Characteristic of neuropsychological deficits in patients diagnosed with manganese encephalopathy due to ephedrone use - case series analysis. / Charakterystyka deficytów neuropsychologicznych u pacjentów z rozpoznana encefalopatia manganowa zazywajacych efedron ­ analiza przypadków.

AIM: The study presents neuropsychological characteristic of 16 individuals with manganese-induced parkinsonism due to intravenous ephedrone use. MATERIAL AND METHODS: Overall cognitive function screening as well as full examination of various cognitive domains (verbal learning, visual memory, working memory, executive functions, construction and visuospatial functions) with the use of elastic neuropsychological test battery were performed. Dyshartric speech disorders were also precisely evaluated. Additionally, all individuals filled in the Beck Depression Inventory (BDI), which is used to assess mood. RESULTS: All patients had evident dysarthric speech disorders accompanied with palilalia and writing disorders (micrographia) in the majority of investigated individuals. Neuropsychological screening diagnosis showed no overall cognitive deficits at the level of dementia. Mild decrease in verbal learning and visual memory processes was found; as well as ideomotor but no construction praxis disorders. Results of working memory and executive function assessment indicated decrease in cognitive flexibility and logical conceptualization abilities, as well as set-shifting disorders. Patients varied significantly in their severity of executive dysfunction. Duration of ephedrone use was found nonsignificant for patients' cognition. The mean BDI score indicated moderate depression. Higher level of depressive symptoms was associated with poorer overall cognitive screening, decrease of visual and verbal learning as well as phonemic verbal fluency.

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.

Recognition of emotional facial expressions in benzodiazepine dependence and detoxification.

INTRODUCTION: The study investigates how benzodiazepine (BZD) use and detoxification affects empathy and the recognition and intensity rating of emotional facial expressions. The sample comprised 43 participants in three groups: (1) during detoxification (N = 13), (2) after detoxification (N = 15), (3) a matched control group (N = 15). Clinical subjects were recruited from in-patients of an addiction treatment unit. METHODS: Empathy levels were tested with the Empathy Quotient (EQ-Short). Recognition accuracy and emotion intensity rating were based on a computerised task displaying static and dynamic facial expressions of joy, anger, sadness, and fear. RESULTS: The controls proved more accurate than both experimental groups in identifying facial expressions of negative emotions. Joy recognition proved most accurate overall. Among the clinical subjects, women in particular exhibited an impaired ability to correctly identify negative emotions from facial expressions. Dynamic stimuli were better recognised than static ones albeit only in the experimental groups. No significant differences were found for emotion intensity ratings and EQ scores. CONCLUSION: Our findings suggest that the impaired facial emotion recognition accuracy is not caused by deficits in empathy. No improvement was recorded post-detoxification which may indicate impaired interpersonal functioning among BZD users. Further research is warranted in light of this study's limitations.

[Cognitive dysfunctions caused by excessive exposure to manganese compounds. Cognitive disturbances in intravenous users of ephedrone (methcathinone) with manganese compounds]. / Zaburzenia funkcji poznawczych spowodowane nadmierna ekspozycja na zwiazki manganu. Zaburzenia funkcji poznawczych u dozylnych uzytkowników preparatów efedronu (metkatynonu).

Intravenous injection of self-produced ephedrone (metcathinone) using potassium permanganate as an oxidant can lead to severe, fixed encephalopathy. This risk applies mainly to young individuals experimenting with "home-made" drugs and results in an irreversible aggravation of overall functioning. Besides multiple neurological symptoms and movement disorders, affected individuals also experience cognitive dysfunction. No systematic research has been conducted in this field. Single case reports and small group descriptions show that assessment with screening tools such as the Mini-Mental State Examination (MMSE) is ineffective. Neuropsychological assessment conducted with other tests indicates significant dysarthric speech disorders, psychomotor function impairment, attentional disorders of varying intensity as well as dysfunctions of verbal and visual working memory processes. Some studies of this group of subjects also indicate working memory and executive function disorders. These dysfunctions seem to be permanent and do not recede following manganese use discontinuation and an improvement of the neuroradiological picture in MRI assessment. A standard test battery should be developed enabling the assessment of both cognitive and neurological dysfunctions that otherwise render some tests impossible to administer.

[Impulsivity and decision making in alcohol-addicted individuals]. / Impulsywnosc a podejmowanie decyzji u osób uzaleznionych od alkoholu.

Decision making processes are the research problem, that has been increasingly undertaken. Alcohol addiction is a disease associated with unfavorable decision making, in spite of its negative consequences. Impulsivity plays an important role in alcoholics' decision making. It can be understood in terms of behavioral and/or cognitive flexibility disorders, that manifest in cognitive function disorders, making it difficult or even impossible to quickly and adequately assess the situation and to adjust behavior according to its requirements.. Neurobiological and genetic research indicate the existing relationship between impulsivity and certain genetic predisposition. In alcohol addicts, impulsivity can be understood also in terms of specific personality traits, e.g. novelty seeking according to the theory of Cloninger. Although the concept of impulsivity itself has been the main topic of many studies, not many of them concern also decision making processes. In studies concerning alcoholics' decision making, the relationship between this processes and behavioral impulsivity defined in many different ways, has been noticed. Some of these works define unfavorable decision making processes itself as a feature of impulsivity. Based on the results of theoretical works and research studies, it seems that it would be worth to define more precisely the concept of impulsivity, in order to determine its effect on decision making. The assessment of whether - and to what extent - the two variables (impulsivity and decision making) can be considered as separate should also be taken into account.

[Cognitive dysfunctions in bipolar disorders]. / Zaburzenia funkcji poznawczych w chorobie afektywnej dwubiegunowej.

The aim of this article is to present the current state of knowledge in the field of cognitive dysfunctions in bipolar disorders (BD). These dysfunctions are considered to be a result of brain activation disorders and occur in such domains as attention, psychomotor speed, visuospatial abilities, different aspects of executive functions (e.g. cognitive flexibility, reaction inhibition), decision making, memory and learning, emotion processing. The picture of cognitive dysfunctions is different in states of mania and depression. Cognitive dysfunctions are present not only in different phases of the disease but also during the remission period, alike in schizophrenia. However, its intensity is smaller comparing to dysfunctions in schizophrenia. Until now, there is no profile of cognitive dysfunctions specific to all BD patients. This article also indicates that there are many different factors which can influence cognitive dysfunctions in BD, e.g. clinical picture (different age of onset, presence of psychotic symptoms), comorbidity of other diseases and influence of pharmacological treatment.