Suicidal ideation, plans, and attempts and the use of psychoactive substances by adolescents

Introduction: Suicidal behavior and substance abuse constitute a serious public health problem. Aim: The study was to analyze the relationships between suicidal behaviors (ideation, plans, attempts) and substance abuse in adolescents. The authors also took into account the respondents’ motivation to attempt suicide and use psychoactive substances, as well as some demographic variables. Participants: The study involved 3493 secondary school students aged 16-17 years. The group included 69.41% girls and 30.59% boys. Methods: The participants were surveyed with a self-report questionnaire designed by one of the authors. Results: Statistically significant relationships were found between the respondents’ suicidal behaviors and the risky use of alcohol, cannabis, amphetamine, and designer drugs. Conclusions: 1. The use of psychoactive substances increases the risk of suicidal ideation and plans, as well as suicidal attempts in adolescents and young adults. 2. Significantly more respondents who report suicidal ideation, plans and attempts, in comparison to those who do not report such thoughts and behaviours, abuse alcohol and consumer cannabis, amphetamine and designer drugs to cope with problems and olster self-confidence. 3. In the group of respondents who report suicidal behaviour, psychoactive substances are consumed by significantly more men than women and by significantly more city inhabitants than people living in the country. 4. Young people, who report suicidal thoughts, plans, and attempts, are initiated into alcohol consumption at an earlier age than their non-suicidal peers.

Taking care of a real self - description of the psychotherapeutic process of a patient with narcissistic personality disorders in the field of dance/movement psychotherapy

Introduction: Dance/movement psychotherapy (DMT) is a psychotherapeutic trend that belongs to the approaches that involve working with the body. Thinking about a wider perspective, DMT belongs to the group of action-oriented psychotherapies. It assumes that the person, while moving, can show his/her emotional states. Additionally, it can lead to development and personal integration. The goal is to deepen awareness. Psychotherapy with dance and movement is practiced among psychotic patients, patients suffering from neurotic or personality disorders, and as a method of personal development. The aim of the work is to describe the psychotherapeutic process of an individual client in the field of dance/movement psychotherapy as a method in which dance leads to development and personal integration. Material and method: Working with a client, Beata, took place in a strictly defined setting. Meetings took place once a week in the same office during 55 minutes. They were of an individual nature. First, Beata was diagnosed according to the DSM-5 [1] and ICD-10 [2] classification, which was supplemented with the PDM-2 diagnosis [3]. During the therapeutic work, the phenomena of transference and countertransference were taken into account, the patient’s behavior was interpreted according to John Bowlby’s attachment theory and mentalization. During practicing DMT it is important to take care of Authentic Movement method, observation of movement using the Laban Bartenieff Movement System (LBMS) method and the Kastenberg Movement Profile (KMP). Results: The changes that DMT psychotherapy started to bring were observed both in the client’s movement and in the verbal layer. The client has acquired the ability to observe her feelings and needs. This influenced her perception of announcement heard from different people and the decisions she made. The DMT therapy with Beata is not over yet, which makes it possible to take a deeper look at topics related to therapeutic goals. Conclusions: Dance/movement psychotherapy has proved to be an effective method of working with patients with personality disorders psychopathology of the narcissistic type. This method makes it possible to build a sense of the patient’s boundaries and needs, and to strengthen self-esteem. Sessions seem to be very helpful in integrating inner life, feelings and experience. In addition, it helps in dealing with the internal tension of patients and gives the opportunity to expand ranges of movement. In the verbal part, it is possible to discuss the problems that the client carries within himself, which cause him fear, anxiety and other unpleasant emotions.

Brief psychotic disorder occurring after Covid-19 in a patient with no history of psychiatric diseases - a case report

Introduction: Although the typical symptoms of SARS-CoV-2 infection are respiratory symptoms, it has been shown that the virus can also attack the central nervous system (CNS) causing neurological and psychiatric symptoms. Aim: The aim of the study was to present a case of a 52-year-old woman, previously untreated for psychiatric diseases, who developed brief psychotic disorder occurring after Covid-19 infection. Case report: A patient in the biological treatment of asthma, came for a follow-up visit, during which the doctor diagnosed psychopathological symptoms in the form of delusions, never previously observed. The interview showed that the patient was discharged from the Isolation ward 10 days before, where she was hospitalized because of SARS-CoV-2 infection. Discussion: There are several theories regarding the mechanisms of pathogenesis of neuropsychiatric symptoms in the course of Covid-19 infection. Much space in the literature is devoted to pathological immune responses. One of the reasons for the development of delusions in the described patient could therefore be the acute phase of the inflammatory reaction in the course of SARS-CoV-2 infection.

