Psychiatria i Psychologia Kliniczna-JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY最新文献

{"title":"When drug-centred psychopharmacology meets person-centred psychopharmacotherapy – antidepressants","authors":"S. Murawiec","doi":"10.15557/pipk.2022.0027","DOIUrl":"https://doi.org/10.15557/pipk.2022.0027","url":null,"abstract":"A vibrant discussion on the monoamine theory of depression and the use of serotonergic modulators in the treatment of this disorder was triggered by a systematic review published by Moncrieff et al. in “Molecular Psychiatry” in 2022. Many experts considered this work as referring to a hypothesis that now is only of historical significance. Another publication, co-authored by Moncrieff, proposed a useful approach to both action and clinical use of psychopharmacotherapy. The drug-centred model postulates that psychoactive agents are substances that affect symptoms indirectly, by exerting specific effects on physiological phenomena underlying mental, emotional and behavioural processes. When planning therapeutic strategy, it should be assessed whether the expected effects of a given medication on mental function and behaviour may prove beneficial in a particular life situation of the person being treated. Therefore, pharmacotherapy can be considered in terms of its impact on mental functions, which may turn out positive (not only for depression, but also for anxiety and other disorders), rather than targeting a specific abnormality. The paper presents different approaches within this framework, including a model based on creative person-centred narrative psychopharmacotherapy (CP-CNP) described by Jakovljević. Combining drug-centred and person-centred psychopharmacotherapy may be the basis for understanding the pharmacological treatment of mental disorders. In the context of the controversy aroused by Moncrieff et al., it can be pointed out that agents known to modulate serotonin transmission modify certain serotonin-mediated mental functions, which may aid the treatment of depression and many other conditions. Therefore, it is not a mechanically understood antidepressant effect. Serotonin modulators are useful in the treatment of depression, as evidenced by both scientific research and the experiences of millions of patients. However, these drugs have a complex, multistage action, which needs to be considered to avoid misunderstandings and oversimplifications.","PeriodicalId":42849,"journal":{"name":"Psychiatria i Psychologia Kliniczna-JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47423837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic approaches for pathological gamblers with psychiatric comorbidities – a literature review","authors":"Łukasz Wieczorek, K. Dąbrowska","doi":"10.15557/pipk.2022.0030","DOIUrl":"https://doi.org/10.15557/pipk.2022.0030","url":null,"abstract":"Research has shown that gambling disorders often coexist with other mental disorders, with worse treatment outcomes in the affected patients than those with a single disorder. This population is also characterised by higher hospitalisation rates, non- compliance and poor response to pharmacotherapy. The aim of this review was to identify, describe and analyse therapeutic approaches used for pathological gamblers with other mental health issues. The EBSCOhost database was used for literature review. Combinations of key phrases referring to gambling disorders and the most frequently identified mental comorbidities were used for the search. The review showed that therapeutic guidelines for gamblers with mental comorbidities are missing. According to previous studies, the cognitive-behavioural approach in individual and group therapy seems to be an effective strategy for gambling disorders overlapping with other psychiatric comorbidities. Motivational interviewing and desensitisation with exposure to stimuli have also been shown to be effective. Pharmacotherapy is an indispensable component of treatment. Therapy via the Internet, which may be particularly attractive for those reluctant to opt for individual or group therapy, is an alternative to traditional sessions. It is necessary to develop treatment guidelines for patients with gambling disorders co-occurring with other mental conditions to provide support for practitioners working with these patients.","PeriodicalId":42849,"journal":{"name":"Psychiatria i Psychologia Kliniczna-JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46110259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microtrauma, microtraumatic relational patterns in our lives. Does constant dripping wears away the stone?","authors":"Tomasz Mlostek","doi":"10.15557/pipk.2022.0032","DOIUrl":"https://doi.org/10.15557/pipk.2022.0032","url":null,"abstract":"The purpose of this article is to present the phenomenon of psychological microtrauma, a trauma that is cumulative in nature and results from prolonged exposure to many stressful situations in one area of suffering that are usually not so severe as those causing post-traumatic stress disorder and are included in criterion A in the Diagnostic and Statistical Manual of Mental Disorders. The introduction to the International Classification of Diseases 11th Revision of a new disorder named complex post-traumatic stress disorder, despite allowing a better understanding of people who experience chronically repeating traumas, does not explain the consequences of microtrauma which can be approached from