Lack of association between rs1049353 polymorphism of the CNR1 gene and suicide attempt frequency in Polish population.

Suicidal behaviour is a major public health problem in Poland. There is compelling evidence that genetic factors contribute to the risk for suicidal behavior. Studies suggest a link between single nucleotide polymorphism (SNP) rs1049353 (1359 G/A; Thr453Thr) of cannabinoid receptor 1 gene (CNR1) and mental disorders, including suicide behaviour. AIM: The purpose of the study was to determine whether 1359 G/ A polymorphism of CNR1 is more frequent in people attempting suicide than in the general population. MATERIALS AND METHODS: A sample of 76 genetically unrelated participants were enrolled into the study: 48 patients after a suicide attempt and the control group - 28 individuals without a history of suicide attempts. The genotyping of 1359 G/A polymorphism of CNR1 gene was performed with the application of Restriction Fragment Length Polymorphism (RFLP) analysis. RESULTS: None of the 1359 G/A polymorphisms of CNR1 gene seem to occur more frequently among individuals who attempted suicide. CONCLUSIONS: Further research with larger samples with different racial and geographic origins are needed in the future.

[The endocannabinoid system role in the pathogenesis of obesity and depression]. / Rola ukladu endokannabinoidowego w patogenezie otylosci i depresji.

Excessive consumption and obesity do not always have to be strictly pathological. The adjustment of food intake as well as the pleasure of eating are the results of the circulation of neurotransmitters, hormones and glucocorticoids which have an ability to regulate the activity of many receptors connected with G protein, including endocannabinoid receptors. The key role of endocannabinoids in pathogenesis of obesity is their overproduction by adipose cells. Endocannabinoids (eCBs) affect CB1 receptors and increase hunger, willingness to intake food, decrease peristalsis and delay stomach emptying. In obese people increased levels of both central and peripheral endocannabinoids are observed. It may be connected with higher availability of endocannabinoid precursors to synthesis from adipose tissue and lipids. Raised concentration of eCBs in the body may be the consequence of their catabolism dysfunction. There is a positive correlation between amount the number of receptors in the peripheral tissues and obesity increase. It is thought that expression of CB1 receptors in mesolimbic system is connected with motivation to consume food in response to rewarding factor. The appetite increase after cannabinoids use is probably caused by rewarding action of the consumed food and it results from excessive dopaminergic transmission in award system. The pharmacological inhibition of endocannabinoids activity leads to weight loss, but may also have negative consequences such as decreased mood, reduced tolerance of pain, intensified anxiety, anhedonia, depressive symptoms, even suicidal thoughts. In post mortem examinations a decrease in CB1 receptor density in grey matter of glial cells in patients with major depression was identified. The pleiotropic and extensive activity of endocannabinoid system can influence a range of neurotransmitters thereby modulating the psychiatric life phenomena, simultaneously being involved in metabolism control and energetic system of human body. Hence it is a link between metabolic disorders and depression and anxiety disorders. Therefore, in obese people depressive comorbidity is higher and it significantly worsens prognosis and decreases life quality.

[Causes of suicide attempts in patients undergoing psychiatric hospitalization--a preliminary study]. / Uwarunkowania zamachów samobójczych u pacjentów hospitalizowanych psychiatrycznie--doniesienia wstepne.

UNLABELLED: Suicide is difficult and dramatic act of deliberately taking one's own life. The causes of suicidal behavior are complex and include both sociological as well as psychological and neurobiological factors associated with the dysfunction of the central nervous system. AIM: The aim of study was to analyse tha causes of suicidal behavior. MATERIALS AND METHODS: The study comprised of 76 individuals. The study group included 48 patients hospitalized in the Babinski Memorial Hospital in Lódz, Poland who have attempted suicide act recently or in the past. Each patient completed psychological tests: Basic Hope Inventory (BHI-12), in evaluating Evaluation Crisis Questionnaire (KKW), The Beliefs about Pain Control Questionnaire (BPCQ). RESULTS: Statistical analysis revealed personality disorders and affective disorders to be the most frequent psychiatric diagnosis among patients, who attempted suicide. Patients from the study group had specific psychological characteristics. The most common suicide method was drug intoxication. CONCLUSIONS: Suicide prevention should include somatic and psychiatric morbidity and a thorough analysis of psychological functioning. This would help to better understand the mechanisms underlying suicide and extract a group of people with a significantly increased risk of suicidal behavior so that we could apply adequate prevention methods.

