LONG TERM TELEMEDICINE STUDY OF COMPLIANCE IN PARANOID SCHIZOPHRENIA

Background: Low compliance is one of the crucial problems of contemporary psychiatry. Relapses, deterioration of cognitive functioning, negative symptoms, neuroleptic resistance are the examples of many consequences of noncompliance in schizophrenia Subjects and methods: The study was designed to assess the compliance in the 200 patients diagnosed with paranoid schizophrenia, all in the state of symptomatic remission and on the stable neuroleptic treatment. The compliance was assessed using a telepsychiatric system, sending reminders: 1 hour before the planned dose to remind them that drug intake is approaching, and at the moment of intake to check if they took the drug. The confirmed drug intakes were counted by the telepsychiatric system. Results: 158 patients completed the study period. The compliance in the first month of the treatment was 44.6% and decreased over the rest of the period to the level of 33.4%. 50% of the schizophrenic patients were compliant at a level lower than 37%. This group was considered the low compliance group, and in this group the compliance increased after 6 months from 9.3% to 10.3% (p<0.0001). Conclusions: The compliance in the group of schizophrenic patients in remission is very low. The telemedicine system improves the compliance in the patients with the worst compliance

IMPACT OF OLANZAPINE ON COGNITIVE FUNCTIONS IN PATIENTS WITH SCHIZOPHRENIA DURING AN OBSERVATION PERIOD OF SIX MONTHS

Objective: The objective of our study was to evaluate the effect of olanzapine treatment on selected cognitive functions in patients suffering from schizophrenia during an observation period of six-months. Subjects and methods: Twenty patients with a diagnosis of schizophrenia according to ICD-10 criteria for research were examined. One day before initiation of olanzapine a baseline assessment was performed. The neuropsychological examination was repeated 28 days, 60 days, 3 months, and 6 months after the beginning of treatment. Cognitive function measurements were performed using Signal, COGNITRON and RT tests, being a part of the computer-based Vienna Test System (VTS). Results: Our study showed an improvement in the assessed cognitive functions. Impairments in cognitive domains were observed at baseline as compared to published normative data, and enhancement in achieved results was observed subsequently in all stages of the treatment until the 6th month. Conclusion: The above results are consistent with a number of other studies on the impact on cognitive functioning in patients with schizophrenia treated with olanzapine

Metaphysics of the new psychiatry

Nowy, kwantowy model mózgu implikuje zmiany w dotychczasowym rozumieniu kliniki zaburzeń psychicznych. Brak orientacji w prawdziwej naturze procesów psychicznych jest przyczyną bezradności w sytuacjach kryzysowych w życiu jak również błędnego spostrzegania mózgu przez analogię do mechanicznej maszyny. Mózg jest biologiczną maszyną kwantową, doświadczającą różnych aspektów energetycznej substancji materii, która jest poszukiwanym poziomem jedności rzeczywistości.The new, quantum model of brain implies the transformation of the contemporary understanding of the clinic of psychiatric disorders. The lack of the orientation in the proper nature of psychic processes, together with the false comprehension of the brain by analogy to mechanic machine, is the reason of a helplessness in the critical life situations in a human being. The brain is the quantum machine, perceiving different aspects of the energetic material substance, which is the wanted level of the unification of reality

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

Thrombocytosis portends adverse prognostic significance in patients with stage II colorectal carcinoma

Thrombocytosis portends adverse prognostic significance in many types of cancers including ovarian and lung carcinoma. In this study, we determined the prevalence and prognostic significance of thrombocytosis (defined as platelet count in excess of 400 × 10 3/μl) in patients with colorectal cancer. We performed a retrospective analysis of 310 consecutive patients diagnosed at our Institution between 2004 and 2013. The patients (48.7% male and 51.3% female) had a mean age of 69.9 years (+/- 12.7 years) at diagnosis. Thrombocytosis was found in a total of 25 patients, with a higher incidence in those with stage III and IV disease (14.4% of patients). Although the mean platelet count increased with the depth of tumor invasion (pT), its values remained within normal limits in the whole patient cohort. No patient with stage I cancer (n=57) had elevated platelet count at diagnosis. By contrast, five of the 78 patients (6.4%) with stage II cancer showed thrombocytosis, and four of these patients showed early recurrence and/or metastatic disease, resulting in shortened survival (they died within one year after surgery). The incidence of thrombocytosis increased to 12.2% and 20.6%, respectively, in patients with stage III and IV disease. The overall survival rate of patients with thrombocytosis was lower than those without thrombocytosis in the stage II and III disease groups, but this difference disappeared in patients with stage IV cancer who did poorly regardless of their platelet count. We concluded that thrombocytosis at diagnosis indicates adverse clinical outcome in colorectal cancer patients with stage II or III disease. This observation is especially intriguing in stage II patients because the clinical management of these patients is controversial. If our data are confirmed in larger studies, stage II colon cancer patients with thrombocytosis may be considered for adjuvant chemotherapy

