Postepy psychiatrii neurologii最新文献

{"title":"Stimulation of bed nucleus of the stria terminalis area for treatment-resistant obsessive-compulsive disorder and comorbid depressive and anxiety symptoms: a systematic literature review.","authors":"Michał Sobstyl, Karol Karamon, Tadeusz Pietras, Kasper Sipowicz, Marcin Rylski","doi":"10.5114/ppn.2025.153598","DOIUrl":"10.5114/ppn.2025.153598","url":null,"abstract":"<p><strong>Purpose: </strong>The bed nucleus of the stria terminalis (BNST) is a tiny nucleus connected by a bundle of axons with the amygdala. The BNST acts as a relay center, coordinating autonomic, limbic, behavioral, neuroendocrine, and motor functions. It plays a key role in anxiety and anxiety-related disorders. This review presents clinical outcomes of deep brain stimulation (DBS) of the BNST in treatment-resistant obsessive-compulsive disorder (trOCD) and treatment-resistant depression (TRD).</p><p><strong>Views: </strong>The medical literature search was conducted in MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL). The identified studies were assessed on the basis of patient characteristics, clinical outcomes, and adverse events related to DBS. The reduction of the Y-OCBS in the reported studies ranged from 27% to 66%, with mean reduction of the YBOCS of 45% at a mean of 58 months. The authors of clinical studies also reported enhanced socio-occupational functioning and quality of life. Adverse effects included hypomania, depressive episodes, weight gain, emotional lability, and seizures. However, most side effects were transient and reversible with stimulation adjustments.</p><p><strong>Conclusions: </strong>Clinical experience with BNST DBS remains limited, with most studies treating trOCD and only two addressing TRD. Reported outcomes suggest reductions in obsessions, compulsions, and affective symptoms, alongside improved daily functioning. The BNST appears to be a promising DBS target for anxiety-related psychiatric disorders.</p>","PeriodicalId":74481,"journal":{"name":"Postepy psychiatrii neurologii","volume":"34 3","pages":"177-188"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From \"bad trips\" to \"transformative and potentially therapeutic trips\": harnessing the potential of psychedelics - narrative review.","authors":"Nikolaos Statharakos, Elisavet Papadopoulou, Aaron J Alvares, Aikaterini Mara","doi":"10.5114/ppn.2025.153603","DOIUrl":"10.5114/ppn.2025.153603","url":null,"abstract":"<p><strong>Purpose: </strong>Psychedelic substances are attracting attention for their therapeutic potential in mental health disorders. Emerging research suggests that even negative psychedelic experiences, or \"bad trips,\" may hold therapeutic potential when managed in controlled settings. This narrative review explores the nature of \"bad trips\", their contributing factors, and their integration into therapeutic practices.</p><p><strong>Views: </strong>Data for this review were identified through systematic searches of PubMed, PsycINFO, and Scopus using keyword \"bad trip\", \"psychedelic therapy\" with the use of Boolean variable AND. Articles were selected based on their relevance, recency, and methodological rigor. Key studies were analyzed to extract findings on psychological mechanisms and therapeutic frameworks related to challenging psychedelic experiences. Bad trips frequently involve intense fear, anxiety, and unresolved traumas. Controlled therapeutic settings allow for these experiences to catalyze emotional processing, trauma resolution, and transformative insights. Historical and contemporary studies highlight long-term mental health improvements following the effective integration of such experiences. Ethical considerations, including informed consent and aftercare, are critical to mitigate risks and optimize outcomes.</p><p><strong>Conclusions: </strong>While distressing, bad trips may act as catalysts for psychological growth in therapeutic contexts with trained facilitators. Further research is needed to refine therapeutic protocols and elucidate the long-term effects of challenging psychedelic experiences, offering innovative approaches to mental health treatment.