[A mistake in forensic psychiatric evaluation or abuse of psychiatry for non-medical purposes - a case report]. / Pomylka w opiniowaniu sadowo-psychiatrycznym czy naduzycie psychiatrii dla celów pozamedycznych - opis przypadku.

In this study we attempted to visualize certain irregularities that took place in the evaluation of a patient with personality disorders performed by psychiatrist expert witness, which resulted in an incorrect diagnosis, leading to wrong ruling of the court and a referral of the patient to clinical therapy lasting six years. The psychiatric and psychological expert opinions submitted to the court and first-hand psychiatric and psychological examination of the patient were analyzed. Efforts were made to show that the failure to comply with the diagnostic criteria in the process of diagnosis and not taking into account the previously issued five forensic psychiatric opinions issued by independent and experienced teams of psychiatrist expert witnesses, as well as not taking into account the nature of the offense committed have led to a number of irregularities in the assessment of the mental state of the patient. Above mentioned shortcomings have caused unjustified legal classification of the offense and six years long detention of the patient in closed psychiatric institutions, in our regard unnecessary. The described case could be regarded as an abuse of psychiatry for the non-medical purposes and thus should have be punish. Based on the presented case it has been demonstrated that insufficient experience in forensic psychiatry and failure to comply with diagnostic criteria of psychiatrists and psychologists expert witnesses had led to a series of blatant offense of civil rights and liberties, and thus unnecessary detention of the patient for six years.

[Emotional and psychosomatic disorder among female patients undergoing breast cancer diagnosis]. / Emotional and psychosomatic disorder among female patients undergoing breast cancer diagnosis.

UNLABELLED: Basics of psychoneuroimmunology indicate factors such as emotions, behaviour, personality and cognitive functions to have impact on weakening of immunological system and worsening the risk to develop medical conditions, including breast cancer. AIM: The aim of research was to attempt a coping of emotional and psychosomatic disorders among women undergoing breast tumor diagnostic process. MATERIALS AND METHODS: 145 female patients were included in the the research, among which 99 belonged to the research group (RG) and 46 belonged to the control group (CG). The average age in GB 49, 67 (± 9,47) i GK 46,43 (± 11,2). The research group members were undergoing diagnosis process for suspected breast cancer. The subjects filled out a survey and Symptom Questionnaire S-II, and were subject to mammographic and ultrasound examination, as well as aspiration biopsy was performed on them. 99 individual subjects were positively diagnosed with breast cancer, and 46 were negatively diagnosed. RESULTS: One in three women belonging to RG displayed emotional disorders. In CG only one in ten displayed symptoms of such disorders. Anxiety was the most common disorder mentioned by both RG and CG. There is however statistically relevant difference in anxiety intensity between the two groups. A statistically relevant corelation has been observed among members of the research group between certain psychosomatic disorders and a number of sociodemographic and medical variables' levels. CONCLUSIONS: Stress-related and formed psychophysiological and psychosomatic reactions are likely to play the role of psychosomatic and emotional factors leading to breast cancer development.

[The epidemiology of suicide in bipolar disorder in the manic episode--preliminary reports]. / Epidemiologia samobójstw w chorobie afektywnej dwubiegunowej w epizodzie maniakalnym--doniesienie wstepne.