psycho-dynamic, clinical and social perspectives. Taking into account the difficulties associated with identifying microtrauma, knowledge of this phenomenon could be useful for clinicians and their patients. The theory of microtrauma is a promising area of research and may finally bring the answer why there is a high prevalence of diagnosing post-traumatic disorder among people who experience not severe but chronic stressful events in one area in terms of content in their daily lives, e.g. discrimination. It shows how much is still ahead of us in understanding trauma and how rich and complex this phenomenon is.","PeriodicalId":42849,"journal":{"name":"Psychiatria i Psychologia Kliniczna-JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43478757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception of family relationships and personal integration in young women suffering from anorexia nervosa","authors":"W. Zagórska, Małgorzata Starzomska-Romanowska, Katarzyna Skowron","doi":"10.15557/pipk.2022.0029","DOIUrl":"https://doi.org/10.15557/pipk.2022.0029","url":null,"abstract":"The presented study concerns finding an answer to the question of perceived quality of relationships in the family of origin and personal integration, as well as the link between these variables among young women suffering from anorexia nervosa. The aim of the study was to determine: (1) the manner of assessing relationships in the family of origin by women suffering from anorexia; (2) the level of their personal integration (as a whole and in relation to its components, particularly trust, autonomy, and a sense of identity); and (3) the associations between the quality of family relationships and personal integration along with its components (psychosocial resources/ego qualities). The intergroup differences were verified in the scope of three types of family relationships: autonomy/control, consistency and communication, and the level of overall personal integration and seven out of eight (due to the age of the respondents) ego qualities identified in the theory proposed by Erikson. A total 60 women aged 18 to 24 years (M = 19.15, standard deviation, SD = 1.89) took part in the study. The research group comprised 29 women with a diagnosis of anorexia nervosa, whereas the control group consisted of 31 healthy women. The Family Relationship Questionnaire (KRR-3) developed by Plopa and Połomski (2010), the Personal Integration Questionnaire (KINTO) authored by Zagórska, Migut and Jelińska (2014), and an original sociodemographic survey were applied. It was assumed that women suffering from anorexia, compared to healthy women, would assess relationships in the family of origin differently, particularly the relationship with the mother, and that they were less strongly integrated, mainly in relation to such resources as trust, autonomy, and a sense of identity. It was also believed that there was a link between the assessment of family relationships and personal integration. The hypotheses concerning overly protective and controlling parental attitudes in women suffering from anorexia were confirmed. They were also found to have a lower level of personal integration and sense of identity. A small number of associations that are difficult to interpret in the case of the relationship with the mother were found between the perceived quality of family relationships and the psychosocial resources of women suffering from anorexia, which may be attributed to denial commonly occurring in persons suffering from anorexia. The picture of the matrix of the studied relationships turned out to be different in both groups, particularly with regard to the relationship between personal integration and the three attitudes of the mother.","PeriodicalId":42849,"journal":{"name":"Psychiatria i Psychologia Kliniczna-JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43044563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disorders due to substance use in ICD-11. Changes in clinical diagnosis","authors":"Robert Modrzyński","doi":"10.15557/pipk.2022.0031","DOIUrl":"https://doi.org/10.15557/pipk.2022.0031","url":null,"abstract":"The latest revision of the International Classification of Diseases (ICD-11) was published on June 18, 2019. ICD-11 introduces major changes in both the nomenclature and understanding of many health conditions, including disorders due to substance use. The introduced modifications mainly include an updated and extended range of substance classes, additional harmful patterns of substance use, a new category referred to as “a single episode of harmful use”, a category for high-risk substance use, and simplification of diagnostic guidelines for substance dependence. Improvement of clinical utility was the primary goal of the work on the ICD-11 system. It is important to note the demand for treatment, which significantly exceeds the available resources, with the difference ranging from 32% to 78%, depending on the disorder. Due to the above problems, the World Health Organization decided that there is a need to increase the identification and early management of mental disorders at the primary health care level. The aim of the paper is to discuss changes in the diagnostic criteria for disorders due to substance use listed in ICD-11. Categories for different patterns of substance use, definitions and diagnostic criteria have been presented.","PeriodicalId":42849,"journal":{"name":"Psychiatria i Psychologia