Determinants of the decision to be vaccinated against COVID-19 as exemplified by employees of a long-term health care centre.

INTRODUCTION: Health care professionals cover the front line in the battle against infectious diseases. Vaccination of healthcare workers represents a vital element of the strategy for enhancing epidemic safety and improving the quality of health care, inter alia, by limiting microorganism transmission, and reducing patient morbidity and mortality. METHOD: The study group consisted of all employees of the long-term health care centre in Lublin, Poland. Participants were requested to complete a questionnaire prepared for the purpose of the study, along with a mandatory COVID-19 vaccination interview questionnaire. RESULTS: The vaccination coverage rate for the group of medical workers was 77.3% and of non-medical 86%. The most frequently indicated sources of information on vaccination were the mass media. Males more often than females used the press as a source of information on vaccination. Scientific articles were the most common source of information for both people with higher education and medical professionals. The most common motive for vaccination for females is concern for the health of one's family, and for HCWs and people with at least secondary education-concern for the health of patients. CONCLUSION: At least one assessed factor influences the decision to be vaccinated. The mass media are of the greatest importance in obtaining information about vaccination.

Activity of selected metalloproteinases in neurodegenerative diseases of the central nervous system as exemplified by dementia and schizophrenia. / Aktywnosc wybranych metaloproteinaz w chorobach neurodegeneracyjnych osrodkowego ukladu nerwowego na przykladzie otepienia i schizofrenii.

OBJECTIVES: The aim of the study was to determine and analyze the correlation between the concentrations of selected metalloproteinases and their inhibitors (TIMP-1 and TIMP-2) in patients with dementia and schizophrenia. METHODS: The concentration of two collagenases and metalloendopeptidase was determined in the study. The study included 29 patients with lateonset dementia, 25 patients with paranoid schizophrenia and 25 healthy controls who were age-matched with the study groups. Symptoms of dementia were evaluated using the Short Mental State Assessment Scale, whereas the symptoms of schizophrenia were assessed using the Positive and Negative Assessment Scale. Blood samples were collected from the participants and the concentrations of MMP-1, MMP7, MMP-13, TIMP-1, and TIMP-2 in the blood serum were evaluated using ELISA method. RESULTS: A two-fold increase in the concentration of MMP-1 and a slight increase in MMP-13 was observed in dementia patients compared to other groups, as well as a lower level of MMP-7 and TIMP-1 and a higher level of TIMP-2 compared to the control group. Patients with schizophreniashowed lower MMP-7 and higher TIMP-2 serum level compared to the controls. No differences in the concentration of MMP-1, MMP-13 and TIMP-1 levels were noticed. In people with late onset dementia an increase in collagenolytic activity was demonstrated. CONCLUSIONS: Increase in collagenolytic activity may indicate an increased remodeling within the central nervous system in late onset dementia. The differencein the fluctuation of the concentrations of the studied enzymes and their inhibitors in dementia and schizophrenia indicates their different involvement in the pathogenesis of these disorders.

Do Polish doctors suffer from occupational burnout syndrome? An attempt to find an answer - Pilot study.

INTRODUCTION AND OBJECTIVE: A nationwide survey, carried out in Poland in 2013, showed that 42% of an examined group of doctors reported occupational burnout syndrome (OBS). The phenomenon of OBS among medical personnel shows a relationship with perceived stress scale (PSS) scores. The aim of the study was to estimate the prevalence of OBS in a group of Polish doctors, and the relationship with selected risk factors and personal resources. MATERIAL AND METHODS: A cross-sectional study using quantitative methodology was used with the application of a questionnaire method and correlation design. Questionnaires were administered to 318 doctors (42 different specialties) working in medical facilities in Poland. All participants in the study completed two standardized questionnaires: Link Burnout Questionnaire (LBQ), Perceived Stress Scale (PSS), and responded to the questions on a proprietary questionnaire. ANOVA variance analysis and analysis of regression was performed. RESULTS: The results of the measurement of four aspects of occupational burnout: psychophysical exhaustion (PE), commitment to relationships with patients (CP), effectiveness in performed work (EW), and existential expectations (EE), were in the medium and high levels range. Every second medical doctor who participated in the research declared a high degree of occupational burnout in each of the aspects of OBS. The high level of PSS scores, the large number of duties per month, the short work experience (years of employment) and the low number of holiday leaves, were the predictors of occupational burnout in the group of doctors taking part in the study. CONCLUSIONS: The prevalence of the signs of OBS among Polish doctors is consistent with the results of research in other countries. Failures in the interventions taken to reduce stress seem to co-exist with the severity of signs of burnout.