UNLABELLED: Suicide is among ten leading causes of death in each country and the third most common cause of death in the age group 16-35. The presence of mental illness is the most important risk factor for suicide. Affective disorders contribute to 15-25% of deaths due to suicide attempts. Depression is the most likely cause of the patients attempt on his life. Contrary to popular opinion, manic episode can also increase the risk of suicide, especially if the patient dominates by productive symptoms in the form of delusions. The aim of study was to determine the frequency of suicide attempts and their determinants in an episode of mania in bipolar disorder. MATERIALS AND METHODS: The study included 16 people with a diagnosed bipolar disorder, hospitalized with manic episode at the age of 28-76. Patients hospitalized in the Department of Adult Psychiatry were selected randomly. The number of suicide attempts, comorbid conditions, and basic epidemiological data were estimated. RESULTS: Five patients declared suicide attempt, one of which wanted to make more than one attempt at suicide. 3 people took it during an episode of depression, two in an episode of mania. The methods of suicide were associated with an overdose of medication and this was accompanied by a greater amount of alcohol intake. 11 persons did not declare any willingness to attempt suicide. CONCLUSIONS: A mania episode did not increase the risk of suicide in bipolar disorder compared to an episode of depression in the study conducted. The importance of somatic illness in patients with bipolar disorder is increased if the suicide attempt occurs in an episode of depression. Alcohol abuse showed no negative effects on suicidal behavior of patients. During abuse was the most common way of commit suicide.

[Suicide attempts in patients with borderline personality--preliminary report]. / Próby samobójcze u pacjentów z osobowoscia borderline- -doniesienie wstepne.

UNLABELLED: Suicide is an act involving intentional taking his own life, which always raises a lot of emotion and controversy. In Poland, the suicide rate in the past few years has averaged about 15/100000 population, but in 2012 the number of suicides was fatal in 4177 cases. Over the years, there are certain fixed patterns in the epidemiology of suicide in Poland. Women often try to commit suicide but men often carry it out. Women usually choose less lethal methods. The highest rate of suicides committed in those states is between 50 and 59 years old. The aim of the study is to determine the prevalence of suicide attempts in patients with personality disorders of emotionally unstable personality type borderline and analysis of the underlying data and epidemiological determinants of suicide attempts. MATERIALS AND METHODS: The study included 12 patients with a diagnosis of personality disorder with borderline type. Mean age of patients was 33 years. 83% were women. There have been a random analysis of hospitalized psychiatric patients. The obtained data were statistically analyzed. RESULTS: 41.67% declared a suicide attempt, more than one 25%, and without suicide attempts was 33.33 % of the respondents. Popular method of choice was drugs (41.67%), followed by hanging (16.67%), and jump out of the window (8.33%). The most common cause was heartbreak, then the stress of job loss and social conflict. 41.67% of patients had no comorbidities. CONCLUSION: Emotionally unstable personality borderline type carries a high risk of suicide attempts. The majority of suicide attempts was by the method of low or moderate lethality. Suicide attempts occurred in patients with the same personality disorder, to a lesser extent in patients with concomitant other disorders. Females more predisposed to committing suicide.

[Selected problems in the forensic-psychiatric evaluation of persons posing a likelihood of repeating a criminal act]. / Wybrane problemy w opiniowaniu sadowo-psychiatrycznym osób stwarzajacych prawdopodobienstwo ponownego popelnienia czynu przestepczego.

In the current penal code, compared to previous regulations, there have been alterations concerning medical security measures. These amendments have been prompted by socio-politic circumstances in Poland as well as implementation of Mental Health Act. According to the current law the court, on the request of expert psychiatrists, can pronounce a sentence of obligatory stay in psychiatric institution for perpetrator of criminal act who has been deemed not sane due to 31 subsection 1 of penal code and who is predictably able of recidivism. In legal-medical practice those less experienced expert psychiatrists may encounter difficulties producing expertise for the court, especially evaluating probability of recurrence of committing a criminal act and resulting request for psychiatric detention. In order to make this issue more acquainted we present a review of literature concerning it.

[Quality of life and depressiveness of women patients diagnosed with ovarian cancer treated with surgery and after previous adjuvant therapy]. / Jakosc zycia i depresyjnosc u pacjentek z rozpoznaniem raka jajnika leczonych operacyjnie oraz po przebytej terapii uzupelniajacej.

