rss_2.0Current Problems of Psychiatry FeedSciendo RSS Feed for Current Problems of Psychiatry Problems of Psychiatry 's Cover impact of the COVID-19 pandemic on the development of anxiety disorders - a literature review<abstract><title style='display:none'>Abstract</title><p><bold>Introduction:</bold> The COVID-19 is a disease caused by the SARS-CoV-2 virus. A number of psychological symptoms have been identified in people living during the COVID-19 pandemic. Most of them are associated with widely understood anxiety disorders, which have always been a significant problem for mental health.</p><p><bold>Materials and methods:</bold> The available literature was reviewed on the Pubmed platform and from other sources. The analysis included original studies, reviews, meta-analyzes and internet sources. The aim of the study was to review the literature on the relationship between the COVID-19 pandemic and the occurrence and severity of symptoms of anxiety disorders.</p><p><bold>Results:</bold> The studies conducted so far show that the COVID-19 pandemic has had a significant impact on the mental state of people around the world, especially in the area of anxiety disorders. Many studies indicate an increase in the prevalence of symptoms of generalized anxiety disorder. Research also indicates a greater incidence of post-traumatic stress disorder and panic disorder in society. Symptoms of somatization were also quite often observed in patients. However, the state of published studies indicates that the pandemic did not significantly affect the severity of symptoms associated with social phobia. In the context of phobic disorders, a new type has been formulated: COVID-19-related phobia.</p><p><bold>Conclusions:</bold> The conducted literature review shows that the current COVID-19 pandemic is associated with an increase in the prevalence of symptoms of anxiety disorders in the general population. The multifaceted nature of the issue of anxiety disorders in the COVID-19 pandemic clearly indicates the need to continue research in this area.</p></abstract>ARTICLE2022-05-02T00:00:00.000+00:00The concentration of MMP-9 and the effects of intravenous anaesthetics on the efficacy of electroconvulsive therapy in patients with drug-resistant depression<abstract><title style='display:none'>Abstract</title><p><bold>Introduction:</bold> This study attempts to assess the concentration of intracellular matrix metalloproteinase (MMP-9) before and after the treatment of depressive episodes with ECT therapy and also to correlate the concentration of this enzyme with the use of commonly used general anaesthetics.</p><p><bold>Materials and methods:</bold> The study group comprised of 37 patients hospitalized in the Department of Adult Psychiatry in Poznan, with a diagnosis of episodes of drug-resistant depression during the course of bipolar and unipolar affective disorders, and who were being treated using electroconvulsive therapy. For the purpose of inducing anaesthesia during the procedure propofol was used in 10 cases, thiopental in 9 cases. Propofol was alternated with ketamine in a further 10 cases and thiopental was alternated with ketamine in another 9 cases. In order to assess the intensity of depression symptoms, the 17 point Hamilton depression scale was used, immediately before commencing ECT therapy, and one day after its completion. The serum concentration of MMP-9 was determined before and after the series of ECT treatments. In order to assess the serum concentration of MMP-9, an ELISA immunoenzymatic method was applied.</p><p><bold>Results:</bold> In this study, a significant reduction of MMP-9 concentration was noted after therapy, relative to the starting concentration, in the serum of patients suffering from depressive episodes resulting from either unipolar or bipolar affective disorders. These results correlated with improved psychiatric state, as assessed by the Hamilton scale. A significantly lower MMP-9 concentration was noted in the serum of patients given alternating thiopental and ketamine anaesthesia.</p><p><bold>Conclusions:</bold> This study suggests the importance of the enzyme as a biological marker for the effective treatment of depression. Furthermore, the choice of general anaesthetic applied during ECT also plays a role.</p></abstract>ARTICLE2022-04-05T00:00:00.000+00:00Knowledge, attitudes and beliefs about electroconvulsive therapy among Polish students<abstract><title style='display:none'>Abstract</title><p><bold>Introduction:</bold> Electroconvulsive therapy (ECT) is an effective and safe treatment for many mental disorders. Nevertheless, the attitudes towards ECT are negative and the use of this method in Poland is decreasing.</p><p><bold>Aim:</bold> The aim of the study was to investigate the general knowledge and attitudes towards electroconvulsive therapy among Polish university students, including students of medicine, psychology and other faculties.