[Treatment of generalized anxiety disorder in terms of cognitive behavioral]. / Terapia zaburzen lekowych uogólnionych w ujeciu poznawczobehawioralnym.

Risk of generalized anxiety disorder (GAD) within life is estimated at 2.6-5.1%. Amongst etiological factors that affect the development of the disorder are: biological and psychological problems, including cognitive models. There are known several cognitive models: metacognitive, Borkovec'c model and the model developed in Quebec. Key cognitive contents that occur with generalized anxiety disorder are focused on two aspects: metacognitive beliefs and intolerance of uncertainty. A primary purpose of cognitive-behavioural therapy (CBT) is the modification of dysfunctional beliefs about worry. Cognitive behavioural therapy is effective in reducing anxiety, makes it easier to operate in the professional sphere and improves the quality of life.

[Depression in metabolic syndrome]. / Depresja w zespole metabolicznym.

The paper is concentrated on a problem of coexisting two syndromes: metabolic and depression. The importance of glucocorticoids, especially a role of glucose and proteins in metabolism, is presented here. The paper also presents the criteria of metabolic syndrome developed by: the USA National Cholesterol Education program Adult Treatment, World Health Organization and International Diabetes Federation. Common existence of both metabolic and depression syndromes was taken into consideration in the light of the latest research. A significance of environmental factors (a life style) in metabolic syndrome was indicated. Basing on the investigation results, a frequency of the occurrence of the individual components of the metabolic syndrome and their correlation with depression syndrome was evaluated. The correlation between laboratory studies in both sexes and revealing depression symptoms were highlighted. The relationship between both unhealthy diet and little activity and the development of depression syndrome ware observed. Finally, an advantageous role of psychological distress as a factor protecting against development of the individual components of metabolic syndrome was emphasized.

[The importance of vitamin B12 in psychiatry]. / Znaczenie witaminy B12 w psychiatrii.

The article drew attention to the construction of a vitamin B12 deficiency and its importance in the human body. Emphasizes the role of cobalamin as a structural element involved, among others cobamides in such reactions as the synthesis of purine and pyrimidine biosynthesis or choline. Two metabolically active forms of cobalamin: methylcobalamin and adenosylcobalamin and their importance to the human body were presented. The process of absorption of vitamin B12 and methionine in revealing the importance of the neurological symptoms was described. The chemical importance and cause vitamin B12 deficiency was stressed. The attention was paid upon the role of acid in methylomalon determination of vitamin B12 deficiency in the human body. Disclosure reports analyzed the relationship of vitamin B12 from the emergence of psychotic symptoms. Particular attention is given to teams which binds to the vitamin B12 deficiency--depressive, delusional and manic. Based on case reports were analyzed cases with deficiency symptoms associated with a deficit of vitamin B12. Also points to the possibility of diagnosing cobalamin deficiency even before the onset of clinical symptoms.

[Anxiety and depression in ulcerative colitis and Lesniovsky-Crohn's disease]. / Lek i depresja we wrzodziejacym zapaleniu jelita grubego i chorobie Lesniowskiego-Crohna.

Ulcerative colitis and Lesniovsky-Crohn's disease are classified as idiopathic diseases. The study highlighted the role of the immune system, environmental and behavioral factors. Lists of infectious agents relevant to the development of ulcerative colitis and morbus Crohni, indicating the importance of the NOD2/CARD15 mutations. Quoted the results of studies on the effect of stress and immune response in patients with diagnosed ulcerative colitis. Discusses the implications arising from somatic mental patients, having regard to the causes of social isolation of patients and their rejection of social support. The study examined the results of research on quality of life of patients treated for ulcerative colitis and Crohn's disease. Stressed the importance of depression and anxiety in the development of idiopathic inflammatory bowel diseases. The results of studies showing the treatment of depression and anxiety as predictors of development idiopathic intestinal diseases were cited. The possibility of increased incidence of schizophrenia was excluded among people living with inflammatory nonspecific bowel disease.

[Professional burnout among psychiatrists]. / Wypalenie zawodowe wsród lekarzy psychiatrów.

Article focuses on the problem of burnout, which affects the medical community. Approximates the three most common definitions of burnout, particularly analyzing the components of a three-dimensional theory of C. Maslach burnout (emotional exhaustion, depersonalization, reduced sense of personal achievement). The author lists the characteristics of socially useful occupations, which may facilitate the emergence of team burnout, among others, lack of professional success, the requirement to engage in group work. The article drew attention to certain personality traits that may predispose to disclose the team burnout--to cope with stress in a passive manner, avoiding, with the personality traits neurotic, assessment of the situation in terms of risk. Brought closer the results of several studies, including environmental health, noting the psychiatrists. Sought to draw attention to the factors that protect against the occurrence of team burnout. It was observed that job satisfaction served as a protective role. They also highlighted the consequences of team burnout among medical staff--frequent changes of jobs, the increasing violence against patients, withdrawal from medical practice, for reasons of sickness absenteeism, conflicts in family life.

[Depression in Parkinson's disease]. / Depresja w chorobie Parkinsona.