The role of leptin in patients recovering from Anorexia Nervosa

Introduction: Anorexia nervosa (AN) is a mental disorder with the highest death rate. The characteristic feature of AN is endocrine dysregulations, including changes in adipose-tissue secreted hormones, especially adipokines. The most widely studied of them is leptin whose role in the pathophysiology and prognosis of AN is confirmed in more and more studies. The aim of the study was to summarize the role of endocrine disruptions with particular emphasis on leptin in the pathophysiology of AN. Material and methods: For the literature review, the electronic databases PubMed, Cochrane and Google Scholar search were used with the following keywords: eating disorders, adipokines, leptin, metreleptin, satiety, hunger, anorexia, obesity, for studies listed from database inception to October 2021. Results: Leptin, produced mainly by white adipose tissue, inhibits the hunger center in the hypothalamus by negative feedback with ghrelin secreted by the gastrointestinal tract. Leptin is involved in numerous biological functions, including body weight regulation, innate and adaptive immunity regulation, reproduction, and bone formation. Studies confirm decreased leptin levels in AN individuals. In recent years, extensive experience has been gained with leptin as a drug in clinical trials. The studies suggested that treatment can restore menstrual function and bone health and improve mood with unclear body weight effects. Conclusions: Focusing on leptin-related changes is a promising approach to improve AN management. Assessment of leptin levels in AN patients could be a useful tool for therapy monitoring. Treatment with leptin could reverse unfavourable changes induced by diet restriction, including mood symptoms, loss of bone mass and menstrual function. However, the results of these studies need confirmation on larger groups of patients.

Pandemic heroes or victims? Healthcare professionals’ well-being during Covid-19 pandemic

Introduction and aim: The SARS-CoV-2 pandemic had a significant impact on the mental condition of the society, increasing anxiety and fear for the future. High levels of anxiety, stress and depression have been observed in the general population. Nurses and doctors, who are in direct contact with patients and their body fluids, are at the highest risk of infection. The aim of this study was to look at the psychiatric health aspects of health care professionals in general during the pandemic. State of knowledge: Work overload and stress-related symptoms make healthcare workers particularly vulnerable to mental distress, increasing the risk of developing mental disorders. Among them, women, students and nurses were most affected. A German study found that nurses working with COVID-19 patients in particular are mentally affected by the consequences of the pandemic. This may be due to the higher workload and the longer time spent in direct contact with COVID-19 patients compared to doctors. The available literature confirmed the construct of coronaphobia in health care workers. The issue of insufficient personalization of protective equipment and the associated feelings of fear and stigma as well as the need for psychological help are addressed and psychiatric services for healthcare professionals. Material and methods: At the beginning of this year, 30 people from the clinical hospital in Lublin were surveyed using a questionnaire containing several questions concerning, among others, comfort of work in the current epidemiological situation, The Patient Health Questionnaire-9, The Generalized Anxiety Disorder-7 and Mini-COPE. Conclusions: The work shows the mental health problems faced by health service representatives on a daily basis in connection with the pandemic that has been going on for many months. The features of depression-anxiety disorders affect the medical staff. The attitude of solidarity and cooperation of all members of society during the pandemic is important.

Genetic determinants of autism spectrum disorders - a review

Introduction: It is estimated that various types of abnormalities from the autistic spectrum disorder occur in up to 2% of the population. These include difficulties in maintaining relationships, communication, and repetitive behaviours. Literature describes them quite well, in contrast to the causes of these disorders, which include both environmental factors and a very long list of genetic aberrations. Materials and methods: The papers available on the PubMed platform and other sources were reviewed to describe the most important genetic factors responsible for the development of autism spectrum disorders. Results: There are many genes and their mutations associated with the prevalence of autism spectrum disorders in patients. One of the main factors is the SHANK gene family, with the type and degree of abnormality in patients depending on the damage to particular genes: SHANK1-SHANK3. Research also shows the potential of targeted symptom-relieving therapies in patients with SHANK3 mutations. A correlation with the occurrence of autism has also been demonstrated for genes responsible for calcium signaling - especially the group of IP3R calcium channels. Their calcium transmission is abnormal in the majority of patients with autism spectrum disorders. A number of mutations in the 7q region were discovered - including the AUTS2, GNAI1, RELN, KMT2E, BRAF genes - the occurrence of which is associated with the presence of symptoms of autism. Autism spectrum disorders occur in about 10% of patients suffering from monogenic syndromes such as fragile X chromosome syndrome, Timothy syndrome, tuberous sclerosis, Rett syndrome or hamartomatic tumor syndrome. Conclusions: Research shows that many mutations can contribute to the development of autism spectrum disorders. Further studies are necessary to discover their therapeutic and diagnostic potential for autism.

New drugs in psychiatry-cariprazine, lurasidone, esketamine

Introduction: Invariably, the search for an “ideal drug” in psychiatry has been going for years, one that is safe and effective, prevents relapse and shows the least possible side effects. Material and methods: The aim of this study authors is to draw attention to new drugs used in psychiatry- cariprazine, lurazidone and esketamine, their mechanism of action, dosage, the most common side effects and metabolism. The article reviews the research and works on these drugs available in Google Scholar and PubMed databases and the characteristics of medical products on years 2010-2021. Results: Cariprazine is a drug registered in Poland for the treatment of schizophrenia in adults since July,13 2017. In the world, it is additionally used in the treatment of manic and mixed episodes in the course of bipolar disorder, depression in the course of bipolar disorder and unipolar depression. Lurasidone in Poland is indicated for the treatment of schizophrenia in adult patients and adolescents from 13 years of age. In the world it is also used to treat depression in bipolar disorder, in some cases off-label in the treatment of mania in bipolar disorder and irritability and anger in autism spectrum disorders. Esketamine in nasal spray in combination with an oral antidepressant has been approved in the US for the treatment of depression in adults for whom other antidepressants have not benefited, in Poland, it is also used in such an indication. Conclusions: The action profile of these drugs, the research to date and the results of treatment with these drugs are very promising. The drugs are safe and well tolerated. However, it is clinical practice that will verify the usefulness and effectiveness of treatment with them and show the effects of long-term therapies with their use.