</p><p><bold>Material and methods:</bold> An original online questionnaire containing 39 questions was used, distributed through student groups on social networking sites. A total of 418 questionnaires were completed. The collected data were statistically analyzed.</p><p><bold>Results:</bold> Significant knowledge gaps and negative beliefs about electroconvulsive therapy were observed among Polish students. Medical and psychology students had more extensive knowledge and more positive beliefs about this method of treatment than students of other faculties. Greater knowledge of the therapy was associated with a more positive attitude towards it. The main source of knowledge about ECT for students of medicine and psychology were lectures and courses, and for students of other faculties – movies. Students, who considered psychiatry as their future specialization, had less knowledge and a more negative attitude towards ECT, relative to the rest of the respondents.</p><p><bold>Conclusions:</bold> There is a need for educational interventions that will change the way how ECT is perceived both in the public opinion and in the medical community. An effective solution to low levels of knowledge for medical students may be the observation of the procedure included in the study programme.</p></abstract>ARTICLE2022-04-02T00:00:00.000+00:00The interaction between stress and metabolic disruption in student population – preliminary study<abstract><title style='display:none'>Abstract</title><p><bold>Introduction:</bold> Approximately 26% of individuals between 18 and 24 years old are overweight or obese, and the number of persons with excessive body mass index (BMI) is growing. Obesity increases the risk of metabolic disruptions, which is well connected with mental health problems. Stressful situations, including entering adulthood and starting university education, affect food choices negatively. The aim of the study was to examine the relationship between psychological stress and body composition in the student population.</p><p><bold>Materials and methods:</bold> The study group consisted of 80 students (76% of women and 24% of men) between 19 and 28 years old from universities in Lublin. To determine anthropometric measurement (fat-free mass (FFM), fat mass (FM), total body water (TBW), intracellular (ICF) and extracellular (ECF) fluids), bioelectrical impedance analysis (BIA) method was applied. The severity of stress symptoms was measured using Perceived Stress Scale (PSS-10).</p><p><bold>Results:</bold> When it comes to 41.25% of participants, they used relaxation techniques, mainly meditation, yoga practice and walking. Most students had optimal body weight. While 60% of individuals had high stress levels. The perceived stress was not related to using the relaxation methods. Individuals with the high stress severity were characterized by lower: TBW, ECF and ICF expressed in liters, and lower FFM represented in kilograms. The inverse relationship between the severity of stress and the aforementioned parameters was also detected (p&lt;0.05).</p><p><bold>Conclusions:</bold> Implementing appropriate healt h education programs to prevent negat ive changes in ant hropometric measurements, psychological stress, and their health-related consequences in the student population should be considered.</p></abstract>ARTICLE2022-04-02T00:00:00.000+00:00Application of metacognitive strategies in the development of emotional and motivational self-regulation of students with special educational needs. Research on children with ADHD<abstract><title style='display:none'>Abstract</title><p>The aim of the presented study is to verify whether the visual methods (Mind Maps and Sketch-noting) considered as metacognitive strategies will help to strengthen emotional and motivational self-regulation in children with ADHD. In this experimental study, 135 participants took part, including 45 primary school students diagnosed with attention deficit hyperactivity disorder with the presentation of mixed symptoms (M = 10.41; SD = 1.42), their parents (N = 45) and teachers (N = 45). The results obtained in the study indicate that after 25 training sessions with the use of both Mind Maps and Sketch-noting, children with ADHD make significantly fewer errors than during the first measurement. However, only in the Sketch-noting group did their average reaction time increase significantly, which indicates that they are more reflective. The presented metacognitive strategies can be successfully applied at school by students with ADHD and constitute a source of support for both students and teachers.</p></abstract>ARTICLE2022-02-14T00:00:00.000+00:00Correlation between the assessment of family relations and psychological factors in mothers of children diagnosed with autism and Asperger’s syndrome<abstract><title style='display:none'>Abstract</title><sec><title style='display:none'>The aim</title><p>The aim of the work was to analyze correlation between the assessment of family relations and the assessment of the child’s functioning and psychological factors (stress-coping style, burnout, adaptation level, coherence, a sense of social suport, and mental health) in mothers of children with Asperger’s syndrome and childhood autism.