</p>","PeriodicalId":74481,"journal":{"name":"Postepy psychiatrii neurologii","volume":"34 3","pages":"189-195"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The discrepancy between the self-assessment of facial size and shape and morphometric facial analysis in young female patients with anorexia nervosa.","authors":"Patrycja Kamieńska, Weronika Kamieńska, Bartosz Jastrzębski, Katarzyna Śniatała, Tamara Pawlaczyk-Kamieńska","doi":"10.5114/ppn.2025.153585","DOIUrl":"10.5114/ppn.2025.153585","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to compare the subjective assessments made by patients with anorexia nervosa (AN) of their faces, including shape and dimensions, with the parameters obtained in the morphometric examination.</p><p><strong>Methods: </strong>Anorexic female patients were invited to participate in the study, which was a complex research focused on the following specific objectives: 1) patients' facial symmetry evaluation based on a direct analysis by a doctor; 2) the relationship between the patient's body mass index (BMI) and degree of subjective satisfaction with the shape and size of the patient's face; 3) the objective dimensions and shape of the AN patients' faces based on the morphometric test; and 4) the relationship between the type of face shape, defined by the morphometric test parameters, and the subjectively felt degree of patient satisfaction as well as their desire to change their facial appearance.</p><p><strong>Results: </strong>The faces of all girls involved in the study were found to be symmetrical. Statistical analyses revealed a relationship between the degree of satisfaction with the shape and dimensions of one's face and the desire to change its appearance.</p><p><strong>Conclusions: </strong>In our study, most female patients with AN were dissatisfied with the appearance of their faces, believing they were wider than they actually were. No significant link was found between facial dissatisfaction and BMI, suggesting that distorted facial perceptions are more likely linked to cognitive and emotional factors than physical conditions.</p>","PeriodicalId":74481,"journal":{"name":"Postepy psychiatrii neurologii","volume":"34 3","pages":"149-154"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of resilience and job satisfaction on the negative effects of secondary trauma exposure among Polish police officers.","authors":"Grzegorz Bąk, Nina Ogińska-Bulik","doi":"10.5114/ppn.2025.153591","DOIUrl":"10.5114/ppn.2025.153591","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of the study was to examine the relationships between psychological resilience, job satisfaction and secondary traumatic stress among police officers, in order to identify the factors influencing the occurrence of negative consequences of indirect trauma exposure.</p><p><strong>Methods: </strong>The study included 237 Polish police officers from the prevention and criminal divisions. The analysis was conducted on the results of a survey obtained from 220 respondents who had contact with traumatized clients as part of their work. Their age ranged from 22 to 59 (<i>M</i> = 39.08; <i>SD</i> = 7.00). The majority of the respondents were men (83.2%). A survey and three questionnaires were used in the study, i.e., The Secondary Traumatic Stress Inventory, the Resilience Measurement Scale, and the Job Satisfaction Scale.</p><p><strong>Results: </strong>The results of the survey indicate that police officers exhibited relatively low levels of secondary traumatic stress symptoms. The study found a negative correlation between psychological resilience, job satisfaction and secondary traumatic stress. Job satisfaction was found to mediate the relationship between resilience and secondary traumatic stress.</p><p><strong>Conclusions: </strong>Psychological resilience and job satisfaction may serve as protective factors against the development of negative consequences resulting from indirect trauma exposure. The study indicates that job satisfaction may play a slightly more significant role in this regard. Increasing resilience and job satisfaction may alleviate STS symptoms and consequently contribute to increased work efficiency.</p>","PeriodicalId":74481,"journal":{"name":"Postepy psychiatrii neurologii","volume":"34 3","pages":"155-162"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychedelic use in Poland: prevalence, correlates and social attitudes.","authors":"Paweł Holas, Justyna Kamińska","doi":"10.5114/ppn.2025.153566","DOIUrl":"10.5114/ppn.2025.153566","url":null,"abstract":"<p><strong>Purpose: </strong>Recent years have witnessed a renewed interest in research exploring the therapeutic potential of classic psychedelics, such as psilocybin and lysergic acid diethylamide (LSD) in the treatment of mental disorders. However, our knowledge of the epidemiology of their use, factors associated with their recreational consumption, and attitudes toward these substances remains limited.