Classical psychedelics in psychiatry - renaissance of interest and therapeutic perspectives. / Klasyczne psychodeliki w psychiatrii ­ renesans zainteresowania i perspektywy terapeutyczne.

Substances that change the states of consciousness have been used in the therapeutics of traditional cultures for hundreds of years. In the Western cultural circle, scientific curiosity and hope for a breakthrough in the treatment of various mental disorders constituted the basis of the first wave of research on humans with the use of psychedelics. After synthesizing LSD, psychedelic substances aroused intense but short-term interest among mental health specialists at the beginning of the second half of the 20th century. In the preliminary studies, substances such as psilocybin or LSD, used as a supplement to psychotherapy, showed promising therapeutic effects, however, due to legal and political reasons, all research work was stopped in the 1970s. The last two decades have been a period of renaissance in the interest in using sychedelic substances in psychiatry. Despite the early stage of work, the clinical research conducted so far has indicated the potential benefits of using psychedelics in the treatment of anxiety, affective disorders, or addictions. Moreover, so far, no serious side effects of this form of therapy have been reported. However, due to a number of barriers of both medical and legal nature, the creation of the first psychiatric drug with psychedelic properties appears to be extremely complicated. Further, precisely constructed studies on large groups of patients are needed to determine whether psychedelics can find practical applications in psychiatric therapy (or even become a long-awaited breakthrough in the treatment of mental disorders).

Correlation between Selected Clinical Symptoms and Severity of Aggression, Impulsiveness and Their Selected Behavioral Manifestations in Patients with Polycystic Ovary Syndrome Phenotype A.

Previous studies on aggressiveness and impulsiveness in women with polycystic ovary syndrome (PCOS) are ambiguous. Furthermore, no biochemical or clinical factors related to these variables have been definitively confirmed. The aim of the study was to clarify whether, in women with phenotype A of PCOS, variables such as body mass index and clinical and biochemical hyperandrogenism have an impact on either the intensity of impulsivity or aggression or on other selected behavioral manifestations of these variables. The study included 95 patients diagnosed with PCOS phenotype A. The criterion for recruitment into the study group and the control group was body mass index. The study was conducted with the use of a closed-format questionnaire and calibrated clinical scales. Higher body mass index (BMI) values in women with PCOS phenotype A are associated with poor eating habits. The severity of impulsivity and aggression syndrome, as well as the tendency to engage in risky sexual behavior and patterns of alcohol consumption among patients diagnosed with PCOS phenotype A, are not dependent on BMI. The severity of impulsiveness and the syndrome of aggression in women with phenotype A PCOS are not associated with clinical symptoms of hyperandrogenism or with androgen levels.

Multiple-Monitored Electroconvulsive Therapy (MMECT) - does it really just belong in psychiatry's past? A case report. / Wielokrotne monitorowane zabiegi elektrowstrzasowe (MMECT) ­ czy na pewno wylacznie domena historii psychiatrii? Opis przypadku.

Electroconvulsive therapy has been a method used in psychiatry since 1938 and despite its rather turbulent history, it is still the most effective method of treating severe mental disorders. Despite its high efficiency and good safety profile, patients with catatonia usually require a large number of treatments. It entails a long hospitalization time and the necessity to repeatedly induce general anesthesia. In 1966, Blachly proposed to induce more than one seizure during a single anesthesia. According to this method, the patient was to be constantly monitored (ECG, EEG) during a series of electroconvulsions, which consisted of two to even eight treatments. For simplicity, the method is called multiple-monitored ECT (MMECT). The work is based on the medical history of a patient diagnosed with catatonic schizophrenia. Due to the insufficient effect of single treatments, we decided to use the MMECT method, which was performed in series of three treatments, twice a week. Thanks to the therapy, catatonic symptoms remitted. Studies in various patient populations have shown that MMECT reduces hospitalization time, the duration of acute symptoms, and the patient's total exposure to anesthetics and muscle relaxants. As the above case shows, MMECT can potentially be considered as a safe treatment alternative in patients that require a large number of treatments, resistant to standard forms of therapy.

