Archives 1992-2013

2013, volume 22, issue 2

Original article

Implementation of the no-smoking law in psychiatric hospitals in Poland after 18 months: preliminary pilot monitoring results

Tomasz Szafrański, Marek Jarema
Postępy Psychiatrii i Neurologii 2013; 22(2): 93-101

Aim. In 2010 a no-smoking law removing an exemption for mental health institutions was introduced in Poland. This report summarizes the initial monitoring results, and offers preliminary observations about the first 18 months of the law’s implementation.
Methods. A questionnaire was circulated to psychiatric hospitals and psychiatric wards to gather information about the level of implementation of the no-smoking law. Also, we asked for information about the accessibility and sources of financing for smoking cessation therapy and pharmacotherapy.
Results. The results are based on the questionnaires send back from 33 wards and hospitals from 8 provinces (voivodeships) in Poland. A total smoking ban was introduced in 10% of the institutions, mainly addiction and child psychiatry units. Eighty five per cent of the institutions had not introduced any therapeutic smoking cessation programs. Also, no pharmacological smoking cessation drugs were accessible in ninety four per cent of the institutions monitored. In 2011 hospitals and psychiatric wards received no additional financing for the implementation of the no-smoking law. A majority of psychiatrists considers that implementation of the no-smoking law in psychiatric institutions is impossible.
Conclusions. Since 2010, when the no-smoking law removing an exemption for mental health institutions was introduced, there has been no significant progress in the implementation of the policy or towards making the indoor premises of mental health institutions smoke-free.

Original article

Worry proneness, worry beliefs and personality – analysis of mutual relations and sex differences

Andrzej Solarz, Konrad Janowski
Postępy Psychiatrii i Neurologii 2013; 22(2): 103-112

Aim. The aim ofthe study was to investigate relations betweenpersonality, worry beliefs and worryproneness, taking sex differences into account. 115 university students (53 women and 62 men) were questioned.
Methods. Penn State Worry Questionnaire, Worry Beliefs Questionnaire and Revised NEO Personality Inventory.
Results. Significant positive correlations between worry proneness and neuroticism and its components were revealed, both in men and in women. Worry proneness was also positively correlated with self-discipline in groups of men and women. Worry proneness was negatively correlated with extraversion, sociability, assertiveness, values and competence in men, but not in women. Worry proneness was negatively correlated with compliance in women, but not in men. Worry proneness was also related to worry beliefs, but correlations were significant only among men. Subjects with different levels of worry proneness differed in intensity of personality traits.
Conclusions. The results of this study reveal several practical applications, especially for the psychotherapy of problematic worry. Psychotherapy focused on the modification of personality traits should be oriented towards different traits in men and in women. Psychotherapy focused on the modification of dysfunctional worry beliefs can be more effective in men than in women. The limitations of the study must be considered when interpreting the findings of this study. The study sample was not representative of the population, because it was selected from a specific group (university students). The results are, therefore, not generalizable to the broader population. The correlational character of the study obstructs any interpretation of causal relationships among personality traits, worry proneness and worry beliefs.

Original article

Factors involved in the inappropriate body mass of patients admitted to psychiatric ward

Urszula Zaniewska-Chłopik, Artur Sofuł, Bertrand Janota, Maria Załuska
Postępy Psychiatrii i Neurologii 2013; 22(2): 113-120

Aim. Assessment ofprevalence andfactors connected with abnormal body weight inpatients with non-organic mental illness admitted to a psychiatric ward.
Methods. A group of 210 schizophrenic, affective and adjustment disorder patients underwent a study procedure aimed at assessing the prevalence of those who are underweight, overweight and obese. The relation between BMI and some demographic factors, as factors connected with the illness, was analyzed.
Results. Out of all the patients that were tested, 8.1% were underweight while 47.6% were overweight. There was no relation observed between BMI and clinical diagnosis, as well as sex, educational level and employment. A positive correlation was observed between BMI and age, the presence of a life partner, antipsychotic medication, duration of the illness and the number of previous hospitalizations; however the negative correlation occurred between BMI and abusing the alcohol or other psychoactive substances. In the analysis of regression different predictors of high BMI in different diagnostic groups were found. In the case ofpatients with adjustment disorders it was low educational level, and having life partner; in schizophrenia the age of the patients and taking antipsychotics whereas no predictors as such were identified in patients with affective disorders.
Conclusions. Being overweight and underweight seem to be important features to take into account in the patients admitted to psychiatric wards. In schizophrenia the positive correlation between BMI and medication with antipsychotics underlines the need for monitoring metabolic parameters, and introducing appropriate education to the patients and their families. Among the patients with adjustment disorder the risk factors seem to be connected with the culture and customs. There exists a need for investigation of the risk factors for overweight patients in largerofpatients with affective disorders.

