Central psychological symptoms from a network analysis of patients with anxiety, somatoform or personality disorders before psychotherapy.

BACKGROUND: Cross-sectional network analysis examines the relationships between symptoms to explain how they constitute disorders. Up to now, research focuses mostly on depression, posttraumatic stress disorder, and rarely assesses larger networks of various symptoms measured with instruments independent of classifications. Studies on large groups of psychotherapy patients are also rare. METHODS: Analyzing triangulated maximally filtered graph (TMFG) networks of 62 psychological symptoms reported by 4616 consecutive nonpsychotic adults in 1980-2015. RESULTS: Case-dropping and nonparametric bootstrap proved the accuracy, stability and reliability of networks in patients' sex-, age-, and time of visit divided subgroups. Feeling that others are prejudiced against the patient was the most central symptom, followed by catastrophic fears, feeling inferior and underestimated. Sadness, panic, and sex-related complaints were less central than we expected. All analysed symptoms were connected, and we found only small sex-related differences between subsamples' networks. No differences were observed for time of visit and age of patients. LIMITATION: Analyses were cross-sectional and retrospective, not allowing examination of directionality or causality. Further, data are at the between-person level; thus, it is unknown whether the network remains constant for any person over time. One self-report checklist and building binary network method may bias results. Our results indicate how symptoms co-occured before psychotherapy, not longitudinally. Our sample included public university hospital patients, all White-Europeans, predominantly females and university students. CONCLUSIONS: Hostile projection, catastrophic fears, feeling inferior and underestimated were the most important psychological phenomena reported before psychotherapy. Exploring these symptoms would possibly lead to enhancement of treatments.

What are we afraid of when we fear for our health? The symptom context of hypochondriacal complaints. / Czego sie boimy bojac sie o swoje zdrowie? Kontekst objawowy skarg hipochondrycznych.

OBJECTIVES: To identify the set of symptoms most frequently co-occurring with hypochondriacal complaints in patients with neurotic or personality disorders. METHODS: Nonparametric Spearman rank correlations between the variables of symptom checklist "O" describing hypochondriacal symptoms and other symptoms were analyzed. To increase the reliability of the results, the analyses were performed independently in two groups: 3,929 patients before admission to a day hospital in the years 1980-2002 (group A) and 3,190 patients before admission in the years 2004-2015 (group B). RESULTS: For selected groups of patients, lists of correlation coefficients were obtained showing the most important (strongest) and statistically significant associations between five hypochondriacal symptoms and somatization symptoms coming from the muscular system, breathlessness, symptoms coming from the cardiovascular system, anxiety symptoms, and compulsive thoughts without specific content. CONCLUSIONS: The multidimensional nature of hypochondriacal complaints and their association with somatization symptoms similar to infection or inflammation were confirmed. Apart from the fears about patient's own health, fears about close relatives are also an important symptom, to which clinical attention should be paid.

Network analysis of body-related complaints in patients with neurotic or personality disorders referred to psychotherapy.

Background: Psychopathology theory and clinical practice require the most complex knowledge about patients' complaints. In patients seeking for psychotherapy, body-related symptoms often complicate treatment. Aim: This study aimed at examining connections between body-related symptoms, and identification of symptoms which may be responsible for emergency and sustaining of anxiety, somatoform and personality disorders with the use of network analysis. Methods: In our retrospective research we used data from a sample of 4616 patients of the Department of Psychotherapy, University Hospital in Cracow, diagnosed with anxiety, somatoform or personality disorders. We constructed the Triangulated Maximally Filtered Graph (TMFG) networks of 44 somatoform symptoms endorsed in the symptom checklist "O" (SCL-O) and identified the most central symptoms within the network for all patients and in subgroups of women vs. men, older vs. younger, and diagnosed in 1980-2000 vs. 2000-2015. We used bootstrap to determine the accuracy and stability of five networks' parameters: strength, expected influence, eigenvector, bridge strength and hybrid centrality. Results: The most central symptoms within the overall network, and in six subnetworks were dyspnea and migratory pains. We identified some gender-related differences, but no differences were observed for the age and time of diagnosis. Conclusions: Self-reported dyspnea and migratory pains are potential important targets for treatment procedures.

