Archives 1992-2013

1993, volume 2, issue 4

Review article

Principles of maintenance treatment in schizophrenia

Postępy Psychiatrii i Neurologii, 1993, 2, 341-350

The author presents an overview of the literature on maintenance treatment of schizophrenia. The role of various factors determining the treatment mode, especially of new therapeutic strategies (intermittent treatment, reduced doses) for the treatment efficacy is analyzed. Data allowing to establishing the optimal maintenance dosage are analyzed as well. (Eds.)

Review article

Role of the family therapy in treatment of schizophrenia

Irena Namysłowska, Anna Siewierska
Postępy Psychiatrii i Neurologii, 1993, 2, 351-357

Contemporary views on family therapy application in the treatment of schizophrenia are outlined. Two main approaches: psychoeducational and systemic are described. Their goals and efficacy are analyzed in the light of the authors'' own clinical experiences. (Eds.)

Review article

Assessment of emotional blunting in schizophrenia

Marek Jarema
Postępy Psychiatrii i Neurologii, 1993, 2, 359-364

Emotional blunting is most often classified, after Bleuler, as a symptom of schizophrenia. However, according to some authors, it is not a typical sign of schizophrenia, since it may be present also in depression. Both the intensity and dynamics (changeability over time) of emotional blunting may be measured, mostly using diagnostic rating scales. It is difficult to decide whether symptoms underlying the diagnosis of emotional blunting are related to this dimension exclusively, since they may be manifestations of a phenomenon due either to emotional blunting, or to an impairment of schizophrenic patients' social functioning.

Review article

Evoked potentials in schizophrenia: An update

Waldemar Szelenberger
Postępy Psychiatrii i Neurologii, 1993, 2, 365-374

Evoked potential data in schizophrenia suggest the existence of functional disorders in different stages of information processing. Impairment in gating of P50 component and a diminished amplitude of Mismatch Negativity (MMN) suggest disordered processing at the level of primary auditory cortex. In several investigations diminished amplitude of P300 component was reported, which points to the moment of problem solving. There are also data on diminished amplitude of N400, which is connected with semantic processing.

Review article

Religion and the schizophrenic patient

Postępy Psychiatrii i Neurologii, 1993, 2, 375-379

On the grounds of the concept of self-identity disorders, considered by the authors to be crucial for the pathological process named schizophrenia, the phenomenon of over-religiosity in schizophrenic patients was described. An attempt was made to analyse the role of possible functions of over-religiousness in various stages of this psychosis development. The potential significance of the patients' religiousness for the process of his rehabilitation was emphasized.


Kurzes Psychoedukationsprogramme für schizophrene Patienten Short psychoeducational program for schizophrenic patients

Postępy Psychiatrii i Neurologii, 1993, 2, 381-388

The efficacy of behavioral programs for schizophrenic patients has been widely acknowledged. These programs optimization for the use in everyday clinical practice has, became the focus of interest now. The present article offers a manual for a standardized educational module covering topics on illness-concept, medication, and relapse prevention measures.


Training the chronically mentally ill to identify prodromal symptoms

Postępy Psychiatrii i Neurologii, 1993, 2, 389-399

Principles of a symptom management training program developed in the Oregon State Hospital (USA) are presented. The author points to four basic factors affecting the course of illness (prodromal symptoms, chronic symptoms, medication side-effects, normal variations in mood), and presents the topics covered by the program (prodromal symptoms identification, medication management skills, coping with chronic symptoms, education on the necessity of abstaining from alcohol and drugs). Particular stages of the training are briefly described, and a detailed description is given of the training in prodromal symptoms identification. Finally, the author comments on the training effectiveness. (Eds.)


Social skills training - the authors' clinical experiences

Joanna Meder, Maryla Sawicka, OLSZYNA WACHOWIAK
Postępy Psychiatrii i Neurologii, 1993, 2, 401-405

The social skills training module has been applied in the Rehabilitation Day Center for some years now. The authors share their clinical experience with users of this method, giving them same helpful suggestions. The social skills training follows a strictly defined, repeatable schedule. It is a directive method, easily implemented due to abundant and very detailed guidelines.


