The paper presents the clinical patterncharacteristics of early stages of dementia ofthe frontal-temporal type and Alzheimer's disease.Characteristics differentiating the two types ofprimarydegenerative dementia are analyzed on thegrounds of neuroimaging examination results, epidemiologicalfactors, clinical picture, and a specificpattern of cognitive impairments.
Genetic factors are of importance for the incidence of Alzheimer's disease. Mutationshave been discovered of three genes: precursor amyloid protein, preseniline1 and preseniline 2.They may be the cause of Alzheimer's disease withthe onset under the age of 60. In the type of thedisease with alater onset (found in a vast majorityof cases), the genetic facilitating factor consists inthe presence of a polymorphic variant ofε4 apolipoproteinE. The focus of current research is onthe search for other genes increasing susceptibilityto the disease. This may not only contribute toa much better understanding of the diseasepathogenesis, but also allow implementing preventiveand therapeutic measures.
A practical, clinical aspect of amnesicsyndromes following focal brain damage ispresented. Controversial issues concerning definitionsand subtypes of these syndromes are discussedand main reasons for such discrepancies arepointed out. Some comments on neuropsychologicaldiagnostics of patients with selective memorydisorders are proposed.
Alzheimer's disease is one of majorcauses of dementia syndromes. Many studies haveevidenced that in this disease the process of lipidsperoxidation in the central nervous system is enhanced.Reactive forms of oxygen produced in thepresence of amyloid protein induce the process of lipid peroxidation impairing nerve cells junction.The brain contains a large amount of polyunsaturated fatty acids, particularly susceptible to damageby free radicals with subsequent peroxidationof lipids. Alphatocopherol is a widely known antioxidantslowing down the process offatty acidsoxidation. The substance was found to restrainneurotoxicity of amyloid deposits and the c.n.s.damage caused by reactive forms of oxygen. Clinicalresearch has confirmed the protective role of tocopherol. The latter drug turned out to slowdown the progress of moderately advanced Alzheimer's disease.
The state-of-the art knowledge aboutprevalence, pathogenesis and treatment of depressivesyndromes associated with sclerosis multiplex,Parkinson's disease and Huntington's chorea is outlinedin the paper. In the authors' opinion this typeof research provides an exceptional opportunity tostudy the relationship between structural changes inthe central nervous system and changes in psychologicaljunctions, thus contributing to the development of an interdisciplinary science termed "neuropsychiatry" by some.
The aim of the study was a multidimensionalanalysis of suicidal behavior in adolescentsand young adults as well as assessment of the risk oftheir attempted suicide (AS) resumption in relationto their psychiatric diagnosis and social functioninglevel. Subjects in the study were 84 patients (aged14-21) admitted after their AS to the Department ofAcute Poisoning, Institute of Occupational Medicinein Łódź, who had never received any psychiatric treatment before. 70% of the sample under studywere girls. The following phenomena were found tobe associated with increased risk of suicidal attemptin young people: parental alcohol dependence, disturbedfamily relations, conflicts with significantothers, and rejection. In almost all cases (with oneexception only) various mental disorders were presentduring their AS: the most frequent were mooddisorders (in 2/3 of the patients), affective and behaviordisorders (in 1/5) and psychotic disorders (inevery tenth case). Moreover, it was found that thelower was the level of general functioning on youngpeople after AS, the higher was the risk of theirre-attempting suicide.
The aim of the analysis was to comparetwo samples of young people after attemptedsuicide (AS) in terms of selected socio-demographic factors and psychological traits.None of the subjects had received any psychiatric treatment prior to their admission to the Departmentof Acute Poisoning, Institute of OccupationalMedicine in Łódź. The two samples consisted ofyoung patients admitted after AS during two consecutiveyears: the first cohort (N=93) in theyears 1989-1990, and the second one (N=84)from January to December 1998. Assessment ofthe two equivalent AS samples at eight years' intervalindicated that despite some differences in thesocio-demographic structure of the two groups(concerning age, place of residence, type ofschool), young people's suicidal behavior was relatedto the same psychological and social factors,mostly to family pathology in a broad sense of theterm and to problems at school.
The Continuous Attention Test(CAT) was administered to 17 adult children (aged17 to 50) of schizophrenic parents, and 17 adultchildren of healthy parents. The latter were selectedusing the matched-pairs procedure so as to be equivalentto the former in terms of age and education.Subjects from the risk group had a lower performancelevel on the CAT as compared to the controls.These preliminary findings suggest that continuousattention deficits in children of schizophrenic parentsmay turn out to be an indicator of geneticsusceptibility to schizophrenia.
Two groups of students with eithera low or high level ofmanifested alexithymia traitswere compared for two parameters of psychologicalfunctioning.The Toronto Alexithymia Scale byTaylor was administered to the total of 178 students. 15.6% of the subjects were assessed asalexithymic. As compared to persons withoutalexithymic traits, they revealed poorer coping indifficult situations (as measured using the Rosenbaumself-control scale) and an external locus ofcontrol (as assessed by Drwal's DELTA questionnaire).According to the author this may suggestthat alexithymic personality traits may impairmechanisms of coping with unfavorable situationsand decrease the individual's self-confidence. Thefinding highlights the role of proper emotional developmentin the formation of optimal behavioralpatterns. (Ed.)
Following a review of the literature,a case of an elderly woman with symptoms of depressivepseudo-dementia is presented
A case is presented of a female patient in whom an intra vitamhistopathological examination revealed fibromuscular dysplasia (FMD). Clinically she manifested arterial insufficiency episodes, as well as anxiety and depressive states. The patient's mental status was improved after treatment with mianserine and prazepam. This is the first FMD case described in psychiatric literature.