Hanna Karakuła-Juchnowicz and Justyna Morylowska-Topolska
A defined and formed identity is the foundation of human mental functioning. The sense of one’s own existence as an individual, together with the conscious image of oneself, plays a fundamental role in regulating behaviors. The ability to see the limits of one’s own body is a significant milestone in human development, because it allows the development of a global sense of self, and that is the basis for the process of identifying one’s own identity.
The paper presents the contribution of Polish researchers (psychiatrists and psychologists) to understanding the phenomenon of the sense of self, identity, and their disorders with particular emphasis on schizophrenia.
Method: A review of the available literature by Polish authors on the subject was undertaken by searching the following data-bases: Polish Bibliography of Medicine, CEJS, NUKAT and National Library Database, using the keywords: identity, self, personality, schizophrenia, ego, within time frame: 1970–June 2017. The article includes only those works which made the original contribution of Polish authors to research on the issue of self and the sense of identity, with particular emphasis on their disorders in schizophrenia.
Results: The works of three Polish authors: J. Reykowski, J. Kozielecki and Z. Zaborowski deserve particular attention in the context of the definition of self and the sense of identity.
The works of A. Kępiński, in turn, have contributed to understanding the problem of disorders of self in schizophrenia. Kępiński’s psychopathological concept was based on the analysis and description of the pathology of self, the pathology of the boundary self–the world, disorders of time-space order and the hierarchy of values. In these terms, he considered the structure of the psychotic world, especially in schizophrenia and melancholy. In his opinion, schizophrenic psychosis manifests itself primarily in the form of the blurring of the boundary self–the world and the pathology of self.
The paper also presents the contribution of J. Zadęcki, M. Rzewuska, J. Wciórka, S. Steuden, M. Huflejt-Łukasik to understanding the disorders of the sense of self in schizophrenia.
Conclusions: The views of Polish authors presented in the paper are an interesting contribution to world literature on research into disorders of self in schizophrenia.
Josef Parnas, Paul Møller, Tilo Kircher, Jørgen Thalbitzer, Lennart Jansson, Peter Handest, Dan Zahavi, Hanna Karakuła-Juchnowicz, Justyna Morylowska-Topolska and Dariusz Juchnowicz
Skala EASE jest listą objawów do częściowo ustrukturalizowanego fenomenologicznego badania subiektywnych lub empirycznych nieprawidłowości (anomalii), które można uznać za zaburzenia podstawowej, „minimalnej” samoświadomości. EASE opracowana została na podstawie samoopisów otrzymanych od pacjentów chorujących na zaburzenia ze spektrum schizofrenii. Skala ma duże znaczenie dla opisu, diagnozy oraz diagnozy różnicowej zaburzeń ze spektrum schizofrenii. Prezentowana wersja zawiera istotne szczegółowe kwestie dotyczące zbierania wywiadu oraz opisy objawów psychopatologicznych (Podręcznik), arkusz wyników (Aneks A), listę pozostałych pozycji Skali stosowanych w czasie wywiadu (Aneks B) oraz porównawczą listę pozycji EASE/BSABS (Bonner Skala für die Beurteilung von Basissymptomen, Bońska Skala do Oceny Objawów Podstawowych) (Aneks C).
Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Basic self-disturbance refers to disruption of the sense of ownership of experience and agency of action and is associated with a variety of anomalous subjective experiences. Little is known about the neurocognitive correlates of basic self-disturbance. In this paper, we review recent phenomenological and neurocognitive research and point to a convergence of these approaches around the concept of self-disturbance. Specifically, we propose that subjective anomalies associated with basic self-disturbance may be associated with: 1. source monitoring deficits, which may contribute particularly to disturbances of “ownership” and “mineness” (the phenomenological notion of presence) and 2. aberrant salience, and associated disturbances of memory, prediction, and attention processes, which may contribute to hyper-reflexivity, disturbed “grip” or “hold” on the perceptual and conceptual field, and disturbances of intuitive social understanding (“common sense”). These two streams of research are reviewed in turn before considering ways forward in integrative models, particularly regarding the role of early neurodevelopmental disturbances, primary versus secondary disturbances, and the state versus trait nature of such pathology. Empirical studies are required in a variety of populations in order to test the proposed associations between phenomenological and neurocognitive aspects of self-disturbance in schizophrenia. An integration of findings across the phenomenological and neurocognitive domains would represent a significant advance in the understanding of schizophrenia and possibly enhance early identification and intervention strategies.
Maciej Zygo, Emilia Potembska, Karol Zygo, Andrzej Stanisławek, Łukasz Karaś and Beata Pawłowska
The aim of this paper was to determine differences and similarities between city dwelling teenagers aged 13–17 years who consumed/did not consume alcohol and their rural counterparts in regard to the severity of Internet addiction symptoms.
Participants and methods: The examined group consisted of 1,191 people (890 girls and 301 boys) aged 13–17 years. The following instruments were used in the study: a sociodemographic questionnaire designed by the present authors, the Internet Addiction Questionnaire designed by Potembska, and the Internet Addiction Questionnaire (KBUI) designed by Pawłowska and Potembska.