Complaints of dyspnea and their associations with personality traits in patients referred to psychotherapy in a day hospital.

BACKGROUND: Breathing difficulties are present in different medical conditions, yet seem to be underresearched in psychiatric patients. AIM: Assessment of prevalence of dyspnea complaints and their associations with personality traits in patients with neurotic or personality disorders referred to psychotherapy. METHODS: Retrospective chart review of medical records of 2450 patients with diagnoses F4-F6 (ICD-10). Analyses of associations between dyspnea reported in a symptom checklist SCL-O and pathological scores in the Neurotic Personality Questionnaire were carried out using univariate and multivariate regression analyses with ORs and 95%CI estimated with licensed STATISTICA 13 (StatSoftPL) software, and R version 4.1.0, RStudio version 1.4.1717 software. RESULTS: Dyspnea was reported by 46.3% women and 36.6% men (14.5% and 10.1% respectively assessed it as severely burdensome). Univariate regression analysis revealed several significant associations between reporting dyspnea or its extreme intensity and pathological scores in the NPQ. Multivariate regression analyses in women confirmed the importance of impulsiveness and exaltation for dyspnea occurrence, and feeling of being dependent on the environment, demobilization, and narcissistic attitude for its extreme intensity. In men impulsiveness, sense of being in danger, irrationality, and ponderings were associated with the presence of dyspnea, and sense of being in danger and envy with its extreme intensity. CONCLUSIONS: Complaints of dyspnea were pretty frequent. Several personality traits measured by the NPQ questionnaire were predictors of their occurrence and feeling of extreme burden.

Neurotic symptoms profile in a day hospital patients with an anamnesis of head injury in the past. / Profil objawów nerwicowych u pacjentów dziennego oddzialu leczenia zaburzen nerwicowych z historia urazów glowy.

OBJECTIVES: The aim of the study was to assess the relationship between the occurrence of brain damage and symptoms of neurotic disorders, reported by patients of the psychotherapeutic day hospital for neurotic and personality disorders before starting treatment. METHODS: Analysis of the cooccurrence of neurotic symptoms with previous head or brain tissue damage. The trauma was reported in a structured interview (Life Questionnaire) completed before treatment in the day hospital for neurotic disorders. Illustrated with OR coefficients (odds ratios), the performed regression analyzes showed statistically significant correlations between brain damage (caused by brain trauma, stroke, etc.) and symptoms listed in the symptom checklist KO"0". RESULTS: In a group of 2,582 women and 1,347 men, some of respondents reported (in the self-completed Life Questionnaire) a previous head or brain injury. Men reported a history of trauma much more often than women (20.2% vs. 12.2%; p < 0.0005). Patients who had a history of head trauma obtained a significantly higher value of the global severity of neurotic symptoms (OWK) in the symptom checklist KO "0" than patients without head trauma. This applied to both the male and female groups. Regression analyzes showed a significant relationship between head injuries and the group of anxiety and somatoform symptoms. In both groups (men and women), ?paraneurological', dissociative, derealization, and anxiety symptoms occurred more frequently. Men more often reported difficulties in controlling the expression of emotions, muscle cramps and tension, obsessive-compulsive symptoms, skin and allergic symptoms, and symptoms of depressive disorders. Women more often reported vomiting when feeling nervous. CONCLUSIONS: Patients with a history of head injuries have a higher global severity of neurotic disorders symptoms than people without such history. Men experience head injuries more often than women, and the risk of developing symptoms of neurotic disorders is higher in men. It seems that patients with head injuries are a special group when it comes to reporting some psychopathological symptoms, especially in the group of men.

Abnormal cortisol awakening responses in patients with neurotic and personality disorders admitted for psychotherapy in day hospital.

