DEPRESSION OR DEPRESSIVENESS IN PATIENTS DIAGNOSED WITH ANOREXIA NERVOSA AND BULIMIA NERVOSA – PILOT RESEARCH

Objectives: The target of this work is to consider if depressive symptoms intercurrent with patients suffering from Anorexia Nervosa (AN) and Bulimia Nervosa (BN) form a depression complex or whether they are physiological depression accompanying adolescence. We wished to observe the perception of these patients,of their functioning, both social and within their families and also looking for common point in the issues mentioned above trying to locate them within the course of the basic illness. Subjects and methods: We studied 19 patients suffering from eating disorders, and aged between 12 and 24 years old. 15 of them suffered from the restrictive form of AN and 4 suffered from BN. The control group consisted of 30 healthy girls in the same age interval. In the study authors used the Beck Depression Inventory (BDI) and the Quebec Quality of Life Questionnaire. Results: Comparison of a number of points acquired in the survey using Beck Depression Scale revealed statistic significance at the level p<0.001 which points to a more frequent occurrence of depression symptoms among persons with eating disorders comparing to control group. The survey using the Questionnaire for Social Quality showed no statistically significant differences between study and control groups (p>0.05). The authors observed a statistically significant increased frequency of suicidal thoughts in the study group compared to the controls. Conclusions: To diagnose depression, depressive symptoms presented by the patients must give the image of depression at the clinical level. The result of the Beck\u27s scale needs to be confronted with the clinical picture. Depression in adolescence requires differentiation from depressiveness

Systematic Review of Literature on Single-Nucleotide Polymorphisms Within the Oxytocin and Vasopressin Receptor Genes in the Development of Social Cognition Dysfunctions in Individuals Suffering From Autism Spectrum Disorder

Introduction: Autism spectrum disorder (ASD) is found in virtually all population groups regardless of ethnic or socioeconomic backgrounds. Among others, dominant symptoms of autism persistent throughout its course of development include, inter alia, qualitative disorders of social communication and social interactions. Numerous studies have been performed on animal models as well as groups of healthy individuals to assess the potential role of oxytocinergic and vasopresynergic systems in normal social functioning. These studies have also discussed their potential participation in the development of social cognition dysfunctions in the course of ASD. This literature review aimed to identify studies examining single-nucleotide polymorphisms of the oxytocin (OXT) and arginine vasopressin (AVP) receptor genes and their differential effects on social cognitive dysfunction in the development of ASD.Methods: A systematic review of literature published within the last 10 years and accessible in PubMed, Google Scholar, Cochrane Library, and APA PsycNET databases was conducted by each author separately. Inclusion criteria required that articles should 1) be published between January 2008 and August 2018; 2) be published in English or Polish; 3) be located in periodical publications; 4) focus on the role of polymorphisms within oxytocin and vasopressin receptor genes in autistic population; 5) provide a clear presentation of the applied methodology; and 6) apply proper methodology.Results: From the 491 studies qualified to the initial abstract analysis, 15 met the six inclusion criteria and were included in the full-text review.Conclusions: The analysis of available literature seems to indicate that there is an association between social cognition dysfunctions in the course of autism and selected alleles of polymorphisms within the OXT receptor AVP 1A receptor genes. However, previous studies neither specify the nature of this association in an unequivocal way nor select genotypes that are the basis for this association

Physiological psycho-sexual development of children and adolescents

Seksualność w modelu ekologicznym jest atrybutem człowieka, niezróżnicowaną siłą napędową o złożonych uwarunkowaniach, znajdującą ujście w formach ukształtowanych przez system, w którym żyje człowiek. Tożsamość płciowa jest podstawowym poczuciem tego, czym jest płeć męska i żeńska, i łączy się z przekonaniem, czy jest się mężczyzną, czy kobietą. Jest ona często wyraźnie zaznaczona pod koniec 2. roku życia, a od około 4. roku życia nie podlega poważnym zmianom. Natomiast z psychologicznego punktu widzenia kształtowanie się tożsamości płciowej jest częścią procesu separacji &#8212; indywiduacji dziecka. Celem niniejszego artykułu jest przybliżenie rozwoju psychoseksualnego dziecka i dorastającego w różnorodnych aspektach tego procesu. Rozwój psychoseksualny przedstawiono na przykładzie relacji z obiektem Kernberga i w ujęciu freudowskim, przeanalizowano tworzenie się tożsamości płciowej. Zaprezentowano zachowania seksualne pod postacią masturbacji dziecięcej, zachowań orientacyjnych i twórczych, które ściśle wiążą się z poziomem emocjonalnym, poznawczym i intelektualnym dziecka i dorastającego. Zaproponowano rozumienie fantazji dziecięcych w ujęciu freudowskim i kleinowskim. Przeanalizowano doświadczanie seksualności w okresie adolescencji przez dziewczęta i chłopców ze zwróceniem uwagi, że ma ono odmienny charakter. Przybliżenie poruszonej tematyki ma służyć lepszemu rozumieniu zachowań dziecka i adolescenta, które nie zawsze muszą skutkować interwencją psychiatry dziecięcego lub psychoterapeuty. Seksuologia Polska 2010; 8 (2): 64&#8211;70Sexuality in the ecological model is a human attribute, the undifferentiated driving force of complex conditionings, which finds its vent in the forms shaped by the system in which humans operate. Sexual identity is a basic sense of what the male and female sex are and is linked with the conviction of one&#8217;s masculinity or femininity. This identity is frequently clearly marked towards the second year of life, and approximately from the age of four it does not undergo any considerable changes. However, from the psychological point of view the process of sexual identity formation is a part of the process of child&#8217;s separationindividualisation. The aim of this paper is to bring closer to the Reader the concept of the psycho-sexual development of a child and adolescent through various aspects of this process. The psycho-sexual development is presented through the example of the Kernberg&#8217;s object relations in the Freudian framework, and the formation of sexual identity is analysed. Various sexual behaviours are presented in the form of infantile masturbation, orientation and creative behaviours, which are closely linked with the emotional, cognitive and intellectual level of a child and adolescent. The authors propose to approach infantile fantasies from the Freud&#8217;s and Klein&#8217;s perspective. Girls&#8217; and boys&#8217; experience of sexuality during adolescence was analysed. It is pointed out that this experience is of a different character. A closer look at this subject should contribute to a better understanding of child&#8217;s and adolescent&#8217;s behaviours which should not necessarily lead to a psychiatric or psychotherapeutic intervention. Polish Sexology 2010; 8 (2): 64&#8211;7