Basic conversation skills and coping in difficult situations skills training - an outline

Postępy Psychiatrii i Neurologii, 1993, 2, 401-405

A part of a whole therapeutic interventions system developed by the Psychiatric Rehabilitation Department is presented in the paper. Namely, an abbreviated version of therapist training is outlined, with an emphasis upon the specific mode of communication between the trainer and his patients.


Difficult situations as perceived by schizophrenic patients treated in psychiatric day hospitals in Warsaw

Joanna Meder, MILENA MORAWIEC, Maryla Sawicka
Postępy Psychiatrii i Neurologii, 1993, 2, 415-421

Eighty six schizophrenic patients currently treated in day hospitals in Warsaw were subjects in the study aimed to develop a list of situations most difficult for those suffering from schizophrenia. The results provide an answer to two questions: firstly, what interpersonal problems are regarded as most frequent and most difficult, and secondly – how patients cope with defining difficult situations.


Evaluation of conversation and interpersonal problem solving skills training efficacy in schizophrenic patients

Postępy Psychiatrii i Neurologii, 1993, 2, 423-430

Marked deficiencies of social functioning observed in the majority of schizophrenic patients contribute, in addition to the illness itself, to this patient's isolation. The deficiencies in question most often pertain to simple daily living activities. These assumptions played an important role in the development of a social skills training program aimed at providing the patient with appropriate coping skills necessary in difficult daily living situations. Trainings of this type have been conducted at our day center for jour years now. Preliminary results of the training efficacy evaluation using questionnaire method are presented in the paper. In a group of 40 schizophrenic patients a definite increment in the social skills level was noted. However, no direct relationship between the training and the patient's mental status improvement was found.


Language disorders in paranoid schizophrenia

Andrzej Czernikiewicz
Postępy Psychiatrii i Neurologii, 1993, 2, 431-439

In order to verify the hypothesis that persons suffering from paranoid schizophrenia often manifest language disorders, 60 schizophrenic patients (30 with sub-chronic and 30 with chronic schizophrenia) were examined. Linguistic analysis of their utterances was conducted using the TLC scale by Andreasen. A high level of linguistic pathology was found in patients in an acute psychotic state, while at the beginning of remission their language disorders were moderate. In the group of chronic patients the frequency of "positive" language disorders and "free associations", was higher, but no relationship was found between the "negative" linguistic pathology level and paranoid schizophrenia chronicity.


An attempt at paranoid syndrome components dynamic assessment using Jaroszyński scale in the course often consecutive schizophrenic episodes

Janusz Perzyński
Postępy Psychiatrii i Neurologii, 1993, 2, 439-442

An attempt was made to evaluate the dynamics of the paranoid syndrome components, as defined by the Jaroszyński scale. Subjects were 18 schizophrenic patients in the course of their ten consecutive hospitalizations. Changes in particular symptom s dynamics were noted, not found in earlier studies concerned with global assessment of the paranoid syndrome.


The effect of family-therapist co-operation on the course of ilness and social functioning of patients with chronic schizophrenic disorders

Postępy Psychiatrii i Neurologii, 1993, 2, 443-453

In the paper four groups of patients with chronic schizophrenic syndromes were compared in terms of the course of illness and the patients functioning in the daily life. The groups were distinguished with respect to duration and regularity of the patient's family co-operation with therapist. The therapeutic work with the families turned out to be related to the following variables studied: duration of the patient's stay in the Day Hospital (longer), dynamics of productive symptoms, patient's criticism toward his illness (increased), number of readmissions after the hospitalization episode under study (lower). As regards patients' social functioning family cooperativeness was found to be associated with the patient's increased self-dependence, as well as with his more frequent and closer interpersonal contacts.


Psychopathological symptoms and premorbid psychosocial adjustment in paranoid schizophrenia

Postępy Psychiatrii i Neurologii, 1993, 2, 455-460

The aim of the study was to seek relationship between current symptoms of patients with paranoid schizophrenia and their psychosocial adjustment prior to the first episode of the psychosis. 72 patients were examined using the Premorbid Adjustment Scale and the Brief Psychiatric Rating Scale (BPRS). Adjustment disorder, especially in adolescence, was found to be associated most of ten with such symptoms as blunting of affect, emotional tension, and hostility. The findings seem to confirm the hypothesis that a predisposition to this disease is developmentally determined.


