Current Problems of Psychiatry最新文献

{"title":"Suicidal ideation, plans, and attempts and the use of psychoactive substances by adolescents","authors":"B. Pawłowska, J. Szymańska","doi":"10.2478/cpp-2021-0016","DOIUrl":"https://doi.org/10.2478/cpp-2021-0016","url":null,"abstract":"Abstract Introduction: Suicidal behavior and substance abuse constitute a serious public health problem. Aim: The study was to analyze the relationships between suicidal behaviors (ideation, plans, attempts) and substance abuse in adolescents. The authors also took into account the respondents’ motivation to attempt suicide and use psychoactive substances, as well as some demographic variables. Participants: The study involved 3493 secondary school students aged 16-17 years. The group included 69.41% girls and 30.59% boys. Methods: The participants were surveyed with a self-report questionnaire designed by one of the authors. Results: Statistically significant relationships were found between the respondents’ suicidal behaviors and the risky use of alcohol, cannabis, amphetamine, and designer drugs. Conclusions: 1. The use of psychoactive substances increases the risk of suicidal ideation and plans, as well as suicidal attempts in adolescents and young adults. 2. Significantly more respondents who report suicidal ideation, plans and attempts, in comparison to those who do not report such thoughts and behaviours, abuse alcohol and consumer cannabis, amphetamine and designer drugs to cope with problems and olster self-confidence. 3. In the group of respondents who report suicidal behaviour, psychoactive substances are consumed by significantly more men than women and by significantly more city inhabitants than people living in the country. 4. Young people, who report suicidal thoughts, plans, and attempts, are initiated into alcohol consumption at an earlier age than their non-suicidal peers.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"94 1","pages":"217 - 224"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77495396","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":"Taking care of a real self - description of the psychotherapeutic process of a patient with narcissistic personality disorders in the field of dance/movement psychotherapy","authors":"Ewelina Drzał","doi":"10.2478/cpp-2021-0015","DOIUrl":"https://doi.org/10.2478/cpp-2021-0015","url":null,"abstract":"Abstract Introduction: Dance/movement psychotherapy (DMT) is a psychotherapeutic trend that belongs to the approaches that involve working with the body. Thinking about a wider perspective, DMT belongs to the group of action-oriented psychotherapies. It assumes that the person, while moving, can show his/her emotional states. Additionally, it can lead to development and personal integration. The goal is to deepen awareness. Psychotherapy with dance and movement is practiced among psychotic patients, patients suffering from neurotic or personality disorders, and as a method of personal development. The aim of the work is to describe the psychotherapeutic process of an individual client in the field of dance/movement psychotherapy as a method in which dance leads to development and personal integration. Material and method: Working with a client, Beata, took place in a strictly defined setting. Meetings took place once a week in the same office during 55 minutes. They were of an individual nature. First, Beata was diagnosed according to the DSM-5 [1] and ICD-10 [2] classification, which was supplemented with the PDM-2 diagnosis [3]. During the therapeutic work, the phenomena of transference and countertransference were taken into account, the patient’s behavior was interpreted according to John Bowlby’s attachment theory and mentalization. During practicing DMT it is important to take care of Authentic Movement method, observation of movement using the Laban Bartenieff Movement System (LBMS) method and the Kastenberg Movement Profile (KMP). Results: The changes that DMT psychotherapy started to bring were observed both in the client’s movement and in the verbal layer. The client has acquired the ability to observe her feelings and needs. This influenced her perception of announcement heard from different people and the decisions she made. The DMT therapy with Beata is not over yet, which makes it possible to take a deeper look at topics related to therapeutic goals. Conclusions: Dance/movement psychotherapy has proved to be an effective method of working with patients with personality disorders psychopathology of the narcissistic type. This method makes it possible to build a sense of the patient’s boundaries and needs, and to strengthen self-esteem. Sessions seem to be very helpful in integrating inner life, feelings and experience. In addition, it helps in dealing with the internal tension of patients and gives the opportunity to expand ranges of movement. In the verbal part, it is possible to discuss the problems that the client carries within himself, which cause him fear, anxiety and other unpleasant emotions.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"37 1","pages":"193 - 216"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84832408","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":"Susac syndrome with cognitive impairment - case report of 31-year-old woman","authors":"Michał Terpiłowski, Barbara Terpiłowska, Anna Orzeł, Dominika Szlichta, Marcin Łata, Michał Próchnicki","doi":"10.2478/cpp-2021-0007","DOIUrl":"https://doi.org/10.2478/cpp-2021-0007","url":null,"abstract":"Abstract Introduction: Susac syndrome (SuS) is a rare immune-mediated disease caused by occlusions of microvessels in the brain, retina and inner ear. It is characterized by the clinical triad of encephalopathy, visual disturbances and hearing loss. The diagnosis of SuS is based mainly on the clinical symptoms and the supporting tests in which characteristic changes occur in the MRI. Case report: Here, we present a case of a patient with possible SuS with