Assessment of cardiovascular disease risk factors in patients treated for schizophrenia. / Analiza czynników ryzyka sercowo-naczyniowego w populacji osób leczonych z powodu schizofrenii.

OBJECTIVES: The aim of the study was the analysis of the occurrence of cardiovascular risk factors (age, sex, smoking, level of cholesterol, systolic blood pressure, body mass index) among patients diagnosed with schizophrenia as well as searching for correlations between them and length of stay at long-term care facilities and clinical variables, such as severity of positive, negative and general symptoms of schizophrenia, illness duration, and type of pharmacotherapy (neuroleptic type and its dose). METHODS: Medical data were collected from 71 patients (30 women and 41 men) aged between 40 and 86 years who were treated in the residential care facility due to paranoid schizophrenia. Information concerning patient's clinical status was collected during periodic check-ups. Theexamination consisted of standard anamnesis regarding patient's general feeling, psychiatric assessment using the PANSS and identifying number of smoked cigarettes. Somatic assessment included: physical examination, measuring blood pressure, pulse, capillary blood glucose levels, height, weight, and BMI. RESULTS: Statistical analysis did not reveal significant differences in length of stay at long-term psychiatric care facility between patients with normal BMI vs. overweight and obese patients (p = 0.85). Study results indicate that prevalence of central obesity, hypertension, abnormal total - and LDL-cholesterol is higher in patients who stay at the long-term psychiatric care facility for a longer period of time. There is at least one cardiovascular risk factor in 74.6% of examined patients treated for schizophrenia. CONCLUSIONS: Imposing "healthy" lifestyle as part of clinical management in long-termcare setting in people treated with neuroleptics (atypical or typical) might reduce risk of body mass increase. Undertaking action towards reducing modifiable cardiovascular risk factors remains highly recommended in mental health care, particularly in long-term care.

The difficulties of secondary prophylaxis of cervical cancer in women suffering from paranoid schizophrenia - a case study. / Trudnosci drugorzedowej profilaktyki raka szyjki macicy u kobiet leczonych z powodu schizofrenii paranoidalnej ­ opis przypadku.

Cervical cancer constitutes 5.32% of all malignant neoplasm cases, it is the sixth most common condition of the cancer type and it is an important problem because of its medical, epidemiological and social implications. The aim of primary prophylaxis is to reduce the number of new cases, while secondary prophylaxis is to provide early diagnoses and treatment of cancer cases. The aim of this work is to present the case of 55-year-old woman treated with chronic paranoid schizophrenia whose gynecologist refused to collect biological material for cytological evaluation. The patient was diagnosed with carcinoma planoepitheliale (G2), then treated surgically and qualified for adjuvant-radiological treatment. Despite the good mental state and a psychiatrists' statement (treating the patient for many years) of the absence of contraindications for hospitalization, a gynecologist-oncologist refused to admit the patient to the ward in fear of a threat to other patients and decided on outpatient palliative treatment of the patient. Finally, radiologist-oncologist performed the complete cycle of irradiation in order to cure the patient. While looking for possible reasons of cervical cancer development in individuals with psychotic disorders, all the possible carcinogenic factors have to be taken into account. Nulliparous women and virgins treated for mental illness must not be denied screening examinations related to cervical cancer. Despite the changes, also related to the implementation of the mental health program, people with mental disorders with underlying physical illness are still stigmatized, even by a higher medical personnel. Moreover, mentally ill patients are denied proper treatment in accordance with the current state of medical knowledge.

Interaction Between Val158Met Catechol-O-Methyltransferase Polymorphism and Social Cognitive Functioning in Schizophrenia: Pilot Study.