</p><p><strong>Methods: </strong>A representative sample of Polish adults (<i>N</i> = 1051) completed an internet-based survey that included demographic questions, assessments of psychedelic substance use, including motivations and contexts, subjective evaluations of psychedelics experience, and attitudes towards psychedelics and psychedelic-assisted therapy (PAT).</p><p><strong>Results: </strong>Between 4% and 8% of Polish adults, equivalent to approximately 2 million people, have experimented with psychedelic substances at least once in their lives. Men were more likely to use psychedelics than women, with the largest group of users being individuals aged 25-34, primarily residing in urban areas. Curiosity emerged as the most common motivation for use, and home was typically reported as the context. The psychedelic experience was often described as a mixture of pleasant and unpleasant sensations. A substantial proportion of participants expressed indifferent or negative attitudes towards both PAT and psychedelics. However, prior psychedelic use, younger age, and a history of lifetime meditation practice were associated with more positive attitudes.</p><p><strong>Conclusions: </strong>Approximately 6% of Polish adults, mostly young men living in urban areas, reported using classic psychedelics, particularly LSD and psilocybin mushrooms. Further research and educational efforts are needed to support the scientific exploration of PAT, and to help shift public perceptions of its therapeutic potential.</p>","PeriodicalId":74481,"journal":{"name":"Postepy psychiatrii neurologii","volume":"34 3","pages":"139-148"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rates and characteristics of drunkorexia in a non-clinical group of adults declaring alcohol consumption.","authors":"Jagoda Różycka, Julia Celban, Franciszek Stefanek, Monika Stojek","doi":"10.5114/ppn.2025.151775","DOIUrl":"10.5114/ppn.2025.151775","url":null,"abstract":"<p><strong>Purpose: </strong>\"Drunkorexia\" describes a phenomenon in which alcohol consumption is associated with unhealthy eating habits. The tendency to use extreme forms of weight control is a way to compensate for the planned drinking episodes. The objective of the study was to characterize the phenomenon in a non-clinical group of adults declaring alcohol consumption, and to assess its relationships with alcohol use and disordered eating related variables.</p><p><strong>Methods: </strong>286 individuals placed in Upper Silesia, Poland participating in the online research program completed the following online surveys: demographics, AUDIT, EAT-26, CEBRACS, and DMBS. CEBRACS>21 cut off was used to identify the drunkorexia group. The inclusion criteria required an age above 18 and a declaration of alcohol consumption. The exclusion criteria were the self-reported formal diagnosis of alcohol dependence or eating disorders.</p><p><strong>Results: </strong>Drunkorexia was observed among 43% of the study group. The drunkorexia group had significantly more problems related to alcohol consumption, endorsed higher dieting and eating restrictions, social motives, eating avoidance, and compensatory behaviors. Hierarchical regression showed that higher AUDIT, oral control on EAT-26, social motives for drinking and restrictive eating, eating avoidance, and altering drinking behavior to control calories accounted for 63% of variance in drunkorexia severity. Cluster analysis indicated two distinct groups: one with pronounced disordered eating behaviors and one with pronounced alcohol consumption behaviors.</p><p><strong>Conclusions: </strong>Drunkorexia appears to be prevalent among people who consume some amount of alcohol without clinical diagnosis of alcohol dependence or eating disorders. Meeting the cut-off for drunkorexia is associated with greater problems related to alcohol use and disordered eating behaviors. The results obtained from the research may suggest drunkorexia as an independent psychological construct with some elements of eating disorders and alcohol abuse. The present study highlights the need to screen for drunkorexia, to educate and support individuals who have difficulties coping with the challenges of their environment or the pressures of the slim body culture.