The prevalence of depression in children and adolescents under 18 years of age treated for mental disorders in Poland between 2005 and 2016.

Introduction: The prevalence of depression in Polish children and adolescents under 18 years of age treated for mental disorders has increased in the last few years in Poland. The purpose of this study was to examine the prevalence of major depression in a population of Polish children and adolescents under 18 years of age treated for mental disorders, stratified by sex and place of residence, in the years 2005, 2009, 2014, and 2016. Material and methods: We analysed the psychiatric treatment data of children and adolescents under the age of 18 years in Poland compiled by the Institute of Psychiatry and Neurology in Warsaw for these years. Results: Major depression was moderately prevalent among children and adolescents treated in all evaluated types of mental health facilities, with a prevalence in this population ranging from 0.8% in 2005 to 4.3% in 2016. The rates of young patients with mood disorders increased from 3.1% in 2005 to 7.0% in 2016. Risk factors for developing major depression in our research group were: being female and living in an urban area. Conclusions: Our findings suggest the need to increase the service capacity for children and adolescents as well as to intensify preventive measures to improve the mental health status of this age group.

Verbal Fluency in Metabolic Syndrome.

Metabolic syndrome (MetS) or otherwise insulin resistance (IR) is described as a cluster of several commonly occurring disorders, including abdominal obesity; lipids disorders, such as hypertriglyceridemia; and low levels of high-density-lipoprotein cholesterol (HDL-C), hypertension (≥130/85 mmHg), and carbohydrates disorders, such as impaired fasting glucose or diabetes mellitus type 2. Type 2 diabetes (T2DM) constitutes insulin resistance, which is a strong risk factor for strokes. Patients with MetS are often prone to cognitive decline. Metabolic risk factors, hypertension, and diabetes, amongst them, have been hypothesized to play a great role in the pathogenesis of Alzheimer's disease (AD) and the development of vascular dementia. For neuropsychological diagnostic and theoretical purposes verbal fluency is defined as a cognitive function that facilitates information retrieval from memory. It engages executive control and other cognitive processes, such as selective attention, selective inhibition, mental set shifting, internal response generation, and self-monitoring, as well as imagination and psychomotor skills. A total of 90 subjects, divided into 2 groups, patients with MetS (45) and healthy controls (45), were assessed. A significant difference in performance was found between the patients and controls, both in the phonetic (p < 0.01) and semantic fluency trials (p < 0.001). The MetS patients produced less words in the letter K and animal categories. The analysis of descriptive statistics shows that the group of patients with metabolic syndrome generated fewer words in both the phonetic and semantic categories. Our study shows that there is an association between metabolic factors and the verbal fluency performance of MetS patients. This is true, especially for phonetic verbal fluency, which is traditionally connected with the frontal cortex. Lower switching signifies possible executive dysfunctions amongst people with MetS. Subjects with this condition generated more diverse words and created less standard associations. This further implies the existence of dysexecutive syndrome and the need for diagnosing patients in this direction and involving this group of people in therapy. The proper correction of MetS components may improve cognitive function.

Communication Abilities of Children with DoC after Severe Brain Injury in ICF Frames.

INTRODUCTION: The ability to communicate is one of the fundamental factors underlying human relationships. Severe brain damage and disorders of consciousness may indispose a person to participate in everyday social and family life. In spite of this fact, however, the issue of holistic approach to communication in the context of severe traumatic brain injury is still not well explained and described. The goal of this article is to introduce a profile of nonverbal behavior of children with disorders of consciousness. MATERIALS AND METHODS: The study included 30 children with minimal conscious state after severe brain trauma, aged between 7 and 16 years old. Research was conducted using the Coma Recovery Scale-Revised and the Bykova-Lukyanov Scale of Communication Activity. RESULTS: Significant differences in communication level between investigated groups were demonstrated, both in Body Function (F = 9.184; p < 0.001) and Activity and Participation (F = 13.100; p < 0.001). CONCLUSIONS: It is possible to map and classify communication ability of children with minimal conscious state by using International Classification of Functioning, Disability and Health (ICF) protocol and the Bykova-Lukyanov Scale of Communication Activity, with specific consideration of Activities and Participation factors. This approach reveals differences in communication and disability level between children with minimal conscious state plus (MSC+) and minimal conscious state minus (MSC-).

Marriage and Post-stroke Aphasia: The Long-Time Effects of Group Therapy of Fluent and Non-fluent Aphasic Patients and Their Spouses.

BACKGROUND: Studies of therapy influence on after-aphasia marital relations are lacking. Much needs to be learned about the range of factors associated with couples benefiting from therapy. Understanding these issues is key to facilitating optimal post-aphasia outcomes from the perspective of the patient and his caretaking spouse. This paper reports an evaluation of a group therapy intervention conducted with aphasic people and their life partners. METHODS: The intervention comprised of 10 sessions of approximately 90 min duration and included two groups of couples, with fluent and non-fluent aphasic partner. The therapy program consisted of basic communication activities within the group which encouraged sharing of personal experience but mostly relied on psychoeducation, gaining knowledge about after-stroke aphasia. The respondents were interviewed and completed neuropsychological assessment. Quality of marriage was determined using Dyadic Adjustment Scale. Marital adjustment was measured twice, before intervention and after 6 months. Long-time effects of therapy included a significant mean difference in quality of marriage between therapy attendants and controls. Marital relationship decline seems to be worse amongst control subjects, who were not involved in any kind of psychological support. In spite of initial non-distressed relationship they report deterioration of their bond in half a year's time. We also showed changes in dynamics of quality of marriage during this time in all investigated groups. The implications of these findings for counseling services are discussed.

Nonverbal communication of trauma patients in a state of minimal consciousness.

INTRODUCTION: In spite of the rapid development in various communication-support technologies for those waking up from a coma, studies describing the sole process of reconstructing communication in this group of patients are scarce. OBJECTIVE: The aim of this study was to analyze communication reactions in a minimal state of consciousness and describe the nonverbal behaviours characteristic for each stages significant for the therapy of communication. MATERIAL AND METHODS: 18 severely brain-injured patients in a minimal state of consciousness participated in the half-year observation study, which included people experiencing at least 4 weeks of consciousness disorder/coma. Age of patients 25±5 years. Psychological assessment included: observation of various attempts of communications undertaken by patients, caregivers and family interview, the Glasgow Coma Scale (GCS) and Individual Communication Sheet. RESULTS: Data analysis showed a significant increase in preverbal communication, both in primal and sensory areas when compared between Stage II (GCS=6-8 points) and Stage III (GCS=9-12 points). After a time, primary communication reached a high level. Patients produced communication attempts from the behaviour organization level, and an increase in the nonverbal communication level was noted. Based on observations, nonverbal communication profiles for each stage of waking up from a coma were introduced. CONCLUSIONS: It was found that in the process of waking up from a coma the patients communicate with the use of the preverbal level of primal communication, the sensory and behaviour organization activities. The characteristics of the communication reactions show that in Stage III there is a significant increase in two preverbal communication areas: primal and sensory acts, when compared with Stage II.