The impact of sex hormones and metabolic markers on depressive symptoms and cognitive functioning in PCOS patients.

The aim of the study was to analyze associations between cognitive deficits and such factors like hormone levels and metabolic risk factors in PCOS women. Fifty-five PCOS patients aged 17-30 underwent analyses for FSH, LH, 17-beta-estradiol, DHEAS, androstenedione, SHBG, lipid profile during the follicular phase. Fasting glucose and insulin concentrations were also measured, as well as their levels after oral-glucose administration. All participants underwent an assessment with: Trail Making Test A and B, Stroop Test, Verbal and Categorical Fluency Test. The intensity of depressive symptoms was measured by the Beck Depression Inventory (BDI). We observed a positive correlation of the depression scores with the OGTT 120' and triglycerides, and a negative correlation of the depression scores with serum HDL. The higher were the insulin levels at 120 min; the more pronounced were the deficits of the verbal psychomotor speed. Higher free testosterone correlated with better verbal psychomotor speed. Androstenedione level was associated with worse scores in executive functions assessment. 17-OH-P levels positively correlated with phonology verbal fluency scores and higher plasma cortisol level at 10 p.m. correlated with worse verbal processing speed. Endocrine and metabolic parameters seem to be important factors mediating cognitive deficits in PCOS.

Anxiety and depression in patients with acute leukaemia treated with hematopoietic stem cell transplantation.

BACKGROUND: Acute leukemia and hospitalization for hematopoietic stem cell transplantation (HCT) are the great psychological stressors. The aim of this study was to assess anxiety and depression associated with such conditions and their psychophysical predictors before and after HCT. SUBJECTS AND METHODS: We conducted a longitudinal study using self-descriptive tools. The questionnaires: LOT-R, AIS, Mini-Mac, CECS, RSCL and HADS were filled by 60 patients with acute leukaemia before and after HCT. RESULTS: Anxiety and depressive symptoms correlated positively with psychological symptom distress. The correlation with depressive symptoms was weak, however, with anxious symptoms was moderate. In both cases, the higher was a level of psychological symptom distress, the higher level of anxiety and depression was observed in patients. The results indicated the weak, positive correlation between onerousness of physical symptoms and a level of anxiety. The greater was the severity of physical symptoms, the higher was the level of anxiety. The negative predictor of anxious symptoms was control of anxiety but it was weakly associated with a lower level of the explained variable. The negative predictor of anxious symptoms was also dispositional optimism whose high level accompanied the lower severity of the explained variable. However, the positive predictor of anxious symptoms was the variable of onerousness of symptoms whose high level accompanied the higher severity of anxious symptoms in the examined group CONCLUSION: Patients with acute leukemia who are hospitalized for HCT require detailed monitoring of their psychological distress to introduce the proper psychological and pharmacological interventions that reduce anxiety as well as boost "dispositional optimism" and mechanisms of control.

Evolution of Religious Topics in Schizophrenia in 80 Years Period.

BACKGROUND: Environment and culture are shown to be an important factor influencing characteristics of psychotic symptoms. Content of hallucinations and delusions is a projection of internal processes on external world. Religion plays a central role to lives of many people, but in schizophrenia religious experience and spirituality is confounded by psychotic symptoms. The aim of this study was to find how content of hallucinations and delusions interact with cultural conditions, that were changing over the decades. SUBJECTS AND METHODS: 100 of case histories from 2012 were randomly selected. From the medical record, content of hallucinations and delusion was extracted and categorized. Data from 2012 was compared with previous study by the authors, obtaining perspective of 80 years of history in the one hospital. RESULTS: Religious content of delusions and hallucinations appeared in 26% of patients. Diversity of the religious and spiritual themes in schizophrenia has been gradually decreasing. Many minor religious entities and figures such as "saints" and "angels" disappeared in 2012. Although, occurrence of contact with God and other religious figures was similar as in previous years, number of "visions" abruptly decreased. All of the religious content was culture-specific. CONCLUSIONS: Religious topics express general plasticity over a time, following cultural changes in society.