Dysregulation of the hypothalamic-pituitary-adrenal axis (HPA axis) has been associated with various psychiatric conditions. The most interesting parameter of the HPA axis function is cortisol awakening response (CAR). Few data exist about the CAR in anxiety or personality disorders and findings are often contradictory showing blunted or increased CAR compared with control groups. The goal of this study was to determine whether patients with neurotic and personality disorders show a specific CAR pattern. The study population comprised 130 patients, mainly females (71.5%), with the primary diagnosis of a neurotic disorder or personality disorder according to ICD-10 admitted for psychotherapy in a day hospital. Pre-treatment cortisol levels were measured in three saliva samples collected in one day. The Symptom Checklist "O" and MMPI-2 were used to assess the pre-treatment levels of patients' symptoms and personality traits. The study revealed a high percentage of CAR non-responders (cortisol increase of less than 2.5 nmol/l) in the study group (43.1%), particularly in females. 49% of them were CAR non-responders compared with 28% in males and 25% in the general population, respectively. CAR non-responders did not differ from the remainder in clinical characteristics. Four different CAR patterns were found in the study group: negative (26.9%), blunted (26.1%), normal (25.4%) and elevated (21.6%) as well as a particular type was not related to clinical characteristics of the patients. The study suggests that abnormal CAR types are observed in patients with neurotic and personality disorders and further research into the mechanism of the findings is required.

Obsessive-Compulsive Symptoms in Obsessive-Compulsive Disorder and in Generalized Anxiety Disorder: Occurrence and Correlations.

OBJECTIVE: Because of the heterogeneity of obsessive-compulsive disorders (OCDs) and their co-occurrence with anxiety disorders, we investigated the prevalence, severity, and correlations between obsessive and compulsive symptoms reported by patients diagnosed with OCD or generalized anxiety disorder (GAD). METHODS: A retrospective study was conducted in 2 groups of patients: 76 patients diagnosed with OCD [F42 according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10)], and 186 patients diagnosed with GAD (F41.1 according to ICD-10), who had presented for therapy at the day ward. The Symptom Questionnaire "O," based on the Symptom Checklist 90-Revised (SCL-90-R) questionnaire, was used to assess obsessive, compulsive, and anxiety symptoms. The analysis took into account the impact of sex and the presence or absence of cognitive dysfunction (as assessed using the Bender Benton Visual Retention and Bender-Gestalt tests) on the associations being investigated. RESULTS: We observed that obsessive and compulsive symptoms were more prevalent and more strongly expressed in the group with OCD than in the group with GAD. However, almost all patients with GAD (94%) confirmed the presence of some obsessive-compulsive symptoms. The study revealed differences in correlations with obsessions and compulsions between the OCD and GAD groups. In the group with OCD, no significant correlation between the severity of obsessions and compulsions was identified, whereas in the group with GAD, a significant positive correlation was found between the severity of those symptoms. In both the GAD and OCD groups, a greater intensity of obsessive-compulsive symptoms was accompanied by an increase in the severity of anxiety symptoms (with this effect noted to a greater extent with obsessions than compulsions). CONCLUSIONS: The study revealed that patients with GAD often have coexisting obsessive-compulsive symptoms, which may not be identified during routine psychiatric examination. Obsessive-compulsive symptoms observed in patients with GAD may show a different structure than obsessive-compulsive symptoms in patients with OCD. The results of this study suggest that compulsions are more specific for the diagnosis of OCD than obsessions. Compulsions, such as counting related to the need for order and symmetry, may be associated with some cognitive dysfunctions and male sex, a finding that requires further research.

The reception of Dr Ludwik Jekels' "apostolic activity" to promote psychoanalysis in Poland before the outbreak of World War I. Part 1. / Reakcje na "apostolska dzialalnosc" dr. Ludwika Jekelsana rzecz psychoanalizy w Polsce do wybuchu I wojny swiatowej. Czesc 1.

