The specificity and the affective sign of autobiographical memories in individuals with depressive disorders and alcohol use disorder. / Specyficznosc i znak afektywny wspomnien autobiograficznych u osób z zaburzeniami depresyjnymi oraz zespolem uzaleznienia od alkoholu.

OBJECTIVES: Mental disorders may disrupt autobiographical memory (AM). An example is over general memories - without details, generalized or semantic. This paper assesses the functioning of AM in a depressive episode (DEP) and alcohol use disorder (ALC). METHODS: The study compared two study groups: hospitalized patients with DEPand ALC, and two control groups: people hospitalized for gastroenterological conditions (CON) and healthy individuals (PAN) (N =39 for each group; mean age: 46.0 ± 13.6 years; no differences). The specificity of AM was examined by the Autobiographical Memory Test.Participants rated memories in terms of vividness, affective intensity and sign. RESULTS: DEP and ALC groups recalled fewer specific memories than the control groups (p <0.001 for: all, positive and negative cue words), with the lowest results in DEP. Clinical groups recalled also more negative and less positive memories (p <0.001) than the control groups, with a deficit of positive ones in DEPand an excess of negative memories in ALC. An analysis of non-specific responses revealed that the ALC group recalled more "extended" memories than the CON group (p <0.005) and more "categorical" ones than control groups (p <0.05). The DEP group remembered more "semantic associations" than the PAN group (p <0.001). CONCLUSIONS: The results confirmed the presence of OGM in both clinical groups. ALC disrupts the mechanism of generating specific memories to alesser extent than mood disorders. Moreover, subjects from the clinical groups assess their past more pessimistically than the controls, with a reduced number of positive memories in people with a depressive episode, and probably an increased number of negative ones in people with ALC.

The comparison of nucleotide metabolites and amino acids patterns in patients with eating disorders, with and without symptoms of depression.

Purines, pyrimidines, and amino acid level have gained attention recently as potential determinants of mental disorders. However, eating disorders patients (ED) have not been yet appropriately studied, especially subjects with coexisting mood disorders. This paper examines the serum level of nucleotide catabolites and plasma amino acids in eating disorders with hyperphagia, with and without Major Depressive Disorder (MDD). Samples were taken from adult persons suffering from eating disorders (two forms: simple obesity and binge eating disorder) with MDD (n = 20) and without (n = 17). Serum nucleotides and plasma amino acids concentrations were analyzed with high-performance liquid chromatography-mass spectrometry. The nucleotides metabolite in MDD patients had a significantly (p < 0.05) lower uridine. Among MDD patients with ED significantly (p < 0.05) higher levels of asparagine, glutamine, proline, and arginine were found as compared to the control group. This study demonstrated differences in nucleotide metabolite and amino acid pattern in depression patients with eating disorders. This may be relevant to the mechanisms and may help identify biomarkers.

Comparison of plasma nucleotide metabolites and amino acids pattern in patients with binge eating disorder and obesity.

Binge eating disorder (BED) increasingly affects population, but the mechanisms of the disease and its biomarkers are not well characterized. Recently, plasma purines, pyrimidines, amino acid and nicotinamide metabolites profiling attracted attention in studies on pathology and biomarkers of mental disorders but has not been adequately studied in BED. Blood and plasma samples were taken from patients with adult obese with BED (n = 20) and control adult obese without BED (n = 17). Plasma samples were analyzed for nucleotides and amino acid concentrations with high-performance liquid chromatography-mass spectrometry. BED had a significantly (p < 0.05) lower uridine and hypoxanthine to creatinine ratio compared to the control group. Among the amino acids BED patients had significantly (p < 0.05) lower concentrations of glutamic acid, leucine, isoleucine and the whole branched-chain amino acids group, while the concentration of citrulline was increased. Among nicotinamide metabolites, 1-methylnicotinamide levels were significantly (p < 0.05) lower. This study highlights potential use of profiling nucleotide metabolite and amino acid pattern in BED patients that may provide information on mechanisms and potential biomarkers. However, further investigation in larger population is necessary to identify clinical correlates of the observed changes.

Application of Solution-Focused Brief Therapy (SFBT) in individuals after stroke.

