Archives 1992-2013

1997, volume 6, issue 4

Nerwice i zaburzenia osobowości koncepcje

Neuroses – ICD-10 and psychiatric practice

Postępy Psychiatrii i Neurologii, 1997, 6, 397-402

Controversial ICD-10 solutions concerning the position and concept of neurotic disorders are discussed. The paper provides also an introduction to issues dealt with in other articles on neurotic disorder s in this volume. (ed.)

Nerwice i zaburzenia osobowości koncepcje

Are there really no neurotic disorders?

Postępy Psychiatrii i Neurologii, 1997, 6, 411-416

The author argues with the view predominating in current classifications of mental disorders that the term "neurosis" is useless and there is no need to distinguish such a diagnostic category. His own conception of neurotic disorders is presented. (ed.)

Nerwice i zaburzenia osobowości koncepcje

The problem of neuroses in recent classifications of mental disorders and the psychoanalytic tradition in psychiatry

Jacek Bomba
Postępy Psychiatrii i Neurologii, 1997, 6, 417-422

The most recent classifications of mental disorder s (DSM-IV and ICD-10) reject the idea of neurosis as a separate type of mental disorder. In DSM-IV this results from a holistic approach to mental disorders, neither discerning their "somatic" and "psychical" components, nor grouping them around basic psychopathological phenomena (such as thinking, mood, anxiety). A compromise character of the ICD-10 is reflected in the lack of a clear standpoint as to the nature of mental disorder s and in adoption of "thematic affinity" as the classification criterion. Consequently, neurosis as a diagnostic category was eliminated from both these classification systems, while the term itself was kept in the ICD-10 for historical reasons only. Thus, despite retaining the term "neurosis", the ICD-10 diagnostic criteria for particular categories (even those formerly regarded as neurotic disorders) include no premises concerning their pathogenesis and mechanism of onset or persistence. This perhaps may facilitate both the allocation of disorders into particular categories and application of medical statistics, but is of little use for the planning of treatment and for scientific research into neurotic disorders. The solution in question is entirely foreign to the psychoanalytic tradition in psychiatry which emphasized the role of underlying mechanisms of neurosis, without resigning from the holistic approach to man and his dysfunctions.

Nerwice i zaburzenia osobowości koncepcje

Personality disorders in the light of the ICD-10

Postępy Psychiatrii i Neurologii, 1997, 6, 435-441

Attempts to classify personality disorders have a long tradition. A number of tools, including inventories, self-rating scales, questionnaires, have been used to diagnose personality. In the 1960s studies on psychiatric diagnostics reliability and validity were launched, resulting in two currently co-existing broad classification systems, DSM-IV and ICD-10. Their shared characteristic is the striving to produce purely descriptive definitions of typical clinical syndromes that would be free from any theoretical assumptions. As regards ICD-10, among personality disorders, behavior disorders in adults were distinguished, while disorders of sexual preferences were separated from these of sexual identification. Moreover, some syndromes formerly considered as neurotic were included among personality disorders. The most controversial seems to be the introduction of the term "borderline personality" into the ICD-10.


Studies on psychotherapy effectiveness in the treatment of patients with neurotic or personality disorders in Poland in the years 1960-1995

Postępy Psychiatrii i Neurologii, 1997, 6, 443-450

The paper presents a meta-analysis of psychotherapy outcome studies published in Poland in the years 1960-1995. In 12 professional journals, one book and 6 unpublished doctoral theses 75 relevant studies were found. The analysis included: dynamics of such research projects, their methodological features (number of subjects, presence of a control group, improvement criteria), as well as the type of facility and of psychotherapy used. The number of outcome studies was found to be growing, and they were most often conducted in in-patient settings. A strong point of the research reports analyzed consists in adequately numerous samples studied. However, there have been strikingly few controlled studies.

Problemy orzecznicze

Motor vehicles driving by people with mental disorders

Postępy Psychiatrii i Neurologii, 1997, 6, 457-460

Mental disorders and psychotropic drugs may impair the ability to drive. In Poland there are no legal regulations concerning either the good practice of physicians treating such disorders, or problems associated with taking psychotropic drugs. The paper presents regulations currently in force in the United Kingdom that might serve as a frame of reference for the development of relevant rules in Poland.

Problemy orzecznicze

Psychiatric court opinions issued after psychiatric observation in Poland in the years 1995-1996: evaluation of formal correctness

Postępy Psychiatrii i Neurologii, 1997, 6, 461-469

Results are presented of an analysis of 300 psychiatric opinions issued by court experts in the years 1995-1996 in 19 psychiatric facilities in Poland. Formal inadequacies were found in all parts of the psychiatric court opinion in the majority of cases under study. Due to these inadequacies (such as e.g. failure to refer to the cited evidence in justification of assessments), the opinion may be regarded by the commissioning agency as incomplete or unclear.

Sprawy organizacyjne

Major problems of the Mental Health Act implementation

Stanisław Dąbrowski, WŁODZIMIERZ BRODNIAK, Stefan Welbel
Postępy Psychiatrii i Neurologii, 1997, 6, 483-488

Main findings are presented of a research into implementation of the Mental Health Act regulations. Using an ABC questionnaire a survey was carried out in the majority of inpatient psychiatric facilities in Poland, while a more detailed research was conducted in 11 selected facilities. The latter part of the study included an analysis of medical records, data obtained from directors of hospital departments, as well as patients' opinions. (ed.)

Sprawy organizacyjne

Selected issues of psychiatric health care

Postępy Psychiatrii i Neurologii, 1997, 6, 489-497

The paper presents the National Consultant's report on the current epidemiological situation in the country, as well as on major resolutions and plans concerning organization of psychiatric services.