Services for patients with intellectual disability and mental health problems in Poland.

BACKGROUND: Poland is a democratic, sovereign state in Central Europe, member of the European Union. The healthcare in Poland is delivered to patients mainly through a public contributor called the National Health Fund, supervised by the Ministry of Health. The care for people with disabilities, including intellectual disabilities in Poland is coordinated by the Governmental Program on Activities for People with Disabilities and their Integration with the Society. The system of care for people with intellectual disability in Poland is constitutionally guaranteed. The aim of this review was to analyze the different forms of care for persons suffering from intellectual disability and mental health problems in our country. METHODS: Analysis of available documents on the policy and organizations of systems of services for this group of patients was performed. RESULTS: Non-governmental organizations play an important role in taking care of people with disabilities. In Poland there are no special psychiatric services dedicated for patients with intellectual disabilities. The comorbid psychiatric disorders are treated in general psychiatric wards or hospitals or in outpatient settings. Offenders with intellectual disabilities in the penitentiary system are referred to therapeutic settings in wards for convicts with non-psychotic mental disorders and intellectual disabilities. Training of medical students and young doctors offers only very limited basic knowledge on intellectual disability within psychiatry curriculum. The is no separate specialty in mental health in intellectual disability within psychiatry. CONCLUSIONS: The main conclusion of this review is that the specialist working with persons suffering from intellectual disabilities in Poland face many challenges regarding the need to introduces positive changes in this field.

Risk Factors for Noncompliance with Antipsychotic Medication in Long-Term Treated Chronic Schizophrenia Patients.

BACKGROUND: The attitudes of schizophrenic patients toward medications directly impact the treatment compliance. Although noncompliance represents a serious concern in long-term schizophrenia treatment, a detailed information on the factors that impair compliance is still limited. The present study aims to assess the factors related to noncompliance with antipsychotics agents, in long-term treated chronic paranoid schizophrenia patients. SUBJECTS AND METHODS: Two groups of such patients (total number n=162) were analyzed and compared: 1). patients with symptomatic remission on haloperidol (n=32), clozapine (n=40) or olanzapine (n=45), and 2). drug resistant patients (n=45). The mean duration of the disease was 19.3 years. RESULTS: Altogether, in our patient sample, a better drug attitude was found in the olanzapine and clozapine groups. Our findings have also revealed that worse attitude toward antipsychotics correlated with an earlier onset of schizophrenia, younger patient age, shorter duration of the disease, higher burden of symptoms, treatment with a typical antipsychotics, and higher severity of akathisia. CONCLUSION: Our results suggest that detecting factors that influence the patient's attitude toward medications might be helpful for designing targeted educational strategies in chronic schizophrenia patients (particularly those with the high risk of noncompliance), and further trials are warranted to explore this topic.

Infulence of Sex Hormones and Inflammatory Processes on Cognition in Schizophrenia.

BACKGROUND: In the literature we can find evidence that sex hormones are involved the alterations of cognition in schizophrenic patients. Another factor, which may have an impact on cognitive domains in this clinical group inflammatory processes. The objective of this review was to explore studies, in which the role of both immunological factors and sex hormones on cognitive functions in schizophrenia are analyzed. METHODS: The search of papers covering this topic in PubMed and Google Scholar was performed. RESULTS: Endocrine factors like: testosteron, estrogen, as well as immunomodulatory are observed to play a role in cognitive functioning in schizophrenia. CONCLUSIONS: More studies are necessary to confirm these possible co-relations.

The Relation Between Emotional Intelligence and Internet Addiction in Katowice High School Students.

