Łukasz Mokros, Jacek Koprowicz, Katarzyna Nowakowska-Domagała, Juliusz Rodak and Tadeusz Pietras
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).
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.
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.
Hypertension is a common problem in the elderly population. It is one of the factors determining the pattern of cognitive functioning of the patients, however the nature and severity of neuropsychological deficits are unclear. The main aim of the study was to assess effectiveness of cognitive task performance and the strategies of verbal material organization in patients with varying levels of productivity and control. The outpatients treated for hypertension (n = 46) were tested with the following neuropsychological tests and the experimental task: Ruff Figural Fluency Test (RFFT), California Verbal Learning Test (CVLT), Semantic Verbal Fluency Task (VF). The level of productivity and control in older hypertensive patients appeared to be important variables differentiating the effectiveness of structured task performance involving the memory and learning of verbal material. Patients with weaker productivity and control show less efficiency in formulating and sustaining a learning plan expressed by the compatibility of responses in subsequent attempts. Weaker productivity and control are associated with high risk of memory problems, especially in situations characterized by a high degree of structure. It is advisable to include an evaluation of certain aspects of executive functions at the initial stage of assessment of patients at risk of brain dysfunction.
The aim of the study was to establish depth and substantive characteristics of intrapersonal conflicts of bloggers. Internal conflicts were analyzed at the levels of individual typological characteristics, self-conception, and value orientation of personality.
The study was based on the method of content analysis and psychodiagnostic tests. 100 respondents (50 respondents who have blogs and 50 respondents who do not have blogs) were examined with Sobczyk’s individual typological questionnaire, Stephenson’s Q sorting, Budassi’s scale of self-assessment, Leary’s interpersonal diagnosis of personality, Fantalova’s value / accessibility correlation in different life spheres. Mann-Whitney test and Spearman’s rank correlation coefficient were applied for statistical data processing.
The results of the survey support the hypothesis regarding the special character of the intra-personal conflicts of bloggers in comparison with those people who do not have blogs and use the Internet less often. In fact, conflicts between real self and virtual self are characteristic of bloggers. Most of the tension is the result of contradiction of ideas about their personal social and communicative competence and the opposition of coping strategies “acceptance of struggle – avoidance of struggle”.
There are different views on how the Internet influences psychological wellbeing. Social networks allow bloggers to present themselves in a certain desired light, to create some image, to stress their unique features, to attract attention to those character properties which are not manifested in real life as desired.
Krzysztof Siejko, Aneta Tylec, Halina Dubas-Ślemp, Piotr Książek, Bartłomiej Drop, Artur Kochański and Katarzyna Kucharska
The aim of this work is to review the role of mental health care center and treatment center specialized in psychiatry in the Polish system of mental health care as a whole.
For many years in Poland, the process of transformation of psychiatric care model from the institutional (inpatient setting, most expensive) to community care model (personalized, much cheaper), has been taking place. The effective - coordinated system of community care should significantly improve cooperation in the treatment, while the community forms of health care should ensure full availability, complexity, and continuity of care provision. In many cases, the community support is inadequate and cannot provide patient with care at his home environment. For mentally ill, there may be a need for the use of the long term health care centers specialized in psychiatry.
A long term mental health care center specialised in mental health plays an important role in long-term care for the mentally ill. As far as a mental health service user’s perspective is concerned, the continuity of care and treatment in the long term health care center (as a health care unit) appears to be more useful and satisfying compared to a residential home for people with chronic mental illnesses. There is a need for broad discussion on the special place of the long term health care center specialized in psychiatry in the present Polish system of mental health care and on the improving of care pathways between inpatient-, day care-and, community care package.
This work basing on a study of medical records is a story of a young patient, repeatedly hospitalized with various diagnoses, in whom the psychiatric symptoms significantly decreased after waking from coma, resulting from an unfortunate accident.
There are presented subsequent stages of treatment and hospitalizations and the analysis of the problem if the restart is possible in terms of mental state, in a patient who for years had experienced omental-delusive experiences of high severity and anxiety, leading to several suicidal attempts with serious consequences.
The discussion also describes the issue of double diagnosis and the criteria for amphetamine-induced psychosis.
Can schizophrenia be cured and its symptoms reset ?