Volunteers' psychological condition during the war in Ukraine - a survey. / Kondycja psychiczna wolontariuszy w trakcie wojny w Ukrainie ­ badanie ankietowe.

OBJECTIVES: Our goal was to fill a literature gap regarding the impact of volunteering on volunteers' mental health. METHODS: Using social media platform "Facebook" volunteers were asked to fill in a self-developed research questionnaire concerning their well-being. The link to the survey remained open from April to May 2022. Overall, 867 participants' responses were analyzed, 703 were included. Respondents were divided into three groups according to how volunteering had affected their well-being. Subsequently two groups were extracted: volunteers operating in Ukraine and those hosting refugees at home. In each of these groups impact of volunteering on volunteers' well-being was examined. RESULTS: 45.10% of participants reported volunteering has positively affected their overall well-being, in 35.56% it had no impact and in 19.35% affected them negatively. Somatic symptoms of anxiety manifested in 11.10% and were more severe in 8.25%. 14.10% of participants reported a greater need of using psychoactive substances. Among volunteers who hosted refugees 52.23% felt increased tension and irritability. 18% of volunteers operating in Ukraine reported a need to see a psychiatrist or a psychologist. CONCLUSIONS: Impact of volunteering on one's mental well-being ranged from positive to detrimental. Initial mood had significant impact on mental well-being after volunteering. The phenomenon of indirect trauma among non-professional volunteers is not sufficiently explored yet and requires further research.

Malignant complications of masturbation - a case study. / Zlosliwe nastepstwa masturbacji - opis przypadku.

We present a case of a 32-years-old female patient diagnosed with paranoid schizophrenia for many years who has developed neuroleptic malignant syndrome (NMS) as a result of long-acting antipsychotic's injection. Since the initial ineffectiveness of benzodiazepines, the course of electroconvulsive therapy (ECT) has been carried out. In spite of the initial promising response to ECT 3 weeks after the admission her somatic and mental state deteriorated greatly, that was hardly explicable solely by the potential loss of effectiveness of ECT or laboratory tests. Diagnostics extended with imaging tests and gynecological examination revealed the connective tissue-covered cap of a popular multivitamin supplement in patient's vagina. During the following deepened interview, she admitted that in fact 6 months ago a piece had gotten stuck while masturbating. However due to the sense of shame and subjective lack of disturbing symptoms she had left it unsaid. One month after the evacuation of the foreign body she has been discharged from the hospital remaining the full remission. The presented case shows that inflammation in the body can complicate catatonia and NMS, causing a non-specific course and difficulties in diagnosis and treatment. In some patients, the inflammatory process may be caused by a foreign body located in various natural orifices in the body. It appears significant in the group of psychiatric patients. Once again it highlights the tremendous role of meticulously conducted interview including the patient's autoerotic life.

Persistent delusional disorder with delusions of poverty - a case study. / Uporczywe zaburzenia urojeniowe o typie zubozenia ­ opis przypadku.

We present a case study of a patient who was hospitalized with the initial diagnosis of psychotic depression with predominant delusions of poverty. During his hospital stay despite antidepressant and antipsychotic treatment with 150 mg of sertraline and 20 mg of olanzapine per day, no symptomatic improvement was achieved. Besides, the psychotic features have risen to the fore along with inadequately vaguely expressed affective component. What drew attention was the coherence and permanence of delusional judgements, which, albeit variable in expression, always concerned one theme - the belief of an inevitable bankruptcy. The whole clinical picture, both with the objectifying interview defining the order of emerging symptoms, was suggestive and the verification of diagnosis was made. Persistent delusional disorder with delusions of poverty with subsequent mood disorder was diagnosed. The treatment with 275 mg of clozapine per day was started and we observed a slow gradual withdrawal of psychosis as well as a total normalization of the affective range. The case illustrates the importance of differential diagnosis of mental states in which psychotic features coexist with affective symptoms. It is helpful to determine the sequence of the symptoms development. It should be noted that although the ICD-10 classification distinguishes exclusively 7 subtypes of persistent delusional disorder, in the clinical practice we can encounter other thematic areas of psychosis. It brings substantial therapeutic and prognostic implications.