The Val158Met catechol-O-methyltransferase (COMT) functional polymorphism may influence social cognitive functioning in patients with schizophrenia. Aspects of social cognition were evaluated with the Facial Expression Recognition Test, the Voice Emotion Recognition Test, and the Reading the Mind in the Eyes Test. The Short Recognition Memory Test for Faces was used as a control measure. The Schedule for the Assessment of Negative Symptoms, Schedule for the Assessment of Positive Symptoms, and Beck Depression Inventory were used to rate of patient symptoms. There were 100 patients with the following genotypes: Val/Val (21), Met/Met (30), and Val/Met (49). The genotype distribution of polymorphism of Val158Met COMT did not differ between the patient and control groups. Schizophrenia carriers of the Val/Val genotype performed worse in social cognitive measures, in comparison with the other groups. No statistically significant correlations were recorded between age at schizophrenia onset and polymorphism of Val158Met COMT. There was an influence of genotype in the control group: the Met homozygotes performing better. Schizophrenia patients homozygous for the Val allele showed significant disadvantages over patients homozygous or heterozygous for the Met allele in social cognitive processes. The COMT genotype may not, however, contribute to the age of onset of schizophrenia.

[Functional polymorphism of genes inactivating biogenic amines and cognitive deficits in paranoid schizophrenia]. / Funkcjonalny polimorfizm genów enzymów inaktywujacych aminy biogenne a deficyty procesów poznawczych w schizofrenii paranoidalnej.

AIM: The aim of the work was to assess relationship between gene polymorphism of enzymes influencing dopaminergic-, serotoninergic, and noradrenergic transfer and cognitive functioning of paranoid schizophrenic inpatients (ICD-10). METHOD: The following methods have been used in the study: The Test of Everyday Attention (TEA) and The Visual Object and Space Perception Battery (VOSP), psychiatric scales (SAPS, SANS, BDI) and techniques of genetic engineering (PCR reaction, RFLP and VNTR techniques). Subject groups included 100 schizophrenic patients (57 male) and 50 healthy controls (20 male). RESULTS: The results revealed positive correlation between polymorphism of Vall 58MetCOMT and cognitive deficits in schizophrenic patients. No statistically significant relationship was elicited between gene polymorphism of Val158Met COMT and VNTR MAO-A in promoter area and schizophrenia onset. Allelic polymorphism ofVall58Met OMT and VNTR MAO-A in promoter area did not differ between the subject groups. The patients with genotype Val/ Val of polymorphism Val 158MetCOMT showed major cognitive deficits.

[The possibility or coercion treatment? Anorexia nervosa--legal regulations. A case report]. / Mozliwosc czy przymus leczenia? Anoreksja psychiczna--uregulowania prawne. Opis przypadku.

Anorexia nervosa is diagnosed on the basis of well-defined diagnostic criteria and requires treatment, as it is associated with the highest mortality rate of all mental illnesses. In Poland, anorexia nervosa is not considered a mental illness, although the opinion of researchers and clinicians are divided. To reduce the death rate of AN correct and early diagnosis, appropriate treatment starting immediately and the appropriate regulations to allow people to take the AN treatment against their will are necessary. In our work, we presented the treatment of patients with severe mental anorexia with a predominance of restrictive behavior as well as the issue of regulations relating to the compulsory treatment of people with eating disorders.

[The newest therapeutic directions in the rehabilitation of patients with mental disorders]. / Najnowsze kierunki terapeutyczne w rehabilitacji pacjentów z zaburzeniami psychicznymi.

In this paper, the authors attempted to present the comprehensive literature review on the newest therapeutic interventions such as cognitive remediation therapy (CRT), mindfulness-based cognitive therapy (MBCT), social cognition and interaction training (SCIT), and acceptance and commitment therapy (ACT) which appeared promising whilst their implementing among schizophrenic patients, patients with anxiety disorders, eating disorders, and affective disorders. In the presented work particular attention was focused on two kinds of psychotherapeutic interventions: social cognitive trainings and cognitive remediation therapy (CRT) and their effectiveness in the rehabilitation process of schizophrenic patients. The growing body of research based on application of the above mentioned techniques in psychiatric population gives remarkable hope to improve quality of cognitive and psychosocial therapeutic interventions and to set up both complex and comprehensive therapeutic programme for patients with mental disorders.

Social cognition and visual perception in schizophrenia inpatients treated with first-and second-generation antipsychotic drugs.

