtaining them in our every day life are. In our world of mind and knowledge we often depreciate the role of positive emotions. Suddenly, being embedded in crisis, we seek the easiest way to get the positive state back. This paper presents various models of addiction with the emphasis of the psychosocial model. Self-sustaining vicious circle mechanisms disintegrate slowly every single sphere of ones personality. The social functioning of the individual is also influenced by the addiction. The authors emphasize the disadvantageous influence of social and civilization changes on the decrease in the amount of positive emotions experienced by the individuals accompanied by the simultaneous increase in "academic intelligence" in developed societies. To describe that phenomenon the authors propose the concept of "civilization cross".

Agnieszka Słopień, Andrzej Rajewski, Bartłomiej Budny, Piotr Czerski
Ocena aberracji regionu q11-q13 chromosomu 15 oraz polimorfizmu genu kodującego podjednostkę GABRB3 receptora GABAA u osób z rozpoznaniem autyzmu dziecięcego i atypowego  779
Evaluation of q11-q13 locus of chromosome 15 aberrations and polymorphisms in the g-aminobutyric acid receptor subunit B3 gene (GABRB3) in autistic patients  779
Summary
The aim of the study was the evaluation of chromosomal aberrations, especially locus q11-q13 of chromosome 15 and polymorphisms in the g-aminobutyric acid receptor subunit B3 gene (GABRB3) and genetic aetiology of autistic disorder. We studied 20 probands (aged 4-27 years old) and their parents and siblings (73 persons). Following cytogenetic methods were used: conventional GTG-banding analysis, study of fra(X), fluorescence in situ hybridisation, with two specific probes: SNRPN and UBE3A/D15S10. Dinucletide (CA)n repeat polymorphism at the GABRB3 gene was analysed using PCR-STR method. Chromosomal analysis revealed paracentomere inversion - 46, XX, inv(9)(p11q13) in 1 patient, but this is frequently found in population chromosomal variation. FISH didn't reveal abnormalities in 15q11-q13 region. ETDT analysis didn't reveal connection between autistic disorder and studied marker. Lack of anomalies in 15q11-q13 region may be related to small number of probands, heterogenity of studied group and small number of studied locus and markers. So conclusions should be related only to this studied group, and not to all autistic patients.

Marek Harat, Marcin Rudaś
Leczenie chirurgiczne chorób sfery psychicznej  793
Surgical treatment of mental disorders  793
Summary
Aim: The surgical treatment of mental disorders - the authors present the neuroanatomical base of stereotactic operations on the limbic system in patients with the mental disorders. Method: Four main procedures are discussed: anterior cingulotomy, anterior capsulotomy, subcaudate tractotomy, limbic leucotomy. Results: On the ground of available literature the authors present the results of these operations which are performed with the use of stereotactic equipment guided by MRI and CT. In this article the indications for different surgical procedures are presented and refer mainly to depression, obsessive-compulsive disorder and anxiety. The authors present the principles of qualification and the exclusion criteria of the patients in the countries in which these kinds of operations are performed.