Association Study of the SLC1A2 (rs4354668), SLC6A9 (rs2486001), and SLC6A5 (rs2000959) Polymorphisms in Major Depressive Disorder.

The membrane excitatory amino acid transporter 2 (EAAT2), encoded by SLC1A2, is responsible for the uptake and redistribution of synaptic glutamate. Glycine modulates excitatory neurotransmission. The clearance of synaptic glycine is performed by glycine transporters encoded by SLC6A9 and SLC6A5. Higher synaptic glycine and glutamate levels could enhance the activation of NMDA receptors and counteract the hypofunction of glutamate neurotransmission described in major depressive disorder (MDD). The aim of the study was to assess whether polymorphisms of SCL1A2 (rs4354668), SCL6A5 (rs2000959), and SCL6A9 (rs2486001) play a role in the development of MDD and its clinical picture in the Polish population. The study group consisted of 161 unrelated Caucasian patients with MDD and 462 healthy unrelated individuals for control. Polymorphisms were genotyped with PCR-RLFP assay. We observed that the frequency of genotype CC and allele C of the SLC1A2 polymorphism rs4354668 was twice as high in the MDD group as in control. Such differences were not detected in SLC6A5 and SLC6A9 polymorphisms. No statistically significant association of the studied SNPs (Single Nucleotide Polymorphisms) on clinical variables of the MDD was observed. The current study indicates an association of polymorphism rs4354668 in SCL1A2 with depression occurrence in the Polish population; however, further studies with larger samples should be performed to clarify these findings.

HSPB1 Gene Variants and Schizophrenia: A Case-Control Study in a Polish Population.

Schizophrenia (SCZ) is a severe psychiatric disorder that has a significant genetic component. HSPB1 (HSP27) is known for its neuroprotective functions under stress conditions and appears to play an important role during the development of the central nervous system, which is in agreement with the neurodevelopmental hypothesis of SCZ. The aim of the present case-control study was to investigate whether HSPB1 variants contribute to the risk and clinical features (age of onset, symptoms, and suicidal behavior) of SCZ in a Polish population. To the best of our knowledge, this is the first study that investigated the association between the HSPB1 polymorphisms and SCZ. Three SNPs of HSPB1 (rs2868370, rs2868371, and rs7459185) were genotyped in a total of 1082 (403 patients and 679 controls) unrelated subjects using TaqMan assays. The results showed that the genotypes, alleles, and haplotypes of the three SNPs were not significantly different between the schizophrenic patients and healthy controls either in the overall analysis or in the gender-stratified analysis (all p > 0.05). However, we did find a significant effect of the rs2868371 genotype on the age of onset, negative symptoms, and disorganized symptoms in the five-factor model of PANSS (all p < 0.01). Post hoc comparisons showed that carriers of the rs2868371 G/G genotype had significantly higher negative and disorganized factor scores than those with the C/G and C/C genotypes, respectively. Further investigations with other larger independent samples are required to confirm our findings and to better explore the effect of the HSPB1 polymorphisms on the risk and symptomatology of SCZ.

An association study of the HSPA8 gene polymorphisms with schizophrenia in a Polish population.