Results: The results show that adolescents who consume alcohol, both those living in urban and rural areas, are characterized by statistically significantly more severe Internet addiction symptoms measured by KBUI as compared to their non-drinking peers.
Adolescents who consume alcohol, both urban and rural residents, are characterised by statistically significantly more severe symptoms of Internet addiction compared to their peers who do not consume alcohol.
Adolescents who live in a city and who consume alcohol are significantly more likely to use Internet pornography than their non-drinking peers.
Adolescents who live in urban areas are significantly more likely to use Internet pornography, play violent computer games and search for acceptance and understanding only in online interactions as compared to adolescents who do not consume alcohol.
Underage city-dwellers who consume alcohol are significantly more likely to use electronic mail, instant messaging and web pages compared to their rural peers.
Introduction: In the 21st century there is an increased prevalence of depression in the world. So far the mechanism of developing depression has not been exactly known. Risk factors of depression occurrence are complex and nowadays it has been emphasized that air pollution can affect the intensity of depressive symptoms.
Objective: The analysis of the scientific works investigating the correlations between air pollution and depression.
Material and method: The material consisted of the studies published between 2007 and 2017. A systematic review of Medline database (using PubMed search engine) was conducted by typing the English phrase (air pollution) and (depression), and 154 results were obtained. Those results which concerned nicotine addiction or dementia diseases were rejected. The inclusion criterion was the number of people tested, n>500 in case of adults, and n>200 in case of children (a small number of publications). All in all, 9 research in the population of adults and 1 research in the group of children were included to the final analysis. In the discussion part of this work some research carried out on animals and related to the subject matter of own analyses were also investigated.
Results: As many as 8 out of 10 analyzed research demonstrated statistically significant correlation between long-term exposure to air pollution (mainly to fine particulate matter, PM) and depression. This correlation mainly concerned intensification of depressive symptoms during long exposure to air pollution. The exposure also resulted in changes in the neuro-transfer of serotonin and as well in neurodegenerative changes in children exposed to long-term pollution with polycyclic aromatic hydrocarbons (PAH) in prenatal life. Testing on animals indicates that air pollution affects the activation of proinflammatory processes in hippocampus, what may incidentally contribute to the formation of depressive and cognitive symptoms.
Conclusions: In view of the increase of depression incidence and constantly sustained air pollution in the world, there is a need for further research on the correlation between air pollution and depression, taking into account the genetic, social and psychological factors.
Ewa Stelmach, Olga Hołownia, Maciej Słotwiński, Aneta Gerhant and Marcin Olajossy
Introduction. Hyponatremia is an important part of psychiatric practice. In order to analyze its causes and symptoms, the literature on hyponatremia in psychiatric patients has been reviewed. The work has been divided into two separate manuscripts. In the first one the authors discuss the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and hyponatremia occurring with the use of psychotropic drugs (antidepressants, antipsychotics, normotimics), while the second paper discusses research on psychogenic polydipsia. The causes of hyponatremia in patients treated in psychiatric wards include: water intoxication associated with polydipsia, somatic comorbidities, side effect of internal medicine and psychiatric drugs. The most common mechanism leading in these cases to hyponatremia is the syndrome of inappropriate secretion of vasopressin (SIADH). The SIADH syndrome is a group of symptoms, first described in 1967 by Schwartz and Bartter in The American Journal of Medicine, which results from the hypersecretion of antidiuretic hormone, also called vasopressin, which causes patients to develop normovolemic hyponatremia. The phenomenon of drug-induced hyponatremia in psychiatric practice is generally observed with the use of antidepressants, antipsychotics and anti-epileptic drugs (used in psychiatry as normotimic drugs).
Aim and method. The first manuscript includes a review of literature on the syndrome of inappropriate secretion of vasopressin (SIADH) and hyponatremia occurring after the use of psychotropic drugs, and is divided into two subsections: 1. The syndrome of inappropriate secretion of vasopressin (SIADH), 2. Hyponatremia and psychotropic drugs (antidepressants, antipsychotics, normotimics).
Conclusion. In the view of the reviewed literature it is extremely important to control the natremia level during pharmacotherapy using the above mentioned drugs, especially in the initial period of therapy.
Aneta Gerhant, Maciej Słotwiński, Olga Hołownia, Ewa Stelmach and Marcin Olajossy
Objective. The study is the second part of the literature review on hyponatremia in patients with diagnosed mental disorders. This article focuses on psychogenic polydipsia as, along with the SIADH, one of the two most common causes of hyponatremia in the mentioned group of patients.
Method: The literature review was based on searching the Medline, the Google Scholar and the Ebsco databases in Polish and English by entering the following phrases: psychogenic polydipsia, the psychosis – intermittent hyponatremia – polydipsia syndrome, water intoxication.