Children growing up in families with alcohol problems experience many emotions and events that are inadequate to their age. All these experiences are related to their subsequent functioning. Having a mother or a father suffering from alcohol dependence has a big impact on who one becomes in the future and how he/she perceives the world and other people.
The purpose of this study was to determine the relationship between the level of self-esteem, satisfaction with life as well as basic hope in the so-called Adult Children of Alcoholics (ACoA), and the attitudes of their parents.
The study involved 49 persons, aged from 18 to 70. To obtain the necessary data we used the Questionnaire Survey for Adult Children of Alcoholics, Rosenberg Self-Esteem Scale (SES), Satisfaction with Life Scale (SWLS), Basic Hope Inventory (BHI-R) and Re-trospective Assessment of Parental Attitudes Questionnaire (KPR-Roc).
The results show a positive correlation between the level of self-esteem and life satisfaction, and the attitudes of autonomy and acceptance in the mothers of our subjects. Also, life satisfaction, self-esteem and basic hope proved to be interrelated, i.e. an increase within one coincided with an increase in the other two. In addition, our results show that experiencing violence in the families of persons with the ACoA syndrome significantly correlates with the retrospective assessment of their parents' attitudes. Fathers in the so-called violent families are perceived as excessively demanding, yet inconsistent, while mothers as more rejecting and less protecting.
Joanna Gałaszkiewicz, Krzysztof Rębisz, Justyna Morylowska-Topolska, Hanna Karakuła-Juchnowicz and Gustaw Kozak
Clozapine is the drug of choice for drug-resistant schizophrenia, but despite its use, 30-40% patients fail to achieve satisfactory therapeutic effects. In such situations, augmentation attempts are made by both pharmacological and non-pharmacological methods. To date, most of the work has been devoted to pharmacological strategies, much less to augemantation of clozapine with electroconvulsive therapy (C+ECT), transcranial direct current stimulation (tDCS) or transcranial magnetic stimulation (TMS).
Aim: The aim of the work is to present biological, non-pharmacological augmentation treatment methods with clozapine.
Material and methods: A review of the literature on non-pharmacological augmentation treatment methods with clozapine was made. PubMed database was searched using key words: drug-resistant schizophrenia, clozapine, ECT, transcranial magnetic stimulation, transcranial electrical stimulation and time descriptors: 1980-2017.
Results: Most studies on the possibility of increasing the efficacy of clozapine was devoted to combination therapy with clozapine + electric treatments. They have shown improved efficacy when using these two methods simultaneously from 37.5 to 100%. The only randomized trial so far has also confirmed the effectiveness of this procedure. Despite the described side effects of tachycardia or prolonged seizures, most studies indicate the safety and efficacy of combined use of clozapine and electroconvulsive therapy. Transcranial magnetic stimulation also appears to be a safe method in patients treated with clozapine. However, further research is needed before ECT can be included in standard TRS treatment algorithms. The data for combining transcranial electrical stimulation with clozapine, come only from descriptions of cases and need to be confirmed in controlled studies.
Conclusions: The results of studies on the possibility of increasing the effectiveness of clozapine using biological non-pharmacological treatment methods indicate a potentially beneficial effect of this type of methods in breaking the super-resistance in schizophrenia. Combination of clozapine and ECT can be considered as the most recommended strategy among these treatment methods.
Introduction: As the global number of diabetes and the burden of depression together with other mental disorders increases, there is a need for better understanding of the connection between these diseases. In patients with diabetes, mental disorders are more common than in the general population, especially anxiety disorders and depression, which are often difficult to detect by health professionals.
Material and methods: Using the keywords searched in the international bibliographic databases: Embase, Medline, Science Direct, Web of Science. We analyzed clinical trials published in English and international journals
Results: Patients with diabetes are exposed to serious physical and mental complications. The occurence of depression and psychiatric disorders among people with diabetes was twice as frequent as in the general population. There are also studies showing a higher risk of suicide among people with diabetes. In addition, patients with both diseases, diabetes and depression, had an increased risk of cardiovascular complications and increased mortality and higher costs of health care. Diabetic patients have increased incidence of anxiety disorders in relation to non-diabetic patients by 20%.
Conclusion: Further researches and integration of medical and psychological treatment are needed. Cooperation between psychiatrists and diabetologists can reduce mental and physical harm in patients with diabetes.