Heat shock cognate 70 (HSC70/HSPA8) is considered to be a promising candidate gene for schizophrenia (SCZ) due to its many essential functions and potential neuroprotective properties in the CNS (e.g., HSC70 is involved in the turnover of the synaptic proteins, synaptic vesicle recycling, and neurotransmitter homeostasis). An alteration in the expression of HSPA8 in SCZ has been reported. This implies that the genetic variants of HSPA8 might contribute to schizophrenia pathogenesis. The present study attempted to determine whether HSPA8 polymorphisms are associated with a susceptibility to schizophrenia or whether they have an impact on the clinical parameters of the disease in a Polish population. A total of 1066 participants (406 patients and 660 controls) were recruited for the study. Five SNPs of the HSPA8 gene (rs2236659, rs1136141, rs10892958, rs1461496, and rs4936770) were genotyped using TaqMan assays. There were no differences in the allele or genotype distribution in any of the SNPs in the entire sample. We also did not find any HSPA8 haplotype-specific associations with SCZ. A gender stratification analysis revealed that an increasing risk of schizophrenia was associated with the rs1461496 genotype in females (OR: 1.68, p < 0.05) in the recessive model. In addition, we found novel associations between HSPA8 SNPs (rs1136141, rs1461496, and rs10892958) and the severity of the psychiatric symptoms as measured by the PANSS. Further studies with larger samples from various ethnic groups are necessary to confirm our findings. Furthermore, studies that explore the functional contribution of the HSPA8 variants to schizophrenia pathogenesis are also needed.

Does pop-culture affect perception of medical procedures? Report on knowledge and attitude towards electroconvulsive therapy among Polish students. / Czy popkultura wplywa na postrzeganie procedur medycznych? Raport o stanie wiedzy i nastawieniu polskich studentów do terapii elektrowstrzasowej.

OBJECTIVES: The aim of the study was to investigate the general knowledge and attitudes towards ECT among Polish students, including students of medical faculties. Furthermore, the influence of pop-culture on society's opinion about ECT was investigated. METHODS: For this purpose, 1,370 students have been examined with the usage of the author's questionnaire, which consisted of questions about socio-demographic data, detailed questions about ECT as well as questions about their opinion about influence of pop-culture on the reception of this procedure. The respondents were divided into four subgroups depending on the faculty of their studies: human sciences, technical, medical and health sciences. RESULTS: The results show that the knowledge about ECT among Polish students is on avery low level, as in many cases the therapy is considered as painful, ineffective or even illegal. CONCLUSIONS: The influence of the media, especially film industry, on creating a negative opinion on the subject of ECT is significant. Furthermore, many respondents obtain their knowledge about this procedure from television or from the Internet, where the information is often incorrect.

Ayahuasca - potential therapeutic properties in psychiatry. Research review. / Ayahuaska ­ potencjalne wlasciwosci terapeutyczne w psychiatrii. Przeglad badan.

Ayahuasca, also known as "the liana of the soul" and "the vine of the soul" is a ritual psychedelic traditionally administered in the form of plant decoction, used by the indigenous people of South America for centuries, and in the last 25 years also in Europe, Asia, Africa, Australia, Canada, and the United States. Its biological activity results from the content of N,N-dimethyltryptamine (DMT), acting mainly as a non-selective agonist of serotonin receptors and beta-carboline alkaloids, which are strong and short-acting monoamine oxidase type A(MAOI-A) inhibitors. For many years there have been reports of both the anti-anxiety and antidepressant effects of ayahuasca, as well as indications of the possibility of its use in the treatment of addictions. The results of studies of its effectiveness in drug-resistant depression seem to be promising, comparable in the opinion of some authors with the effect of therapeutic action of ketamine. In the article, we try to explain the complex profile of action and the resulting potential benefits, but also the risk of interaction and adverse effects associated with the taking of ayahuasca, which is important given the high variability of herbal mixtures used to produce the decoction.

An Analysis of Five TrkB Gene Polymorphisms in Schizophrenia and the Interaction of Its Haplotype with rs6265 BDNF Gene Polymorphism.