UNLABELLED: In the present study undertaken to assess the quality of life and depression of women patients diagnosed with ovarian cancer. The aim of the study was to assess quality of life and severity of depression of women diagnosed with ovarian cancer treated with surgery, and then underwent adjuvant radio or chemotherapy treatment. MATERIAL AND METHODS: The principle of study was to included on random selection 42 women diagnosed with ovarian cancer who were treated surgically, and then subjected to adjuvant therapy. Quality of life was based on patient self-assessment using the EORTC QLQ C-30 form. The severity of depression was assessed by the Beck Depression Scale. RESULTS: Our results showed that in the vast majority the quality of life of women with ovarian cancer who develop depression, evaluate their own quality of life at a low level. In contrast patients who did not get depressed in most cases evaluated their own quality of life at the average level. In studies it has been shown that patients manifesting symptoms of depression compared to women not having these symptoms differ in a statistically significant way, in terms of quality of life. CONCLUSIONS: The results indicate that women diagnosed with ovarian cancer who have demonstrated the co-existence of depression presented a lower quality of life. The study indicates that in the majority of cases the severity of depression of patients diagnosed with ovarian cancer were mild.

[Quality of life and depressive symptoms in patients diagnosed with uterus cancer]. / Jakosc zycia i depresyjnosc u pacjentek z rozpoznaniem raka trzonu macicy.

UNLABELLED: In the present study quality of life and depressive symptoms as well as the influence of illness on emotional state in patients with diagnosis of uterus cancer was evaluated. The aim of the study was to evaluate quality of life and depressive symptoms in women diagnosed with uterus cancer who underwent surgical treatment and complementary therapy. MATERIAL AND METHODS: The study has been conducted on randomly chosen group of 100 patients diagnosed with uterus cancer who underwent surgical treatment and adjunctive therapy. Surveys has been conducted 6 months after completed therapy when no recurrence of carcinomatous disease was confirmed. Quality of life was evaluated using quality of life questionnaire EORTC QLQ-C30 and depressive symptoms were measured by means of Beck's depression self-rating scale. RESULTS: In the conducted study in most cases patients with diagnosis of uterus cancer didn't show symptoms of depression and in 40% of patients there were mild symptoms of depressive disorder. The results show that patients without depressive symptoms had better quality of life compared to those with concomitant depressive symptoms and it was statistically significant. CONCLUSIONS: Patients with diagnosed uterus cancer in whom no symptoms of depression were detected presented with better quality of life compared to patients with depressive symptoms. Emotional state of patients with uterus cancer can be an important factor influencing their quality of life.

Oxygen uptake efficiency plateau is unaffected by fitness level - the NOODLE study.

BACKGROUND: Endurance athletes (EA) are an emerging population of focus for cardiovascular health. The oxygen uptake efficiency plateau (OUEP) is the levelling-off period of ratio between oxygen uptake (VO2) and ventilation (VE). In the cohort of EA, we externally validated prediction models for OUEP and derived with internal validation a new equation. METHODS: 140 EA underwent a medical assessment and maximal cycling cardiopulmonary exercise test. Participants were 55% male (N = 77, age = 21.4 ± 4.8 years, BMI = 22.6 ± 1.7 kg·m- 2, peak VO2 = 4.40 ± 0.64 L·min- 1) and 45% female (N = 63, age = 23.4 ± 4.3 years, BMI = 22.1 ± 1.6 kg·m- 2, peak VO2 = 3.21 ± 0.48 L·min- 1). OUEP was defined as the highest 90-second continuous value of the ratio between VO2 and VE. We used the multivariable stepwise linear regression to develop a new prediction equation for OUEP. RESULTS: OUEP was 44.2 ± 4.2 mL·L- 1 and 41.0 ± 4.8 mL·L- 1 for males and females, respectively. In external validation, OUEP was comparable to directly measured and did not differ significantly. The prediction error for males was - 0.42 mL·L- 1 (0.94%, p = 0.39), and for females was + 0.33 mL·L- 1 (0.81%, p = 0.59). The developed new prediction equation was: 61.37-0.12·height (in cm) + 5.08 (for males). The developed model outperformed the previous. However, the equation explained up to 12.9% of the variance (R = 0.377, R2 = 0.129, RMSE = 4.39 mL·L- 1). CONCLUSION: OUEP is a stable and transferable cardiorespiratory index. OUEP is minimally affected by fitness level and demographic factors. The predicted OUEP provided promising but limited accuracy among EA. The derived new model is tailored for EA. OUEP could be used to stratify the cardiorespiratory response to exercise and guide training.

Below or all the way to the peak? Oxygen uptake efficiency slope as the index of cardiorespiratory response to exercise-the NOODLE study.

