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Hyper-coherence and increased energy of gamma oscillations in patient with first onset schizophrenia and cerebral white matter damage

Abstract

Background: According to current knowledge, gamma frequency is closely related to the functioning of neural networks underlying the basic activity of the brain and mind. Disorders in mechanisms synchronizing brain activity observed in patients diagnosed with schizophrenia are at the roots of neurocognitive disorders and psychopathological symptoms of the disease. Synchronization mechanisms are also related to the structure and functional effectiveness of the white matter. So far, not many analysis has been conducted concerning changes in the image of high frequency in patients with comorbid schizophrenia and white matter damage. The aim of this research was to present specific features of gamma waves in subjects with different psychiatric diagnoses and condition of brain structure.

Methods: Quantitative analysis of an EEG record registered from a patient diagnosed with schizophrenia and comorbid white matter hyperintensities (SCH+WM), a patient with an identical diagnosis but without structural brain changes present in the MRI (SCH-WM) of a healthy control (HC). The range of gamma waves has been obtained by using analogue filters. In order to obtain precise analysis, gamma frequencies have been divided into three bands: 30-50Hz, 50-70Hz, 70-100Hz. Matching Pursuit algorithm has been used for signal analysis enabling assessing the changes in signal energy. Synchronization effectiveness of particular areas of the brain was measured with the aid of coherence value for selected pairs of electrodes.

Results: The electrophysiological signals recorded for the SCH+WM patient showed the highest signal energy level identified for all the analyzed bands compared to the results obtained for the same pairs of electrodes of the other subjects. Coherence results revealed hipercompensation for the SCH+WM patient and her level differed substantially compared to the results of the other subjects.

Conclusions: The coexistence of schizophrenia with white matter damage can significantly disturb parameters of neural activity with high frequencies. The paper discusses possible explanations for the obtained results.

Open access
Modern faces of hysteria, or some of the dissociative disorders

Abstract

The concept of “hysteria” comes from the Greek word “hystera” (uterus) and dates back to the time of Hippocrates, at least. Modern classifications differ regarding the area encompassed by the concepts of dissociation and conversion differ. Mental health professionals in the United States (DSM-5) use a standard classification of mental disorders codifying dissociative disorders as a distinct class of disorders, but subsumes conversion disorders under “somatoform disorders”. The history of hysteria is as long as the history of mankind. Apparently, both the essence and mechanisms of dissociative disorders remain unchanged despite the fact that many years have passed. According to Owczarek et al., dissociative symptoms are caused by the malfunctioning of defence mechanisms and anxiety. This article provides an overview of the available literature on the etiology and pathogenesis of dissociative disorders as well as disorders such as amnesia, dissociative fugue, trance and possession.

Open access
Omega – 3 fatty acids in schizophrenia – part I: importance in the pathophysiology of schizophrenia

Abstract

Despite the increasing offer of antipsychotic drugs, the effectiveness of pharmacotherapy in schizophrenia is still unsatisfactory. Drug resistance, lack of complete remission and the increasing risk of metabolic complications are the reasons why the new forms of therapy in schizophrenia among which unsaturated essential fatty acids omega 3 (EFAs ω-3) affecting the proper functioning of nervous system, are mentioned, are being looked for.

Fatty acids represent 50-60% of the dry weight of the brain and diet is one of the factors that influence the value of each of the fat fractions in the neuron membranes. Patients with schizophrenia tend to have irregular nutritional status concerning essential fatty acids ω-3, which might result from metabolic disorders or irregular consumption of fatty acids.

Apart from being a review of the literature on this subject, this very paper characterizes essential fatty acids ω-3, their metabolism, the most important sources in the diet and the opinions of experts in the field about the recommended intake. It pays attention to the role of essential fatty acids in both the structure and functioning of the central nervous system is, as well as their role in the pathophysiology of schizophrenia, with particular emphasis on the membrane concept by David Horrobin. The assessment of the errors in consumption and metabolism of essential fatty acids are described as well.

The evidence was found both in epidemiological and modeling studies. It supports the participation of EFAs in etiopathogenesis and pathophysiology of schizophrenia. Further research is needed, both observational and interventional, as to the role of essential fatty acids ω-3 in the functioning of the CNS as well as the development and course of schizophrenia.

Open access
On the border of deep spirituality and psychosis… A case study

Abstract

This article is a case study of a 28-year-old patient diagnosed with F23. The report is preceded by an extensive literature review describing the situation of the mentally ill, in which psychiatry intermingles with spirituality and the sacrum.

The aim of the study was to investigate the relationship between religion/spirituality and schizophrenia as well as to draw attention to the complex problem of differential diagnosis of religious and spiritual problems. When is psychiatric treatment enough and when is intervention of a priest really essential?

The authors discuss the problem of mental disorders in connection with religion and spirituality in the clinical context. The article shows that it is very important that the processes of diagnosis and treatment take into account the patients’ individual traits, beliefs, values and spirituality.

Open access
Psychopathological symptoms in children and adolescents diagnosed with autism spectrum disorders with comorbid epilepsy - case report

Abstract

The number of diagnoses of Autism Spectrum Disorders (ASD) is on the rise, which encourages the search for their causes spurs researchers to study co-occurrence of ASD with other diseases and disorders. This study aims at highlighting the importance of the clinical problem of autism spectrum disorders and its comorbidity with epilepsy. This is one of the most common co-morbidities happening to children.

Regarding the psychopathological symptoms, it needs emphasizing that both in case of an isolated ASD and epilepsy itself, the accompanying psychiatric symptoms are confirmed. The research conducted so far also shows that in the course of epilepsy in the child / youth, mental health problems are often revealed, particularly depression and anxiety disorders. Episodes of depression and anxiety disorders are also mentioned as the most common comorbid psychopathological symptoms associated with ASD. An accurate and rapid diagnosis of epilepsy can improve the functioning of the child in the family environment and can improve communication skills. It is also important for the overall intellectual and psychological development. Making a correct diagnosis of the problem is equally crucial as choosing the right methods of medical and psychological care. Moreover,, it determines the early use of adequate, safe and effective forms of treatment.