The paper sets out to present Dr Ludwk Jekels' activity for the development of psychoanalysis in Poland between 1909 and 1914. Ludwik Jekels was the first Polish psychoanalyst and the first translator of Sigmund Freud's works into Polish. Throughout numerous years he gained his psychoanalytic skills in the classical Viennese school of psychoanalysis while attending lectures conducted by Freud himself. The article analyses a number of previously unknown and unpublished historical sources (e.g., Ludwik Jekels' memories and correspondence as well as daily newspapers and scientific journals). The research allowed the current knowledge of Dr Jekels' activity and achievements in his early career as a psychoanalyst to be significantly complemented. The first part of the paper presents briefly Dr Jekels' professional development and the causes why he gained interest in psychoanalysis. A little-known period of psychoanalytic activity prior to his first public presentations in Krakow and Warsaw in 1909 was reconstructed. The article includes a detailed review of Jekels' first lectures on psychoanalysis, including one which has been completely unknown to the historians of medicine. The varied reactions of the Polish neurologists and psychiatrists' to Jekels' promoting activity and psychoanalysis itself were critically assessed.

The reception of Dr Ludwik Jekels' "apostolic activity" to promote psychoanalysis in Poland before the outbreak of World War I. Part 2. / Reakcje na "apostolska dzialalnosc" dr. Ludwika Jekelsa na rzecz psychoanalizy w Polsce do wybuchu I wojny swiatowej. Czesc 2.

The paper sets out to present Doctor Ludwik Jekels' activity for the development of psychoanalysis in Poland between 1909 and 1914. The second part of the paper focuses mainly on the period of 1911-1912 when Ludwik Jekels was the most active in promoting psychoanalysis. The article also includes the discussion of Jekels' book publications including two translations of Sigmund Freud's works and the first Polish publication on psychoanalysis entitled Szkic psychoanalizy Freuda (An Outline of Freud's Psychoanalysis). The reactions of the scientific circles, particularly those associated with the Lviv School of Psychology, were also analyzed. The access to previously unpublished sources allowed the authors, for the first time, to report on Jekels' educational activity in Krakow and Lviv. The sources also gave insight to Jekels' completely unknown actions to promote psychoanalysis in Cieszyn Silesia. Jekels' lectures were followed by a wide range of reactions from the public with the medical community increasingly criticizing psychoanalysis. The pinnacle of Jekels' activity was the Second Congress of Polish Neurologists, Psychiatrists and Psychologists was organized in Krakow in 1912. It was the culmination in the discussion on the place of psychoanalysis in the Polish science. The paper presents the participants of the psychoanalytic session with a special focus on Dr Jekels' contribution, the way how psychoanalysis discussion was conducted and the effects of the congress on further development of psychoanalysis. In conclusion an attempt was made to assess the overall significance of Dr Jekels' activities in Poland.

Neurotic personality traits and associated dysfunctional attitudes as factors predisposing patients to suicidal ideations at the end of intensive psychotherapy. / Nerwicowe cechy osobowosci i zwiazane z nimi dysfunkcjonalne postawy pacjentów jako czynniki predysponujace do wystapienia mysli samobójczych pod koniec intensywnej psychoterapii.

OBJECTIVES: To determine the relationshipsbetween personality traits typical for neurotic disorders and dysfunctional attitudes declared by patients without suicidal ideations (SI) prior to treatment and SI at the end of an intensive psychotherapy with a predominant psychodynamic approach in the day hospital for neurotic, behavioral, or personality disorders. MATERIAL AND METHOD: KO "O" Symptom Checklist for assessing SI, Neurotic Personality Questionnaire KON-2006 for evaluation of neurotic personality characteristics and patients' attitudes, and a Life Questionnaire, all completed by a group of 680 patients of a day psychotherapy ward, treated for the first time. Statistical analysis encompassed 466 non-SI patients, 4% of whom had SI at the end of treatment. RESULTS: A number of attitudes have been identified in patients who were significantly predisposed to SI at the end of intensive psychotherapy: physical aggression towards relatives (p < 0.001), grandiose fantasies (p = 0.043), resignation tendencies (p = 0.022), resignation feeling associated with the experience of loss of life opportunities (p = 0.037), and being guided mainly by intuition (p = 0.035). It was also observed that declaring certain attitudes was significantly associated with less than average chance of SI at the end of treatment. CONCLUSIONS: In patients who declared these attitudes, there was a higher risk of SI at the end of the psychotherapy cycle than in the remaining patients (10-30% vs. 4%), which indicates the presence of specific dysfunctions of personality, in the case of which intensive psychotherapeutic work requires particular caution -it can trigger emotional stress leading to SI instances. It can be assumed that SI are the result of the reconstruction of defense mechanisms while working on insight, confrontation with the causes and consequences of the patients' own physical aggression towards the loved ones, the realization of the size of their grandiose thinking and the insight into its function, and the insight into the causes of resignation attitudes.