</p></sec><sec><title style='display:none'>Participants and methods</title><p>The study included 70 mothers of children treated in mental health clinic (52 mothers of children with Asperger’s syndrome and 18 mothers of children with autism). The study used a battery of psychological tests.</p></sec><sec><title style='display:none'>Results</title><p>In the group of mothers of children with autism, there are significant correlations between the assessment of relations in the family and stress-coping styles and burnout. In the group of mothers of children with Asperger’s Syndrome, there are significant correlations between the assessment of family relations and the assessment of the child’s disorder, burnout, a sense of coherence, emotional support and mental resilience.</p></sec><sec><title style='display:none'>Conclusions</title><p>Based on the statical analyzes, the following conclusions were formulated: 1. Positive assessment of family relations by women raising children with autism is associated with the use of a task-oriented stress-coping style, whereas negative assessment – with the loss of personal involvement.2. Positive assessment of family relations by women raising children with Asperger’s syndrome is associated with a sense of control, instrumental support, mental resilience, and negative – with the assessment of the child’s disorder as a threat, burnout, loss of efficacy, personal involvement and decreased emotional control.</p></sec></abstract>ARTICLE2022-01-29T00:00:00.000+00:00Inkblots as a cultural phenomenon: On the centenary of the Rorschach test<abstract><title style='display:none'>Abstract</title><sec><title style='display:none'>Introduction</title><p>Approved or not, the Hermann Rorschach test can be considered more than just a test to a clinical trial. Reflection on it as a broader phenomenon may yield what is the most valuable: better knowledge of human nature.</p></sec><sec><title style='display:none'>Objective</title><p>This article aims to present the dual nature of Rorschach's inkblots: as a test of “guessing” the meaning of signs and as a test of perception.</p></sec><sec><title style='display:none'>Method</title><p>Narrative literature review on the meaning and interpretation of the Rorschach test.</p></sec><sec><title style='display:none'>Results</title><p><italic>The nature and reception of inkblots.</italic> The inkblots have a dual nature: they require visual perception, and at the same time they are signs, whose meanings are extracted in the process of interpretation. This process is largely subject to cultural determinants; it also depends on the structure of stimuli and on their artistic expression.</p><p><italic>Charles Sanders Peirce's theory of signs and the sign nature of inkblots.</italic> According to Peirce, the interpretation of a sign, as a triadic structure, belongs to the ontic order and is a continuous process, taking place perpetually. Mental interpretation, as it were, follows the ontic dimension and constitutes a kind of reflection of this dimension.</p><p><italic>The phenomenology of perception and the interpretation of inkblots.</italic> Perception as viewed by Rorschach found its unintended, though strikingly consistent, complement in the philosophy of Maurice Merleau-Ponty. This is particularly clear in the acknowledgment of the role of the body in perception and in emphasis placed on the active and dynamic nature of the subject–object relationship.</p><p><italic>Rorschach and Merleau-Ponty vs. Peirce: similarities and differences.</italic> The seemingly completely different ways of understanding interpretation in Peirce's semiotics (indirect cognition) and in Merleau-Ponty's phenomenology (direct cognition), actually show important similarities. I draw attention to the ontic dimension of interpretation and its systemic character, which both philosophers stress, and to the view of interpretation as a perpetual process that is never completed, both in Peirce's semiotics and in Merleau-Ponty's phenomenology.</p></sec><sec><title style='display:none'>Conclusion</title><p>The semiotic and perceptual nature of the inkblots created by the Swiss psychiatrist reflects two basic and mutually complementary ways in which humans experience the world. This experience has both a psychological and an ontic nature, which makes it possible for an examination using the Rorschach test to become an encounter with an existential dimension.</p></sec></abstract>ARTICLE2022-01-21T00:00:00.000+00:00Refeeding syndrome in patients with anorexia nervosa - case reports<abstract><title style='display:none'>Abstract</title><p><bold>Introduction:</bold> Refeeding syndrome RS is a life-threatening acute hormonal and metabolic disorder that occurs in patients with moderate or severe malnutrition as a result of improperly administered nutritional therapy.