In a case study of a female patient with paranoid syndrome the complaint phenomenon defined as everything that the patient in her individual way communicates about her experienced suffering was analyzed in terms of both the complaint content and function. Particular emphasis was laid on the phenomenon of role shifting – from the complaining party to the accuser. Considering the patient's global expression as a message serving to communicate with the environment, the author draws attention to the interactive nature of symptoms, and strives to determine the psychodynamic mechanism of their onset.
An attempt was made to describe and interpret a case of a 35-year-old male submitted to group psychotherapy of psychodynamic orientation. Hypotheses deal with the patient's change of sex, as well as with the time and way of disclosing this fact in the course of treatment. Hypotheses posed are verified by the reported data.
The importance of the family system for the course of treatment is analyzed in the case of a 14-year-old female patient hospitalized in the Psychiatric Department for Children and Adolescents.
The paper presents the process of therapeutic work with a family seeking treatment for their child's primary nocturnal enuresis. The therapy included analysis of the parents' genograms, and the nocturia treatment technique developed by Andrzej Samson.
The course of treatment of a schizophrenic patient during 15 years is presented. The patient's important life events are outlined, as well as mutual relations between members of his family system, type of his symptoms, and therapeutic interventions administered. An attempt was made to distinguish successive stages of the therapy process against the background of the dynamics of the family situation development.
Stages of individual supportive therapy of a schizophrenic patient in a day clinic are described, with the emphasis on the dynamics of the therapeutic relationship.
A case is described of a 20-year-old male with a severe obsessive-compulsive syndrome. Due to considerable diagnostic problems his treatment was started late. Extremely marked bradykinesia and a complete ritualization of obsessive behaviors sequences of many days' duration were particularly salient in this patient. In his magic activities he was accompanied by his parents, especially mother. Multifaceted therapeutic interventions were undertaken by the author, following his consideration of etiopathogenetic hypotheses.
The paper presents the course of depressive syndrome treatment with amitryptiline in a patient in whom the genetically determined slow type of the drug hydroxylation was found.
Two cases of initially misdiagnosed Huntington's chorea are presented, with the focus on the symptoms due to which the correct diagnosis was delayed.
Psychopathological picture and the course of treatment of bipolar affective disorder in a patient suffering from scleroderma are presented.
Two cases of concurrent schizophrenia and rheumatoid arthritis are described. Moreover, results of histocompatibility locus antigens examination in these patients are presented.
A case of a female patient aged 62, suffering from recurrent depression in the past 12 years is presented. The first two episodes resembling the picture of neurosis were followed by the next two in the form of major depression. Further three relapses had an atypical clinical pattern, with predominating delusions of pregnancy, disappearing after antidepressant treatment. The last of the observed episodes of the patient's illness was again a fully developed depressive syndrome, without pregnancy delusions.
Two cases of female patients suffering from bipolar affective disorder are presented. In each of the cases depressive episodes meeting the criteria of "major depression", as well as short-term manic states were observed. A single episode of atypical depression manifesting in kleptomaniac behaviors subsided following administration of antidepressants.
Clinical picture, diagnostic problems and the course of treatment in two cases of the Marfan syndrome with concurrent psychotic symptoms are discussed.
Due to the diversity of clinical manifestations of the Addison-Biermer disease not only hematological, neurological and gastro-intestinal symptoms, but also mental disorders, including even psychotic syndromes, may be present. Each of these syndromes may occur separately or concurrently with the other ones.
The paper presents a case of 19-year-old woman twice hospitalized in a gynecology department for secondary amenorrhea. Psychological analysis has revealed psychogenic factors of her eating disorder in the context of the hypophyseal-ovarian axis dysfunction involving hypogonadotrophic hypogonadism. Both the course and effects of a biological (hormonal) treatment, as well as an attempt at psychotherapy with psychological assessment are discussed.
In the presented case of a female patient initially diagnosed as suffering from anorexia nervosa the gluteno-dependent coeliac disease (diarrhoea chylosa) was eventually recognized. Due to diagnostic and therapeutic difficulties the issue of differential diagnosis of cachexic states, and particularly, of malabsorption syndromes, was dealt with in more detail.
A case of a male patient repeatedly hospitalized for paranoid-catatonic type schizophrenia is presented. During many relapses of the schizophrenic disorder he manifested symptoms "imitating" psychotic (catatonic) symptoms. However, their occurrence was closely related to the current situation in the patient's environment, and they completely disappeared as soon as his situation changed. Diagnostic and therapeutic difficulties resulting from concurrence of conversion-type and dissociative symptoms resembling psychotic symptoms are discussed. The author deals also with the problems of the relationship between schizophrenic psychosis picture and inappropriate defence mechanisms of personality.
A case is presented of boy aged 11 years, referred to the Clinic because of obsessive-compulsive symptoms and chronic tics, in whom callosal dysgenesis was diagnosed. Mutual relationships between these disorder s are discussed.
Mental status and psychomotor development of battered children, who have experienced physical and psychological trauma before the age of three, are presented in the paper.
A case is presented of a patient born in a concentration camp, then transferred to an orphanage, an UNRRA center, and adopted after the war. Due to numerous chronic physical complaints and psychological dysfunctions he was many times submitted to in- and outpatient treatment, as well as to examinations conducted for the purposes of medical court opinion. In the procedure of court opinions preparation association was found between the patient's disorders and his concentration camp experiences, including his early childhood exposure to various detrimental factors inherent the concentration camp life.
The Clérambault syndrome of erotomaniac delusions in a patient with paranoid schizophrenia is discussed in terms of its clinical picture and psychiatric court opinion formulation.
The authors describe offence-relevant and irrelevant determinants of difficulties encountered in the course of issuing psychiatric court opinions in the case of two policemen, perpetrators of offences committed in the state of inebriation.
Two cases are presented of teenage perpetrators of homicide, exemplifying the more and more widespread phenomenon of committing such crimes without any important or comprehensible motives (of not psychopathological nature though). Sources of such motives (e.g. in order to gain unusual experience, or peer group acceptance) and their relation to perpetrators' personality are analyzed. Moreover, possible detrimental influences of some large-scale social and cultural phenomena on psychological development of children and adolescents are considered. Finally, the authors deal with the issue of difficulties in psychological assessment and formulation of psychiatric court opinions in such cases.
A case is presented of a 55-year-old man with a rich criminal record, accused of frauds, who had been earlier misdiagnosed as suffering from "genealogical paranoia" and recognized as non-accountable. The aetiology and principles of diagnosing fantastic pseudology (pathological lying) are discussed and differential diagnosis of the latter condition and paranoia are outlined.
A case is presented of 63-year-old male, who committed over 20 sexual offences in the years 1952-1996, and with short intervals has spent 39 years in penal institutions. Due to the punishable acts charged to him, he was many times submitted to psychiatric court examinations. The paper includes an analysis of the subject's childhood and adolescence environmental and upbringing conditions, a description of his functioning during imprisonment, results of psychiatric court examinations, and his accountability assessment.
The paper presents a case of difficulty in psychiatric court opinion formulation, due to a failure to take into account full medical records and expert opinions. This resulted in considerable discrepancies with previous diagnoses, thus leading to differences in the accountability assessment.