What exactly is catatonia in children and adolescents. / Czym jest katatonia u dzieci i mlodziezy.

The current study is a review of the literature on catatonia syndrome with focus on children and adolescent's specificity. Previous catatonia conceptualizations were significantly modified in the newest classification systems. Catatonia may be considered either a separate syndrome or a specifier of the course of other psychiatric disorders. Although diagnostic criteria for children and adolescent do not differ from those for adults, the clinical presentation and course may not be the same. In this age group relatively common are somatic conditions taking the form of catatonia. There is agrowing body of literature focused on catatonia in the course of pervasive developmental disorder. On the other hand, pervasive refusal syndrome and lethal catatonia are discussed in the literature, but they are not present in the classification systems. In the current paper basic treatment guidelines were also described. First-line treatment is the use of benzodiazepines and electroconvulsive therapy. The diagnosis and treatmentof catatonia is of great practical importance. While improper diagnosis and non-optimal treatment may have fatal consequences, in the case of proper diagnosis an effective treatment may be administered.

Problems and Strengths in Psychiatric Nursing in Poland: Current Legal Regulations and Results of Survey.

Introduction: National health resources are considered inadequate to meet the needs of Mental Health services in Poland due in part to insufficient funding. The status of the nursing profession is autonomous and independent, and one that bears much public trust. Nevertheless, psychiatric nursing is in deep crisis.Aim of the study: To determine the strengths and limitations of the psychiatric nursing system in Poland.Method: Participants of a major Psychiatric Nursing Conference in Poland were surveyed in terms of professional job satisfaction and current problems encountered in psychiatric nursing. Results were appropriately categorized and subjected to quantitative analysis.Results: There were 74 subjects, amounting to a 70% response rate who completed the study questionnaire. Problem areas were focused on how the mental health system is organized and on staff working conditions that included terms of employment and salaries. The main reasons for job satisfaction were those issues associated with the treatment process. Two participants replied that they were not satisfied.Discussion: The numerous problems encountered in Polish psychiatry nursing require further debate and the updating of legal regulations to increase funding. Recently introduced regulations on the minimal standards acceptable for nurse/bed ratios have however been postponed until 2021. The issues concerning job satisfaction have also been referred to in previous studies.Implication for practice: The crisis facing psychiatric nursing in Poland requires systemic changes in both legal regulations and financing. Notwithstanding, such professionals and their societies could facilitate the necessary changes through enhancing public debate and stimulating nursing-focused research.

Self-reported effects of methadone on cigarette smoking in methadone-maintained subjects.

Subjects maintained on methadone evidence a high level of interest in quitting cigarette smoking. Readiness to quit may result, at least partially, from direct pharmacological interactions between methadone and brain nicotinic acetylcholine receptors. The aim of the present study was to assess: (1) self-reported changes in smoking habits after admission to a methadone maintenance treatment (MMT) program; (2) acute effects of methadone administration on smoking behavior in MMT patients. The study was conducted between May and December 2001, in two public outpatient MMT clinics located in Warsaw, Poland. The patients (41 men, 30 women) reported smoking fewer cigarettes after admission to the program. Most subjects (67.6%) changed their favorite brand of cigarettes after admission. Mean nicotine content (mg/cigarette) significantly decreased. On the other hand, the subjects did not report any effects of methadone administration on smoking parameters. The above findings suggest that initiation of MMT is associated with positive changes in smoking behavior. However, these changes may not be related to direct pharmacological interactions between methadone and nicotine.

Time-dependent changes in alcohol-seeking behaviour during abstinence.

Exposure of alcohol addicts to alcohol-related environmental cues may elicit alcohol-seeking behaviour even after protracted abstinence. The purpose of the present study was to assess time-dependent changes in alcohol-seeking behaviour in rats trained to respond for alcohol. The rats were re-exposed to alcohol-associated stimuli after 1, 28 or 56 days of withdrawal. During the re-exposure session, the rats were first allowed to respond in extinction. Then, reinstatement of alcohol-seeking behaviour was evoked by a complex of discrete alcohol-associated cues (auditory and light cues combined with taste and smell of alcohol). Extinction behaviour depended on abstinence duration with maximal responding after 28-day abstinence. Reinstatement of alcohol-seeking behaviour evoked by the discrete cues was highest after 56-day abstinence. No correlations were found between individual alcohol intakes, extinction behaviour and cue-induced reinstatement. These results suggest that: (i) alcohol-seeking behaviour may become more intense after long-term imposed abstinence; (ii) alcohol self-administration, extinction behaviour, and reinstatement of alcohol-seeking behaviour may be regulated by separate neural mechanisms.

Taste function in methadone-maintained opioid-dependent men.

It has been shown repeatedly that opioid dependence is associated with increased consumption of refined sugars. It is possible that this association results from altered taste reactivity in opioid-dependent subjects. Thus, in the present study, we compared taste responses to sweet, bitter, sour and salty solutions in methadone-maintained opioid-dependent men and healthy control subjects. The two groups did not differ in terms of rated intensity or pleasantness of sucrose (1-30%), quinine (0.001-0.005%), citric acid (0.02-0.1%) and sodium chloride (0.18-0.9%) solutions. Proportions of 'sweet-likers', i.e. subjects rating a 30% sucrose (0.88 M) solution as the most pleasant, were also similar in both groups. In line with the previous findings, the methadone-maintained subjects reported adding more table sugar to caffeinated beverages. The results of the present study suggest that changes in taste reactivity may not be responsible for altered dietary choices in opioid addicts.