AIM: The BDNF dysfunction in the schizophrenia has been soundly documented. The TrkB gene is a high-affinity receptor of the BDNF that is changed in schizophrenia and mood disorders. The study had two aims: first, to identify whether the five nucleotide polymorphisms (SNPs) in TrkB gene are associated with a diagnosis of schizophrenia; and the latter, if any association exists between the TrkB SNPs and psychopathology, suicide attempts, and family history of schizophrenia in a Caucasian population. METHODS: Case-control study (401 patients and 657 healthy controls) was used to examine a predisposition for schizophrenia. The tests for psychopathology, suicide attempts, and family history of schizophrenia were conducted only in patient group. The severity of the schizophrenia was measured using the five-factor model of the PANSS. In addition, the haplotype analysis for both the separate for SNPs of TrkB gene and in combination with the rs6265 SNP BDNF gene was conducted. RESULTS: Our case-control study revealed that the genetic variants of rs10868235 (T/T polymorphic genotype) and rs1387923 (G/G polymorphic genotype) of the TrkB gene were associated with a higher risk of developing schizophrenia in men. However, the A/A wild genotype of rs1387923 was connected with a lower risk for both the development of and the family manifestation of schizophrenia in men. The G polymorphic allele of rs1565445 was associated with an increased risk of suicide in schizophrenia. The tested SNPs of the TrkB gene did not modulate the psychopathology of schizophrenia. The haplotype that was built with five SNPs in the TrkB gene was protective for men, but after joining the rs6265 SNP of the BDNF gene, a haplotype that was protective for women was created.

Association of HSPA1B Polymorphisms with Paranoid Schizophrenia in a Polish Population.

This study aimed to find the potential association between HSPA1B polymorphisms and risk of paranoid schizophrenia, clinical variables of the disease, and suicidal behavior. A total of 901 unrelated Polish subjects of Caucasian origin (377 schizophrenia patients and 524 controls) were recruited. Four single-nucleotide polymorphisms (SNP) were genotyped using PCR-RFLP (rs539689, rs9281590) and TaqMan assays (rs263979, rs6547452). A strong tendency towards statistical significance (p = 0.051) was observed in rs539689 allele distribution between patients and controls in overall study subjects. After stratification according to gender, we found that rs539689 was significantly associated with schizophrenia in males, but not in females. The minor allele C had a protective effect in males [OR 0.73 (95% CI 0.61-0.88, p < 0.05)]. In addition, two SNPs (rs539689, rs9281590) were significantly associated with PANSS scores. Another important finding was a strong significant association between the HSPA1B rs539689 polymorphism and attempted suicide in schizophrenic patients. The C/C genotype and C allele were protective against suicidal behavior in entire sample (p < 0.001), in males (p < 001), and in females (p < 0.05), although associations were weaker than in males. Our findings support that HSPA1B gene may be involved in susceptibility to schizophrenia and clinical presentation of the disease in a sex-dependent manner, and may play a role in suicidal behavior in the Polish population of schizophrenic patients. Further independent analyses in different populations should be performed to clarify the role of HSPA1B in the pathogenesis of schizophrenia.

Vagus Nerve Stimulation For Treatment Resistant Depression: Case Series Of Six Patients - Retrospective Efficacy And Safety Observation After One Year Follow Up.

OBJECTIVE: One year observation and evaluation of the VNS (vagus nerve stimulation) efficacy and safety for patients with treatment resistant depression in Polish conditions. METHODS: An open label, uncontrolled and one center retrospective study of VNS therapy was implemented with stable pharmacotherapy in 6 patients with treatment resistant depression (TRD). For the first 3 months, only VNS parameters were altered but the pharmacological treatment was unchanged and in the following 9 months, medication and VNS dosing parameters were altered according to the clinical state of the patients. RESULTS: The baseline 24-item Hamilton Depression Rating Scale (HAMD-24) score averaged 24. Both response (>50% reduction in baseline scores) and remission rates after 3 months of treatment were only 40%. After 1 year of VNS therapy, the response rates increased to 86%. Most frequent side-effects were voice alteration (86% at 3 months of stimulation) and headaches (40%). CONCLUSION: VNS treatment was safe and effective in TRD patients and its efficacy increased with time. Efficacy ratings are similar to the previously reported studies using a congenial protocol.

The prevalence of seasonal affective disorder among the blind and patients with serious visual impairment.