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 longterm 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

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 longterm 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

Jakość przywiązania u osób dorosłych ze zdiagnozowanym płodowym zespołem alkoholowym

Celem badania było określenie charakteru wzorców przywiązania w grupie dorosłych osób z płodowym zespołem alkoholowym (foetal alcohol syndrome, FAS) pochodzących z rodzin zastępczych, adopcyjnych i biologicznych. Zakładano, iż osoby te rozwijają pozabezpieczne style przywiązania w większym stopniu, niż to ma miejsce w populacji ogólnej. Materiał i metoda: W badaniu uczestniczyły dwie grupy po 30 osób. Procedura badania składała się z dwóch faz. W pierwszej wykonano diagnozę występowania objawów FAS u dzieci na podstawie Czterocyfrowego Kwestionariusza Diagnostycznego FASD – tzw. Kwestionariusza Waszyngtońskiego. Miało to na celu ocenę spektrum poalkoholowych wrodzonych zaburzeń rozwojowych. W drugiej fazie zbadano charakter przywiązania u 30 osób z FAS będących obecnie młodymi dorosłymi, wykorzystując do tego polską wersję kwestionariusza Experience in Close Relationships-Revised. Dodatkowo w obu fazach przeprowadzono poszerzone wywiady z rodzicami lub opiekunami badanych z FAS. W celu porównania wyników tych osób w stosunku do populacji ogólnej zbadano grupę kontrolną – 30 osób młodych dorosłych z wykluczonym FAS. Wyniki: Dorosłe osoby ze zdiagnozowanym FAS osiągały wysokie wyniki w przywiązaniu pozabezpiecznym, w którym znaczącą rolę odgrywały unikanie przywiązaniowe i obawa przed tworzeniem bliskich relacji. Stopień braku ufności przywiązaniowej wśród osób z FAS jest znacząco wyższy niż w populacji ogólnej. Wśród wskazanych prototypów przywiązaniowych w grupie osób z FAS dominował typ zaabsorbowany – 40%, mniej częsty był ufny – około 27% – i oddalająco-unikający – około 23%. W grupie kontrolnej dominował typ ufny – dotyczyło to ponad 61% osób. Rzadziej odnotowano typ zaabsorbowany – około 21% – oraz lękowo-unikający – około 13%. Wnioski: W przywiązaniu osób dorosłych ze zdiagnozowanym FAS dominują pozabezpieczne style przywiązania oparte na unikaniu i niepokoju, które mogą prowadzić do zaburzeń w kształtowaniu więzi. Trudności w tworzeniu bliskich związków u dorosłych osób z FAS mogą prowadzić do znacznego obniżenia poziomu jakości życia

The potential role of the novel hypothalamic neuropeptides nesfatin-1, phoenixin, spexin and kisspeptin in the pathogenesis of anxiety and anorexia nervosa

Due to the dynamic development of molecular neurobiology and bioinformatic methods several novel brain neuropeptides have been identified and characterized in recent years. Contemporary techniques of selective molecular detection e.g. in situ Real-Time PCR, microdiffusion and some bioinformatics strategies that base on searching for single structural features common to diverse neuropeptides such as hidden Markov model (HMM) have been successfully introduced. A convincing majority of neuropeptides have unique properties as well as a broad spectrum of physiological activity in numerous neuronal pathways including the hypothalamus and limbic system. The newly discovered but uncharacterized regulatory factors nesfatin-1, phoenixin, spexin and kisspeptin have the potential to be unique modulators of stress responses and eating behaviour. Accumulating basic studies revelaed an intriguing role of these neuropeptides in the brain pathways involved in the pathogenesis of anxiety behaviour. Nesfatin-1, phoenixin, spexin and kisspeptin may also distinctly affect the energy homeostasis and modulate food intake not only at the level of hypothalamic centres. Moreover, in patients suffered from anxiety and anorexia nervosa a significant, sex-related changes in the plasma neuropeptide levels occurred. It should be therefore taken into account that the targeted pharmacomodulation of central peptidergic signaling may be potentially helpful in the future treatment of certain neuropsychiatric and metabolic disorders. This article reviews recent evidence dealing with the hypothetical role of these new factors in the anxiety-related circuits and pathophysiology of anorexia nervosa