搜索结果：Psychiatria polska

Treating schizophrenia involves many difficulties. It is estimated that around 20-33% of patients do not respond to the proposed therapy with available antipsychotic drugs, which is associated with the occurrence of problems with everyday functioning. Currently used drugs are mainly characterized by regulation of the dopaminergic system. This review compiles information on the effectiveness of a complex drug (xanomeline with trospium) for schizophrenia with a new mechanism of action. The drug, known as KarXT, targets proteins in the brain known as muscarinic receptors. Activation of these receptors suppresses the release of the neurotransmitter dopamine, whose deficiency is associated with the occurrence of key symptoms of schizophrenia, such as hallucinations and delusions. The drug offers hope for better efficacy in treating schizophrenia and better tolerability than current therapies. On September 27, 2024, the FDA approved Cobenfy (known as KarXT - xanomeline with trospium), a new oral medication for adults with schizophrenia. The approval of Cobenfy is a landmark moment in the treatment of schizophrenia because it offers a new, innovative treatment option for this challenging condition.

The aim of the study was to search for the relationship between insomnia, stress, and occupational burnout and to identify factors influencing their severity among health care workers. This survey-based study was conducted among 216 health care workers. It was performed using the author questionnaire, the Perceived Stress Scale (PSS-10), the Athens Insomnia Scale (AIS), and the Maslach Burnout Inventory (MBI). Analysis of the effects of stress (PSS-10) and insomnia (AIS) on occupational burnout showed that stress correlated significantly (p ˂ 0.05) and positively (r ˃ 0) with all MBI subscales; that is, the more severe the stress, the higher the levels of emotional exhaustion, depersonalization, but also personal accomplishment. Insomnia correlated significantly (p ˂ 0.05) and positively (r ˃ 0) with all MBI subscales - the more severe the insomnia, the higher the levels of emotional exhaustion, depersonalization, but also personal accomplishment. (1) Age and work experience were the sociodemographic variables that determined the occurrence of insomnia among the surveyed participants. (2) The form of employment may be an important factor that determines the level of stress, insomnia, and job burnout. Those employed under permanent contracts had lower levels of stress and job burnout, more often suffered from insomnia, and had higher levels of personal accomplishment. (3) In the study group, stress and insomnia influenced all aspects of job burnout. As stress and insomnia increased, so did levels of depersonalization, emotional exhaustion, but also personal accomplishment.

Depression is becoming an increasingly significant challenge for public and societal health, affecting both adults and children and adolescents worldwide. Diagnosis is based on identifying five characteristic symptoms persisting for at least two weeks. Diagnosing children may be more challenging due to the masking of symptoms in behavioral patterns. Treatment mainly involves medications such as selective serotonin reuptake inhibitors (SSRIs), but due to limited availability of approved drugs, off-label use is often resorted to. Fluoxetine is an important drug in the treatment of depression in children, showing efficacy and good tolerability. However, patients should be monitored for suicidal thoughts. Sertraline, although not registered for the treatment of depression in children, is often used off-label and shows a positive response to treatment. Escitalopram, approved for the treatment of depression in children over 12 years of age, is stronger and more selective than citalopram, but its approval is based on limited clinical trials. Children and adolescents have different pharmacokinetic and pharmacodynamic profiles, requiring a personalized approach to therapy. Therapy monitored by drug concentration in the blood (TDM) is an important tool for adjusting the dose to the patient's needs. The role of pharmacists in monitoring antidepressant therapy in children and adolescents is valuable and can contribute to improved clinical outcomes. The article analyzes the efficacy and safety of antidepressant drugs in children and adolescents, with an emphasis on SSRIs, and identifies issues related to therapy selection, with particular emphasis on personalized care and the growing role of TDM in optimizing treatment outcomes.

