[The stabilizing effect of dehydroepiandrosterone on clinical parameters of metabolic syndrome in patients with schizophrenia treated with olanzapine - a randomized, double-blind trial]. / Stabilizujacy efekt dehydroepiandrosteronu na kliniczne parametry zespolu metabolicznego u pacjentów chorych na schizofrenie leczonych olanzapina - badanie randomizowane z podwójnie slepa próba.

OBJECTIVES: Epidemiological studies have shown that low levels of dehydroepiandrosterone might increase the risk of developing metabolic syndrome. The aim of this study was to evaluate whether dehydroepiandrosterone supplementation in schizophrenic patients treated with olanzapine would influence the anthropometric and biochemical parameters of metabolic syndrome. METHODS: Male schizophrenic patients (no=55) participated in a twelve-week, randomized, double blind, placebo controlled study. They received 100 mg dehydroepiandrosterone (DHEA) or placebo as an augmentation of olanzapine treatment (an average dosage 15 mg/day). Main outcomes of the study were changes in lipid profile, fasting glucose levels, body mass index and waist circumference values. RESULTS: Forty five patients completed the study. There were no major changes in the overall cholesterol value, HDL cholesterol, LDL cholesterol or triglycerides in either group. The results of the repeated measures analysis of the system: fasting glucose level 2x, (at the beginning and end of the study), 2x (the study group and the control group), showed a significant interaction (F =5.7, df= 1.000 p= 0.021). The blood glucose level was decreased in the DHEA group. Furthermore, increases in waist circumference (delta= -1.11, t=-2.87; df=20; p=0.01) and BMI value (delta= -0.48, t=-2.38; df=19; p=0.028) were observed in the placebo group. CONCLUSIONS: Dehydroepiandrosterone supplementation results in stabilization of BMI, waist circumference and fasting glycaemia values in schizophrenic patients treated with olanzapine. To confirm the insulin-like effect of dehydroepiandrosterone, long-term research concentrating on the evaluation of glucose metabolism has to be performed.

[Sexological questionnaire for screening research. Theory and validity]. / Kwestionariusz seksuologiczny--narzedzie do badan przesiewowych: zalozenia i trafnosc.

AIM: The aim of the research was to construct a questionnaire basing on the presently standing criteria of sexual dysfunctions and sexual disorders (according to ICD-10), that would enable the diagnosis of symptoms, as well as to verify its validity. METHOD: 102 patients (46 women and 56 men, mean age of 32.09, SD = 10.29) of sexological clinics who declared they had symptoms of sexual dysfunctions or disorders were asked to participate and fill in the questionnaire which was later evaluated in a clinical study on the basis of ICD-10 research criteria. RESULTS: Results show that using the questionnaire enables the diagnosis of 100% of gender identity disorders, almost all sexual dysfunctions and disorders connected to sexual orientation. The sensibility and specificity of the questionnaire were also examined and proved very high. CONCLUSIONS: The Sexological questionnaire for screening research presents with good validity, sensibility and specificity.

People with diabetes need a lower cut-off than others for depression screening with PHQ-9.

AIMS: This study evaluated the psychometric characteristics of the Polish version of the PHQ-9 in detecting major depression (MDD) and 'MDD and/or dysthymia' in people with and without type 2 diabetes. METHODS: Participants were randomly selected from a diabetes outpatient facility (N = 216) and from among patients admitted to a medical center and psychiatric hospital (N = 99). The participants completed the PHQ-9. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to identify the presence of psychiatric symptoms. The optimal cut-offs for PHQ-9 in people with and without type 2 diabetes were investigated based on two methods: 1) Youden's index which identifies cut-off points useful in scientific research; 2) a second method of two-stage screening for depressive disorders to provide guidance for clinical practice. RESULTS: The Polish version of the PHQ-9 is a reliable and valid screening tool for depression in people with and without type 2 diabetes. An optimal cut-off of ≥ 7 was indicated by Youden's index and ≥ 5 by the two-stage method for screening for MDD and 'MDD and/or dysthymia' in the group with type 2 diabetes. A cut-off of ≥ 11 was optimal for screening for both MDD and 'MDD and/or dysthymia' among people without diabetes (Youden's index). The two-stage approach suggested a ≥ 10 score for screening for MDD and ≥ 9 for screening for 'MDD and/or dysthymia' in people without diabetes. CONCLUSIONS: A lower cut-off score of the PHQ-9 is recommended for people with type 2 diabetes as compared to the general population.

[A questionnaire of insight into schizophrenia--"my thoughts and feelings"]. / Kwestionariusz wgladu w schizofrenie--"Moje mysli i odczucia".

AIM: Construction of a brief, self-rating questionnaire of insight into schizophrenia, that can be useful in everyday practice. METHOD: The questionnaire is based on reports of patients with good remissions, confronted with the group interviews with severely psychotic patients without insight. They led to the formulation of 16 questions with three possible answers reflecting lack of insight, full insight and partial insight. 6 items that have the most discriminating power of patients with and without insight were selected in the study of 367 patients assessed by psychiatrists acting as the competent judges. The reliability of this questionnaire is good--alfa Cronbach = 0.8. In the next study with 128 patients, a similar reliability was fund--alfa Cronbach = 0.77. The validity measured as the correlation with PANSS item "Lack of Judgment and Insight" was acceptable r = -0.55. RESULTS: The 6-items questionnaire of insight into schizophrenia--"My thoughts and feelings" has good reliability and acceptable validity. The discussion of results with the patient, based on rules of cognitive behavioural therapy aiming at the shaping of insight was described as well as the preliminary sten norms were described. CONCLUSIONS: The questionnaire may be useful in the screening of patients with low insight into schizophrenia as well for a psychoeducative discussion of its results.

[Brief measure to assess perception of self-influence on the disease course. Version for schizophrenia]. / Krótka skala poczucia wplywu na przebieg choroby--wersja dla schizofrenii.

AIM: Elaboration of a brief scale for screening of perception of self-influence on the course of schizophrenia, which could be used during usual psychiatric examination. METHODS: Group focus interview of patients with favourable and unfavourable course of schizophrenia led do the formulation of the 57 items Likert's scale. The study of 403 persons with schizophrenia, assessed by their psychiatrists as having low or high perception of self-influence on the course of schizophrenia resulted in a choice of 5 items that had the strongest power of discrimination of those two groups of patients. The psychometric proprieties were assessed in the group of 90 patients with schizophrenia. RESULTS: The reliability Alfa Cronbach = 0.78 and validity (r = 0.45) assessed by correlations with the clinical assessment CONCLUSIONS: Brief measure to assess perception of self-influence on the disease course--Version for schizophrenia has good reliability, acceptable validity and can be used for screening of patients with low perception of self-influence on the disease course.