Neuropsychological assessment and eye movement study in schizophrenia and endogenous depression

Alina Borkowska, MARCIN ZIÓŁKOWSKI, Janusz Rybakowski
Postępy Psychiatrii i Neurologii, 1993, 2, 461-468

Structural changes, regional cerebral blood flow disturbances, and metabolic disorders in the frontal and temporal lobes of the brain as well as in basal nuclei have been reported in schizophrenic patients. Smooth pursuit eye movement disorders suggest dysfunctions of subcortical structures. Moreover, an increased activation of the left cerebral hemisphere is found in schizophrenia, while an enhanced activation of the right cerebral hemisphere is reported in depression. The paper presents, firstly, results of neuropsychological tests assessing, among other things, the frontal lobe junctions, and secondly – neuropsychological examinations results allowing to evaluate activation level of the cerebral hemispheres. Two groups were compared in the study: schizophrenic patients (N=20) and those with endogenous depression (N=27). The examination was conducted in the state of symptoms exacerbation, prior to starting medication. The neuropsychological examination indicated a more pronounced frontal lobe dysfunctions in schizophrenic patients as compared to depressive subjects. Neuropsychological tests indicated an increased activation of the left cerebral hemisphere in schizophrenic patients, and of the right cerebral hemisphere in patients with depression.


Hospitalizations for hebephrenic schizophrenia in Poland in 1983-1992

Krystyna Nurowska, JOANNA DIDUCH, Jacek Wciórka
Postępy Psychiatrii i Neurologii, 1993,2,469-474

On the grounds of mental hospitals routine statistical records the frequency of diagnosing hebephrenic schizophrenia in patients hospitalized for the first time over the last decade was analysed. The diagnosis, indicating marked regional differentiation, was made in 0.4% of cases. No gender differences were found in the registered incidence of this psychosis. In 73% of cases the onset was before the age of 30%.


Hospitalizations for catatonic schizophrenia in Poland in 1983-1992

Krystyna Nurowska, JOANNA DIDUCH, Jacek Wciórka
Postępy Psychiatrii i Neurologii, 1993, 2, 475-480

On the grounds of mental hospitals routine statistical records the frequency of diagnosing catatonic schizophrenia among first admissions hospitalized over the last decade was anlyzed. The diagnosis, showing a marked regional differentiation, was made in 2.8% of cases. Catatonic schizophrenia was recognized more frequently in female patients in the 20-29 age group.


Hospitalizations for paranoid schizophrenia in Poland in 1990-1992: selected epidemiological and sociodemographic variables

Krystyna Nurowska, JOANNA DIDUCH, Jacek Wciórka
Postępy Psychiatrii i Neurologii, 1993, 2, 481-487

Paranoid schizophrenia incidence was analysed on the grounds of data from routine statistical records of mental hospitals in Poland. This diagnosis was made in 72% of first admissions for schizophrenia. Regional differences were found in this diagnosis frequency. Registered incidence of paranoid schizophrenia turned out to be higher in female patients. Early onset was more frequent in men, while late onset – in women. Indirect indices suggest that premorbid adjustment level of these patients was lower than that in the general population.

Streszczenie rozprawy doktorskiej

Psychometric verification of the so-called

Postępy Psychiatrii i Neurologii, 1993, 2, 489-498

In order to determine the so-called "schizophrenic defect" in terms of the concept distinguishing positive and negative schizophrenic symptom s, 53 patients diagnosed by the DSM-III -R criteria were examined using clinical scales (BPRS, the Hamilton Depression Scale, scales of negative [SANS] and positive [SAPS] symptoms by Andreasen, as well as data from the clinical examination, EEG records, and the dexamethasone inhibition test results. Research findings allow to associate, the "defect" with the negative dimension of the disease, and suggest some relationship between negative symptoms and some of the clinical variables under study. (Eds.)