Limited data exist on the relationship between diabetes distress (DD), quality of life, and metabolic control in Polish adolescents with type 1 diabetes mellitus (T1DM) during transition to adult care. This study examines associations among Polish 18-year-olds with T1DM as they transition from pediatric to adult diabetes care. This cross-sectional study enrolled 110 consecutive patients aged 18 years with T1DM who completed the Problem Areas in Diabetes (PAID) questionnaire and Short Form Health Survey (SF-36v1). Continuous glucose monitoring (CGM) parameters were used to evaluate metabolic control. Diabetes distress (DD) correlated with all quality of life scales but not with glycemic control. Women reported higher diabetes-related distress (p = 0.017) and poorer mental health (p = 0.009) than men. Smokers demonstrated worse glycemic parameters (p = 0.016) and poorer mental health (p = 0.008). Unexpectedly, poorer glycemic control was associated with better quality of life. A longer disease duration and an earlier age at onset were associated with worse glycemic control. Diabetes distress is more closely associated with quality of life than metabolic control in Polish 18-year-olds with T1DM. Females, individuals with longer disease duration, and smokers may benefit from targeted interventions emphasizing both psychological support and diabetes education.

Schizophrenia spectrum disorders (SSDs) in children and adolescents are rare but clinically severe conditions. In Poland, evidence regarding diagnostic practices and system-level determinants of pediatric SSD diagnoses remains limited. This study aimed to analyze nationwide trends in first-time inpatient diagnoses of SSDs in youth between 2014 and 2019, with a focus on age distribution, diagnostic coding patterns (F20, F21, F25), and selected indicators of service utilization and reimbursement. A retrospective register-based analysis was conducted using national inpatient data from the Polish National Health Fund (NFZ) for the years 2014-2019. The study included 9,034 patients aged 0-17 years who received a first-time diagnosis of SSDs coded as F20, F21, or F25 according to ICD-10. Trends in age at diagnosis, diagnostic category distribution, hospitalization volume, and reimbursement indicators were analyzed descriptively over time. Between 2014 and 2019, 9,034 inpatients aged 0-17 years received first-time SSD diagnoses. Schizophrenia (F20) overwhelmingly predominated across all age groups, while F21 and F25 were rarely used. A shift toward younger adolescents was observed, with a growing proportion of diagnoses in the 13-14-year-old age group and a gradual decline among patients aged 15-17 years. Hospitalization numbers remained relatively stable, while the volume of reimbursed services declined and total refunds increased, suggesting rising per-case costs despite lower service utilization. The findings indicate a shift toward earlier diagnostic labeling of schizo- phrenia spectrum disorders in Polish youth and a marked overreliance on the F20 code, suggesting diagnostic oversimplification. These patterns are likely influenced by systemic and reimbursement-related factors and by the limited developmental sensitivity of the ICD-10 classification, particularly in pediatric psychiatry. Comparable coding tendencies and age-distribution shifts have been reported in U.S., German, and Scandinavian register-based studies, indicating that the Polish findings reflect administrative and structural influences on diagnostic practice rather than true epidemiological differences. Adoption of developmentally informed classification principles, such as those embodied in DSM-5, may improve diagnostic accuracy, care planning, and resource allocation in child and adolescent psychiatry.

Craniopharyngiomas are rare and benign intracranial tumours arising in the sellar region. Typically, patients with craniopharyngioma present with headaches, visual disturbances and endocrine deficits due to compression of adjacent proximal structures. Primary psychiatric clinical presentation has been rarely reported. We present the case of a 59-year-old female with craniopharyngioma with suprasellar extension into the third ventricle and a clinical picture dominated by behavioural changes. Due to mental disturbances, the patient was diagnosed and underwent initial surgical treatment in another medical facility. She was admitted to our Department due to a mental disorder relapse attributed to tumour regrowth. On admission, she was singing religious songs spontaneously or in response to questions, and neuropsychological examination revealed disturbances of memory, attention, executive functioning and decreased drive. The patient was scheduled for reoperation. Following subtotal resection, she was discharged home without psychiatric symptoms. Two years later, after initial improvement, the patient was readmitted with the same mental disorder and tumour regrowth. She underwent a second reoperation and was discharged with improved mental status. After a 2-month follow-up period, the patient's family reported a complete resolution of behavioural disturbances. Based on the literature review and our observation, we assume that the psychiatric manifestation of craniopharyngioma might be associated with dysfunction of suprasellar structures, namely the hypothalamus, and in such cases, resection should be carried out to the maximum safe extent.