</p><p><bold>Material and method:</bold> The aim of this study is to describe the cases of two female patients suffering from anorexia nervosa, who developed a refeeding syndrome after starting nutritional therapy. Additionally, the available literature was reviewed in order to characterize the issue, including negative consequences and prevention of the refeeding syndrome.</p><p><bold>Results:</bold> In both cases, the development of the refeeding syndrome was found in the patients, resulting from the excessive supply of energy and nutritional substrates in a short time, preceded by a previous, months long period of starvation and exhaustion of the organism (both patients had a decrease in the body mass index - BMI - to the value of about 14 kg / m<sup>2</sup>). In patient 1, the symptoms concerned mainly the cardiovascular system: a significant increase in the concentration of N-terminal B-type natriuretic propeptide (NT-proBNP) and tachycardia, as well as a decrease in the concentration of inorganic phosphates and hypokalemia. On the other hand, in the case of patient 2, symptoms such as confusion or deep disturbances of consciousness, which led to hospitalization in the intensive care unit, dominated the clinical picture.</p><p><bold>Conclusions:</bold> Refeeding syndrome may develop during nutritional rehabilitation, especially in the case of a sudden, inadequately planned supply of nutrients. Particular care should be taken in patients with extremely low BMI when reintroducing nutrition.</p><p>The presented case reports draw attention to the possibility of cardiological complications and mental disorders of the realimentation syndrome, and indicate the behavior of patients (eating excessive food) that may lead to the development of the refeeding syndrome.</p></abstract>ARTICLE2022-01-17T00:00:00.000+00:00When does schizophrenia really begin? - A case report confirming the neurodevelopmental theory of schizophrenia<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction:</bold> According to the neurodevelopmental theory, schizophrenia is a cognitive-behavioral manifestation of the non-physiological development of the CNS, which was caused by the interaction of genetic and environmental factors during its formation.</p> <p><bold>Aim, material and methodology:</bold> The aim of this article is to present a clinical case in which exposure to numerous adverse environmental factors in the pre and postnatal period could cause the development of schizophrenia in adulthood. The analysis of the clinical case and the medical records of a patient diagnosed with paranoid schizophrenia, suffering from numerous perinatal complications, was performed.</p> <p><bold>Case report:</bold> A woman, 23 years old, unmarried, studying at post-secondary school - archivistics. Currently, psychiatrically hospitalized for the second time. A patient from the first, twin, fraternal pregnancy. The delivery took place by caesarean section, complicated. In the APGAR scale, she scored 4 points in the 1st minute, and 6 points in the 3rd minute. By day 30, the patient had experienced preterm retinopathy, viral infection, salmonella, jaundice and anemia. In the second month of her life, she was treated with surgery due to intestinal obstruction. Psychomotor development was disturbed. At 9 years of age, there was a retinal detachment. Until the end of junior high school, she was educated in a special school for the visually impaired.</p> <p><bold>Conclusions:</bold> The neurodevelopmental theory assumes that the increased risk of developing schizophrenia is associated with unfavorable factors in the developmental period. Identifying the causes underlying the development of the disease is a key step towards prevention, more efficient diagnosis, and improvement of the effectiveness of treatment of patients suffering from this disease.</p> </abstract>ARTICLE2021-10-22T00:00:00.000+00:00The relationships between obstructive sleep apnea and psychiatric disorders: a narrative review<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction:</bold> Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Its prevalence tends to increase worldwide. Untreated sleep apnea is associated with a higher risk of metabolic diseases, cardiovascular diseases, stroke, road accidents, and death, but also it is suggested that it increases the risk of mental disorders.</p> <p><bold>Method:</bold> The literature review was based on a search of articles on Medline, Pubmed, and Google Scholar from 2003 to 2021 using the keywords: obstructive sleep apnea; mental disorders; cognitive functions; affective disorders; depression; bipolar disorder; schizophrenia; psychotic disorders. The analysis included original studies, meta-analysis, and review articles.