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The role of beta-adrenolytic drugs in treating anxiety disorders

Summary

Introduction: Beta blockers are mainly used in treating cardiovascular diseases. However, it has been observed that these drugs have also an anxiolytic potential. Over the years, a number of clinical trials have been conducted aimed at determining the effectiveness of beta blockers in treating anxiety disorders.

The aim of the article: The main objective of the article is to present the significance and position of adrenolytic drugs in the pharmacotherapy of anxiety disorders on the basis of available literature. Moreover, the authors also decided to take into account the data from current research results, considering the problem of side effects of using adrenolytic drugs - especially the controversial reports on their effect on the development of affective disorders.

Method: An analysis was conducted of articles from Medline/PubMed database, selected on the basis of the following key words: anxiety disorders, beta blockers, adrenolytic drugs, as well as on the basis of their dates of publication: 1960-2017. In order to conduct a reliable and complete review of literature, the authors decided to include works from quite an extended period of time. The articles included in the review were published in Polish and English.

Results: The review of articles concerning the treatment of anxiety disorders clearly suggests that propranolol is effective in reducing the frequency of panic attacks and the tendency for avoidance behavior in patients with agoraphobia. Other studies report on potential benefits in terms of early interventional prevention and treating posttraumatic stress disorder with propranolol. However, there is lack of randomized clinical trials concerning the therapeutic effect of other adrenolytic drugs in treating anxiety disorders. Early research works reported that (mainly lipophilic) beta blockers may have a depressogenic effect; however, the latest studies have not confirmed it.

The contemporary research on the therapeutic potential of beta blockers in treating anxiety disorders is insufficient. What seems to be most promising, however, are reports concerning the desirable effects of using adrenolytic drugs in treating posttraumatic stress disorder, which implicates the necessity of conducting further research verifying the validity of their application.

Open access
Schizophrenia as a process of mental dissolution

Abstract

In creating his Psychophysiological Theory, Jan Mazurkiewicz transplanted John Hughlings Jackson’s method into the field of psychiatry. Like his precursor, he distinguished four evolutionary levels, but this time with regard to mental activity. According to Mazurkiewicz’s approach, disease is the reverse of evolution. Doing damage to the highest evolutionary level, it allows evolutionarily lower levels to take control of the patient’s psyche. Distorted by the etiological factor, the lower mental levels manifest as mental disease. In his Psychophysiological Theory, Mazurkiewicz distinguishes three types of dissolution: intra-level dissolution (psychoneuroses), slow dissolution or dissociation proper (schizophrenia), and rapid, delirium-like dissolution (impaired consciousness). Kaczyński noted that, based on an in-depth analysis of the phylogenetic and ontogenetic development of the successive evolutionary levels of the nervous system, Mazurkiewicz transposed the principles of the Jacksonian concept of hierarchical evolution – dissolution. Within a dozen or so years from birth to maturity, the process of evolution of mankind is recapitulated, with the speed of lightning, in an individual – from instincts, which are phylogenetically the oldest, to the highest functions of the frontal lobes. The present paper makes mention of research conducted at Lublin’s Department of Psychiatry which expands on Mazurkiewicz’s theory.

Open access
What do we know about sleep paralysis?

Summary

Introduction: Sleep paralysis (SP) is a condition that widely occurs among people all over the world. It has been known for thousands of years and is rooted in the culture of many countries. It arouses strong emotions, though still little is known about it. The clinical picture of the disorder can be very diverse. It is often accompanied by hypnopompic and hypnagogic hallucinations, somatic complaints and the feeling of intense anxiety. A feeling of paralysis in the body with inhibited consciousness is always observed with the experience. SP pathophysiology is not fully understood, however, most theories explaining this phenomenon are based on the assumption that it results from dysfunctional overlap of REM sleep and wakefulness. It is experienced by healthy people, but it is more often associated with somatic and mental disorders, which is why it is becoming an object of interest for researchers.

Aim: The aim of this work is to present the most important information about the disorder known as sleep paralysis - its history, cultural context, pathophysiology, prevalence, symptomatology, coexistence with other somatic and mental disorders as well as diagnostics and available forms of prevention and treatment.

Materials and methodology: The available literature was reviewed using the Google Scholar bibliographic databases searching the following keywords: sleep paralysis, REM sleep parasomnias, sleep disorder, night terrors and time descriptors: 1980-2018.

Results 1. Sleep paralysis has already been described in antiquity, and interpretations related to its occurrence are largely dependent on culture and beliefs.

2. Symptomatology of the disorder is very diverse: both mental and somatic symptoms are present.

3. The pathophysiology of the disorder has not been fully explained. The basis of most theories regarding sleep paralysis is the assumption that it results from the dysfunctional overlap of REM sleep and wakefulness.