OBJECTIVE: To examine the effects of Solution Focused Brief Therapy (SFBT) in individuals after stroke on self-efficacy, symptoms of depression and anxiety. DESIGN: Randomized controlled trial. SETTING: Clinic of Adult Neurology of Medical University of Gdansk and M. Copernicus Pomeranian Traumatology Centre in Gdansk. SUBJECTS: A total of 62 patients, aged 54.0 ± 9.6 years. INTERVENTIONS: They were randomly assigned to one of the two groups: SFBT participating in 10 therapy sessions and control - not participating in any psychotherapy. MAIN MEASURES: Symptoms of depression and anxiety according to Hospital Anxiety and Depression Scale, Mini-Mental Adjustment to Cancer (scale originally designed for cancer patients) and Self-efficacy Scale were examined at baseline of the study and later in the same time intervals in both groups. RESULTS: The intensity of depression and anxiety complaints drops in the SFBT group (from 5.0 to 2.0 and 8.0 to 4.0 respectively; both p < .001 Friedman's ANOVA (analysis of variance)) whilst in the control group remains unchanged. In addition to the gradual reduction of destructive attitudes (from 34.5 to 17.0), the increase in the number of constructive attitudes (from 42.0 to 50.5) and increased self-efficacy (from 79.0 to 96.0) was observed after therapy but not in the control group. CONCLUSIONS: The authors suggest SFBT as a simple, beneficial and inexpensive method to manage patients after stroke.

Autobiographical memory and its meaning in selected mental disorders. / Pamiec autobiograficzna i jej znaczenie w wybranych zaburzeniach psychicznych.

This paper presents the general characteristics of the phenomenon of autobiographical memory (AM), the current knowledge of the subject and describes hitherto identified distortions of AM in mental disorders.AM is the part of memory concerning the personal past of an individual. It includes episodic and semantic memories associated with an identity. It affects an activity and structuring of goals, it is set in human experience and emotions and it helps in creating plans. The evolutionary sig-nificance of AM is probably to facilitate short-term goal-oriented behaviors by comparing them with the previous ones. People with AM disorders often have difficulties in social functioning.The disorders of emotional life and affect, which are present in most psychiatric disorders, deform AM. It was confirmed, inter alia, in post-traumatic stress disorder, depression, autism, schizophrenia, and alcohol dependence syndrome. Overgeneral memories (the inability to recall memories that are fully filled with details) being typical of depression, and flashbacks (the involuntary recall of memories which are highly filled with visual-sensory content) being characteristic of PTSD are considered one of the most studied deficiency of AM. The study of AM potentially carries many cognitive and clinical implications. It may facilitate the prediction of the onset of a depressive episode in patients at risk; it can also help to develop psychotherapeutic techniques which are helpful in its treatment, which has in part already taken place. Few studies relate to neurofunctional changes in AM and they need a follow-up.

Hollow mask illusion - is it really a test for schizophrenia? / Czy iluzja wkleslej maski rzeczywiscie jest testem na schizofrenie?

OBJECTIVES: The aim of the study was an assessment of the phenomenon of depth perception in schizophrenic patients compared to healthy subjects. METHODS: We conducted a comparison erroneous assessment of the concave side of the mask as convex, using the popular website presenting rotating Charlie Chaplin's mask. The study was performed in patients hospitalized at the Stanislaw Kryzan Psychiatric Hospital in Starogard Gdanski diagnosed with paranoid and undifferentiated schizophrenia based on ICD-10 criteria and control group matched for age and education; each group included 58 subjects. RESULTS: The correct perception of depth in the hollow mask illusion regards approx. 30% of patients with paranoid and undifferentiated schizophrenia during exacerbation and it is three times higher in this group than in the general population. Except the number of relapses and hospitalization in anamnesis, it shows no correlation with another clinical and demographic data such as: the age of onset, the duration of illness, and results on Positive and Negative Syndrome Scale (PANSS). CONCLUSIONS: The correct perception of the hollow mask may be potentially one of the subsequent premises for the diagnosis of schizophrenia in doubtful cases. The simplicity and general availability is also an argument for conducting the test.

Clinical utility of chosen factors in predicting post-stroke depression: a one year follow-up.

OBJECTIVES: The aim of the study was to identify possible interrelation between the presence of post-stroke depression (PSD) and chosen clinical and demographic parameters. METHODS: Initially 116 patients (61.4 ± 12.6 years, women N = 42) hospitalized in Neurology Department, Medical University of Gdansk (April 2003 - December 2005) due to first ischemic stroke, were included in the study. We analysed demographic data, the lesion's side and location according to neuroimaging and global neurological deficit estimated on the first day after the stroke and at discharge using NIHSS (National Institutes of Health Stroke Scale) and Barthel Index of Activity of Daily Living. Psychiatric evaluation was done:6 (42 ± 3 days) and 12 weeks (84 ± 7 days), as well as 6 (±14 days) and 12 months (±14 days) after stroke based on ICD-10 and functional assessment scale (Rankin Scale). RESULTS: Depression was diagnosed in 29 patients (27.6%). No correlation was found between PSD and sex or age. On the first day and at discharge patients without PSD were functioning slightly better but the difference was not statistically significant. We found association between the presence of PSD and the results of Rankin scale with the exception of degree of improvement during whole observation. In the group of patients with PSD left hemisphere strokes were slightly more common, but the difference did not reach statistical significance. The location of lesions in frontal lobes and basal ganglia was associated with presence of depression. CONCLUSIONS: We found the association between the presence of PSD and location of lesions (frontal lobes or basal ganglia), as well as with the degree of functional improvement during 12 months after stroke.

