Social functioning and the quality of life of patients diagnosed with schizophrenia.

INTRODUCTION: Schizophrenia to a considerably great degree impairs the social functioning of the persons affected in the spheres of interpersonal and occupational contacts, as well as self-care. It brings about serious cognitive, perceptual, motor and emotional deficits, inevitably leading to the social withdrawal of patients. This phenomenon may assume various forms, from the limitations in interpersonal relations, through narrowing these relations to only some circumstances, to the total cessation of social contacts. OBJECTIVE: The objective of the study is presentation of the most important problems related with social functioning and quality of life of patients diagnosed with schizophrenia, based on scientific studies conducted in Poland and worldwide. STATE OF KNOWLEDGE: The family of a schizophrenia patient exerts a great effect on the social functioning. While undertaking proper actions the family may become a co-therapist and significantly facilitate the patient's adjustment to life in society and his/her playing a specified role. Analysis of disorders in social functioning of patients with schizophrenia, in the context of social cognition, indicates the fact that these disorders have their source in the lack of capabilities for identification of own and other people's internal states, whereas mentalization is the essence of social cognition. CONCLUSIONS: Therapy, any psychosocial impact as well as rehabilitation, neutralizes the causes for patients' withdrawal from social life. Training of social skills is necessary which teaches patients to return to the situation when they would be able to function properly in their environment.

Vulvodynia and depression - a case study. / Wulwodynia i depresja ­ opis przypadku.

The analysis of the case of vulvodynia coexisting with depression. Remission in terms of pain and affective symptoms was achieved simultaneously after including gabapentin in the treatment at a dose of 900 mg/d. Depressive disorders may constitute a risk factor for vulvodynia and occur as a secondary condition to pain. The frequency of other functional pain syndromes such as fibromyalgia and temporomandibular syndrome is much higher in patients with vulvodynia than in the overall female population. The risk of suicide in vulvodynia, similarly to other chronic pain syndromes, is relatively high, especially with coexisting depressive symptoms.

LEVOMILNACIPRAN--A SUCCESSOR OF MILNACIPRAN WITH A HIGHER NORADRENERGIC SELECTIVITY.

A new antidepressant, levomilnacipran, is the levorotatory enantiomer of milnacipran. The drug belongs to selective serotonin-norepinephrine reuptake inhibitors (SNRI) and has the highest noradrenergic selectivity of all members of this group of antidepressants. Clinical trials have confirmed the effectiveness of levomilnacipran in the treatment of depression. The drug was placed on the US market in the form of prolonged-release capsules, which greatly simplifies the treatment of psychiatric patients. The safety of the drug is also higher than the safety of a racemate, resulting in a beneficial impact on the therapeutic effect. In this paper we present current information on the pharmacological and clinical properties of the newest antidepressant--levomilnacipran.

VORTIOXETINE - THE NEW ANTIDEPRESSANT AGENT WITH PROCOGNITIVE PROPERTIES.

Depression symptoms resulting from cognitive function impairment are emphasized by both DSM-5 and ICD-10 diagnostic criteria for major depressive disorder and depressive episodes. Nonetheless, the role of cognitive dysfunctions seem to remain underestimated in case of depressive disorders, thus they are rarely perceived as therapeutic target. Vortioxetine is a relatively new, multi-functional agent. With its unique properties and strong affinity towards serotonin transporter (5-HTT), vortioxetine is a modulator and stimulator of serotonergic transmission. Vortioxetine is an antidepressant drug suitable for therapy in various types of depression: severe, anxiety-associated, and of elders. It acts equally strong as SNRIs or agomelatine and has favorable effects on cognitive functioning. Although vortioxetine has not undergone comprehensive preclinical testing, the available data indicate that this particular agent may be more advantageous in terms of its procognitive effects, as compared to other drugs - which often seemed to be analogous in preclinical and clinical testing. In vitro examination of hippocampal pyramidal cells revealed that vortioxetine improves both synaptic transmission and neuroplasticity responsible for memory and learning patterns. Contrary to fluoxetine, the long-term treatment with use of vortioxetine on mice resulted in enhanced visual and spatial memory, along with reduced occurrence of typical depressive behavior. In addition, vortioxetine is a very first drug efficiently augmenting cognitive function in adults diagnosed with severe depressive episode, irrespective of its curative potential on the affective sphere. It may exert even stronger direct effect (assessed with DSST) on cognitive functions than duloxetine. With its supplementary capacity of acting directly on several subtypes of serotonin receptors, vortioxetine is certainly more than just a SSRI. It has been proved that it is as effective as venlafaxine and more efficient than agomelatine in MDD treatment, additionally exerting procognitive effects. In addition, vortioxetine may be beneficial in overcoming sexual dysfunction in patients, who have been suffering from such condition as a result of treatment with other antidepressant agents. The drug is generally well tolerated with the most prevalent side effects being mild to moderate nausea along with (mostly transient) headaches. Vortioxetine may significantly improve the quality of life in patients suffering from depression.