Original article

Cognitive functioning in the hypomania/mania period of bipolar disorder

Julita Świtalska
Postępy Psychiatrii i Neurologii 2013; 22(2): 121-128

Aim. The aim ofthe study was to compare the neuropsychological functioning ofhypomania/mania bipolarpatients and healthy control groups.
Method. Cognitive functions were examined in 30 hypomanic or manic bipolar patients aged 23-68 (M = 48, 18 women and 12 men) who fulfilled the ICD-10 criteria for hypomanic or manic episode (YoungMania Rating Scale score > 11). The comparison group consisted of 30 healthy subjects aged 23-71 (M = 46, 20 women and 10 men), matched in age, years of education and gender to the bipolar group. A neuropsychological battery assessed executive functions and working memory.
Results. The bipolar patients in a hypomanic or manic episode revealed severe neuropsychological deficits in working memory and executive functions in comparison to the healthy control group.
Conclusions. Neuropsychological dysfunctions were observed during manic or hypomanic states. They should be considered in diagnosis and neuropsychological treatment.

Review article

Type A behaviour as a predictor of ischemic heart disease – is it still a current problem?

Dawid Miśkowiec, Paulina Kwarta, Andrzej Witusik, Tadeusz Pietras
Postępy Psychiatrii i Neurologii 2013; 22(2): 129-136

Aim. The purpose of the study was a systematic review of the literature in order to present the current view on the impact of type A behavior pattern (type A personality, TAP) on the development of ischaemic heart disease (IHD).
Review. Cardiovascular disease and above all the IHD have become a plague of our age. They have been for a long time the major cause of death and permanent disability in the world. The etiopathogenesis of IHD is extremely complex. There are many generally accepted somatic risk factors for IHD, such as hypertension, hyperlipidemia, obesity or diabetes. However, the role of some behavioural risk factors for IHD, such as the presence of some personality features, is still being discussed.
Conclusions. An overview of the literature indicates that the concept of the TAP concept has lost its actuality. Current views on the relationship between personality traits and risk of IHD focus on the new concept of personality type D.

Review article

Heredity of mental disorders – a review of the Polish psychiatric literature in the Interwar Period

Ryszard Kujawski
Postępy Psychiatrii i Neurologii 2013; 22(2): 137-147

Aim. The aim of the article was to present research publications and views on the heredity of mental disorders in the first half of the twentieth century, mainly in the interwar period in Poland.
Review. The article cites various items of Polish, mainly psychiatric, literature of the first half of the twentieth century, indicates the methods which were used in the study of heredity (family studies, statistical studies), describes various aspects of the debate on heredity of mental disorders (phenotype, genotype, monogenic, polygenic inheritance, mutations, Mendelian inheritance and includes the classification of hereditary diseases of the nervous system).
Conclusions. Initially, consideration of the heredity of mental illness was associated with degeneration theory, popular in the nineteenth century. At the beginning of the twentieth century the study of heredity in psychiatry was associated with eugenics and social hygiene. In the 1930s a theoretical basis for the discussion of sterilization emerged. Psychiatrists postulated the creation of the Polish institute for the study of heredity. Juliusz Morawski (1878-1928), Stefan Borowiecki (1881-1937) and Karol Mikulski (1901-1940) were the most prominent Polish psychiatrists involved with the heredity of mental disorders.

Case report

Neurofibromatosis type 2: case report

Tadeusz Mendel, Teresa Wierzba-Bobrowicz, Henryk Skarżyński, Tomasz Stępień, Anna Członkowska
Postępy Psychiatrii i Neurologii 2013; 22(2): 149-155

Aim. Case report of a patient with neurofibromatosis type 2, the first person in the world to receive a bilateral resection of the schwannoma with sequentional implantation of auditory brainstem implants (ABI) that stimulate the auditory nuclei of the brainstem.
Case. The case report of the 30-year old patient is presented. At the age 26 he had a bilateral resection of schwannoma with sequential implantantion of auditory brainstem implants. Patient had done also subtotal resection of schwannoma localized in vertebral canal, sacrum and retroperitoneum. The lower extremities paresis disappeared.
Comment. Patients with neurofibromatosis type 2 should be treated by a team of different specialists.

Case report

Blepharoptosis in neurological praxis: case report

Marcin Rogoziewicz, Małgorzata Wiszniewska
Postępy Psychiatrii i Neurologii 2013; 22(2): 157-161

Aim. The authors present the pathophysiology, incidence, causes, types and treatment of ptosis and look at the diagnostic possibilities which may be useful in determining the causes of the symptom.
Case. A 76 year old patient with bilateral ptosis who, after diagnostic tests were carried out, was diagnosed with isolated idiopathic ptosis.
Conclusions. The authors want to emphasize the fact that a detailed physical examination, carefully taken medical history and analysis of patients' photographs can be useful in determining the cause of ptosis. The presented characteristic of ptosis may help neurologists with the diagnosis of similar cases of this condition.