[Perception of physiological visual illusions by individuals with schizophrenia]. / Postrzeganie fizjologicznych zludzen wzrokowych przez osoby cierpiace na schizofrenie.

Visual perception by individuals with schizophrenia has not been extensively researched. The focus of this review is the perception of physiological visual illusions by patients with schizophrenia, a differences of perception reported in a small number of studies. Increased or decreased susceptibility of these patients to various illusions seems to be unconnected to the location of origin in the visual apparatus, which also takes place in illusions connected to other modalities. The susceptibility of patients with schizophrenia to haptic illusions has not yet been investigated, although the need for such investigation has been is clear. The emerging picture is that some individuals with schizophrenia are "resistant" to some of the illusions and are able to assess visual phenomena more "rationally", yet certain illusions (ex. Müller-Lyer's) are perceived more intensely. Disturbances in the perception of visual illusions have neither been classified as possible diagnostic indicators of a dangerous mental condition, nor included in the endophenotype of schizophrenia. Although the relevant data are sparse, the ability to replicate the results is limited, and the research model lacks a "gold standard", some preliminary conclusions may be drawn. There are indications that disturbances in visual perception are connected to the extent of disorganization, poor initial social functioning, poor prognosis, and the types of schizophrenia described as neurodevelopmental. Patients with schizophrenia usually fail to perceive those illusions that require volitional controlled attention, and show lack of sensitivity to the contrast between shape and background.

[Mineralization of the basal ganglia as the supposed cause of poor tolerance of zuclopenthixol in a patient with long-term untreated paranoid schizophrenia]. / Mineralizacja jader podstawy jako domniemana przyczyna zlej tolerancji zuklopentyksolu u chorej z wieloletnia nieleczona schizofrenia paranoidalna.

Formations described as intracranial calcifications can appear in the course of diseases of the central nervous system, other systems and organs (e.g. endocrine), but also as a disorder of idiopathic character. They are frequently located in subcortical nuclei and usually constitute an incidental finding. This report presents the case of a patient suffering from paranoid schizophrenia for approximately 40 years, who did not agree to any treatment and was hospitalized against her will because she was the threat to the lives of others. She was treated with zuklopentixol resulting in positive symptoms reduction and considerable improvement in social functioning. Unfortunately neurological symptoms appeared: bradykinesis, rigidity--of the type of the lead pipe, balance, posture and gait abnormalities, disturbances in precise hands movements, double-sided Rossolimo's sign, plantar reflex without the participation of the big toe on the left. Neuroimaging studies have demonstrated changes in the form of lenticular nuclei calcification and reduction of signal intensity in posterior parts of both putamens. Neurological symptoms decreased significantly after switching to atypical neuroleptic (olanzapine), and the patient did not require any additional treatment. Mineralization of the basal ganglia can often be associated with psychiatric disorders and it shouldn't be neglected because it can require modification of pharmacotherapy or additional neurological treatment.

[Screening post-stroke depression using the Hospital Anxiety and Depression Scale]. / Badanie przesiewowe depresji poudarowej z uzyciem Hospital Anxiety and Depression Scale (HADS).

INTRODUCTION: Hospital Anxiety and Depression Scale (HADS) for its simplicity is potentially useful for screening depressive and anxiety disorders in post-stroke patients. To our best knowledge HADS hasn't been assessed in the Polish population of post-stroke survivors. AIM: Assessment of clinical value of HADS in screening depressive and anxiety disorders in post-stroke patients. METHOD: Patients included in this study were admitted do the Department of Neurology of the Medical University of Gdansk between 3rd April and 5th December, after first incident of ischaemic stroke. 116 subjects were included, depression was diagnosed in 29 and anxiety disorder in 16 of patients (13 with comorbid depressive episode). The test was done by 75 patients, 193 visits were assessed, from the following time after stroke: 6 weeks, 12 weeks, 6 months and 12 month. RESULT: Using the cut-off value > or = 7 points, the results were as following: depression subscale--sensitivity: 90.0%, specifity 92.2%, anxiety subscale: sensitivity: 86.5%, specifity 94.9%, which was the most optimal cut-off point. Cronbach a: for the depression subscale was 0.892, for the anxiety subscale was 0.815; each position of the scale correlated with the general result of both scales' result in a degree which increased the Cronbach a value. CONCLUSION: Hospital Anxiety and Depression Scale is useful for screening depression and anxiety in post-stroke patients. It is recommended to lower the cut-off value to 7 points.

[Somatopsychic and cenesthetic types of schizophrenia: common features and discrepancies]. / Postaci somatopsychiczna i cenestetyczna schizofrenii: podobienstwa i róinice.