Anxiety symptoms in obsessive-compulsive disorder and generalized anxiety disorder. / Objawy lekowe w zaburzeniu obsesyjno-kompulsyjnym i w zaburzeniu lekowym uogólnionym.

OBJECTIVES: Due to the co-occurrence of symptoms of anxiety disorders and obsessive-compulsive disorders, and the hypothesis about common etiopathological factors, we performed a research addressing the occurrence and severity of anxiety symptoms, the severity of groups of neurotic symptoms, and conducted factor analyses in two groups of patients: diagnosed with obsessive compulsive disorder (OCD) and with generalized anxiety disorder (GAD). MATERIAL AND METHODS: A retrospective study was conducted on two groups of patients: 76 - diagnosed with OCD, and 186 - diagnosed with GAD. The source of information about the presence and severity of symptoms was the Symptom Checklist "O" (KO"O"). The impact of sex and the presence or absence of cognitive impairments (Bender's and Benton's tests) on the investigated associations were accounted for. RESULTS: No significant differences in the severity of most anxiety symptoms were found between the groups of patients diagnosed with OCD or GAD. Patients with GAD were characterized by a significantly higher intensity of phobic disorders, conversion disorders, cardiac autonomic dysfunctions, and hypochondria, when compared to patients with OCD. Factor analyses identified the existence of three similar factors in the OCD and the GAD groups: 'anxiety/depressiveness', 'obsessions' and 'compulsions'. Additional factors were, among others, 'depressiveness' in OCD and separation anxiety in GAD. CONCLUSIONS: The research indicates that anxiety plays a significant role in the clinical picture of OCD and may reach a severity similar to that observed in GAD. The presence and severity of anxiety and somatization symptoms can be associated with the presence of cognitive impairments, which requires further investigation.

Neurotic personality and lower urinary tract symptoms in day hospital patients diagnosed at pretreatment between 2004 and 2014. / Osobowosc nerwicowa a objawy z dolnego odcinka ukladu moczowego u pacjentów kwalifikowanych do leczenia psychoterapia na oddziale dziennym w latach 2004­2014.

OBJECTIVES: Evaluation of the association between the occurrence of lower urinary tract symptoms in patients qualified for psychotherapy and the severity and profile of their neurotic personality disorders. MATERIAL AND METHODS: Retrospective analysis of questionnaires included in the medical records of 2,450 patients qualified for psychotherapy in 2004-2014 in terms of correlations between the symptoms of pollakiuria and unconscious urinary incontinence, and the global severity of neurotic symptoms (OWK), global severity of neurotic personality disorders (XKON) and abnormal values of 24 scales of the KON-2006 questionnaire. Correlations in the form of OR coefficients with 95% confidence intervals were estimated using logistic regression analyzes. RESULTS: Lower urinary tract symptoms are associated with a significantly greater severity of neuroticism, both described by the global severity of symptoms (OWK) as well as by the global neurotic personality disorder index (XKON) and abnormal values of the KON-2006 questionnaire scales. The occurrence of both symptoms was associated with the following scales: 'Negative self-esteem' and 'Envy', the occurrence of pollakiuria - with the scales 'Feeling of being dependent on others', 'Demobilization', 'Conviction of life helplessness' and 'Feeling of lack of influence', the occurrence of unconscious urinary incontinence - with the scales 'Feeling of being alienated' and 'Exaltation' for both genders, and only in men 'Risk avoidance' (low 'Risk tendencies'), 'Conviction of life helplessness', 'Difficulties in interpersonal relations'. Extreme severity of pollakiuria was more strongly associated with many of the mentioned scales, and also slightly differently with other scales, e.g., in men - with the 'Sense of overload' and 'Imagination, fantasizing'. CONCLUSIONS: Neurotic personality traits described by abnormal values of the KON-2006 questionnaire scales are associated with the presence (and also to some extent with the severity) of psychogenic lower urinary tract symptoms. Connections may be bi-directional - in some cases experiencing and self-description of personality traits may be secondary to suffering associated with pollakiuria and incontinence.

