[General principles of effective communication between physician and patient with selected mental disorders]. / OgÓlne zasady skutecznej komunikacji miEdzy lekarzem a chorym z wybranymi zaburzeniami psychicznymi.

Faced with the growing frequency of mental disorders occurrence and considering the necessity of improving the patient care, it is particularly important that physicians of different specialties knew the general principles of effective communication with patients who are mentally ill. Equally important is to spread the knowledge of the symptomatology of various mental illnesses. Studies published by the Institute of Psychiatry and Neurology involving persons between 18 and 64 years old, show that 8 millions Poles suffers or suffered from mental disorders. This represents almost 25% of Polish society. The above data confirm, that basic knowledge of criteria for diagnosing mental disorders and their treatment by primary care physicians, determines the success of the entire health care system. It must be taken into consideration that frequently patients seeing general practitioner (GP) are suffering from more than one mental illness or it is accompanied by somatic disease. Adequate communication determines effective treatment. Simple yet exact message, ability to adapt it to patient and problems reported by him, is a valuable means in daily medical practice. It reduces the risk of iatrogenic disorder, encourages the efficiency of the entire therapeutic process. Good cooperation with the patient is also determined by patience, empathy, understanding, and competence. The aim of this study is to present the principles of effective communication between doctor and patient suffering from selected mental disorders. The article defines the concept of communication. It shows symptomatology of primary psychiatric disorders. Moreover, the most common difficulties in relationship between the doctor and the patient had been pointed.

[The use of psychotropic drugs during breast-feeding]. / Stosowanie leków psychotropowych u kobiet karmiacych piersia.

Breast milk is the best source of nutrients and provides much better protection than immune modified milk. In the United States around 500 000 cases of mental disorders affecting pregnant women are diagnosed each year. It is estimated that approximately 1/3 of these women need psychotropic drugs in a period of breast-feeding. Despite the serious consequences of depression and its well-known effect on a newborn, the women are still reluctant to begin pharmacological treatment. The fear of side effects unfortunately still plays an important role in making such a decision. It has been proved that all psychiatric drugs can transfer into breast milk, but their levels are very low or even negligible for the newborn. Most laboratory tests do not reveal an adequate sensitivity to detect these low concentrations. One have to remember that in case of any disturbing symptoms which may result from the use of these drugs, the only procedure is to discontinue breastfeeding immediately. The knowledge of these effects of particular groups of psychotropic drugs in breast-feeding mothers is essential for every practitioner. This knowledge should also be available not only to psychiatrists, but gynecologists and pediatricians as well. For this reason, it seems to be reasonable to summarize the results of previously published studies dealing with the topic.

[Comparison of increase in depressive disorders in dependence of BMI value]. / Porównanie nasilenia zaburzen depresyjnych w zaleznosci od wartosci wskaznika BMI.

UNLABELLED: In recent years, the research for the relation between depression and obesity is the basis of many studies. Interest in this subject results from the continuous increase in the incidence of both diseases and complications thereof, which constitute a serious social and economic problem. The aim of the study is to establish the dependence between depressive disorders and BMI. MATERIAL AND METHODS: One hundred twenty three patients aged 18-67 years with a diagnosis of depressive episode (F32) and recurrent depressive disorder (F33.0-F33.8) were used in the study. 21 items Hamilton Depression Rating Scale (HDRS21) was used to evaluate intensification of depressive disorders. Appraisal of psychiatric conditions with HDRS21 was performed twice: at the beginning of the study and after receiving the response on pharmacotherapy (averagely after 8 weeks). RESULTS: No relation between depressive disorders and BMI has been observed. CONCLUSIONS: Study did not demonstrated explicit link between BMI value and increase in depressive disorders. Considering the complexity of this problem, another studies should be carried out.

Laterally Positioned Flap Procedure with Augmented or Nonaugmented Palatal Connective Tissue Grafts in the Treatment of Multiple Adjacent Gingival Recessions: A Two-Year Follow-Up Study.

The most commonly used technique for covering gingival recessions is the coronally advanced flap (CAF) technique due to its high success rate. In clinical situations where there is less keratinized tissue apical to the defect due to unfavorable anatomical conditions, a more advantageous technique for this situation should be considered, specifically the laterally positioned flap (LPF). The aim of this study was to compare the gingival thickness after gingival recession coverage using the laterally positioned flap supported by an augmented and non-augmented connective tissue graft (CTG). Thirty-four patients with 105 gingival recessions of Miller's class I and/or II were enrolled in this study. The method of choice was the laterally positioned flap. The test group was treated with previously augmented CTG harvested from the palatal mucosa while the control group was treated with a non-augmented CTG. Clinical measurements were recorded at baseline, 6, 12 and 24 months after intervention. Clinical results showed a statistically more significant percentage of average and complete gingival recession coverage in the test group. The LPF in combination with an augmented CTG proves to be an effective alternative to the CAF. Greater improvement in gingival thickness was observed in the LPF with augmented CTG than in non-augmented CTG.