4. The prevalence of SP at least once in a lifetime is 7.6% in the general population, although it is estimated that it is much more frequent in people with various mental and somatic disorders.

5. Treatment of SP is associated with a change in lifestyle and the use of pharmacotherapy and psychotherapy.

Open access
Changes in body perception caused by mental illness on the basis of Great Thoughts of Nervous Patient by Daniel Paul Schreber

Abstract

The article presents a study on delusory changes in perceiving one’s own body in a patient with mental illness. The story of Daniel Paul Schreber is an example of strongly experienced delusions, which, in the described form are contemporarily attributed to schizophrenia. This story, coming from over one hundred years ago, is still vivid, and actualizes the image of mental illness and suffering connected with it in the thoughts of the reader. The author presents these characteristics focusing mainly on the symptoms of dysmorphognosia or dysmorphophobia, which became an important element of delusional constructs. He describes the nature of the experienced symptoms in detail, documenting them with extensive quotations from „Diary of a mental patient” written by such patient. The study of mental illness presented in the paper reveals the meanders of distorted psyche and some changes that are happening in it under the influence of delusions. It is a study undertaking the issue of describing and understanding the symptoms of mental disorders.

Open access
Functioning of a family with a child suffering from cystic fibrosis and short bowel syndrome - case study

Abstract

This article presents the problem of the functioning of a family with a child suffering from two painful, chronic and incurable diseases - cystic fibrosis and short bowel syndrome. Its aim is to learn about the impact of these diseases on the occurrence and course of mental disorders in a child and on the functioning of the whole family in which such a child is brought up. Like any long-term illness of a child, it has influenced changes in the functioning of the family system. The parents’ functioning and the flexibility of the family system conditioned the acceptance of the diagnosis and determined further participation of the family in the treatment process. This article also discusses the risk of unfavorable attitudes of parents towards the child’s illnesses, which may contribute to the development of mental disorders in the child patient, as well as in his/her parents or siblings. In the process of treatment and rehabilitation, the necessity for cooperation of medical staff, the patient and his/her parents has been emphasised.

Open access
Neurotic symptoms in clinical practice: Mieczysław Kaczyński’s approach

Abstract

The aim of this study is to acquaint the readers with some pieces of practical guidance on the therapy of neurotic disorders offered by Professor Mieczysław Kaczyński to his colleagues and students at the Lublin Clinic of Psychiatry. Patients who report so-called neurotic complaints are a group that requires a very thorough clinical analysis. Professor Kaczyński emphasized that it was necessary to make a distinction among patients with a neurotic reaction, a pseudoneurotic syndrome, and ‘neurosis proper’ or psychoneurosis. The first group includes patients who report a psychological trauma as a trigger of their complaints. Therapeutic intervention brings good outcomes leading to resolution of the condition. A group of patients that is very important from the point of view of diagnosis are those in whom neurotic complaints are masking an onset of a somatic or mental illness or an existing illness which is running a mild course. In such cases, a cursory examination leading to a mistaken diagnosis of neurosis can have devastating effects. A misdiagnosis is easy to make, for example, in patients with increased intracranial pressure (“the neurasthenic stage of a brain tumour”) or an onset of a mental illness (the pseudoneurotic syndrome of early schizophrenia). Therefore, often, before the final diagnosis is arrived at, multiple follow-up examinations are needed to monitor the structure and dynamics of the disease. Only when the first two diagnostic options have been excluded, can the physician classify the disorder as a neurosis (psychoneurosis). In such cases, it is necessary to find the etiological agent, which, more often than not, is a situation of conflict or frustration that the patient is unconscious of. A failure to analyze a case in this way may result in the patient’s resignation response, potentially leading to suicide. It appears that Professor Kaczyński’s remarks on the clinical picture of neurotic disorders largely round out the information provided in ICD-10 under F.40–F.48.

Open access
An overlooked issue: sexual dysfunctions in men addicted to alcohol

Abstract

Introduction According to the data obtained in the EZOP Poland study (2015), the prevalence of alcohol dependence in lifetime in Poland amounts to about 2.2% of the population, entailing enormous social, family and personal harm, including health damage. It is estimated that about 72% of alcohol-dependent patients complain about one or more problems related to the sexual sphere, which may result from both the development of somatic complications in the course of alcohol dependence, and from psychiatric complications that themselves can lead to sexual dysfunction. There are reports and clinical observations indicating that the occurrence of sexual dysfunction (SD) can affect the shortening or interruption of the period of abstinence.

Aim The aim of this work is to show sexual dysfunctions in alcohol-dependent men and to discuss the factors that may affect the occurrence of the above-mentioned dysfunctions.

Material and methods The available literature was reviewed using Medline, Google Scholar and ScienceDirect browsers by entering the keywords: alcohol dependence, sexual dysfunction, comorbidity, alcohol-caused diseases and time descriptors: 1979-2016.