Changes in ego strength in patients with neurotic and personality disorders treated with a short-term comprehensive psychodynamic psychotherapy. / Zmiany w zakresie sily ego u pacjentów z zaburzeniami nerwicowymi i zaburzeniami osobowosci leczonych krótkoterminowa kompleksowa psychoterapia psychodynamiczna.

OBJECTIVES: Analysis of changes in ego strength in the course of group psychotherapy in patients treated with neurotic and selected personality disorders (F40-F61, ICD-10). METHODS: 82 patients (61 women and 21 men) participated in the study. They underwent intensive short-term group psychotherapy treatment in a day hospital for neurotic and behavioural disorders. The assessment of the patients' personality functioning was carried out at the onset and the end of the psychotherapy. The assessment was reported as a value on the ego strength scale by means of the MMPI-2 questionnaire. RESULTS: The comparative analysis with the use of the t-Student test for related measurements, which was carried out for the measurement of ego strength values at the onset and the end of the therapy, demonstrated a statistically significant positive change both for the entire examined group and the groups which considered the gender and diagnosis distribution. CONCLUSIONS: Short-term intensive comprehensive group psychotherapy with elements of individual psychotherapy results in obtaining the desired changes in the personality functioning manifested through the increase in ego strength.

Dr Jekels' health resort in Bystra near Bielsko: the first treatment centre which adopted psychoanalysis in Poland. / Sanatorium doktora Jekelsa w Bystrej kolo Bielska ­ pierwszy polski zaklad leczniczy poslugujacy sie psychoanaliza.

The paper sets out to present the history of a health resort and hydrotherapy centre in Bystra near Bielsko from 1898 to 1912. At that time Dr Ludwik Jekels, one of the Polish psychoanalysis forerunners, was the owner of the centre. Initially, Dr Jekels was very enthusiastic about climatic treatment and hydrotherapy, until 1905 when he got interested in psychoanalysis. Shortly afterwards he became its staunch supporter and adopted it as a curative procedure in his health resort. That was the first documented case of psychoanalysis use in Poland. This paper presents the development of the therapeutic centre in Bystra and the characteristic of typical patients receiving treatment there. It also briefly reports on medical histories of the conditions of patients who received psychoanalytic treatment. The paper also focuses on another significant area of Dr Jekels'contact with Sigmund Freud ranging from an accidental meeting in Vienna around 1898, through the summer of 1910 when Jekels looked after Freud's daughters in his spa, to 1912 which saw Jekels'receiving psychoanalytic treatment from Freud. It also presents a detailed analysis of hypotheses why Jekels decided to sell the health resort and move to Vienna. Finally, the significance of Jekels'currently underrated therapeutic work for the development of the Polish psychoanalysis is reiterated.

Changes in intensity of neurotic symptoms associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders. / Zmiany w nasileniu objawów nerwicowych wiazace sie z redukcja mysli samobójczych u pacjentów poddanych psychoterapii w dziennym oddziale leczenia nerwic i zaburzen behawioralnych.