Open access
Risk behaviors at late childhood and early adolescence as predictors of depression symptoms

Abstract

The study aims to answer following questions: (1) What are the risk behaviors among children at late childhood and early stage of adolescence? (2) What are the differences between boys and girls concerning problem behaviors? (3) Do risk behaviors predict symptoms of depression? Participants fulfilled the set of three tools: (1) Children Depression Inventory authored by M. Kovacs (1992); (2) List of experienced risk behaviors and (3) List of open questions concerning the knowledge and experience with smart drugs. The study group consisted of 130 boys and girls attending the fifth and sixth grade of primary school. The study shows differences between boys’ and girls’ risk behaviors, as well as the similarities. The findings indicate that gender-related disparities in problem behaviors exist even at the early stages of puberty. Boys under one parent custody declare significantly more risk behaviors than girls under one parent custody. Finally, the symptoms of depression were predicted by cumulative number of risk behaviors and – on tendency level – by type of parental custody.

Open access
Stolen motherhood-case study of postpartum depression

Abstract

Aim: The objective was to analyze the case of postpartum depression complicated with extended suicide attempt.

Method: The analysis of clinical case and medical history.

Results: In 25-year-old patient, two weeks after childbirth, postpartum depression episode occurred. In the further course of illness psychotic symptoms (delusions, mood disorders), suicidal and infanticide thoughts emerged. Four weeks after childbirth, the patient killed her baby and took an unsuccessful suicidal attempt. Based on medical records, several risk factors of postpartum depression were identified: 1. obstetric and child-related risk factors: Caesarean section, premature birth, obstetric complications during pregnancy, infant’s difficult temper, difficulties related to breastfeeding; 2. psychological risk factors: baby blues, high anxiety level during pregnancy, high level of stress related to child care.

Conclusions: Psychoeducation of women during pregnancy, including their families, is an extremely crucial element of postpartum depression prevention. It is also necessary to raise awareness among healthcare professionals who have frequent contact with mothers after childbirth: midwives, gynaecologists and paediatricians.

Open access
Changes in the levels of kynurenic acid and selected proinflammatory cytokines after pharmacological treatment and electroconvulsive therapy (ECT) in patients with depressive disorder

Abstract

The aim of the present study was to compare the concentrations of KYNA, 3-OH-KYN and the cytokines TNF-α and IL-6 in patients with depression vs. healthy controls as well as in patients with depression treated pharmacologically vs. those treated using ECT. We also evaluated the relationship between the concentrations of KYNA, 3-OH-KYN and the cytokines TNF-α and IL-6 and clinical improvement measured on the MADRS scale in patients treated pharmacologically and those treated with ECT.

Subjects and methods: The study group comprised 29 patients aged 28 to 60 years with a diagnosis of a major depressive episode. Eleven of the patients received pharmacological treatment and 18 were treated with ECT.

Patients were assayed for serum levels of KYNA and the cytokines IL-6 and TNF-α. Clinical improvement was measured on the MADRS depression rating scale and the clinical global impression (CGI) scale.

Results: Significant differences were found in KYNA levels between depressive patients and healthy controls. Pharmacological treatment significantly contributed to the increase in KYNA levels and ECT – to the increase in TNF-α levels in depressive patients.

Conclusions:

  1. Depressive patients have significantly lower concentrations of KYNA than healthy individuals
  2. Depressive patients who have undergone pharmacological treatment have significantly higher KYNA concentrations than before treatment.
  3. Depressive patients who have undergone ECT treatment have significantly lower TNF-α concentrations than before treatment.
  4. High pre-treatment levels of IL-6 are associated with a lower MADRS improvement index in pharmacologically treated patients with depression.

Open access
Is it time for baclofen to be included in the official recommendations concerning the treatment of alcoholism?

Abstract

Alcohol dependence and its treatment is not an exactly resolved problem. Based on the EZOP [Epidemiology of Mental Disorders and Accessibility of Mental Health Care] survey, which included a regular analysis of the incidence of mental disorders in the population of adult Polish citizens, we were able to estimate that the problem of alcohol abuse in any period of life affects even 10.9% of the population aged 18-64 years, and those addicted represent 2.2% of the country’s population. The typical symptoms of alcohol dependence according to ICD-10, include alcohol craving, impaired ability to control alcohol consumption, withdrawal symptoms which appear when a heavy drinker stops drinking, alternating alcohol tolerance, growing neglect of other areas of life, and persistent alcohol intake despite clear evidence of its destructive effect on life. At the moment, the primary method of alcoholism treatment is psychotherapy. It aims to change the patient’s habits, behaviours, relationships, or the way of thinking. It seems that psychotherapy is irreplaceable in the treatment of alcoholism, but for many years now attempts have been made to increase the effectiveness of alcoholism treatment with pharmacological agents. In this article we will try to provide a description of medications which help patients sustain abstinence in alcoholism therapy with particular emphasis on baclofen.

Open access
Oral health in female patients with eating disorders

Abstract

The study aimed to evaluate oral health in women with eating disorders. The clinical study covered 30 patients aged 14-36 years suffering from diagnosed eating disorders and treated in closed psychiatric institutions. The control group comprised 30 healthy women at the mean age corresponding to that of the patient group. No relationships were confirmed between eating disorders and the intensity of dental caries. Eating disorders contribute to increased loss of dental hard tissues. In women suffering from eating disorders non-specific lesions in oral cavity are more common than in healthy women.

Open access