</p>","PeriodicalId":74481,"journal":{"name":"Postepy psychiatrii neurologii","volume":"34 2","pages":"63-74"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amino acids, purines, and pyrimidines as potential biochemical markers of bipolar disorder - current state of knowledge.","authors":"Krzysztof G Sadko, Hubert Wichowicz","doi":"10.5114/ppn.2025.151782","DOIUrl":"10.5114/ppn.2025.151782","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the paper is to provide an overview of knowledge about changes in blood serum levels of amino acids, purines and pyrimidines in individuals with bipolar disorder, including suggestions for potential ways of modifying the course of the disease using these substances in the diet of people in this group.</p><p><strong>Views: </strong>According to the majority of the papers in the literature, amino acids, which could possibly be used in tests for bipolar disorder, are closely related to the neurotransmitters considered to be involved in the pathogenesis of the disease. Among them the most important are phenylalanine, a substrate of tyrosine, and following this such neurotransmitters as dopamine, noradrenaline and adrenaline - which play a key role in the regulation of mood and cognitive functions - tryptophan, a precursor of 5-hydroxytryptamine (serotonin), then glycine, serine and threonine (connected with NMDA receptor). Reduced serum levels of branched-chain amino acids (leucine, isoleucine, and valine) are observed in bipolar patients, but some reports have proposed that the usage of them in diet to alleviate manic symptoms is more important clinically. Purines and pyrimidines also play important roles in neurotransmission and neuromodulation, influencing the activity of several neurotransmitters. The most promising data are those concerning adenosine and uric acid.</p><p><strong>Conclusions: </strong>At the present stage of knowledge and time of writing there is some promising data suggesting directions for further investigation, but the evidentiary value of it remains weak. The problem requires further research, such as the full assessment of patients' profiles for amino acids, purines and pyrimidines, and the confirmation of this approach needs to be established in larger numbers of patients.</p>","PeriodicalId":74481,"journal":{"name":"Postepy psychiatrii neurologii","volume":"34 2","pages":"99-107"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of migraine aura: a study of a population at a single Polish headache treatment centre.","authors":"Izabela Domitrz, Piotr R Chądzyński","doi":"10.5114/ppn.2025.151777","DOIUrl":"10.5114/ppn.2025.151777","url":null,"abstract":"<p><strong>Purpose: </strong>Migraine without aura is the most common type of the condition, whereas migraine with aura is substantially less common. Several features of aura symptoms may help us to define a different management approach. The aim of the study is to describe the characteristics of migraine aura and assess its impact on the daily lives of Polish patients. The characteristics assessed included type and severity of aura as well as the risk of migraine chronification.</p><p><strong>Methods: </strong>The study included a group of 111 (87.4% female and 12.6% male) consecutive patients from the Headache Treatment Outpatient Clinic at Bielański Hospital in Warsaw diagnosed with episodic (72%) and chronic (28%) migraine with and without aura. The patients were diagnosed according to the International Classification of Headache Disorders 3rd edition of the International Headache Society.</p><p><strong>Results: </strong>The final analysis was performed on the selected 28 patients (22 female and 6 male) with migraine with aura. Three patients with aura were diagnosed with chronic migraine. Twelve percent of all 111 migraine patients had migraine attacks both with and without aura. The most common (86%) aura type was the typical aura.</p><p><strong>Conclusions: </strong>The study confirms that visual symptoms are the most common manifestation of aura among the patients studied. In some cases, the visual symptoms can be accompanied by other features of the typical migraine aura such as paraesthesia and speech disturbances. Other types of aura, such as vestibular and hemiplegic symptoms, occur very rarely. Only 10.7% of patients with migraine with aura transformed into the chronic type of the disease in comparison to 33.7% of patients with migraine without aura.