</p> <p><bold>Discussion:</bold> The result obtained from researches published so far does not allow for drawing unequivocal conclusions. There is a lot of bias present in study protocols and inclusion/exclusion criteria. Nonetheless, it seems that some disorders have a better proven correlation with OSA. Cognitive impairment, depression, and anxiety disorders are linked to OSA not only in terms of the overlapping of symptoms but also of a causal relationship. Psychotic disorders and bipolar disorders connections with OSA are confirmed, but they are not yet well understood. All correlations are found to be possibly bidirectional.</p> <p><bold>Conclusion:</bold> 1. Multiple lines of evidence increasingly point towards a bidirectional connection between OSA and mental disorders, and the cause and effect relationship between these two groups of disorders requires further research.</p> <p>2. Due to reports of an increased risk of OSA with antipsychotic drugs, caution should be exercised when initiating therapy with this type of drug in patients with known risk factors for it.</p> <p>3. Screening for OSA in psychiatric patients should be introduced as OSA can increase cognitive impairment, affective, and psychotic symptoms.</p> </abstract>ARTICLE2021-09-30T00:00:00.000+00:00Psychopathological conditions and somatic consequences of a suicide attempt with a corrosive substance in a patient suffering from long-lasting paranoid schizophrenia - a case study<abstract> <title style='display:none'>Abstract</title> <p><bold>Background:</bold> Schizophrenia is a chronic mental illness that affects 20 million people worldwide. Patients diagnosed with paranoid schizophrenia are characterized by cognitive deficits and the so-called negative symptoms, which significantly lower their quality of life and have implications for their independence and ability to fulfill various social roles.</p> <p><bold>Aim:</bold> This study aims to present the case of a 49-year-old woman who has been suffering from schizophrenia for a long time and, due to a psychotic exacerbation with delusions and auditory hallucinations in the form of ordering voices, attempted suicide by ingesting a highly corrosive chemical agent used for unblocking pipes (the so-called “mole”).</p> <p><bold>Case report:</bold> The patient was admitted to the 1st Department of Psychiatry, Psychotherapy and Early Intervention of SPSK 1 in Lublin for psychiatric treatment, after being transferred from the SPSK 1 Surgery Clinic, where she was initially admitted after the suicide attempt.</p> <p><bold>Discussion:</bold> The psychotic exacerbation in the patient could have resulted from sensory deprivation due to her feeling of loneliness and deep social isolation.</p> </abstract>ARTICLE2021-10-22T00:00:00.000+00:00Dance and Movement Psychotherapy - description of the method and group sessions in General Psychiatric Ward<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction:</bold> Dance and movement psychotherapy is a psychotherapeutic approach, which assumes that expressive movement can reflect the emotional state of the moving person. It is a method in which movement is supposed to lead to personal integration and development, and the psychotherapist is supposed to create conditions in which emotions can be safely expressed and transmitted, and can meet with acceptance.</p> <p><bold>Material and method:</bold> The aim of this study is to describe a case series of patients treated at the General Psychiatric Ward who participated in group sessions of dance and movement psychotherapy (DMT), and to analyse the impact of psychotherapy on their treatment process. In 2019, 12 patients of the General Psychiatric Ward were included in dance and movement psychotherapy (DMT) sessions. The sessions took place once a week from October 2019 to December 2019 and lasted 1h and 10 min. A common element in movement that could be observed in most people in this group was tense shoulders and free forearms and hands. In addition, it was possible to observe in the group members compact flow, free time, multidirectionality, light weight according to the LMA System. Under the influence of the applied interventions it was possible to observe how the bodies of individual group members relax and their chests open. It was also observed how the participants activated their deep abdominal muscles and settled into the therapeutic space. At the same time it was apparent how the patients became attentive to their bodies and movement, which, in turn, translated into their sense of confidence and reduction in anxiety and tension.</p> <p><bold>Discussion:</bold> The main problem of semi-open groups is the impaired ability to integrate patients and the difficulty in finding trust and a sense of security. In addition, resistance to attachment naturally arises in group members. Patients do not have the opportunity to experience all stages of the development of the therapy group, especially the last one, the phase of ending psychotherapy. Nevertheless, the semi-open therapy group seems to have some advantages and some problems are highlighted, so that psychotherapeutic work on them can be deepened.