PURPOSE: Social cognition captures affect recognition, social cue perception, "theory of mind," empathy, and attributional style. The aim of our study was to assess social cognition in schizophrenia inpatients being treated with first-generation antipsychotic drugs (FGAs), n=28 (perphenazine and haloperidol, FGAs) or with second-generation antipsychotic drugs (SGAs), n=56 (olanzapine and clozapine, SGAs). SUBJECTS AND METHODS: Eighty-four patients completed the Facial Expression Recognition Test, the Voice Emotion Recognition Test, the Short Recognition Memory Test for Faces, and the Reading the Mind in the Eyes Test. Patients also completed the Visual Object and Space Perception Test (VOSP) as a control task, which would not engage social cognition. The patients were compared with fifty healthy controls matched for age and gender. RESULTS: There were no significant differences on social cognitive performance between the FGA- and SGA-treatment groups. Nor was olanzapine superior to clozapine, FGAs or both. However, patients treated with FGAs performed significantly worse on VOSP compared to both groups treated with SGAs, a 10% difference. CONCLUSIONS: We cannot conclude that SGAs were associated with better social cognition than FGAs. However, there were small but significant advantages for SGAs in non-social visual processing function, as evaluated with the VOSP.

[Is Huntington's disease a neurological or psychiatric disorder? case report]. / Choroba huntingtona zaburzeniem neurologicznym czy psychiatrycznym? Opis przypadku.

Huntington's disease is a rare, although commonly known neurodegenerative disease, caused by dynamic point mutation within the IT-15; it is inherited autosomally dominantly. IT-15 mutation includes multiple (36-250) repetitions of trinucleotide sequence (CAG) encoding a glutamine at the amino end of Huntington (mHtt). It is one of the nine polyglutamine diseases (PolyQ), characterized by a CAG repeat. The pathophysiology of Huntington's disease is associated with dysfunction and loss of neurons and gliosis within the striatum, particularly around the caudate nucleus and frontal lobes. Huntington's disease is characterised by the triad of symptoms: cognitive, motor and psychopathological disturbances. Approximately 80% of patients with HD show some of the mental disorders. The most common are affective disorders, in 30-40% symptoms of depression are present. Depression often precedes the onset of neurological symptoms.

Attentional and emotional functioning in schizophrenia patients treated with conventional and atypical antipsychotic drugs.

BACKGROUND: Effectiveness of antipsychotics in treating emotional and cognitive deficits in schizophrenia still remains controversial. The aim of our study was to assess emotional and cognitive functioning in schizophrenic inpatients currently treated with typical antipsychotics (perphenazine, perazine, fluphenazine, and haloperidol) and in another group of schizophrenic inpatients currently on atypical antipsychotics (olanzapine, risperidone, amisulpride, and quetiapine). MATERIAL/METHODS: One hundred patients with DSM-IV schizophrenia or schizoaffective disorders (39 treated using typical antipsychotics and 61 treated with atypical antipsychotics) under naturalistic treatment conditions, and 50 healthy controls were given the following: Test of Everyday Attention, Facial Emotion Recognition Test, Facial Memory Recognition Test, and "Reading the mind in the eyes" Test. RESULTS: Patients with a diagnosis of schizophrenia revealed the following deficits: facial emotion perception, empathy /theory of mind, visual selective attention/speed, attentional switching, and auditory-verbal working memory. Our results show a significant difference between schizophrenic and healthy controls in all tasks, with schizophrenic patients performing worse than controls. Interestingly, our patients on atypical neuroleptics performed similarly compared to schizophrenic patients treated with conventional neuroleptics on all tasks provided. There were some significant relationships between emotional and cognitive deficits and clinical variables. CONCLUSIONS: Our findings remain consistent with other recent studies in which atypical antipsychotics did not show a clear advantage over typical antipsychotics on both emotional and cognitive functioning.

[Functional polymorphism of genes inactivating catecholamines and emotional deficits in paranoid schizophrenia]. / Funkcjonalny polimorfizm genów enzymów inaktywujacych katecholaminy a deficyty procesów emocjonalnych w schizofrenii paranoidalnej.

