Archives 1992-2013

2013, volume 22, issue 4

Special article

Psychiatry of my dreams

Rainer Höflacher
Postępy Psychiatrii i Neurologii 2013; 22(4): 233-237

In his speech the author, using the dream convention, considers various critical approaches to contemporary psychiatric practice and related controversies, especially in the context of the expectations of those that should be served by it and, even if they are, it is not always to the best effect. He also indicates some solutions that might be treated as responses to these expectations, and discusses the idea of positive psychiatry. (Ed.).

Original article

Mothers 'personality and coping when caring for adult children with schizophrenia

Beata Joanna Kasperek-Zimowska, Stanisława Józefa Steuden, Katarzyna Charzyńska
Postępy Psychiatrii i Neurologii 2013; 22 (4): 239-242

Objectives. Assessment of the relationship between mothers 'personality traits (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness) and their ways of coping in the situation of caring for an adult child with schizophrenia.
Methods. 71 mothers who cared for an adult child with chronic schizophrenia were included in the study. The NEO-FFI Personality Inventory, developed by Costa and McCrae and the Ways of Coping with Child's Illness Questionnaire (WCCI) developed by B. Kasperek-Zimowska and S. Steuden were used for data collection.
Results. High correlation coefficients were found between the neuroticism scale and the surrender scale (r=0.52; p<0.001), between neuroticism scale and nursing grievance scale (r=0.40; p<0.001) and between neuroticism scale and focusing on feeling guilty scale (r=0.39; p<0.00).
Conclusions. Mothers with high level of neuroticism disengaged from active coping with the child's mental illness. Mothers with high agreeableness sought support in coping with the child 's illness but did not distance themselves from the illness, which could increase the risk of burnout.

Original article

Health locus of control, knowledge of illness and perception of recovery aiding factors among patients with bipolar affective disorder

Beata Anna Kulig
Postępy Psychiatrii i Neurologii 2013; 22 (4): 243-249

Objectives. The aim of this study was to explore relationships between health locus of control and patients ' knowledge about bipolar affective disorder (BAD) as well as their perception of factors aiding recovery.
Methods. The research involved 32 patients with bipolar disorder. The locus of health control was determined by use of the Multidimensional Health Locus of Control Scale (MHCL). The respondents ' knowledge was evaluated on the basis of the questions concerning basic information about the illness, and negative and positive factors influencing the patient's health. Additionally, the perception of the recovery supporting factors was estimated by the Factors Aiding Recovery Questionnaire.
Results. An external locus of control dominates in the group ofpatients examined, and is manifested through the patients' belief that their health depends on other people, mainly medical staff. The conviction that one's health depends on external factors is linked with a belief that the patient's own involvement in the process of recovery and search for emotional support from others is of no significance. At the same time, patients disregard the significance of the impact of their own actions and competences on the recovery process.
Conclusions. In a group ofpatients diagnosed with bipolar disorder, the positioning of the locus of control may be a modifying factor, influencing e a patient's engagement in the process of recovery. This finding can be used when planning therapeutic interventions.

Original article

Acceptance of illness, beliefs about pain control and coping strategies among patients scheduled for surgery for osteoarthritis of the spine

Paweł Zielazny, Przemysław Biedrowski, Małgorzata Lezner, Barbara Uzdrowska, Aneta Błaszczyk, Marzena Zarzeczna-Baran
Postępy Psychiatrii i Neurologii 2013; 22 (4): 251-258

Objective. Degenerative diseases of the spine are a serious medical, psychological and social problem. The main symptom of spinal degeneration is pain, which aflects the level of acceptance of the disease, the level ofpain control and strategies for coping with pain. The aim of this study was to assess the degree of acceptance of the disease, as well as of beliefs about pain control and coping strategies among patients scheduled for elective surgery because of degenerative diseases of the spine.
Method. The study was conducted on 60 patients of the Pomeranian Neurosurgery Trauma Center in Gdansk. The study used the following scales: Acceptance of Illness Scale (AIS), The Beliefs about Pain Control Questionnaire (BPCQ), The Pain Strategies Questionnaire (CSQ).
Results and conclusions. Most of the subjects presented an average acceptance of the disease. The largest group ofpatients believed that the pain they felt was mainly influenced by medical personnel. Among the respondents, the most common strategy for dealing with their pain was praying and hoping, and a declaration that they were coping. The study showed no significant relationship between the level of acceptance of the disease and the locus of control ofpain and strategies for coping with it. It also revealed very few links between strategies of coping with pain and demographic variables.