Family factors and personality factors affecting daily SNS usage in individuals aged 14-19 years

Introduction: In recent years, social networking sites (SNS), such as Facebook, Twitter or Instagram have gained immense popularity and have become an essential part of many people’s everyday lives. In Poland, 19 million people, i.e. about a half of the whole population, are active SNS users. Aim: The aim of the present study was to analyze the relationship of family and personality factors with daily SNS usage time in adolescents aged 14 to 19 years. Participants: The study included 291 junior-high and high school students aged 14–19 years. In this sample, 246 individuals had an SNS profile. Methods: The following instruments were used: an Inquiry Form designed by the present authors, Gough and Heilbrun’s Adjective Check List, the Coping with Stress Questionnaire by Janke, Erdmann and Boucsein and the Buss and Durkee Hostility-Guilt Inventory. Results: Based on correlation coefficients, significant associations were found between increased daily SNS usage and negative relationships with parents, maladaptive coping, and increased aggression. Conclusions: 1. Participants who spent more time using SNS were more likely to feel lonely in their families and have a sense of not being accepted and understood by their parents. 2. Young people who spent more time using SNS were more likely to respond to a stressful situation with a sense of helplessness and resignation and to cope by downplaying their problems and seeking substitute gratification or support. 3. Young people who spent more time using SNS were more likely to respond with indirect aggression, negativism, suspicion, hostility and verbal aggression.

Susac syndrome with cognitive impairment - case report of 31-year-old woman

Introduction: Susac syndrome (SuS) is a rare immune-mediated disease caused by occlusions of microvessels in the brain, retina and inner ear. It is characterized by the clinical triad of encephalopathy, visual disturbances and hearing loss. The diagnosis of SuS is based mainly on the clinical symptoms and the supporting tests in which characteristic changes occur in the MRI. Case report: Here, we present a case of a patient with possible SuS with psychiatric symptoms. A 31-year-old woman was admitted to the Department of Psychiatry due to deteriorating mental health for several weeks manifested as a negative mood and suicidal thoughts. During hospitalization, a neurological consultation was conducted, in which the patient was identified as conscious, psychomotor sluggish, with impaired verbal contact and persistent hearing and vision impairment. Cross-sectional assessment of cognitive functions revealed that the patient had a generalized syndrome of neuropsychological deficits, which confirms the diagnosis of dementia. Discussion: This case summary provides an example of a woman diagnosed with SuS manifested as a cognitive impairment with associated vision and hearing deterioration. It is worth emphasizing the fact that such presentation of the triad of at disease onset is rare. The characteristics of the organic changes in the brain described in the MRI probably explain the symptoms described in that case. The prognosis of SuS depends on early diagnosis and treatment. Conclusions: A diagnosis of SuS should always be considered in the presence of nonspecific neuropsychiatric symptoms and progressive multifocal neurological symptoms, hearing loss, and visual impairment. An important fact is that the typical triad of SuS symptoms in most cases does not occur simultaneously, which makes the diagnostic process very difficult and may lead to misdiagnosis.

The relationships between obstructive sleep apnea and psychiatric disorders: a narrative review

Introduction: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Its prevalence tends to increase worldwide. Untreated sleep apnea is associated with a higher risk of metabolic diseases, cardiovascular diseases, stroke, road accidents, and death, but also it is suggested that it increases the risk of mental disorders. Method: The literature review was based on a search of articles on Medline, Pubmed, and Google Scholar from 2003 to 2021 using the keywords: obstructive sleep apnea; mental disorders; cognitive functions; affective disorders; depression; bipolar disorder; schizophrenia; psychotic disorders. The analysis included original studies, meta-analysis, and review articles. Discussion: The result obtained from researches published so far does not allow for drawing unequivocal conclusions. There is a lot of bias present in study protocols and inclusion/exclusion criteria. Nonetheless, it seems that some disorders have a better proven correlation with OSA. Cognitive impairment, depression, and anxiety disorders are linked to OSA not only in terms of the overlapping of symptoms but also of a causal relationship. Psychotic disorders and bipolar disorders connections with OSA are confirmed, but they are not yet well understood. All correlations are found to be possibly bidirectional. Conclusion: 1. Multiple lines of evidence increasingly point towards a bidirectional connection between OSA and mental disorders, and the cause and effect relationship between these two groups of disorders requires further research. 2. Due to reports of an increased risk of OSA with antipsychotic drugs, caution should be exercised when initiating therapy with this type of drug in patients with known risk factors for it. 3. Screening for OSA in psychiatric patients should be introduced as OSA can increase cognitive impairment, affective, and psychotic symptoms.