AIM: The aim of our work was to assess qualitatively and quantatively emotional deficits in patients diagnosed with schizophrenia following ICD-10 criteria in early and late stages of the schizophrenic process and the evaluation of the relationship between genes polymorphism of enzymes influencing dopaminergic, serotoninergic, and noradrenergic transfer and emotional functioning of the examined patients. METHOD: In our study the following methods have been used: Short Recognition Memory test for Faces (TPRT), Facial Expression Recognition Test (FERT), "Reading the mind in the eyes" Test and psychiatric scales (SAPS, SANS, BDI) and molecular techniques (PCR reaction, RFLP and VNTR techniques). 100 paranoid schizophrenia patients (43 female and 57 man) and 50 healthy controls (30 female and 20 man) were invited to participate in the study. RESULTS: Our results revealed an association between polymorphism of Val158Met COMT and emotional deficits in schizophrenic patients. Furthermore, the relationship between polymorphism of MAO-A and empathy/theory of mind deficit was found. No relationship was elicited between polymorphism of Val158Met COMT and VNTR MAO-A in the promoter area and schizophrenia onset. Allelic distribution of polymorphism of Val158Met COMT and VNTR MAO-A in the promoter area did not differ between the groups. The patients with genotype Val/Val of polymorphism Val158Met COMT showed major emotional deficits. The patients with genotype of 4/4 of polymorphism VNTR MAO-A showed deeper empathy/theory of mind deficits.

[Genetic polymorphism of a MAO in mental disorders]. / Polimorfizm genu MAO w zaburzeniach psychicznych.

Amin oxydase (monoaminoxydase, MAO) is an enzyme which catalyses chemical reactions of biogenic amines. It plays a crucial role in pathogenesis of mental disorders associated with the dysfunction of the central monoaminergic systems (schizophrenia, affective disorders, some forms of alcohol dependence, and personality disorders). MAO has got two isoforms such as MAO-A and MAO-B. The genes coding of MAO are localised at the short arm of chromosome Xp11. In each sequence of genes there is a probability of functional polymorphism occurrence which leads to a variable expression or a change of MAO activity and it exerts an impact on the onset of some mental disorders, such as: schizophrenia, affective disorders, some forms of alcohol dependence, and personality and behavioural disorders. Dynamic development of psychiatric genetics may have crucial impact on considerable progress in understanding molecular background of mental disorders.

[Genetic polymorphism of COMT in mental disorders]. / Polimorfizm genu COMT w zaburzeniach psychicznych.

Many neurobiochemical studies show abnormalities within dopaminergic neuropathways, particularly altered dopamine transmission in etiopathogenesis of mental disorders. Evaluation of genes associated with the dopaminergic system include five well known subtypes of dopaminergic receptors, dopamine transporter and enzymes associated with the synthesis and degradation of dopamine, such as tyrosine hydroxylase, dopa decarboxylase, monoamine oxidase (MAO) and catechol O-methyltransferase (COMT). None of these genes is 'a' pathognomonic factor of schizophrenia onset. In each sequence of the following genes 'a' functional polymorphism can occur. The polymorphisms of genes MAO-A and COMT have been described in relation to various expression or altered activity of these enzymes, their influence on cognitive functions, affective and anxiety disorders, learning disabilities, aggressive behaviour, eating disorders or gender differences.

[Stress oxidative in schizophrenia]. / Stres oksydacyjny w schizofrenii.

Etiopathogenesis of schizophrenia development is unknown yet in 1% of human population. There is damaged metabolism of biological membranes, abused production of free radicals and altered activity of antioxidant enzymes in patients with schizophrenia. Recently, a study showed that many of the genes and proteins whose expression is modified in the schizophrenic brain are related to glutathione and oxidative stress pathways. According to the researchers changes in permeability of biological membranes in brain could involve the pathophisiology of all--subtypes of schizophrenia as a result of oxidative stress. Brain is particularly sensitive to oxidative damage. There is a lot of phospholipids and polyunsaturated fatty acids in brain tissue under physiological conditions. The changes in polyunsaturated fatty acids metabolism, increased lipid peroxidation and the presence of oxidative stress are found in schizophrenia. They can course to appear instabilities of neuron membranes or even cell death owing to oxidative stress. Mainly to getting to know the molecular disease mechanism is associated with a disorder of the brain. The results suggest that at least some of the schizophrenia disease process can be traced in peripheral tissue like plasma, blood cells or liver. In various types of schizophrenia antipsychotic treatment affects oxidative state of erythrocyte membranes in a different way. Research into changes of antioxidant enzymes level during the treatment of typical and atypical neuroleptic drugs could contribute to widening the knowledge on the reasons of undesirable effects during pharmacotherapy with typical neuroleptic drugs.