Obsessive-compulsive disorder (OCD) is a condition in which the key symptoms are obsessive thoughts and motor compulsions. The prevalence of obsessive-compulsive disorder is about 2-3%. The issue of the effectiveness of internet-based therapeutic interventions based on cognitivebehavioral therapy (iCBT) for people suffering from obsessive-compulsive disorder (OCD) has not been thoroughly investigated in Poland yet. The aim of this article is to present the results of existing studies on sample iCBT programs for people with OCD and to analyze their effectiveness. In addition to reviewing the conducted research on the therapeutic effectiveness of iCBT, we also presented the results of analyses of the main predictive factors that may influence the effectiveness of internet-based cognitive behavioral therapy when working with patients with OCD. The following scientific databases were reviewed in search for relevant literature: PubMed/MEDLINE, Web of Science, and EBSCO. The presented study is a review of works published in the last 15 years (from 2010 to 2024). The following key words were used while searching for relevant articles: icbt, internet based cognitive behavioral therapy; internet cognitive behavioral therapy; internet-based intervention ocd; internet-delivered cognitive behavior therapy, and ocd, obsessive compulsive disorder, obsessive-compulsive symptoms. Eventually 38 research papers were selected for further analysis. The initial research suggests that fully automated iCBT programs, as well as those including therapist support, are promising approaches to working with patients and are an effective way to increase access to treatment for people with OCD.

The phenomenon of "hikikomori" is characterized by spending most of the day in one room, visibly avoiding social situations and interpersonal relationships, and leaving one's room only at night so as not to be noticed by others, and spending a lot of time surfing the Internet or playing video games. Although first described in Japan, cases have been described from around the world. Studies on hikikomori available in the literature indicate a wide range of disorders diagnosed in this group of patients such as anxiety disorders, personality disorders, mood disorders, and psychotic disorders. However, it is most often observed with ASD (autism spectrum disorder). The aim of this study is to consider hikikomori as a specific presentation of psychotic decompensation in people with ASD. In the case of a 10-year-old boy with ASD, sulpiride brought an improvement in social withdrawal, which, together with the symptoms presented by him, may indicate the possibility of psychotic decompensation in the form of hikikomori. Due to the lack of therapeutic guidelines for the management of people with hikikomori, this may be a valuable guideline for the implementation of appropriate pharmacotherapy by clinicians, in which attention should also be paid to frequently occurring other psychiatric disorders.

To explore the mediating role of negative resources distribution in the relationship between sense of hopelessness and intensity of self-aggression in problematic substance users. Beck's concept was used to define sense of hopelessness, while Gaś's concept of psychological aggression syndrome was used to define self-aggressive behavior. Two dimensions of this syndrome were crucial for our research ‒ self-destructive tendencies and hostility towards oneself. The mediating functions of resource distribution consistent with the desperation principle are described based on Conservation of Resources Theory by Hobfoll. The study encompassed 606 individuals. The mean age was 42.58. The study used the Beck Hopelessness Scale (BHS) in the Polish adaptation by Oleś and Juros, the Psychological Inventory of Aggression Syndrome (IPSA), and the Polish adaptation of Hobfoll's Conservation of Resources-Evaluation (COR-E). Our research showed a significant positive correlation between sense of hopelessness and intensity of self-destructive behaviors in problematic substance users. Distribution of resources is a mediator of the relationship between feeling of hopelessness and the frequency of self-aggressive behaviors: an increase in the feeling of hopelessness leads to a significant unfavorable distribution of resources, while an unfavorable distribution of resources co-occurs with an increased risk of self-destructive behaviors. In a group of problematic substance users, intensity of their sense of hopelessness is correlated with a tendency to self-aggressive behaviors. Distribution of resources moderates this correlation.

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The Secondary Traumatic Stress Inventory (STSI), which is a modified version of the PTSD Symptom List (PCL-5), is designed to assess the symptoms of secondary traumatic stress in professionals working with traumatized individuals. The aim of the study was to determine the psychometric properties of the STSI and establish diagnostic criteria allowing for the assessment of the severity of disorders following secondary traumatic stress. The research was conducted among 900 people representing eight occupational groups exposed to secondary trauma. In total, data from 810 participants was analyzed, the majority of whom (64%) were women. The mean age of the subjects was 43.9 years (SD = 9.60). The STSI was performed in conjunction with several other measurement tools. STSI is characterized by a high reliability index (Cronbach's alpha = 0.94). Four factors were found to correspond to the main criteria of post-traumatic stress disorders, viz. intrusions, avoidance, changes in cognition and emotions, and increased arousal and reactivity. The confirmatory analysis confirmed the validity of adopting the four-factor structure. A cut-off point of 33 was found to be predictive of possible disorders after secondary traumatic stress. The highest risk of disorders was noted among medical personnel, the lowest among therapists and police officers. STSI is an accurate and reliable tool for assessing secondary traumatic stress and can be used both in research and clinical practice as a predictor of disorders after secondary traumatic stress.