BACKGROUND: Emotional intelligence (EI) is described as the capacity to be aware of, control, and express one's emotions, and to handle interpersonal relationships judiciously and empathetically. It is considered as one of the most important predictors of success, quality of relationships, and overall happiness. Dynamically changing environment of the youth and young adults in recent years may influence their EI development, affecting their lives significantly. The purpose of this study was to analyse the way how the Internet is used by high school students, to determine the amount of time they spend on the Internet, identify the level of EI and to explore if there is any correlation between those factors. SUBJECTS AND METHODS: 1450 high school students from Katowice, at the age from 18 to 21 years took part in an anonymous survey consisting of three parts: The Trait Emotional Intelligence Questionnaire - Short Form (TEIQue-SF), Internet Addiction Test and authorial test giving information about the way of spending time online. The questionnaires were collected from May 2018 to January 2019. RESULTS: 1.03% of the respondents fulfilled the Internet addiction criteria. Students at risk for addiction (33.5%) turned out to be a larger group. A statistically significant correlation between TEIQue-SF and Internet Addiction Test score (P<0.0001, r=-0.3308) was observed. Another significant correlation was found between TEIQue-SF score and amount of time spend on the Internet (p<0.0001, r=-0.162). CONCLUSION: A significant part of high school students used Internet excessively. Such behaviours were positively correlated with lower EI test results.

Suicidality in treatment resistant depression: perspective for ketamine use.

Suicidal ideations or attempts in patients with major depressive disorder (MDD) are emergent conditions that require immediate treatment. Numerous therapeutic interventions to reduce suicide risk in psychiatric disorders are effective in long-term suicide prevention, but there is necessity of sufficient, rapid pharmacological treatment of suicidal risk in MDD. Ketamine, an N-methyl-D-aspartate (NMDA) antagonist, has been reported to have rapid antidepressant effect. Depressive symptoms, anxiety, hopelessness, suicidal ideation had decreased within hours after ketamine infusion. Ketamine's rapid symptoms relief and reduction of suicide thoughts has aroused growing interests in psychiatric association.

Cognitive deficits in adults with obstructive sleep apnea compared to children and adolescents.

Obstructive sleep apnea (OSA) can negatively affect the patient's physical and psychological functioning, as well as their quality of life. A major consequence of OSA is impaired cognitive functioning. Indeed, several studies have shown that OSA mainly leads to deficits in executive functions, attention, and memory. As OSA can present in all age groups, these associated cognitive deficits have been observed in adults, as well as in children and adolescents. However, these cognitive deficits may have a different clinical picture in young patients compared to adults. In this review, we analyze the most affected cognitive domains in adults and children/adolescents with OSA, as evaluated by neuropsychological and neuroimaging studies. We found that deficits in working memory, attention, or executive functions cognitive domains are found in both adults and children with OSA. However, children with OSA also show changes in behavior and phonological processing necessary for proper development. Moreover, we examine the possible OSA treatments in children and adults that can have a positive influence on cognition, and therefore, improve patients' general functioning and quality of life.

Sleep and inflammatory markers in different psychiatric disorders.

Many psychiatric disorders, like schizophrenia, affective disorders, addictions and different forms of dementia are associated with sleep disturbances. In the etiology and course of those diseases inflammatory processes are regarded to be an increasingly important factor. They are also a frequently discussed element of the pathology of sleep. In this literature review reports on correlations between poor sleep and inflammatory responses in various psychiatric conditions are discussed. The link between schizophrenia, affective disorders and inflammatory cytokines is a complex phenomenon, which has been already confirmed in a number of studies. However, the presence of sleep deficits in those conditions, being a common symptom of depression and psychoses, can be an additional factor having a considerable impact on the immunological processes in mental illnesses. In the analyzed data, a number of studies are presented describing the role of inflammatory markers in sleep disturbances and psychopathological symptoms of affective, psychotic, neurogenerative and other disorders. Also attention is drawn to possible implications for their treatment. Efforts to use, e.g., anti-inflammatory agents in psychiatry in the context of their impact on sleep are reported. The aspect of inflammatory markers in the role of sleep deprivation as the treatment method in major depressive disorder is also discussed. A general conclusion is drawn that the improvement of sleep quality plays a crucial role in the care for psychiatric patients.

Analysis of Urinary Incontinence and Depression among Young Women.