OBJECTIVES: Analysis of associations between changes in the intensity of neurotic symptoms and reduction of suicidal ideation (SI) or lack of SI reduction, in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach in a day hospital. METHODS: Symptom Checklist KO"O" and Life Inventory completed by 461 women and 219 men treated in the psychotherapeutic day hospital due to neurotic, behavioral or personality disorders between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. RESULTS: The reduction of neurotic symptoms intensity was greater in patients of both genders who improved in terms of SI than in those who did not. This referred to global intensity of neurotic symptoms (OWK coefficient) in both genders (p<0.001), as well as to the majority of the neurotic symptoms subtypes in both genders (p<0.05): Phobic disorders, Other anxiety disorders, Obsessive-compulsive disorders, Conversions and dissociations, Autonomic disorders, Somatization disorders, Neurasthenia, Avoidance and dependence, Sexual dysfunctions, Dysthymia; and in case of women (p<0.05): Hypochondriasis, Depersonalization and derealization, Impulsiveness and histrionism and Non-organic sleep disorders. CONCLUSIONS: The results show effectiveness and comprehensiveness of intensive psychotherapy as a treatment method that leads to improvement in terms of both SI and neurotic symptoms. This suggests that the applied therapy may be effective in preventing suicidality in this group of patients. The observed associations also point in favor of hypothesis on similarities in etiopathogenesis of and partly identical personality-related factors predisposing to SI and neurotic disorders.

Dr. Karol de Beaurain - a psychiatrist's profile. Part 1. / Dr Karol de Beaurain ­ sylwetka psychiatry. Czesc 1.

The paper sets out to recall the profile of Karol de Beaurain, a psychiatrist who belonged to the circle of first Poles who used psychoanalysis in treatment. So far, dr Beaurain has been known from brief references in publications relating to the life and works of Stanislaw Ignacy Witkiewicz (Witkacy) whose psychoanalytic sessions he conducted between 1912 and 1913. De Beaurain was born in 1867 and studied medicine at Swiss universities (Zurich, Berne, Geneva) where he defended his doctoral thesis as well. He was prepared for the career of a health resort physician and when he returned to Poland, he settled down in Poronin where except for working as a district physician, he also engaged in social and cultural activities. Around 1910 his professional interest shifted towards psychiatry and psychotherapy. In the final months of 1911 he relocated to Zakopane where he opened a private practice for "neu-rotic diseases". At the same time he started treating patients with the use of psychoanalytic methods. The first part of the paper concerns the life of doctor de Beaurain from birth and the period of studies and preparation for his professional career until the time when he started his psychoanalytic work.

Dr. Karol de Beaurain - a psychiatrist's profile. Part 2. / Dr Karol de Beaurain ­ sylwetka psychiatry. Czesc 2.

The paper sets out to recall the profile of Karol de Beaurain, a psychiatrist, who was one of first Poles to use the psychoanalytic method in treatment. So far, he has been mostly known as the one who was Witkacy's psychoanalyst. Stanislaw Ignacy Witkiewicz and Eugenia Dunin-Borkowska are the first patients who are known by their names and who received psychoanalytic treatment in the history of the Polish medicine. Stanislaw Ignacy Witkiewicz's letters and drawings originating from the psychoanalysis period served as a source of information about Witkacy's psychoanalysis. The paper illustrates dr Beaurain's fate during World War I when he was first a military doctor in Skoczów and then an assistant in prof. Piltz's Neurological-Psychiatric Clinic in Kraków where he actively participated in the creation of a multidimensional programme of war neurosis treatment. After the war finished, initially Beaurain stayed at his assistant post at the Psychiatric Clinic in Kraków but then in 1921 he relocated to the National Psychiatric Hospital in Dziekanka near Poznan. With his professional expertise he contributed to the strengthening of the Great Poland region psychiatry that had experienced qualified personnel shortages after the German qualified staff left. The growing numbers of patients and the overload of professional duties were probably the factors that led to dr. Beaurain's premature death while he was holding the position of the head physician at the National Psychiatric Hospital in Owinska in February 1927.

Ludwika Karpinska, "Polish Lady Philosopher" - a forgotten forerunner of Polish psychoanalysis. / Ludwika Karpinska: "polska pani filozof" ­ zapomniana prekursorka polskiej psychoanalizy.