</p> <p><bold>Conclusions:</bold> Although conducting a group process in a semi-open community is not a comfortable situation for the psychotherapist and the patients due to the difficulty of finding a sense of security and the naturally occurring resistance to attachment, the sessions seem to be very helpful in integrating the patients’ community and in dealing with the inner tensions of each member.</p> </abstract>ARTICLE2021-10-22T00:00:00.000+00:00Deep brain stimulation in the obsessive-compulsive syndrome<abstract><title style='display:none'>Abstract</title><p><bold>Introduction</bold> The authors present an overview of current views on the treatment of obsessive-compulsive disorder refractory to pharmacological and psychological treatment.</p><p><bold>Aim:</bold> To review the mechanisms of stimulation of deep brain structures and to evaluate the effectiveness of therapy in obsessive-compulsive disorder.</p><p><bold>Method:</bold> Review and analysis of the Polish and foreign scientific articles from the years 1999-2016.</p><p><bold>Conclusions:</bold> According to the literature considered, in half of the examined patients there was an improvement of over 35% on the Y-BOCS scale, in some patients even a reduction of symptoms reaching 81-83% was described. Previous studies have been carried out on small groups of patients. Since 2009, the method of invasive treatment with deep brain stimulation of the obsessive-compulsive syndrome is registered in the EU. In spite of the above, additional studies are necessary on a larger group of patients in order to precisely estimate the effectiveness of the procedure and elaborate the criteria for qualifying patients for inclusion in the procedure.</p></abstract>ARTICLE2019-04-15T00:00:00.000+00:00Jacob Levy Moreno’s Psychodrama As a Work Technique For Treating Patients in Group and Individual Psychotherapy<abstract><title style='display:none'>Abstract</title><p><bold>Introduction.</bold> The basic purpose of this article is to present Jacob Levy Moreno’s psychodrama method as the psychotherapeutic technique useful in work with patients during individual and group psychotherapy.</p><p><bold>Material and Method:</bold> The author presents the analysis of case studies of patients treated in individual and group psychotherapy. He instances the examples of psychodramatic work on the stage as well as monodramatic and reports their importance in the process of patient psychotherapy. He discusses the effects of these act ivities in the context of changes in the emotional and interpersonal functioning of patients.</p><p><bold>Results:</bold> The given examples of monodrama and psychodramatic works illustrate the mechanisms of the changes offered by the method, e.g. insight, abreaction, acceptance of internal impulses, confrontation with the feelings of other people, training of alternative behaviors. In the article one can follow each subsequent step of analyzing intrapsychic conflicts of patients, which, thanks to the play on the stage, can be named and experienced by them.</p><p><bold>Conclusions:</bold> Psychodrama, used in the psychotherapeutic work of the group and in individual work with the patient (in the form of a monodrama), gives great opportunities to broaden the insight of the patient into very complicated internal mechanisms of conflicts and deficits. Psychotherapist - leader encourages patients to be creative and to spontaneous development of their blocked personality elements. The specificity of psychodrama is a relatively quick resolution of many years of ongoing conflict and permanent reparation of traumatic experiences, even from early childhood.</p></abstract>ARTICLE2019-04-15T00:00:00.000+00:00GHB receptors - a new trend in psychopharmacology?<abstract><title style='display:none'>Abstract</title><p><bold>Introduction:</bold> Gamma-hydroxybutyric acid (GHB) is commonly known as a recreation drug or the so-called “date rape drug”. It is also used in medicine to treat narcolepsy and alcohol addiction. GHB has an affinity for two types of receptors: GABA<sub>B</sub> and the relatively recently discovered GHB receptors. GHB receptors were first cloned in 2003 in mice and then in 2007 in humans. So far, evidence has been presented for their impact on dopaminergic transmission, which may imply that they play a role in the pathogenesis of diseases such as schizophrenia. At the same time, it has been demonstrated that benzamide antipsychotic drugs have an affinity for GHB receptors, which is why it is postulated that some of the effects of these drugs may result precisely from this affinity.</p><p><bold>Aim:</bold> The study presents the current state of knowledge about GHB receptors and their potential role in the pathogenesis of schizophrenia, and discusses drugs which show an affinity for this receptor.