Kliniczna-JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45797688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Borderline personality disorder in ICD-11 and DSM-5 – the relational nature of the criteria for the disorder","authors":"Agnieszka Krzysztof-Świderska, Dominika Małek","doi":"10.15557/pipk.2022.0023","DOIUrl":"https://doi.org/10.15557/pipk.2022.0023","url":null,"abstract":"The paper illustrates the relational nature of the psychiatric category of borderline personality disorders based on the analysis of symptomatic criteria set out in the International Classification of Diseases and Related Health Problems, 11th Revision (ICD-11) issued by the World Health Organization (WHO), as well as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) developed by the American Psychiatric Association (APA). We point to the appreciation of the relational nature of the phenomenon, which is noticeable already in a very cursory analysis, in the latest WHO and APA classification systems. The clinical manifestations of these criteria seem not only to be interconnected, but also to result from one another, suggesting a fundamentally structural nature of the phenomenon. All the described difficulties relate to interpersonal relationships – both in terms of the direct causes of disfunctions and long-term family and social consequences. This particularly applies to the borderlinetype emotionally unstable personality disorder, which is inseparably linked to emotional volatility and instability, and which is difficult to define using criteria in a way that does not give rise to diagnostic challenges. Therefore, we draw attention to difficulties with relationships, which are an important diagnostic criterion. Both ICD-11 and DSM-5 contain separate diagnostic categories for relationship problems, which, as it turns out, not necessarily coexist with other disorders. Linking relationship pathology with personality disorders may be of great importance for establishing the correct diagnosis and therefore choosing an appropriate treatment strategy.","PeriodicalId":42849,"journal":{"name":"Psychiatria i Psychologia Kliniczna-JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48906496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depersonalisation – a key to understand the complexity of dissociative phenomena","authors":"Radosław Tomalski, I. Pietkiewicz","doi":"10.15557/pipk.2022.0022","DOIUrl":"https://doi.org/10.15557/pipk.2022.0022","url":null,"abstract":"The concepts of depersonalisation and derealisation refer to alteration in how an affected individual feels about oneself and their environment. Both these experiences may range from mild and episodic to severe and chronic. When clinically severe, these symptoms can be the basis for the diagnosis of depersonalisation-derealisation disorder; however, they are viewed as transdiagnostic, as they accompany various mental disorders. Literature emphasises the heterogeneous nature of the discussed construct, which includes several dimensions such as derealisation, somatopsychic depersonalisation, autopsychic depersonalisation and affective depersonalisation. This phenomenological complexity is reflected in the complex neurobiological mechanisms responsible for depersonalisation experiences, of which the theory of cortico-limbic inhibition is best described. Symptoms of depersonalisation and derealisation can be triggered by a variety of factors, such as physiological states (fatigue, stress, etc.), central nervous system abnormalities or psychoactive substances. In many cases, however, traumatic experiences are crucial, with most empirical evidence pointing to the role of emotional abuse and neglect. Trauma can alter responses of the autonomic nervous system, which mediates the symptoms of depersonalisation and derealisation (e.g. freeze response). The attachment style may be another mediator. Although depersonalisation and derealisation were conventionally assigned to the category of detachment, it has been suggested that they also bear features of compartmentalisation under certain circumstances. The analysis of the impact of various developmental processes on the formation of the complex phenomenon of depersonalisation sheds new light on the understanding of dissociative disorders and the importance of dissociation in psychopathology.","PeriodicalId":42849,"journal":{"name":"Psychiatria i Psychologia Kliniczna-JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42669322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indirect self-destructiveness in women with schizophrenia","authors":"K. Tsirigotis","doi":"10.15557/pipk.2022.0021","DOIUrl":"https://doi.org/10.15557/pipk.2022.0021","url":null,"abstract":"Background: Many authors emphasise the influence of gender differences on mental health and the course and experience of mental illness, and/or postulate a gendered perspective in mental health research. Research holistically considering indirect selfdestructiveness in women with schizophrenia is hard to find in the international literature; studies have been performed on the sole basis of some discrete manifestations of indirect self-destructiveness. Aim: The aim of this study was to explore the indirect self-destructiveness syndrome and its categories in women with schizophrenia. Method: A group of 125 women with paranoid schizophrenia, aged 27–57, were examined by using the Polish version of the Chronic Self-Destructiveness