Urinary incontinence has a negative impact on a health related quality of life, and it contributes to depression. Depression is a serious illness affecting health, family and professional activity of many people in all sectors of society. Both conditions concern young women. Following study presents depression among young women suffering urinary incontinence. There are various aspects of the young women's comorbid depression and urinary incontinence, mentioned in the present literature: coexistence of depression and urinary incontinence, area of postpartum period, associated sexual dysfunction, and impact on the professional sphere. To conclude, it should be highlighted that the problem of urinary incontinence and depression affects not only elderly, as it would be suspected, but on a large scale also young women and there is a strong need of the further prevention and investigation these coexisting diseases.

Psychiatric Comorbidity in Older Adults with Intellectual Disability.

BACKGROUND: The population of older adults with intellectual disability (ID) is large and growing due to a significant increase of life expectancy caused by improvements in health and social care. Multimorbidity is highly prevalent in this population and co-morbid psychiatric disorders are especially frequent. SUBJECT AND METHODS: The aim of this article is to review the prevalence and consequences of psychiatric comorbidity in the population of older adults with ID. We therefore performed a literature search of studies relevant to adults with ID, published since January 2006, using the following keywords: intellectual disability and comorbidity, intellectual disability and mental disorders, intellectual disability and polypharmacy. RESULTS: Psychiatric comorbidity is frequent among patients with ID and correlates with older age. Mental disorders are present in up to 40% of older adults with ID and the most prevalent are challenging behaviour, depression, anxiety and dementia. Patients with ID and at least one co-morbid mental disorder are at a high risk of polypharmacy. Importantly, psychiatric comorbidity was found to significantly increase service use and costs of care. CONCLUSIONS: Further investigation of the population of older adults with ID is needed, with special attention to development of clear treatment guidelines in order to effectively manage co-morbid mental illnesses and physical health problems.

Comorbidity of substance use and mental disorders.

INTRODUCTION: Comorbidity is a term defined as the presence of two or more conditions occurring either at the same time or having a close relationship to the same individual. World Health Organization (WHO) define it as the "co-occurrence in the same individual of a psychoactive substance use disorder and another psychiatric disorder". Progressive deinstitutionalisation, despite indisputable benefits and improvement of life quality in psychiatric patients, resulted in appearance of new burdens, such as deterioration of family life. Furthermore, wide availability of alcoholic beverages and drugs in communities where the patients live, led comorbid substance abuse disorders to emerge as one of the biggest challenges in the modern psychiatry. There is a limited amount of data concerning the background of the patients with a dual diagnosis, available in the literature, and therefore our aim was to create a sociodemographic profile of such individuals. MATERIALS AND METHODS: The study was conducted among the patients treated in a drug rehabilitation centre of the Upper Silesian Association "Familia" in Gliwice, Poland using authors' own questionnaire, consisting of 75 items. The study group consisted of 9 females and 91 males (n=100), average age of the patients equalled 29.7 years (95%CI: 28.5-31 years; min/max value: 20/48 years), all the patients had an established dual diagnosis. OUTCOMES: 66% of the study group was single, with permanent residency, living with family either in city (47%) or in village (19%). Remaining 34% was spread through the other options (1-4%), with the highest percentage in "single, with permanent residency, living alone in the city" (4%). CONCLUSIONS: Obtained data, demonstrated high homogeneity among the patients with a dual diagnosis in terms of a socio-demographical profile.

Neurosyphilis - the white matter disintegration? - two case reports.

BACKGROUND: There is evidence for neurosyphilis being associated with the central nervous system vasculitis involving medium and small vessels. As the hemispheric white matter is the major target of these vascular alterations the white matter axonal and myelination disruption may be observed employing measure for the rate of water molecule diffusion. High apparent diffusion coefficient (ADC) correspond to unimpeded water diffusion and indicating white matter disintegration. CASE REPORTS: In a retrospective study exploringcentral nervous system magnetic resonance (MR) images of two subjects presenting with neurosyphilis the ADC values were found to be increased as related to normal values being accompanied with normal appearing white matter of hemispheres. CONCLUSIONS: Applying ADC analysis to evaluate the brain in patients with neurosyphilis may reveal undetectable changes and explain the scale of abnormalities that occur in CNS. The increased mean ADC valuesin the normal appearing white matter of the hemispheres may correlate with neuropsychoatric symptomatology in syphilis.