psychiatric symptoms. A 31-year-old woman was admitted to the Department of Psychiatry due to deteriorating mental health for several weeks manifested as a negative mood and suicidal thoughts. During hospitalization, a neurological consultation was conducted, in which the patient was identified as conscious, psychomotor sluggish, with impaired verbal contact and persistent hearing and vision impairment. Cross-sectional assessment of cognitive functions revealed that the patient had a generalized syndrome of neuropsychological deficits, which confirms the diagnosis of dementia. Discussion: This case summary provides an example of a woman diagnosed with SuS manifested as a cognitive impairment with associated vision and hearing deterioration. It is worth emphasizing the fact that such presentation of the triad of at disease onset is rare. The characteristics of the organic changes in the brain described in the MRI probably explain the symptoms described in that case. The prognosis of SuS depends on early diagnosis and treatment. Conclusions: A diagnosis of SuS should always be considered in the presence of nonspecific neuropsychiatric symptoms and progressive multifocal neurological symptoms, hearing loss, and visual impairment. An important fact is that the typical triad of SuS symptoms in most cases does not occur simultaneously, which makes the diagnostic process very difficult and may lead to misdiagnosis.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"34 1","pages":"83 - 86"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89591411","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":"Depression and the use of antidepressants in cardiovascular diseases from a cardiologist’s perspective","authors":"D. Blat, E. Stelmach","doi":"10.2478/cpp-2021-0008","DOIUrl":"https://doi.org/10.2478/cpp-2021-0008","url":null,"abstract":"Abstract Introduction: Cardiovascular diseases, especially coronary heart disease or heart failure, are often chronic. Aim and method: The aim of this study was to review the literature on the prevalence of depressive disorders and the use of antidepressants in cardiovascular disease. For this purpose, articles available in PubMed and Google Scholar databases were used. Results: About one in five patients with cardiovascular disease suffers from major depressive disorder. Psychosocial stress, depression and anxiety, are associated with poorer prognosis and make it more difficult for patients to make positive lifestyle changes and comply with medical recommendations. Conversely, depressive symptoms are associated with an increased risk of cardiovascular incidents. Regarding pharmacotherapy, selective serotonin reuptake inhibitors (SSRIs) are considered safe drugs, while tricyclic antidepressants are not recommended. In the treatment of depression and cardiovascular diseases, supplementation or a diet rich in omega-3 fatty acids is worth mentioning. Conclusions: The above literature review highlights the need for a multidirectional approach that is essential to diagnose, understand and then treat these, often comorbid, conditions of cardiovascular disease and depression.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"44 1","pages":"87 - 93"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80119767","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":"New drugs in psychiatry - cariprazine, lurasidone, esketamine","authors":"Kinga Pożarowska, Adam Rusinek, Gracjan Rudziński, E. Soroka, J. Masiak","doi":"10.2478/cpp-2021-0010","DOIUrl":"https://doi.org/10.2478/cpp-2021-0010","url":null,"abstract":"Abstract Introduction: Invariably, the search for an “ideal drug” in psychiatry has been going for years, one that is safe and effective, prevents relapse and shows the least possible side effects. Material and methods: The aim of this study authors is to draw attention to new drugs used in psychiatry- cariprazine, lurazidone and esketamine, their mechanism of action, dosage, the most common side effects and metabolism. The article reviews the research and works on these drugs available in Google Scholar and PubMed databases and the characteristics of medical products on years 2010-2021. Results: Cariprazine is a drug registered in Poland for the treatment of schizophrenia in adults since July,13 2017. In the world, it is additionally used in the treatment of manic and mixed episodes in the course of bipolar disorder, depression in the course of bipolar disorder and unipolar depression. Lurasidone in Poland is indicated for the treatment of schizophrenia in adult patients and adolescents from 13 years of age. In the world it is also used to treat depression in bipolar disorder, in some cases off-label in the treatment of mania in bipolar disorder and irritability and anger in autism spectrum disorders. Esketamine in nasal spray in combination with an oral antidepressant has been approved in the US for the treatment of depression in adults for whom other antidepressants have not benefited, in Poland, it is also used in such an indication. Conclusions: The action profile of these drugs, the research to date and the results of treatment with these drugs are very promising. The drugs are safe and well tolerated. However, it is clinical practice that will verify the usefulness and effectiveness of treatment with them and show the effects of long-term therapies with their use.