Scale (CS-DS); for comparison, a group of 175 men with schizophrenia and a sociodemographically well-matched group of 125 healthy women were examined. Results: The intensity of indirect self-destructiveness and most of its categories were found to be greater in the group of women with schizophrenia compared to men with schizophrenia (transgression, poor health maintenance, personal and social neglects) and healthy women (transgression, personal and social neglects, lack of planfulness, helplessness). Nevertheless, women with schizophrenia displayed signs of better psychosocial adjustment than schizophrenic men. Conclusions: Comprehensive therapeutic, i.e. psychiatric, psychological and social, interventions should serve to enhance the “self ” defence and self-care functions, and improve the evaluation of adequacy and efficiency in women with schizophrenia. Working with such patients towards increasing their life satisfaction, although life did not spare them suffering, seems to be equally important in (psycho) therapy. The mobilisation and orientation of their actions towards those in favour of their development and health appear as crucial.","PeriodicalId":42849,"journal":{"name":"Psychiatria i Psychologia Kliniczna-JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41933558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does pandemic denial help or harm? Belief in and experience of COVID-19 as factors affecting psychological consequences of using neurotic defence mechanisms","authors":"I. Kaźmierczak, Irena Jelonkiewicz-Sterianos, Iwona Nowakowska, Joanna Rajchert, A. Zajenkowska, Adrianna Jakubowska, Marta Bodecka-Zych","doi":"10.15557/pipk.2022.0020","DOIUrl":"https://doi.org/10.15557/pipk.2022.0020","url":null,"abstract":"Objective: The COVID-19 pandemic may activate thoughts of death, leading to aversive psychological states. In such situations, defence mechanisms emerge; however, their adaptability depends on many factors. The aim of the study was to investigate the relationship between neurotic defence style and depressive symptoms. We assumed that the sense of coherence underlies this correlation and investigated how both believing (or not) in COVID-19 and having (or not) experience of this disease differentiate this mechanism. Methods: This cross-sectional study (N = 720) was conducted through an online panel. Results: For COVID-19 believers who had no experience of the disease, the higher their neurotic defence style, the lower their sense of coherence, which was negatively correlated with depressive symptoms. The same pattern was found for non-believers who have experienced COVID-19. In the group of individuals who believed and experienced COVID-19, the relationship between neurotic defence style and sense of coherence was non-significant. In turn, respondents who neither believed in nor have experienced COVID-19 displayed a positive relationship between neurotic defence style and sense of coherence. Discussion: Although self-deception strategies might be adaptive, they contribute to increased distress, if continued to be used once an individual confronts reality.","PeriodicalId":42849,"journal":{"name":"Psychiatria i Psychologia Kliniczna-JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43376897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Music therapy and music-based intervention as a form of therapeutic and educational work with preschool and early school-aged children with selective mutism","authors":"E. Kos","doi":"10.15557/pipk.2022.0025","DOIUrl":"https://doi.org/10.15557/pipk.2022.0025","url":null,"abstract":"Selective mutism is an increasingly recognised disorder among preschool- and early school-aged children. Currently, therapists are searching for optimal therapeutic intervention techniques for working with children affected by selective mutism. Music therapy is proving to be an effective modality for working with children who are communicatively isolated in preschool and school environments, which manifests itself in absent, impaired or difficult relationships with peers. This text characterises the specific features of selective mutism. In the initial section, the author discusses the multifactorial aetiology of selective mutism. In the following section, the author presents selected techniques for initiating improvisational musical activity as one of the therapeutic approaches in working with children with selective mutism. The author emphasises the potential of music therapy in the process of lowering the level of anxiety (getting rid of the fear of speaking) and restoring free non-verbal communication as soon as possible in children of preschool and early school age. The author also draws attention to the specific nature of the relationship between the therapist and the child, which is conducive to the effective course of the music therapy process. The main conclusion of the study is that music therapy, which shows a great psychological, medical, and especially pedagogical potential, can contribute to a reduction in communicative tension and promote a relatively rapid acquisition of spontaneous speech in children. Thus, it represents a worthwhile therapeutic option in working with children with selective mutism in kindergartens and schools.","PeriodicalId":42849,"journal":{"name":"Psychiatria i Psychologia Kliniczna-JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43895777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}