BACKGROUND: Seasonal affective disorder (SAD) is an interesting disorder in which depression should occur at a particular time of a year, each year and it should disappear at a specific time of the year. While the prevalence of SAD among generally healthy individuals is well known, the information about the prevalence of this disorder among the blind and visually impaired patients is very limited. The aim of the study was to investigate the prevalence of SAD among the blind and people with serious visual impairment in polish population. SUBJECTS AND METHODS: 250 blind or seriously visually impaired individuals and 258 healthy controls were assessed with the usage of Seasonal Pattern Assessment Questionnaire (SPAQ). In research group survey was conducted with the Computer Assisted Telephone Interview (CATI) technique. In control group the questionnaire was distributed via Internet. The results were analysed with the usage statistical package - Statistica 13.1. RESULTS: The results revealed that among people suffering from SAD there is statistically significant difference in SPAQ scores between completely blind and seriously visually impaired people. The study shows that is the control group age is negatively correlated with score in SPAQ score, while in the study group age is positively correlated with SPAQ score. The data show that there is a difference in occurrence of SAD between men and women. CONCLUSION: The study has shown a significant difference in occurrence of SAD between study and control groups. What is more the analysis has indicated major difference in the occurrence of SAD between men and women from the study group. Taking into consideration the fact that this is the second analysis of this type in Europe further investigations are needed.

Association study of the excitatory amino acid transporter 2 (EAAT2) and glycine transporter 1 (GlyT1) gene polymorphism with schizophrenia in a Polish population.

Background: Excitatory amino acid transporter 2 encoded by SLC1A2 is responsible for approximately 90% of glutamate uptake. Glycine transporter 1, encoded by SLC6A9, is responsible for maintaining a low concentration of the N-methyl-D-aspartate receptor (NMDAR) co-agonist - glycine in the synaptic cleft, suggesting its participation in the development of the NMDARs hypofunction described in schizophrenia. Aim: The aim of this study was to evaluate whether the functional polymorphism-181 A/C (rs4354668) of the SLC1A2 and the rs2486001 (IVS3+411 G/A) in the SLC6A9 are involved in schizophrenia development and its clinical picture in the Polish population. Methods: The study group consisted of 393 unrelated Caucasian patients (157 [39.9%] females and 236 [60.1%] males; mean age 41±12) diagnosed with schizophrenia according to the DSM-5, and 462 healthy controls. The results of the Positive and Negative Syndrome Scale (PANSS) were presented in the five-dimensional model. Polymorphisms of SLC1A2 and SLC6A9 were genotyped with the use of PCR-RFLP assay. Results: There were no statistically significant differences in the frequency of genotypes and alleles between the patients and controls for SLC1A2 and SLC6A9 polymorphisms in either the entire sample or after stratification according to gender. In the haplotype analysis, men with CA haplotype had more than 1.5 higher risk to develop schizophrenia than women (OR=1.63 [95% CI=1.17-2.27, p<0.05]). The influence of gender, genotypes of both analyzed polymorphisms and gender x genotype interactions on individual dimensions of the PANSS scale has not been observed. Also, there was no association of either polymorphism with suicide attempts. Conclusion: The results of the present study did not indicate an association of polymorphism-181 A/C (rs4354668) in SLC1A2 and rs2486001 in SLC6A9 with onset of schizophrenia and its psychopathology in a Polish population.

Association Studies of HSPA1A and HSPA1L Gene Polymorphisms With Schizophrenia.

BACKGROUND: Schizophrenia is a severe psychiatric disorder with a strong genetic component. The HSP70 chaperones are particularly interesting in terms of schizophrenia, especially with regard to neurodevelopmental hypothesis, because they are critical regulators in normal neural physiological function as well as in cell stress responses. AIM OF THE STUDY: The present study aimed to determine whether genetic variants in the HSPA1A (rs1008438, rs562047) and HSPA1L (rs2075800) genes are associated with the risk of paranoid schizophrenia and the clinical presentation of the disease. METHODS: A total of 1080 unrelated Polish subjects of Caucasian origin (401 schizophrenia cases and 679 healthy controls) were recruited. Three single nucleotide polymorphisms (SNP) were genotyped using PCR-RFLP (rs562047) or TaqMan (rs1008438, rs2075800) assays. All analyses were conducted for the full sample and within subgroups stratified by gender. RESULTS: There were no statistically significant differences in genotype or allele distributions of all polymorphisms tested between the schizophrenia and control groups. We also failed to find any schizophrenia predisposing haplotype in the whole group. A sex-stratified analysis revealed haplotypic association with paranoid schizophrenia in men, albeit the risk effect was contributed only by a rare haplotypes. More importantly, rs562047 variant was significantly associated with PANSS total and PANSS negative scores in schizophrenia. CONCLUSIONS: Our results support previously reported associations between HSPA1A and HSPA1B SNPs and schizophrenia symptomatology. Further population-based prospective studies with larger sample sizes from different ethnic groups should be performed to clarify the role of different HSP70 genes in the pathogenesis of schizophrenia.