</p><p><bold>Material and method:</bold> The literature review was based on a search of articles indexed between 1965 and 2018 in Medline, Google Scholar, ScienceDirect and Research Gate databases. The following search terms were used: GHB receptor, GHB, sulpiride, and amisulpride.</p><p><bold>Result and discussion:</bold> 1. It is possible that GHB receptors are involved in the pathogenesis of schizophrenia, although more research is needed in this area. 2. Part of the effects of some benzamide antipsychotic drugs (such as amisulpride) may be due to their affinity for GHB receptors.</p></abstract>ARTICLE2019-04-15T00:00:00.000+00:00Affective disorders in pregnancy and the postpartum period – from statistics to treatment. A synchronic approach.<abstract><title style='display:none'>Abstract</title><p>The progress of medicine in the recent decades has strongly improved perinatal care, especially its somatic-related aspects. Pregnancy and childbirth have become much safer, but the mental strain and stress have remained the same. The models of motherhood and the number of children in a family have changed, giving rise to significant requirements concerning the quality of life of the offspring. These changes have brought about new psychological challenge for women and a team of psychiatrists and gynaecologists – obstetricians. The aim of this study is to look at the affective disorders affecting women during pregnancy and postpartum: the postpartum depression and so-called baby blues, which were both compiled in the form of a table in the final part of this work to illustrate the differences between these two mental disorders.</p></abstract>ARTICLE2019-04-15T00:00:00.000+00:00Positive Interventions in the Therapy of Schizophrenia Patients<abstract><title style='display:none'>Abstract</title><p>Positive psychology directs its research interests primarily to healthy people. The most important goal is to build a positive attitude towards yourself and the surrounding world. Recently, positive psychology has set a new area of research interest, which is clinical psychology. In recent years, several positive psychotherapy programs have been developed for people with schizophrenia experience. The article presents the latest trends in positive psychotherapy for people with schizophrenia. They involve taking into account the individual differences of each patient and the specificity of his / her psychopathology. As far as the therapeutic goals are concerned, there are interventions focused on strategies for enhancing positive emotions and wellbeing or the method of activating the strengths of character. Taking into account the methods of therapeutic work, they can be divided into training methods or those of the behavioral-cognitive psychotherapy as well as those that take into account the various aspects of meditation. The article presents the distribution of therapeutic programs in terms of the range of therapeutic goals in which the most important are: intensification of positive experiences, building of strengths of character and well-being. Therapeutic programs have been shown to focus not only on breaking down negative attitudes towards one’s own illness and life, but also on those that try to deal with the unsolved schizophrenia problem - negative symptoms.</p></abstract>ARTICLE2019-04-15T00:00:00.000+00:00Safety of concomitant treatment with Non-Vitamin K Oral Anticoagulants and SSRI/SNRI antidepressants<abstract><title style='display:none'>Abstract</title><p><bold>Introduction:</bold> Warfarin has been considered as a “gold standard” in the prevention and treatment of thromboembolic events since 1954. Since the introduction of direct oral anticoagulants in the last few years (NOAC-Non-Vitamin K antagonist Oral Anticoagulants) prescriptions volume for apixaban, edoxaban, dabigatran and rivaroxaban have been gradually surpassing warfarin. The benefits include: anticoagulation from day one, fixed daily dosing, elimination for the need of international normalised ratio (INR) monitoring, fewer interactions with food and co-administered medicines with reduced risk of bleeding and better overall life quality.</p><p><bold>Objectives:</bold> Assessing evidence for the safe use of Non-vitamin K Oral Anticoagulants (NOAC) with Selective Serotonin Reuptake Inhibitors (SSRI) and Serotonin and Noradrenaline Reuptake Inhibitors (SNRI).</p><p><bold>Method:</bold> Review of literature published between 2014 and 2016 was made using the key words: Selective Serotonin Reuptake Inhibitor, Serotonin and Noradrenaline Reuptake Inhibitors, apixaban, dabigatran, edoxaban, rivaroxaban, bleeding, interaction, depression with time description from 2014 to 2018. Evidence within the literature was then compared with guidelines from the National Institute for Health and Care Excellence (UK), British National Formulary (UK), Clinical Excellence Commission (Australia), Thrombophilia and Anticoagulation Clinic (USA) and Summaries of Product Characteristics (SPC).