Decision-making in panic disorder. Preliminary report.

BACKGROUND: The impaired decision-making with high risk-aversive behavior and elevated impulsivity are reported as a trait feature in anxiety disorders including panic disorder (PD). It is hypothesised that PD patients exhibit difficulties in executive functions which can influence patients behavioural strategies e.g. problem solving, decision making, planning, impulse control. The aim of this study was to asses decision making process, risk-taking and impulsivity in PD patients as compared to healthy controls. MATERIAL AND METHODS: Twenty-one psychotropic drug-naive PD outpatients and 20 healthy subjects matched by age and sex were examined. Cognitive decision-making and risk-taking behaviour was measured with CGT (Cambridge Gambling Task) from CANTAB battery. The PD severity was assessed with Panic and Agoraphobia Scale (PAS). The level of anxiety and depression was assessed with HADS (Hospital Anxiety and Depression Scale). Impulsivity was evaluated with the Barratt Impulsiveness Scale, 11th version (BIS-11). RESULTS: There were no statistically significant differences on CGT in PD patients as compared to healthy control. However, having observed more closely, there are some differences between patients and healthy control. PD patients with higher anxiety level in HADS exhibited lower percentages of risky decisions comparing to PD with lower anxiety in HADS. PD patients with higher depression level in HADS demonstrated slowed decision-making when compared to PD patients with low level of depression in HADS. Total impulsivity and its attentional and motor dimensions were significantly higher in panic disorder patients versus healthy controls. CONCLUSION: There were no statistically significant differences with regard to CGT assessed decision-making between drug-naive PD patients and healthy controls. The PD patients with higher HADS-D depression level demonstrated slowed decision-making as compared to PD patients with low level of depression.

Analysis of facial expressions in patients with schziophrenia, in comparison with a healthy control - case study.

INTRODUCTION: Deficits in area of communication, crucial for maintaining proper social bonds, may have a prominent adverse impact on quality of life in patients with schizophrenia. Social exclusion, lack of employment and deterioration of family life, may be consequences of aggravated social competencies, caused by inability to properly exhibit and interpret facial expressions. Although this phenomenon is known since first clinical descriptions of schizophrenia, lack of proper methodology limited our knowledge in this area. Aim of our study was to compare facial expressivity of the patient with schizophrenia, and the healthy individual. METHODS: 47-years old patient suffering from schizophrenia, and 36-years old healthy individual were invited to participate in our study. They underwent the examination in Human Facial Modelling Lab in Polish-Japanese Institute of Information Technology in Bytom (Silesia, Katowice). Both participants were presented with two video materials, first one contained different facial expressions, which they had to imitate. Second one a part of comedy show, during which spontaneous reactions were recorded. Acquisition of facial expressions was conducted with marker-based technology of modelling. Obtained data was analyzed using Microsoft Excel. RESULTS AND CONCLUSIONS: An overall facial expression intensity, expressed as an average value of distances traveled by markers during shifts from neutral position was higher in case of a healthy participant during both part of the study. The difference was especially visible in case of an upper half of the face. Utilization of marker-based methods in analysis of human facial expressions seem to be reliable and remarkably accurate.

Telepsychiatry and Virtual Reality an the Teatment of Patients with Intellectual and Developmental Disabilities.