Background: The ratio of oxygen uptake (VO2) to minute ventilation (VE) is described as the oxygen uptake efficiency slope (OUES). OUES has been suggested as a valuable submaximal cardiorespiratory index; however, its characteristics in endurance athletes remain unknown. In this study, we a) investigated OUES between different time intervals, b) assessed their prediction power for VO2peak, and c) derived new prediction equations for OUES tailored for well-trained individuals. Materials and Methods: A total of 77 male (age = 21.4 ± 4.8 yrs; BMI = 22.1 ± 1.6 kg·m-2; peak oxygen uptake = 4.40 ± 0.64 L·min-1) and 63 female individuals (age = 23.4 ± 4.3 yrs; BMI = 23.1 ± 1.6 kg·m-2; peak oxygen uptake = 3.21 ± 0.48 L·min-1) underwent the cycling cardiopulmonary exercise test. OUES was measured at 75%, 90%, and 100% of exercise duration. Prediction power and new models were derived with the multiple linear regression method. Results: In male subjects, OUES [mL·min-1/L·min-1] from 75% = 4.53 ± 0.90, from 90% = 4.52 ± 0.91, and from 100% = 4.41 ± 0.87. In female subjects, OUES [mL·min-1/L·min-1] from 75% = 3.50 ± 0.65, from 90% = 3.49 ± 0.62, and from 100% = 3.41 ± 0.58. OUES did not differ between time intervals in male (p = 0.65) and female individuals (p = 0.69). OUES strongly predicts peak VO2 independently from the measuring interval (ß = 0.71-0.80; R 2 = 0.50-0.63). The prediction model designed for elite athletes was OUES [mL·min-1/L·min-1] = -1.54 + 2.99; BSA [m2]-0.0014; (age [in years]; sex [1 = male, 2 = female]) (R 2 = 0.36). Conclusion: OUES enables an accurate prediction of peak cardiorespiratory fitness in elite endurance athletes. OUES is a feasible alternative to maximal exercise testing. A new prediction equation should be used for highly trained individuals. Physicians should understand OUES physiology to properly assess the cardiorespiratory response to exercise in athletic cohorts.

Is the Ventilatory Efficiency in Endurance Athletes Different?-Findings from the NOODLE Study.

Background: Ventilatory efficiency (VE/VCO2) is a strong predictor of cardiovascular diseases and defines individuals' responses to exercise. Its characteristics among endurance athletes (EA) remain understudied. In a cohort of EA, we aimed to (1) investigate the relationship between different methods of calculation of VE/VCO2 and (2) externally validate prediction equations for VE/VCO2. Methods: In total, 140 EA (55% males; age = 22.7 ± 4.6 yrs; BMI = 22.6 ± 1.7 kg·m-2; peak oxygen uptake = 3.86 ± 0.82 L·min-1) underwent an effort-limited cycling cardiopulmonary exercise test. VE/VCO2 was first calculated to ventilatory threshold (VE/VCO2-slope), as the lowest 30-s average (VE/VCO2-Nadir) and from whole exercises (VE/VCO2-Total). Twelve prediction equations for VE/VCO2-slope were externally validated. Results: VE/VCO2-slope was higher in females than males (27.7 ± 2.6 vs. 26.1 ± 2.0, p < 0.001). Measuring methods for VE/VCO2 differed significantly in males and females. VE/VCO2 increased in EA with age independently from its type or sex (ß = 0.066-0.127). Eleven equations underestimated VE/VCO2-slope (from -0.5 to -3.6). One equation overestimated VE/VCO2-slope (+0.2). Predicted and observed measurements differed significantly in nine models. Models explained a low amount of variance in the VE/VCO2-slope (R2 = 0.003-0.031). Conclusions: VE/VCO2-slope, VE/VCO2-Nadir, and VE/VCO2-Total were significantly different in EA. Prediction equations for the VE/VCO2-slope were inaccurate in EA. Physicians should be acknowledged to properly assess cardiorespiratory fitness in EA.

Amantadine in Treatment of Dysthymia-The Pilot Case Series Study.