Discussion: Psychogenic polydipsia occurs in up to 25% of patients treated for mental disorders. It most frequently concerns patients with schizophrenia. 30% of patients with psychogenic polydipsia suffer from hyponatremia with or without symptoms of water intoxication. In the etiology of psychogenic polydipsia, the influence of dopaminergic and noradrenergic neurotransmission has been considered, as well as angiotensin, which is claimed to have dipsogenic properties. In order to reduce the severity of the disorder, attempts have been made to administer the following groups of medications: β-blockers, opioid receptor antagonists, angiotensin convertase inhibitors and angiotensin receptor antagonists. Other methods include replacing classic antipsychotic drugs with clozapine. There are also reports of a reduced severity of polydipsia with hyponatremia after introducing risperidone and olanzapine. Preventing episodes of water intoxication in patients with psychogenic polydipsia requires the monitoring of their body weight and a suitable reduction of fluid intake by them.
Results: Mentally ill patients, especially those with chronic schizophrenia, should be monitored for psychogenic polydipsia and the concomitant hyponatremia.
Magdalena Razmus, Beata Daniluk and Piotr Markiewicz
Introduction: The perception of one’s own body, its mental representation, and emotional attitude to it are the components of so-called “body image” . The aim of the research was to analyse phantom pain and non-painful phantom sensations as results of limb loss and to explain them in terms of body image distortion.
Material and method: Three methods were used in the study of 22 amputees (7 women and 15 men, between 43 and 76 years old, M = 61, SD = 11.3): (1) a clinical interview; (2) The Questionnaire of Body Experiencing after Limb Amputation; (3) modified version of The Pain Questionnaire based on The McGill Pain Questionnaire.
Results: The prevalence of phantom limb pain was 59%. Some various non-painful phantom sensations after amputation were experienced by 77% of respondents. There was a statistically significant relationship between phantom pain and non-painful phantom sensations in a group of participants experiencing phantom limb phenomenon at the moment of the research.
Conclusions: Deformation of body image in the form of phantom pain and non-painful phantom sensations is a frequent experience after limb loss. We suggest that phantom limb is a form of out-of-date or inadequate body image as an effect of the brain activity trying to keep a kind of status quo. A co-occurrence of non-painful phantom sensations and phantom pain suggests that these both forms of post-amputation sensations may share neural mechanisms. Results indicate, that there exists somatosensory memory which may be manifested in similarities between pre- and post-amputation sensations.
The goal of the article is to describe the theoretical and empirical research of characteristics of families under non-normative crises, having as an example the families of combatants participated in the anti-terrorist operation in Ukraine. The following family crises are discussed: normative crises, as period of transition from one stage of the family life cycle to another and non-normative crises caused by traumatic life events.
Research methodology. In order to differentiate more clearly the families of war veterans (those who returned from the anti-terrorist operation zone were examined) and their reactions to the crisis, a sample consisted of chosen nuclear families and the attention was focused on the marital subsystem as a family basis. At the end, survey and psychological testing of war veterans’ wives were conducted; the following diagnostic techniques were used: the author’s questionnaire, FACES-3 method (D.Olson), the questionnaire of family anxiety (E.Eydemiller); the methods of mathematical statistics were used to estimate the data.
Research results. The data of the empirical study of the 36 families of war veterans who participated in the military operations in the ATO zone (Ukraine) show that such non-normative family crisis is characterized by family system imbalance and its correction requires adaptation of the family as a whole system to the new reality. Most war veterans’ families undergo series of transformations associated with changes in family structure, communication, significant emotional stress.
Discussion. Psychological assistance to war veterans’ families should include psychological learning, prevention and resolving of marital relationship problems, including construction of a new family image, joint life prospects, discussion and transformation of family rules and regulations, development of family cohesion and communication.
Grzegorz Opielak, Maciej Kozioł, Tomasz Zuzak, Piotr Piech and Ryszard Maciejewski
Introduction: On account of its radical character, suicide is differently perceived by the society. The consequence of this phenomenon is the issue of moral evaluation by the society in the practical aspects of daily life, such as religious, psychological and social ones. Regarding society’s complexity, it is understandable that the knowledge and the evaluation of this act amongst people are different.
Materials and methods: In the study a method of the diagnostic survey was applied. The questionnaire was conducted amongst 168 individuals ranging from 18 to 49 years of age. The study involved 69 women and 99 men. The arranged personal data questionnaire served as the evaluation of perceiving the suicidal act and people’s knowledge about this occurrence.
Results: Respondents claim that suicidal behaviours affect 72.5% of young people, and 22.7% of adult men. Large group of the study participants had personal experience with individuals after a suicide attempt (41.92%). As many as 49.7% of individuals are fierce opponents of suicidal acts while 46.1% are of an opinion that ‘the one who commits suicide should not be condemned or judged’.
Conclusions: Respondents present vast knowledge about the universality of suicide phenomenon and its most frequent causes. They are against such behaviour, but do not condemn individuals who committed this act. The study participants show understanding of ways to prevent suicide.