Archives 1992-2013

An interesting model is presented, simulating characteristics of human behavior and the course of schizophrenia in man in an experiment on rats. Many assumptions of the so-called neurodevelopmental concept of the pathogenesis of schizophrenia are verified in the model, by means of destruction of limbic structures in early stages of fetal life. (Eds.)

The Borna disease virus is the cause of cerebral meningitis and encephalitis in sheep and horses. This fatal disease is endemic in the Central Europe region. The virus is characterized by a strong neurotropism and in this respect indicates a considerable affinity to the limbic system. Clinical symptoms of the infection as well as intensity of inflammatory reaction of the c.n.s. "depend on the response on the infected organism's immunological system. In recent years a hypothesis has been posed concerning a probable contribution of this factor to the pathogenesis of some mental and neurological disorders in man. A review of the state-of-the-art research literature on prevalence of infection with the Borna disease virus in affective disorders, schizophrenia, and in some neurological conditions is presented in the paper.

In order to evaluate relationships between the clinical picture and neuroradiological pattern in schizophrenia MRI examination was performed in 70 patients. Cortical atrophy was found in 37% of the subjects. These patients were older, and hospitalized not only more often, but also for longer periods. Intensity of schizophrenic symptoms (including positive, negative and depressive ones) did not differentiate between patients with and without cortical atrophy. T2 relaxation time measurements revealed more numerous changes in the right cerebral hemisphere. T2 time values from the right frontal middle gyrus were significantly higher in patients with less marked schizophrenic symptoms. T2 time values from the grey matter of the frontal inferior gyrus in the right hemisphere were the higher the older were the patients, while T2 values from the corresponding area in the left hemisphere were the higher the later was the onset of schizophrenia. T2 time values from the amygdaloid nucleus were positively correlated with psychopathological symptoms intensity prior to treatment, positive symptoms intensity after treatment, clinical improvement after treatment, and with the breadth of the Sylvian fissure. Further research is needed to explain the significance of the parameters under study for clinical practice.

A comprehensive rehabilitation program based on social skills training has been evaluated. The analysis included not only behaviour change, but also the dynamics of positive and negative emotions intensity. Subjects in the study were patients suffering from chronic schizophrenia.

In the presented case after three years of constant, regular sessions and work on "psychotic fantasy" the patient's deep anxiety content was revealed as the motive of her incomprehensible behavior in the acute psychotic phase. Such non-psychotic experience of psychotic content enables the patient to re-integrate painful, rejected and actively forgotten experiences. This is often possible in a stable and long-term therapeutic relationship.

The paper presents selected opinions and a review of empirical research on the use of direct coercion in mental hospitals. (Eds.)

Subjects in the study were 856 patients hospitalized in 31 mental hospitals on the grounds of criminal detention. It has been found that within the past three months prior to the study 31% of the subjects manifested verbal aggression, and 19% – physical aggression. These behaviors were usually directed against other patients, less often – against the staff. In the same period almost 7% of the patients left the hospital willfully, while 9% attempted to do so. Within one month preceding the study physical constraint was used towards 9.2% of the patients.

Architectural, organizational and therapeutic solutions aimed at safety maintenance in three North American centers of forensic psychiatry are outlined.

The paper presents a study of defense mechanisms employed by neurotic patients as compared to healthy people, as well as change of these mechanisms in the process of psychotherapy. (Eds.)

The authors review the present state of knowledge related to neurobiological principles of clinical application of compounds acting at AMPA/kainate receptors. Despite of the fact that at present this class of drugs is not widely used in the therapy of neurologic and psychiatric disturbances, there is a sound theoretical background to start clinical trials in neurodegenerative disorders, brain ischemia, Parkinson's disease and epilepsy.

On the grounds of archival materials unpublished so far, the paper presents the situation in Russian psychiatry after the Bolshevik revolution. The new regime that according to Soviet ideologists was a guarantee of social justice, has brought terror, famine, death, and thought control following the official ideology. Psychiatrists were involved in Bolsheviks' activities from the very beginning. This was due to: 1) an increased prevalence of reactive disorders among prisoners, 2) striving to utilize psychiatrists' experience in work therapy, since the latter was considered by Bolsheviks to be the basic method of resocialization of the detained, 3) transformation of psychiatric facilities into agricultural colonies for the imprisoned and into labor camps, 4) establishment of forensic psychiatry institutes' that were to assess psychiatric disorders in prisoners. In 1918 such an Institute was established in Pyotrogrod, and in 1921 – in Moscow. The Pyotrogrod Institute, in contradistinction to that in Moscow, was characterized by a liberal approach towards the patients and more frequent diagnoses of non-accountability, owing to the humanitarian attitude of L. G. Orszanski, Director of the Pyotrogrod Institute. However, the patient saved from a labor camp was committed to a mental hospital with similarly dramatic living conditions. E.g. in the St. Nicolas the Miraculous Hospital in Pyotrogrod the mortality rate after the year 1917 amounted in some months to 60-80%. The Soviet penal code based on the concepts of "dangerousness of the individual" and "social safety measures" provided grounds for abuse in Soviet psychiatry. In the former Soviet Union the first "specbolnica" (special psychiatric hospital) for political prisoners was established in Kazań in 1939. A substantial part of Soviet psychiatrists, particularly during the first period of the Bolshevik dictatorship, proudly defended the patients' rights. E.g. appeals of Pyotrogrod psychiatrists for preservation the orthodox churches in the psychiatric hospitals. In the years 1936-1951 a battle was fought between followers and opponents of Pavlovism. It was won by the followers, due to the Communist party support. For many years to come Pavlovism was the official ideology of the Soviet psychiatry. It was promoted also in satellite countries, including Poland.

A presentation by the National Consultant for Psychiatry outlining organizational and legal issues dealt with by the national system of supervision in psychiatry. (Eds.)