Dysthymia is a common chronic mood disorder in which isolated symptoms of depression persist for at least 2 years. Despite the many medications recommended for the treatment of dysthymia, no recommendations have yet been made for the treatment of patients who fail to achieve clinical improvement. This justifies attempts to identify second-line drugs for the treatment of dysthymia. In an open and naturalistic case study, five patients diagnosed with dysthymia in whom at least one antidepressant treatment was ineffective were treated with amantadine. In the age- and gender-matched external control group, patients were treated with sertraline at 100 mg/day. Depressive symptoms were assessed using HDRS-17. Two men and three women were treated with 100 mg amantadine for 3 months with 3-5 months follow-up. After 1 month of treatment with amantadine, a significant reduction in the intensity of depressive symptoms was achieved in all patients, and the clinical improvement increased over the next 2 months of treatment. No deterioration in well-being was observed in any patient after discontinuation of amantadine. The effect of amantadine treatment was comparable to that of sertraline treatment in patients with dysthymia who improved with this drug. The present study indicates that amantadine is an effective and well-tolerated drug in the treatment of dysthymia. Amantadine may be associated with a quick improvement in symptoms in the treatment of dysthymia. Treatment with this drug seems to be associated with good tolerability and persistency of the therapeutic effect after the discontinuation of the treatment.

Depressive and Other Adverse CNS Effects of Fluoroquinolones.

Fluoroquinolones (FQs) are widely used drugs around the world. This is a result of their broad spectrum of antibacterial activity, high bioavailability, and known efficacy. Since they appeared on the market, their prescribing frequency has gradually increased. In 2011, FQs became the third most prescribed class of antibiotics in the US. Widespread use of these drugs resulted in an increasing number of reported side effects. In 2016, the FDA warned about significant side effects, including mental disorders in the form of anxiety, psychotic symptoms, insomnia, and depression. Psychiatric adverse reactions to FQs occur with a frequency of 1 to 4.4% and the mechanism of their formation is not entirely clear. It is believed that the antagonistic effect of FQs on the GABA receptor or interaction with the main receptor for the glutamatergic system-NMDA-is responsible for this. The paper is a structured review of 68 selected publications and the latest summary of CNS adverse effects that occur during FQ use. Prescribers should be aware of the risk factors for FQ toxicity, including elderly patients with underlying medical conditions or receiving concomitant medication; however, these adverse events may also occur in other groups of patients.

Management of nicotine dependence in patients with psychiatric disorders - recommendations of the Polish Psychiatric Association - part I. / Postepowanie w uzaleznieniu od nikotyny u pacjentów z zaburzeniami psychicznymi ­ zalecenia Polskiego Towarzystwa Psychiatrycznego ­ czesc I.

Smoking and nicotine dependence are still one of the main reasons for a number of serious and life-shortening somatic diseases. At the same time, they are more prevalent in mentally ill individuals than in the general population. This work, which constitutes the first part of recommendations of the Polish Psychiatric Association, presents the scale of the phenomenon in the general population and among people with psychiatric disorders, diagnostic criteria of nicotine dependence and nicotine withdrawal. It discusses the impact of smoking and exposure to cigarette smoke on the development and course of psychiatric disorders as well as on the treatment of psychiatric disorders, including interactions between nicotine and psychotropic medications. Many psychiatric patients can reduce smoking or achieve complete abstinence if they are offered adequate motivation and therapeutic support. Contrary to popular belief, smoking cessation and nicotine dependence treatment do not negatively affect the symptoms of psychiatric disorders; patients' mental conditions can improve following smoking cessation therapy. The best results in terms of maintaining abstinence are achieved with a treatment approach that combines pharmacotherapy with psychotherapeutic intervention integrated into routine psychiatric care.

Management of nicotine dependence in patients with psychiatric disorders - recommendations of the Polish Psychiatric Association - part II. / Postepowanie w uzaleznieniu od nikotyny u pacjentów z zaburzeniami psychicznymi ­ zalecenia Polskiego Towarzystwa Psychiatrycznego ­ czesc II.