Prydynol — leczenie poneuroleptycznych objawów pozapiramidowych

Anticholinergic substances like atropine had been yet used in traditional medicine. Nowadays cholinolitics are broadly used in medicine, especially in neurology with muscle spasticity. Pridinol is the cholinolitic used in psychiatry. The article describes pharmacokinetics, mechanism of pridinol action, its tolerance and toxicology, together with the broad spectrum of its clinical indication with the special consideration of the place the drug has in the treatment of neuroleptic-induced extrapyramidal symptoms. Pridinol is the drug, offering multiple therapeutic gains. It may be very useful for patients with neuroleptic-induced extrapyramidal symptomsSubstancje o działaniu cholinolitycznym, takie jak atropina, były już wykorzystywane w tradycyjnej medycynie. Obecnie cholinolityki są powszechnie używane w medycynie, szczególnie w schorzeniach neurologicznych ze spastycznością mięśni. Prydynol jest cholinolitykiem wykorzystywanym w psychiatrii. W artykule omówiono farmakokinetykę, mechanizm działania prydynolu, tolerancję i toksykologię oraz szeroki zakres jego wskazań klinicznych, ze szczególnym uwzględnieniem miejsca, które prydynol zajmuje w leczeniu pozapiramidowych objawów, towarzyszącym leczeniu neuroleptykiem. Prydynol jest lekiem oferującym wiele korzyści terapeutycznych. Może on pomóc wielu pacjentom, u których występują poneuroleptyczne objawy pozapiramidowe

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

Study program on opinions of schizophrenic patients treated with antipsychotics

Wstęp. Brak współpracy pacjenta w leczeniu jest jedną z najczęstszych przyczyn przerywania leczenia i braku skuteczności terapii zaburzeń psychicznych. Wiele czynników może mieć wpływ na niestosowanie się pacjentów do zaleceń lekarskich, na przykład rodzaj schorzenia, zjawisko stygmatyzacji chorobą psychiczną i jakość relacji pacjent&#8211;lekarz. Celem badania była ocena opinii pacjentów leczonych lekami przeciwpsychotycznymi nowej generacji. Materiał i metody. Badaniem objęto grupę 1400 pacjentów schizofrenicznych, leczonych ambulatoryjnie jednym z leków przeciwpsychotycznych drugiej generacji. Wyniki. Pacjenci uważali, że najważniejszymi objawami, na których ustąpienie zwracają szczególną uwagę, są: lęk i napięcie, urojenia i omamy. Wśród objawów niepożądanych neuroleptyków pacjenci zwracali największą uwagę na senność, zaburzenia seksualne, otyłość i objawy pozapiramidowe. Ponad 80% pacjentów leczonych nowoczesnymi neuroleptykami chciało leczyć schizofrenię; 82% pacjentów uważało, że stosowanie leków przeciwpsychotycznych powoduje objawy niepożądane. 81% pacjentów uważało, iż stosowanie leku przeciwpsychotycznego poprawia ich poziom funkcjonowania w społeczeństwie i rodzinie; 74% pacjentów schizofrenicznych obawiało się objawów niepożądanych leków przeciwpsychotycznych, a 70% nie mówiło innym, że pobierają lek przeciwpsychotyczny; 77% pacjentów twierdziło, że leczenie schizofrenii jest skuteczne. Nie więcej niż 40% pacjentów czuło się źle lub nienaturalnie, stosując nowoczesny lek przeciwpsychotyczny. Wnioski. Pacjenci leczeni lekami przeciwpsychotycznymi drugiej generacji mogą odznaczać się dobrą współpracą. W opinii pacjentów, najważniejsze w leczeniu schizofrenii jest ustąpienie objawów wytwórczych i objawów afektywnych. Najbardziej kłopotliwymi objawami niepożądanymi neuroleptryków są: sedacja, zaburzenia seksualne, otyłość i objawy pozapiramidowe. Zjawisko stygmatyzacji pacjenta jest powszechne w grupie osób ze schizofrenią.Introduction. Noncompliance is one of most frequent reasons of discontinuation of therapy and lack of effectiveness of psychiatric disorders treatment. Many factors may influence on noncompliance, e.g. type of disease, phenomenon of stigmatization with mental disease and quality of patient-doctor relation. The study aimed to explore opinions of patients treated with new generation antipsychotics. Material and methods. One thousand four hundred out-patients treated with one of second generation antipsychotics were studied. Results. Patients considered anxiety, tension, delusions and hallucinations the most important symptoms to be released from. Most attracting neuroleptic side effects were drowsiness, sexual dysfunctions, obesity and extrapyramidal symptoms. More than 80% of patients treated with modern neuroleptics wanted to treat schizophrenia; 82% patients thought that the treatment with atipsychotics produces side effects. In opinion of 81% of subjects level of family and society functioning was improved by intake of antipsychotics; 74% patients worried about side effects of antipsychotics and 70% did not tell nobody they take antipsychotic drug; 77% of patients claimed that schizophrenia treatment is effective. No more than 40% of patients felt bad or unnatural using antipsychotic drug. Conclusions. Patients treated with second generation antipsychotics may be characterized with good compliance. In opinion of patients most important in the treatment of schizophrenia are productive and affective symptoms. Most interfering side effects of neuroleptics are sedation, sexual dysfunctions, obesity and extrapyramidal symptoms. Stigmatization phenomenon is abundant in the examinated group of people with schizophrenia