Promoter Polymorphisms of TNF-α Gene as a Risk Factor for Schizophrenia.

BACKGROUND/AIMS: The latest data showed a link between mental disorders and altered immune function. Schizophrenia is a multifactorial disease with numerous changes in the immunological system. The TNF-α gene is a strong candidate for schizophrenia susceptibility. The focus of this paper were the -1031 T/C, -863 C/A, -857 C/T, -308 G/A single nucleotide polymorphisms (SNPs) of the TNF-α gene. METHODS: We conducted a case-control study of 401 patients with schizophrenia and 606 healthy subjects. The connections between tested SNPs and clinical variables (PANSS, age of onset, a family history, and suicide attempts) were also examined. RESULTS: The presence of genotypes: the C/C at -1031 T/C; the C/C at -863 C/A; the G/G at -308 G/A in the TNF-α gene was associated with a higher risk of schizophrenia in men. The presence of A allele at -308 G/A increased a risk of schizophrenia in women. Three haplotypes were associated with a higher risk of schizophrenia in men but not women. We did not reveal any associated tested SNPs with intensity of schizophrenia symptoms. CONCLUSION: Our results indicate that in addition to -308 G/A, other promoter polymorphisms of TNF-α gene are associated with schizophrenia susceptibility depending on the sex. Tested SNPs are not associated with the psychopathology of schizophrenia.

Polymorphic Variants of TNFR2 Gene in Schizophrenia and Its Interaction with -308G/A TNF-α Gene Polymorphism.

AIM: Many data showed a role of inflammation and dysfunction of immune system as important factors in the risk of schizophrenia. The TNFR2 receptor is a molecule that adapts to both areas. Tumor necrosis factor receptor 2 (TNFR2) is a receptor for the TNF-α cytokine which is a strong candidate gene for schizophrenia. The serum level of TNFR2 was significantly increased in schizophrenia and associated with more severe symptoms of schizophrenia. METHODS: We examined the association of the three single nucleotide polymorphisms (rs3397, rs1061622, and rs1061624) in TNFR2 gene with a predisposition to and psychopathology of paranoid schizophrenia in Caucasian population. The psychopathology was measured by a five-factor model of the PANSS scale. We also assessed a haplotype analysis with the -308G/A of TNF-α gene. RESULTS: Our case-control study (401 patients and 657 controls) revealed that the genetic variants of rs3397, rs1061622, and rs1061624 in the TNFR2 gene are associated with a higher risk of developing schizophrenia and more severe course in men. However, the genotypes with polymorphic allele for rs3397 SNP are protective for women. The rs1061624 SNP might modulate the appearance of the disease in relatives of people with schizophrenia. The CTGG haplotype build with tested SNPs of TNFR2 and SNP -308G/A of TNF-α has an association with a risk of schizophrenia in Caucasian population depending on sex. Our finding is especially true for the paranoid subtypes of schizophrenia.

Electroconvulsive therapy in 77-year-old patient with pacemaker: a case report.

The treatment of a 77-year-old patient suffering from severe psychotic depression with a cardiac pacemaker is described. Because of treatment-resistant depression, electroconvulsive therapy (ECT) was introduced. In the course of ECT, there was a great improvement in his mental state without any cardiac complications. This case may be evidence for the safety and effectiveness of ECT in the elderly, even with cardiac comorbidities. Some recommendations for ECT in patients with pacemakers are discussed.