Schizophrenia links with altered language structure and may be evolutionary consequence of language development. High heritability of the disease led to recent endeavour in explaining the genetic background. Genome-Wide Association Studies (GWAS) indicate schizophrenia as highly polygenic disease with many receptor and synaptic plasticity pathways engaged. Here we present a systematic review on the topic of schizophrenia GWAS findings and its potential relevance to language skills. We used GWAS catalog data to identify all significant associations in schizophrenia (including selected endophenotypes) and studied its relevance in the context of published data on language phenotypes associations. Among genes involved in language evolution, FOXP1 and ROBO2 were indicated by GWAS as associated with schizophrenia. Evidence on schizophrenia linked SNPs was found for association with intelligence, educational attainment, cognitive abilities and language processing brain structures imaging results. The review discusses hypotheses of language alterations in schizophrenia as a consequence of impaired synaptic plasticity and neural network formation.

This article discusses the issue of differential diagnosis of cases of suicide that are prompted by the murder of another person or persons. Long-standing use of violence by the perpetrator against the victim motivated by jealousy, will of revenge, hatred, a desire to physically hurt another person, and a desire to brutally kill another person quickly and in a cruel manner indicates that we are dealing with a post-aggression suicide, and not an extended one. Extended suicide has been defined as being motivated by altruism and as a result of deep mental disturbances as well as a transference of one's problems onto close family members with whom the perpetrator is emotionally involved. Authors suggest that the true differentiation between "post-aggression suicide" and "extended suicide" may play an important role in forensic psychiatric opinions conducted at the request of law enforcement agencies and the justice system.

The aim of the study was to investigate whether the prevalence of self-declared depressive symptoms among adolescents attending secondary schools in Krakow is associated with increased frequency and type of psychoactive substance use, and whether depressive symptoms, viewed as a categorical or dimensional variable, may be important in detecting risk of psychoactive substance use among adolescents. A cross-sectional analysis was performed in a group of 1,515 17-year-old students with the use of the Beck Depression Inventory and an original Stimulants questionnaire. The analysis of the risk of using psychoactive substances was carried out in relation to independent variables expressed as continuous variables. In the group of boys, each additional point on the Beck scale increased the overall risk of substance use by 3.3%, cigarette smoking by 2.7%, drinking alcohol by 2.7%, and drug use by 4%. In the group of girls, each additional point on the Beck scale increased the risk of substance abuse - overall by 3.7%, cigarette smoking by 3.6%, drinking alcohol by 3.1%, and drug use by 5.9%. Depressive symptoms, approached as a continuous variable, increase the risk of psychoactive substance use in both boys and girls, in particular a strong relationship is observed in the group of girls with low severity of symptoms. The presence of declared depressive symptoms increases the risk of using psychoactive substances, especially alcohol and tobacco, and to a lesser extent drugs, in both boys and girls. The use of a dimensional approach made it possible to identify the relationship between increasing depressive symptoms and psychoactive substance use in the group of girls regarded as 'healthy' ('with a negative screening diagnosis') in the categorical approach.

The aim of the study was to see if and to what extent the length of time spent in front of a TV, computer, laptop or tablet screen differentiates the development of children. The study included 46 girls and 55 boys aged 6-10. The children were tested with the IDS-2 test, while parents were asked to fill out questionnaires, regarding demographic information, time of contact with media and child development. Diagnosis was made for ASD, ADHD, depressive symptoms and anxiety disorders. The results indicated significant differences between children spending more than two hours a day in front of a computer or TV and those with less contact time, in terms of large motor development and the social-emotional sphere in the test used to diagnose autism. The results are consistent with reports indicating a potential link between media contact time and ASD traits in children. It is therefore reasonable not only to limit the amount of time early school-age children spend in contact with the media, but also to closely monitor those who exceed this time limit.