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"83 1","pages":"111 - 124"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83722902","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":"When should a psychiatrist remember to test homocysteine levels? - a literature review","authors":"K. Nowak, Sylvia Chiriboga, Izabela Halczuk, H. Karakuła-Juchnowicz","doi":"10.2478/cpp-2021-0006","DOIUrl":"https://doi.org/10.2478/cpp-2021-0006","url":null,"abstract":"Abstract Introduction: Homocysteine is an endogenous sulfur amino acid, formed as a result of biochemical changes in methionine. The normal concentration of homocysteine in healthy people is within the range of 5 - 15 µmol / l, and values above 15 µmol / l are referred to as hyperhomocysteinemia. Moreover, it has been shown that the level of homocysteine may be associated with the occurrence of mental disorders. The aim of this article was to search for a relationship between the level of this amino acid and the incidence and prognosis of bipolar disorder, depression, anxiety disorders, schizophrenia or Alzheimer’s disease. Material and method: For the review of the literature, available articles from the PubMed database and Google Scholar were used under the following keywords: homocysteine, depression, bipolar disorder, schizophrenia, Alzheimer’s disease in the period from 1992 to 2021. Results: The research conducted so far shows that there is a significant correlation between elevated levels of homocysteine and the above-mentioned mental disorders. Conclusion: In order to prevent the consequences of the increased level of homocysteine, its concentration in blood serum should be monitored periodically and appropriate treatment should be implemented in case of abnormal results. It is important to educate patients about the consequences of hyperhomocysteinemia i.a. atherosclerosis, stroke, ischemic heart disease, osteoporosis, neural tube defects, mental disorders and neurodegenerative diseases. It should be also established a strategy to lower the level of this amino acid through lifestyle changes, as well as the supply of folic acid, vitamins B12, B6, B2, N-acetylcysteine and betaine.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"46 1","pages":"69 - 82"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74450341","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":"When does schizophrenia really begin? - A case report confirming the neurodevelopmental theory of schizophrenia","authors":"Julita Szarpak, Karol Ciejka, Weronika Perczyńska, M. Flis, Paulina Wróbel-Knybel","doi":"10.2478/cpp-2021-0003","DOIUrl":"https://doi.org/10.2478/cpp-2021-0003","url":null,"abstract":"Abstract Introduction: 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. Aim, material and methodology: 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. Case report: 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. Conclusions: 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.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"257 23","pages":"26 - 37"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72419595","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":"Psychopathological conditions and somatic consequences of a suicide attempt with a corrosive substance in a patient suffering from long-lasting paranoid schizophrenia - a case study","authors":"M. Romaniuk, Julita Poleszak-Szabat, P. Krukow","doi":"10.2478/cpp-2021-0004","DOIUrl":"https://doi.org/10.2478/cpp-2021-0004","url":null,"abstract":"Abstract Background: 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. Aim: 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”). Case report: 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. Discussion: The psychotic exacerbation in the patient could have resulted from sensory deprivation due to her feeling of loneliness and deep social isolation.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"82 1","pages":"38 - 45"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79693022","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":"The ketogenic diet: a co-therapy in the treatment of mood disorders and obesity - a case report","authors":"Agata Pieklik, Martyna Pawlaczyk, J. Rog, H. Karakuła-Juchnowicz","doi":"10.2478/cpp-2021-0002","DOIUrl":"https://doi.org/10.2478/cpp-2021-0002","url":null,"abstract":"Abstract Introduction: There has been a growing interest in the ketogenic diet (KD) due to its suggested therapeutic potential to support numerous chronic diseases. KD is characterized by high amounts of fats and a reduced amount of carbohydrates and protein intake. During following the nutrition protocol, ketones are synthesised, which are the primary source of energy. The elevated concentration of ketones in blood serum inhibits hunger, what leads to reduced body weight. Some authors suggest KD has antidepressant potential and could stabilise mood by affecting neurotransmitters homeostasis in the central nervous system. Material and methods: The aim of the study was to assess the effect of KD on body weight reduction and improvement of mood in the patients with mood disorder diagnosis. To interpret the results of nutritional intervention, the laboratory parameters and structuralised scales and questionnaires were used. Results: After following 4-week therapy, the reduction of body weight, correction of some laboratory measurements and reduction in mood symptoms were noticed. Conclusions: The ketogenic diet affects the anthropometric measurements. However, a variety of simultaneous therapeutic approaches makes impossible determination of the effect on depressive symptoms.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"38 1","pages":"17 - 25"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77799488","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":"Dance and Movement Psychotherapy - description of the method and group sessions in General Psychiatric Ward","authors":"Ewelina Drzał, Marcin Łata","doi":"10.2478/cpp-2021-0001","DOIUrl":"https://doi.org/10.2478/cpp-2021-0001","url":null,"abstract":"Abstract Introduction: 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. Material and method: 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. Discussion: 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. Conclusions: 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.","PeriodicalId":56342,"journal":{"name":"Current Problems of Psychiatry","volume":"98 1","pages":"7 - 16"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79477753","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}