Results

• Alcohol dependence is associated with the occurrence of various types of sexual dysfunctions (SD).

• The diagnosis of SD should take into account all possible causes that may lead to the development of SD in this group of patients, including the comorbidity of somatic diseases or the negative impact of drugs on sexual function.

• Occurrence of SD is connected with a higher risk of abstinence interruption.

• There is a need to carry out more research in order to better understand the relationship between alcohol dependence and the prevalence of sexual dysfunctions.

Open access
A Psycholexical Classification of Ukrainian Descriptors of Individual Differences

Abstract

The aim of the psycholexical study was to classify the terms describing individual differences in the Ukrainian language.

Method. To accomplish this objective, we analysed 220,000 entries included in a universal dictionary of Ukrainian and identified 20,024 terms – adjectives, participles, type-nouns, and attribute-nouns – used to describe human characteristics. The identified person-descriptive terms were classified by a team of five trained judges into 13 categories and subcategories. The judges’ taxonomic decisions were tested for validity and interjudge agreement.

Results. This procedure yielded lists of Ukrainian personality descriptors, consisting, respectively, of 2,426 adjectives, 2,255 participles, 1,653 attribute-nouns, and 1,474 type-nouns. The analysis of semantic redundancy of terms representing different parts of speech but having the same common morpheme among dispositional descriptors identified a total of 1,634 morphemes that differed in terms of meaning. The analysis identified 212 (22.0% of morphemes) type-nouns that could not be replaced by any different part of speech with the same morpheme to describe the same personality trait.

Conclusions. Ukrainian personality lexicon has a comparable or higher diversity of personality-descriptive vocabulary, attested to by the presence of 96% Big Factors markers from international comparative analyses of psycholexical structures of natural languages. The results of the study contribute to the debate on universals in the description of individual differences and constitute the basis for future questionnaire-based studies aimed at identifying the psycholexical structure of the Ukrainian language.

Open access
The dynamics of structural changes in the social-role attitudes of students during studies at higher educational institution

Abstract

The purpose of the paper — to present the theoretical considerations and the results of empirical study concerning on the intentional characteristics of professional consciousness (on the example of social-role attitudes of students). The structure, the dynamics of changes in the social-role attitudes of students during studies at higher educational institution in different forms of studies (full-time and part-time) and the influence of the quality of program content transferred during the education process on the shaping of students' professional awareness were also discussed.

The methodology of the research. We used the method of questioning and incomplete sentences in the research. The sample consisted of 94 students of 1 - 5 courses in the following fields: psychology, primary education, mathematics and physics. The study involved 17 part-time students and 77 full-time students. The age of full-time students was from 17 to 22 years old, and the age of part-time students was from 24 to 35 years old. Methods of mathematical statistics are used to evaluate the data.

The results of the research. The data of the empirical research of the students' social-role attitudes show that they have content peculiarities as for the specifics of manifestation at different stages of professional training and on different forms of studies at higher educational institution. Social attitudes regarding the role of “student” and the role of “professional” which have three-component structure (cognitive, emotional and behavioural) vary in degree of awareness and completeness, and are ambivalent. This increases their resilience to changes.

The discussion. The results of the studies show that the social-role attitudes undergo changes as a result of target influences in the process of professional training of future specialists at higher educational institution. Therefore, the definition of social-role attitudes features will contribute to the development of the effective technologies in the professional training of specialists.

Open access
Eveningness and its possibility of predicting burnout symptoms among physicians and nurses – preliminary results

Abstract

Introduction.

A sense of burnout may seriously impair one’s functioning and well-being. It may also hamper the quality of care over a patient. The present study therefore assesses sleep quality and chronotype as predictors of a sense of burnout in physicians and nurses of a district hospital.

Material and methods.

The study group comprised 16 physicians and 31 nurses of a district hospital in Central Poland. The participants completed the Link Burnout Questionnaire (LBQ), Chronotype Questionnaire, and Pittsburgh Sleep Quality Inventory. A linear regression model was constructed for each LBQ dimension by means of stepwise elimination. Each model was adjusted to empirical data (p<0.05).

Results.

A rise in Psychophysical exhaustion was predicted by greater scores for Morningness-Eveningness (ME) and Distinctness (DI) of the rhythm. A higher ME score was associated with higher scores in Relationship deterioration and Sense of professional ineffectiveness, with the latter also associated with presence in the nurses group. The nurses group also demonstrated higher Disillusionment and Psychophysical exhaustion scores than the physicians group.

Conclusions.

Eveningness predicted greater burnout in the studied sample. Thus, chronotype should be considered an important burnout risk factor and it can act as a starting point for devising behavioural interventions.

Open access