The most common psychiatric disorders in cancer patients are anxiety disorders. These arise from negative experiences and personal traumas of the patient, the fear of developing cancer, the fear of death, and anxiety about painful examinations and procedures. This article aims to determine the occurrence and intensity of stress and anxiety in patients diagnosed with proliferative disease of the haematopoietic system and their sociodemographic correlates. The study involved 100 patients diagnosed with proliferative disease of the haematopoietic system (acute leukaemia, chronic leukaemia, lymphoma, plasma cell myeloma, erythraemia). Participants completed the Perceived Stress Scale, State-Trait Anxiety Inventory and a questionnaire on sociodemographic variables and disease characteristics. Differences between patient results and tool validation group results were examined using one-sample Student's t-tests. Relationships between variables were determined using Spearman's rho and the Kruskal-Wallis test. Patients with proliferative disease of the haematopoietic system exhibit higher levels of stress compared to the general population. Sociodemographic variables, such as marital status and occupational situations, had significant implications for stress intensity. The participants showed a moderate level of state anxiety and a lower inclination to react with fear compared to the tool normalisation group. As in the case of stress, the presence of loved ones, occupational situations and age significantly influenced the intensity of anxiety. The higher the stress among the participants, the higher their experienced anxiety. Coping with cancer, i.e. fighting the disease, involves the search for emotional and instrumental support by affected individuals. Supportive environmental conditions such as stable family and professional situations are crucial for the psychological well-being of the participants.

The aim of our study was to acknowledge the levels of stress, the main stressors and the difficulties of being a dentistry and medicine student. A total of 994 clinical students from both dental and medical undergraduate degrees at Jagiellonian University Medical College in Kraków, Poland were enrolled in the study, of whom 830 were medical and 164 were dental students. We used two independent international stress questionnaires, both validated for the Polish translation and environment: the Perceived Stress Scale and the Perceived Medical School Stress Instrument. Both medical and dental students had high levels of stress: 20.9 ± 7.37 and 21.24 ± 6.84, respectively. The level of stress was slightly higher among dental students, however, the results were not significant (p = 0.767). Dental students significantly more often were concerned that they will not be able to endure the long hours and responsibilities associated with clinical training (p = 0.001), however, medical student significantly more often agreed that medical school fosters a sense of anonymity and feelings of isolation among the students (p = 0.01). Polish clinical medical and dental students experience high levels of stress, which is slightly higher among dental ones.

Depressive disorders are one of the most common psychiatric problems in the general population, and they often also affect people struggling with infertility. It has been proven that this problem is widespread in many countries around the world and affects both women and men, but with greater intensity of depressive symptoms in infertile women. Assisted reproductive technologies, such as in vitro fertilization, are a key method in the treatment of infertility, but they may also increase the risk of depression related to unsuccessful conception attempts. Antidepressants, especially SSRIs commonly used to treat symptoms of depression, can have many negative effects on fertility, but the risk of infertility is statistically lower with drug therapy than with untreated depression. Psychological support, including psychotherapy, can be an important element of infertility treatment, increasing the chances of getting pregnant by relieving stress, reducing the severity of symptoms of mental disorders, and thus improving the quality of life. The following study aims to provide information on the interdependence between depression and infertility, highlight the scale of the phenomenon of co-occurrence of depressive symptoms and infertility, and present directions for counteracting this problem.

It is estimated that approximately 1% to 3% of people in the world suffer from celiac disease, which mainly affects Caucasians. The HLA-DQ2 and HLA-DQ8 haplotypes present in the majority of the European population diagnosed with celiac disease are helpful in diagnosing the disease. The main symptom is chronic inflammation of the small intestine and atrophy of the intestinal villi, but neurological and psychopathological symptoms, such as depression or severe anxiety, may also occur. Numerous studies show that a gluten-free diet alleviates the psychological symptoms associated with celiac disease. However, strict dietary requirements often constitute a challenge for patients, changing their current lifestyle and limiting its comfort. In patients with celiac disease, increased symptoms of depression and anxiety are observed, and the duration of the disease affects the severity of the above symptoms. Currently, therapeutic benefits are attributed especially to a gluten-free diet, but recent scientific reports indicate a comparable clinical effect in patients using probiotics. The course of the disease is also influenced by the emotional support of the patient's family, causing a milder course of the disease. Caregivers of patients should pay special attention to the symptoms of anxiety and depression in their patients, because they are often unnoticed, which leads to an unfavourable course of the disease.