</p>","PeriodicalId":74481,"journal":{"name":"Postepy psychiatrii neurologii","volume":"34 2","pages":"87-92"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of and factors in suicidal thoughts in 14-15-year-olds. A Polish-Ukrainian study.","authors":"Krzysztof Ostaszewski, Milena Markiewicz, Maryna Klimanska, Inna Haletska, Halyna Herasym, Larysa Klymanska, Iryna Mirchuk, Viktor Savka, Oksana Zelena","doi":"10.5114/ppn.2025.151776","DOIUrl":"10.5114/ppn.2025.151776","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent suicidal behaviour is a serious and concerning public health problem that requires ongoing attention. The study aimed to assess the prevalence of suicidal thoughts among 14-15-year-olds in Lviv (Ukraine) and Warsaw (Poland) and to identify associated psychosocial factors.</p><p><strong>Methods: </strong>Self-report data were collected online in Autumn 2020 in two randomly selected samples of adolescents aged 14-15 living in Lviv (<i>N</i> = 1085) and Warsaw (<i>N</i> = 794). School classrooms were the source of the randomized samples. Differences in the prevalence of suicidal thoughts and risk/protective factors in the two study locations were analysed. The questionnaire and methodology were taken from the Polish Mokotów study.</p><p><strong>Results: </strong>Significantly more adolescents in Warsaw (25.0%) declared having had suicidal thoughts at least once or twice in the previous year than those in Lviv (16.3%). In both locations, suicidal thoughts were significantly more prevalent among girls. Regression analyses indicated that symptoms of depression, lack of energy, emotional or mental health problems that prompted consultation with a specialist, online victimisation, and being in the company of peers who use drugs were associated with an increased frequency of suicidal thoughts both in Lviv and Warsaw. Alcohol use/abuse and feeling unsafe at school appeared to be risk factors in Lviv only. Positive family relationships reduced the frequency of suicidal thoughts and buffered the negative impact of symptoms of depression in both samples. Religiosity was a statistically significant protective factor in Lviv.</p><p><strong>Conclusions: </strong>Despite some limitations, such as the use of a single-item tool to measure suicidal thoughts and the cross-sectional design of the study, the results provide support for preventive measures that include early detection and treatment of adolescent depressive disorders and other mental health problems, helping families maintain good relationships with their teenage children, countering cyberbullying, and increasing the sense of security at school as well as preventing risky behaviours.</p>","PeriodicalId":74481,"journal":{"name":"Postepy psychiatrii neurologii","volume":"34 2","pages":"75-86"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-onset ornithine transcarbamylase deficiency mimicking cognitive, behavioral and gait disorders: a case report and literature review.","authors":"Aleksandra Przybycień, Wiesława Hołub-Kucharska, Jerzy Węgielnik, Jarosław Sławek","doi":"10.5114/ppn.2025.151783","DOIUrl":"10.5114/ppn.2025.151783","url":null,"abstract":"<p><strong>Purpose: </strong>Progressive cognitive disorders are not always caused primarily by neurodegenerative diseases. This case report emphasizes the importance of taking rare metabolic disorders into consideration in the differential diagnosis in patients of all ages. It also shows the possible risk of corticosteroids in the treatment of unexplained neurological symptoms.</p><p><strong>Case description: </strong>We report on the case of a 60-year-old female who presented mild dementia with progression and fluctuations for the last 5 years, scanning speech and wide-base gait. Due to a significantly elevated level of anti-thyroid peroxidase antibodies, steroid responsive encephalopathy in autoimmune thyroiditis (STREAT) was suspected and steroids were administered. This was a trigger factor for the patient developing coma with severe hyperammonemia. Consequent genetic testing identified a pathogenic variant of the <i>OTC</i> (ornithine transcarbamylase) gene.</p><p><strong>Comment: </strong>Late-onset ornithine transcarbamylase deficiency can be a rare cause of cognitive impairment. It is reasonable to determine the level of ammonia in patients with non-specific symptoms, as hyperammonemia can cause permanent brain damage.</p>","PeriodicalId":74481,"journal":{"name":"Postepy psychiatrii neurologii","volume":"34 2","pages":"116-123"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}