</p><p><bold>Results:</bold> 1. Serotonin plays a critical role in maintaining homeostasis. Use of SSRI/SNRI compromises its platelet reuptake increasing risk of bleeding. 2. Increased tolerability and safety of NOAC over Warfarin, although caution is advised when NOAC is used with SSRI/SNRI with less evidence suggesting pharmacodynamic interactions. 3. It is not recommended to use NOAC with strong CYP and P-gp inhibitors.</p><p><bold>Conclusions:</bold> With limited literature evidence, caution is advised when co-prescribed NOACs with SSRI/SNRI, especially with other cofactors and interacting medicines further increasing risk of bleeding.</p></abstract>ARTICLE2019-04-15T00:00:00.000+00:00Characteristics of selected traits of Adult Children of Alcoholics in the context of theirparents’ attitudes<abstract><title style='display:none'>Abstract</title><p>Children growing up in families with alcohol problems experience many emotions and events that are inadequate to their age. All these experiences are related to their subsequent functioning. Having a mother or a father suffering from alcohol dependence has a big impact on who one becomes in the future and how he/she perceives the world and other people.</p><p>The purpose of this study was to determine the relationship between the level of self-esteem, satisfaction with life as well as basic hope in the so-called Adult Children of Alcoholics (ACoA), and the attitudes of their parents.</p><p>The study involved 49 persons, aged from 18 to 70. To obtain the necessary data we used the Questionnaire Survey for Adult Children of Alcoholics, Rosenberg Self-Esteem Scale (SES), Satisfaction with Life Scale (SWLS), Basic Hope Inventory (BHI-R) and Re-trospective Assessment of Parental Attitudes Questionnaire (KPR-Roc).</p><p>The results show a positive correlation between the level of self-esteem and life satisfaction, and the attitudes of autonomy and acceptance in the mothers of our subjects. Also, life satisfaction, self-esteem and basic hope proved to be interrelated, i.e. an increase within one coincided with an increase in the other two. In addition, our results show that experiencing violence in the families of persons with the ACoA syndrome significantly correlates with the retrospective assessment of their parents' attitudes. Fathers in the so-called violent families are perceived as excessively demanding, yet inconsistent, while mothers as more rejecting and less protecting.</p></abstract>ARTICLE2018-04-11T00:00:00.000+00:00Clozapine-resistant schizophrenia – non pharmacological augmentation methods<abstract><title style='display:none'>Abstract</title><p>Clozapine is the drug of choice for drug-resistant schizophrenia, but despite its use, 30-40% patients fail to achieve satisfactory therapeutic effects. In such situations, augmentation attempts are made by both pharmacological and non-pharmacological methods. To date, most of the work has been devoted to pharmacological strategies, much less to augemantation of clozapine with electroconvulsive therapy (C+ECT), transcranial direct current stimulation (tDCS) or transcranial magnetic stimulation (TMS).</p><p>Aim: The aim of the work is to present biological, non-pharmacological augmentation treatment methods with clozapine.</p><p>Material and methods: A review of the literature on non-pharmacological augmentation treatment methods with clozapine was made. PubMed database was searched using key words: drug-resistant schizophrenia, clozapine, ECT, transcranial magnetic stimulation, transcranial electrical stimulation and time descriptors: 1980-2017.</p><p>Results: Most studies on the possibility of increasing the efficacy of clozapine was devoted to combination therapy with clozapine + electric treatments. They have shown improved efficacy when using these two methods simultaneously from 37.5 to 100%. The only randomized trial so far has also confirmed the effectiveness of this procedure. Despite the described side effects of tachycardia or prolonged seizures, most studies indicate the safety and efficacy of combined use of clozapine and electroconvulsive therapy. Transcranial magnetic stimulation also appears to be a safe method in patients treated with clozapine. However, further research is needed before ECT can be included in standard TRS treatment algorithms. The data for combining transcranial electrical stimulation with clozapine, come only from descriptions of cases and need to be confirmed in controlled studies.</p><p>Conclusions: The results of studies on the possibility of increasing the effectiveness of clozapine using biological non-pharmacological treatment methods indicate a potentially beneficial effect of this type of methods in breaking the super-resistance in schizophrenia. Combination of clozapine and ECT can be considered as the most recommended strategy among these treatment methods.</p></abstract>ARTICLE2018-04-11T00:00:00.000+00:00en-us-1