Review article

The effect of anti-epileptic drugs on homocysteine metabolism in patients with epilepsy and its clinical consequences

Anna Bochyńska, Ałła Graban
Postępy Psychiatrii i Neurologii 2013; 22(4): 259-268

Objective. To present the current state of knowledge on the effects of anti-epileptic drugs on the metabolism of homocysteine in patients with epilepsy, and discuss its clinical consequences.
Review: Homocysteine (Hcy), an amino acid produced in the exogenous pathway of metionine, is essential for the proper development of the nervous system. Hyperhomocysteinemia (hHcy) is a riskfactorfor cerebrovascular disease, dementia, inborn defects and impaired cognitive functions. Some antiepileptic drugs can change metabolism of homocysteine, leading to an alteration of the plasma Hcy levels. Vitamin B and folate supplementation is a strategy to reduce Hcy levels in patients with epilepsy, treated with antiepileptic drugs.
Conclusions. Better knowledge of the pathomechanisms of various clinical conditions should help neurologists prevent many dangerous complications more effectively. It should also improve patients' quality of life, their compliance and adherence.

Review article

Monomania - the clinical and socio-legal issues

Ryszard Kujawski
Postępy Psychiatrii i Neurologii 2013; 22(4): 269-277

Objective. The purpose of this article is to present the issues related to monomania in the clinical and socio-legal context, with a focus on Polish literature.
Views. Monomania was a diagnostic term, especially popular in France in the nineteenth century, which appeared in the first clinical classifications of mental illness. On the one hand, the concept of monomania, gave rise to the isolation of depression and mania in the modern sense, and on the other, it contributed to the development of knowledge about delusional, anxiety and personality disorders. Apart from its clinical significance, monomania occurred in a broader social and legal context, initiating a discussion on diminished responsibility. Monomania was also broadly discussed in the Polish psychiatric literature of the second half of the nineteenth century, which followed its development and defined its conceptual changes. In the first half of the twentieth century monomania appeared in Polish psychiatric literature mostly in the context of the discussion about diminished responsibility. Polish psychiatrists participated in the creation of legislation concerning diminished responsibility, which was adopted in Poland adopted in 1932.

Case report

Is trichotillomania a disorder of the obsessive-compulsive spectrum? A case report

Agata Nowacka, Antoni Florkowski, Marta Broniarczyk-Czarniak, Joanna Łacisz, Agata Orzechowska
Postępy Psychiatrii i Neurologii 2013; 22(4): 279-287

Objectives. According to current classifications trichotillomania (TTM) is a psychiatric disorder characterized by hair loss due to uncontrolled, impulsive hair pulling. The aim of this paper is to estimate the validity of reassigning trichotillomania to a group of obsessive-compulsive disorders.
Case report. The case report presents a patient suffering from trichotillomania with concomitant trichophagia. She underwent, in a clinical setting, a course of treatment with lithium and a TCA as well as clomipramine, which produced partial improvement.
Commentary. It is not only symptomatology and clinical course but also neurobiological and genetic background that mark the distinction between trichotillomania and obsessive-compulsive disorders, which in the clinical setting implies distinct therapies and different rate of treatment responders.

Case report

Rehabilitation of the patient with subacute combined degeneration of the spinal cord in the course of vitamin B12 deficiency

Marek Tradecki, Andrzej Pozowski, Mateusz Kowal, Jadwiga Kuciel-Lewandowska
Postępy Psychiatrii i Neurologii 2013; 22(4): 289-293

Objective. We present a case of a man diagnosed with the spinal cord degeneration (SCD) in the course of vitamin B12 deficiency, along with the rehabilitation used in his therapy.
Case. The first symptoms occurred in December 2011. The reason for the patient's functional dysfunction was recognised in January 2012, and the patient was subsequently admitted to the rehabilitation unit in June 2012. After the rehabilitation, his stability of posture and gait efficiency were improved.
Commentary. This case shows that it may be essential for the SCD patients to undergo rehabilitation to speed their recovery. Rehabilitation should be considered as an integral part of the treatment ofpeople suffering from SCD.