Parkinson's disease (PD) belongs to degenerative diseases of brain in which, apart from many somatic symptoms, there also occur depressive disorders of mental sphere. This paper presents possible reasons for the development of depression in PD: psychological resulting from the presence and the development of chronic disease as well as neurochemical disorders that reveal in this background. It has been highlighted that the presence of PD has a significant effect on the patients' life quality The paper discusses possible important factors for the progress of depression syndromes: decrease in everyday life activities, somatic state heaviness, worsening of motor functions, cognitive deficits. The possible occurrence of typical depression syndrome manifested in PD, its modifications and possible axial symptoms were analyzed. Two modifications of depression syndrome were also described. The results of the study on the increased lethality in patients with PD were presented. Special attention was paid to the occurrence of apathy with no key signs of depression syndrome. The existence of relations linking the apathy with cognitive disorders were highlighted. The paper discusses the occurrence of factors that may affect the revealing of apathy, as well as the presence of possible brain dysfunctions in patients.

[Adjustment disorder during military service]. / Zaburzenia adaptacyjne w warunkach sluzby wojskowej.

UNLABELLED: Adjustment disorders in soldiers of mandatory military service are one of most frequent causes of early military discharges. Their occurrence brings about economic, social and medical consequences. THE AIM: The analysis of reasons and circumstances for adjustment disorders in solders of mandatory military service accepted by Medical Military Boards as unfit for military service. MATERIAL AND METHODS: Studies included 91 cases of soldiers of mandatory military service hospitalised at the Psychiatry Clinical Department of Psychiatry in 10th Clinical Military Hospital in Bydgoszcz for the occurrence of symptoms of adjustment disorder acc. to criteria ICD-10 and certified by Medical Military Boards. The examined soldiers were at the age of 19-24, and the period of their military service ranged from one week to three months. To evaluate statistical correlations chi-square test (chi2) was used. RESULTS: Before the call-up, more than a half of the soldiers revealing symptoms of adjustment disorder lived in the country or in big urban agglomerations. Those soldiers had primary or vocational education certificates and every third was brought up in one-parent family. In the tested population of soldiers there was found a statistical relation between the appearance of adjustment disorders and the education of soldiers' mothers, parents' diseases and factors impeding their military service. CONCLUSIONS: Factors conducive to adjustment disorders under conditions of mandatory military service in the studies carried out included: education of soldiers' mothers, raised difficulties while serving in the army and parents' diseases.

[Anxiety and coronary heart disease]. / Lek i schorzenia kardiologiczne.

A high proportion of diseases resulted from cardiologic reasons has arisen an interest in the problem of prevention against cardio-vascular diseases. According to the WHO reports, by 2020, a coronary heart disease and depression will have become the most frequent reason of disability in the world. The paper presents studies estimating the effect of fear on the possibility of coronary heart disease pathogenesis. The studies analyzed the problem how fear may affect sudden deaths for cardiologic reasons. There was emphasized the significance of factors coexisting with fear in women and men as well as a role of fear and depression occurring in ventricular arrhythmia in patients with ischemic heart disease. The paper describes possible mechanisms leading to sudden cardiac deaths. The author indicated the role of the central nervous system controlling the cardiovascular system and the significance of genetic background of conducive psychosocial factors, such as: nicotinism and type "A" behaviour. Results of the studies estimating heart rhythm irregularities and elevated fear level were included; it was noticed that disturbances in cardiac performance variability were a predictive factor of sudden deaths for cardiological reasons. The paper emphasizes a special role of physicians in cardiological mortality prophylaxis.

[Association between the TPH2 gene and suicidal behavior]. / Zwiazek genu TPH2 i jego rola w wystepowaniu zachowan samobójczych.

The paper describes the location of TPH gene and the role of serotonin for a human organism. It analyses the path of serotonin formation from tryptophan as a result of hydroxylation and decarboxylation. It underscores the part the TPH gene plays in disclosing depressive disorders and suicidal tendencies. The opinions of different researchers on the relation between the individual TPH alleles and the occurrences of suicidal tendencies have been presented, indicating the obstacles in determining clear results of the research. The paper pays attention to the fact that variants of TPH may influence human behaviour. The author has also pointed to the role of hydroxyindole acetic acid in cerebrospinal fluid, which may be significant in suicidal tendencies. Pathogenesis of periodical depressive mood disorders has also been emphasized. A location of serotonin transporter gene and a role of its polymorphism in arising depressive disorders have been presented. Genetically conditioned differences in effectiveness of the therapy in patients with recognised diagnosis of depressive syndrome indicate strong relations with pharmacokinetic and pharmacodynamic mechanism of antidepressant activities.

[Job burn-out]. / Wypalenie zawodowe.

This paper is concentrated on the issue of the professional burn-out, including the vocational group of physicians. It attempts to define this phenomenon, its reasons and symptoms. Three types of the burn-out sources have been established: individual, interpersonal and organisational. Negative and positive correlations between different aspects resulting from the professional and familiar environments are presented. The paper points to the consequences of the vocational burn-out that may occur in the physician-patient relationship. Three stages of this issue are shown, basing on the directions made by the American Psychology Association. Selected studies on medical staff in the Polish health care service have been analysed. The paper warns against the escalation of this problem in the medical community. It also brings up the most significant consequences of the professional burn-out syndrome, such as: low work quality, disturbances in the doctor-patient relation, resigning from vocational activity. Since this phenomenon is expanding in ever-widening circles, the European Forum of National Medical Associations has issued a declaration concerning the burn-out syndrome among physicians. The declaration urges international medical associations to face the increasing problem.