BACKGROUND: Treatment and rehabilitation of people with intellectual and developmental disabilities is a multidisciplinary challenge, which require implementing new attitudes. The use of modern technology solutions like telepsychiatry or virtual reality may be a valuable addition to the traditional methods. OBJECTIVE: The objective of this review was to explore the usability of new technological solutions in this special population of patients. METHODS: The search in the PubMed was conducted using the following terms: (intellectual disability (Title/Abstract) OR developmental disability OR learning disorder (Title/Abstract)) AND virtual reality (Title/Abstract) OR telepsychiatry OR telemedicine OR e-mental health AND English (lang) AND (1995/01/01(PDAT): 2017/07/31(PDAT)). RESULTS: Telepsychiatry may be a useful tool in situations, when the direct access to professional assistance is limited, in solving particular problems like e.g. managing challenging behavior, also to support patients' parents and for diagnostic and educational purposes. Virtual reality can be a safe and effective method of improving different skills, developing physical fitness, and enriching the ways of spending the leisure time. CONCLUSIONS: Using modern technology is a relatively new and promising field in which new ideas may develop to support the already existing services for patients with intellectual and developmental disabilities.

The Role of Hormones and Inflammatory Markers in Cognitive Functioning of Schizophrenic Patients.

BACKGROUND: In the literature we can find evidence that immunological processes are involved the alterations of cognition in schizophrenic patients. Another factor, which may have an impact on cognitive domains in this clinical group are hormones. OBJECTIVE: The objective of this review was to explore studies, in which the role of both immunological and endocrine factors on cognitive functions in schizophrenia are analyzed. METHODS: The search of papers covering this topic in PubMed and Google Scholar was performed. RESULTS: The studies focusing on this co-relation are not numerous. The role such hormones like cortisol, insulin and sex hormones may be important in the immunomodulatory processes influencing cognition in schizophrenia. CONCLUSIONS: More studies are necessary to confirm these possible co-relations.

Sleep disturbances in women with polycystic ovary syndrome.

Sleep disturbances in women with Polycystic Ovary Syndrome (PCOS) have been reported in recent years. The majority of published studies are related to Obstructive Sleep Apnea (OSA) while not many researches have analyzed any other causes of sleep disturbances. A group of ninety five women with Polycystic Ovary Syndrome were enrolled into the study. Sleep disturbances were assessed using validated questionnaires. On the grounds of Athens Insomnia Scale (AIS) evaluation a clinically significant insomnia was ascertained in 12.6% of women with PCOS, while according to Insomnia Severity Index (ISI) in 10.5%. Clinically significant insomnia according to both AIS and ISI, occurred significantly more often in women with PCOS than in women without PCOS based on the chi-square test. The Mann-Whitney U test revealed statistically significant difference between women with and without PCOS based on total values of ISI. An excessive daytime sleepiness occurred at 7.4% of women with PCOS. Statistically significant dependance between: clinically significant insomnia in both AIS and ISI and excessive daytime sleepiness indicated by Epworth Sleepiness Scale (ESS) was observed. Sleep disorders are common in women with PCOS. Screening assessment of sleep disturbances should be a part of medical diagnostics in women with PCOS.

The role of selective estrogen receptor modulators in the treatment of schizophrenia.

BACKGROUND: Gender differences in schizophrenia have been recognized for a long time and it has been widely accepted that sex steroid hormones, especially estradiol, are strongly attributed to this fact. Two hypotheses regarding estradiol action in psychoses gained special research attention - the estrogen protection hypothesis and hypoestrogenism hypothesis. A growing number of studies have shown benefits in augmenting antipsychotic treatment with estrogens or selective estrogen receptor modulators (SERM). METHODS: This review is focused on the role of selective estrogen receptor modulators in the treatment of schizophrenic patients. In order to achieve this result PubMed was searched using the following terms: schizophrenia, raloxifene, humans. We reviewed only randomized, placebo-controlled studies. RESULTS: Raloxifene, a selective estrogen receptor modulator was identified as useful to improve negative, positive, and general psychopathological symptoms, and also cognitive functions. All reviewed studies indicated improvement in at least one studied domain. Augmentation with raloxifene was found to be a beneficial treatment strategy for chronic schizophrenia both in female and male patients, however potential side effects (a small increase in the risk of venous thromboembolism and endometrial cancer) should be carefully considered. CONCLUSIONS: SERMs could be an effective augmentation strategy in the treatment of both men women with schizophrenia, although further research efforts are needed to study potential long-term side effects.