The aim of this paper is to discuss the development of the concepts of cenesthetic type of schizophrenia and somatopsychic type of schizophrenia along with the review of differences between those two diagnostic approaches in scope of their historical background and the current diagnostic concepts. Those independently described diagnostic phenomena have some common features. However, the cenesthetic type of schizophrenia emphasises sensory elements of the disorders and includes a broader spectrum of the psychopathology while the somatopsychic type of schizophrenia focuses on the thought disorders and strictly schizophrenic psychopathology.

Psychogenic axial myoclonus: report on two cases.

Axial myoclonus (AM) is characterized by sudden muscle jerks involving axial and proximal muscles. It includes propriospinal myoclonus (PSM) which consists of trunk flexion or extension jerking with activity arising in axial muscles and spreading to caudal and rostral muscles at low velocity along propriospinal pathways. We report on two patients displaying flexion AM jerks in the absence of structural lesion of the central nervous system or electrophysiological evidence of organic origin. A conversion disorder was diagnosed. The jerks disappeared after psychoeducation with the patients remaining symptom free in 6-year long follow-up. The diagnoses of psychogenic axial (propriospinal-like) myoclonus were established. The literature on psychogenic axial (propriospinal-like myoclonus) is limited to a case report. Our cases demonstrate a good response to psychotropic medication and psychoeducation and fulfill the psychogenic movement disorder criteria. The phenomenology of psychogenic abnormal movements is diverse and PSM-like clinical picture may be a novel presentation.

[Abdominal dystonia in a patient with schizophrenia: a case report]. / Dystonia miesni brzucha u pacjentki cierpiacej na schizofrenie: opis przypadku.

The case of 31-year-old woman suffering from schizophrenia with movement disorder is described. The patient had a 7-year history of schizophrenia. In course of the psychiatric treatment the patient presented dystonic movements within abdominal muscles. The dystonic movements were of mixed character, including voluntary and involuntary ones what might have suggested their psychogenic origin. Subsequent to the exclusion of the neurological origin of the movement disorder and poor response to antipsychotic treatment, clozapine was introduced resulting in full remission of positive symptoms and functional improvement with a diminished intensity of the involuntary movements. Psychogenic movement disorders are uncommon in schizophrenic patients. Movement disorders may occur as an adverse reaction to antipsychotic treatment, especially with typical ones. However, the abdominal muscles dystonia is an uncommon manifestation of dystonia of idiopathic, drug-induced or psychogenic origin. In such cases, a liaison between the neurologist and psychiatrist is advocated and the therapeutic process using antipsychotic treatment is necessary.

Wilson's disease associated with delusional disorder.

Wilson's disease (WD), or hepatolenticular degeneration, is a genetic neurodegenerative disorder of copper metabolism. It is an uncommon medical condition that produces psychiatric symptoms during the early phase in approximately 50% of patients. Reported herein is a case of WD in a young man presenting persistent delusional disorder of organic etiology, which resolved entirely after 4 months of combined pharmacotherapy. The present case demonstrates the importance of considering the occurrence of psychotic symptoms in WD patients given that psychiatric manifestations in WD are known to be uncommon as well as inhomogeneous. It also supports the hypothesis that psychopathologic features in WD have an organic foundation.

[The stroke variables assessment as a prognostic factor for post-stroke depression with the emphasis on the cerebral SPECT regional blood flow asymmetry]. / Ocena wartosci wybranych parametrów udaru, ze szczególnym uwzglednieniem asymetrii przeplywu mózgowego krwi mierzonego metoda SPECT, jako czynników prognostycznych wystapienia depresji poudarowej.

AIM: The aim of this paper was to assess the risk for depression in a 6-month-long post stroke follow up period as related to the stroke variables (i.e. stroke localisation, haemodynamic parameters). METHOD: The stroke localisation was determined with CT and/or MRI. Subsequently all the examined individuals underwent SPECT examination. The follow up examinations were performed by the consultant psychiatrist in 6, 12 and 24 weeks subsequent to the stroke episode. The depressive episode diagnosis was established on the basis of ICD-10 diagnostic criteria. RESULTS: Only right-handed patients (43 men aged 57.3 +/- 11.6 and 17 women aged 62.5 +/- 14.4) with unilateral brain lesion were examined. 23 subjects (38%) developed depression in the follow-up period. 5 women (29%) and 18 men (ca. 42%) developed a depressive episode. Only one of the observed depressive episodes met ICD-10 criteria for severe depressive episode. 10 patients suffered from moderate depressive episode and 12 subjects exhibited a mild depressive episode. CONCLUSIONS: The results obtained with CT and/or MRI techniques revealed no correlation between the post-stroke depression and stroke lateralisation. However the localisation of the deep brain functional abnormalities revealed with SPECT correlated with the occurrence of the affective disorders as related to the asymmetry in regional blood flow measures.