The development of treatment methods for nicotine dependence has progressed slowly because people with psychiatric disorders are usually excluded from participating in clinical trials. There are several therapeutic options to support smoking cessation, including psychological and pharmacological interventions, which should be offered to smokers with mental disorders. The first step in helping tobacco smokers and nicotine-dependent individuals is the assessment of smoking intensity and confirmation of nicotine dependence. Currently, we have several methods of treating nicotine dependence - starting from education and psychotherapy, through pharmacotherapy and replacement therapy, and ending up with obtaining gradual progress with the application of harm reduction. Pharmacological treatment options include nicotine replacement therapy, varenicline or bupropion. The effectiveness of such interventions can be improved by providing anti-smoking therapy under psychiatric treatment and promoting harm reduction as an acceptable initial therapeutic goal. The harm reduction strategy is an approach that should be taken into account individually, particularly in the case of individuals unable to stop smoking, patients with limited insight into their illness, patients experiencing an exacerbation of their illness and persistently uncooperative patients. In this paper, recommendations of the Polish Psychiatric Association on the diagnostics and different treatment methods for nicotine dependence in patients with psychiatric disorders are presented.

Examining the Nutrition of Cardiological Patients in Hospitals: Evaluating the Discrepancy between Received Diets and Reference Diet Based on ESC 2021 Guidelines-Hospital Diet Medical Investigation) (HDMI) Study.

Cardiovascular diseases (CVDs) are the leading causes of death worldwide. CVDs have become the dominant cause of death and have been a significant health challenge since the second half of the 20th century in the Polish population. The aim of our HDMI (hospital diet medical investigation) study was to examine the quality of the hospital diets given to cardiac patients and assess how much they adhere to the European Society of Cardiology (ESC) 2021 guidelines. By comparing the diets received by patients with the recommended dietary patterns outlined in the ESC 2021 guidelines, we sought to identify discrepancies. The study was conducted in two steps: creating a 7-day model menu and comparing it with the received diets and then making comparisons with ESC 2021 guidelines. Additionally, we designed a survey to obtain the characteristics of the hospitals. The results show that the nutrition in hospitals remains substandard. None of the diets had an appropriate salt supply or predominance of plant-based food patterns. Only 1/7 diets avoided sweetened beverages, and 2/7 diets had an appropriate amount of fiber. This underscores a gap in the healthcare system to improve patients' health by implementing dietary interventions that foster the development of healthy eating habits.

[Assessment of psychosocial attitudes among homosexual men]. / Ocena postaw psychospolecznych mezczyzn o orientacji homoseksualnej.

UNLABELLED: Homosexuality, though more than 20 years no longer exists in the classification of diseases as a deviation, it is still by many people seen as such behavior. The aim of the study was to assess the situation and psychosocial attitudes in the group of homosexual men. MATERIAL AND METHODS: The study involved a group of 187 men aged 20-54 years. The study population was characterized by hiding homosexual orientation, lack of a permanent partner for more than half of them and the tendency to avoid safe sex and taking a passive role in intimate contact. In the study a questionnaire prepared by the authors was used. RESULTS AND CONCLUSIONS: Most respondents hid his homosexuality from others, and over half of them do not have a permanent partner. Representatives of the study group, in most cases do not prefer safe sex and in intimate contact acted as passive.

Psychotic disturbances in adult female patient with congenital hypopituitarism due to mutation in PROP1 gene.

INTRODUCTION: Untreated congenital hypopituitarism in adult patient is - nowadays - a very rare observation. CASE: A 52 years old female patient, was referred to the Department of Psychiatry for psychotic symptoms, manifested as auditory pseudohallucinations with delusional interpretation, significant psychomotor agitation, anosognosia, attempts of symptom dissimulation and negativism. At admission, attention was drawn to her short stature and low body weight. Because of general weakness, she was hardly moving, her skin was pale, dry, cold, little elastic and desquamating. Neither axillary nor pubic hair could be traced. Basic studies revealed anaemia, significant hyponatraemia and hypercholesterolaemia. Hormonal tests confirmed diagnosis of hypopituitarism. Genetics studies revealed mutations (150delA and 296_297delAG) in PROP1 gene. Combined somatic and neuroleptic treatment considerably improved the physical and psychic status of the patient, as well as strengthened her social functioning. CONCLUSIONS: An exogenous, psychotic episode identified in the patient was induced by multihormonal hypopituitarism and disappeared after hormonal replacement therapy.