The paper presents the profile of the psychologist, Ludwika Karpinska-Woyczynska, the first Polish woman who acted for the popularisation of psychoanalysis and experimental psychology. Karpinska belonged to the first generation of the "Polish Freudians", a group which also involved Ludwik Jekels, Stefan Borowiecki, Herman Nunberg, Jan Nelken and Karol de Beaurain. Karpinska's difficult path to gain higher education will be presented. Thepaper lays an emphasis on Karpinska's contribution to the development of the international psychoanalysis and offers an overview of her most significant psychoanalytic publications (Polish and foreign ones) up to the outbreak of World War I. It demonstrates her participation in scientific conferences and collaboration with the most important psychoanalytical centres in Zurich and Vienna together with their representatives (Jung, Freud, Jekels) drawing simultaneous attention to the broader historical background of the presented events. Karpinska's post-war work was inextricably linked to the research on intelligence quotient of children and youth and psychotechnical studies. Furthermore, the paper illustrates the activities of the Municipal Psychological Lab in Lodz, where Karpinska was a Head between 1920 and 1930, as well as her scientific achievements in intelligence quotient research, most significant publications of 1921-1930, her collaboration with foreign centres of a similar profile and the efforts she made to establish the Vocational Guidance Service.

Trait and state anxiety in patients treated with intensive short-term group psychotherapy for neurotic and personality disorders. / Lek-cecha i lek-stan u pacjentów leczonych intensywna, krótkoterminowa psychoterapia grupowa z powodu zaburzen nerwicowych i osobowosci.

OBJECTIVES: The study aimed to determine the severity of trait and state anxiety in patients treated for neurotic and personality disorders with intensive, short-term group psychotherapy and to analyse the change of anxiety intensity in the course of treatment. METHODS: 116 patients (81 females and 35 males) participated in the study. The measurement of anxiety intensity was conducted with the State-Trait Anxiety Inventory (STAI) at the beginning and at the end of treatment. RESULTS: The majority of patients (69% of the study group) demonstrated a high intensity of state anxiety at the beginning of the treatment with 47.4% being classified as very high. High intensity of trait anxiety was observed in 64.7% of participants (50.9% -very high). RCI (Reliable Change Index) and RCV (Reliable Change Value) indicated a significant change in state anxiety intensity in 62.1% of participants (48.3% - significant decrease, 13.8% increase). At the end of treatment more than a half of patients manifested medium and low intensity of both trait and state anxiety. CONCLUSIONS: At the beginning of psychotherapy the majority of patients demonstrated high intensity of both trait and state anxiety. In the course of therapy a considerable reduction of intensity of trait and state anxiety is observed. Significant deterioration in trait anxiety is observed in one out of every thirteen treated patients. Polish adaptation of STAI questionnaire is a useful tool for monitoring effectiveness of psychotherapy and may be successfully applied for screening and detailed diagnosis of neurotic and personality disorders.

Post-War Research on Post-Traumatic Stress Disorder. Part I. Research before 1989. / Powojenne badania stresu pourazowego w Krakowie. Czesc I. Badania do 1989 roku.

The paper presents the post-war history of post-traumatic research conducted at the Department of Psychiatry of the Jagiellonian University and the analysis of the main research approaches and selected publications. The time after World War II passed in Poland in two directions: coping with the finished war trauma and simultaneously the experience of communist persecution trauma. First scientific publications appeared in the fifties and were focused on the research of former concentration camps prisoners (KZ-Syndrome). Between 1962 and 1989 a special edition of Przeglad Lekarski, which concentrated entirely on war trauma research, was published. The journal was nominated for the Peace Nobel Prize twice. The research team from the Department of Psychiatry headed by Professor Antoni Kepinski made a very extensive description of KZ-Syndrome issues. The paper summarizes the most important contemporary research findings on psychopathology of KZ-Syndrome (Szymusik), reaction dynamics (Teutsch), after camp adjustment (Orwid), paroxysmal hypermnesia (Póltawska), somatic changes (Gatarski, Witusik). The result of the study was the basis for the development of a methodology and a new look at the classification of the consequences of post-traumatic stress disorder, as well as the development of ethical attitudes towards patients.