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Self-image and selected clinical variables in the context of childhood abuse in subjects with alcohol dependence

Abstract

Objective: The objective of the study was to determine the differences in selected clinical variables and self-image in people with alcohol dependence differing in severity of physical, emotional and sexual abuse experienced before age 18.

Method: The study included 90 people with alcohol dependence. The following research tools were used: Early Trauma Inventory (ETI), Adjective Check List (ACL), MAST, SAAD, and a questionnaire designed by the authors. In order to identify groups with varying indices of physical, emotional and sexual childhood abuse, a cluster analysis method was used.

Results: Two groups of subjects with alcohol dependence were identified: Group 1 with high indices of physical, emotional and sexual childhood abuse and Group 2 with low indices. In terms of self-image the subjects in Group 1 compared to subjects in Group 2 were characterized by a lower self-esteem, self-acceptance, resistance to stress, less intense needs for achievement, endurance, order, nurturing others, interaction with opposite-sex partners, subordinations but more intense need for change. The age of alcohol use initiation and the onset of regular alcohol drinking was statistically significantly lower in Group 1. The severity of alcohol dependence was significantly lower in Group 2. The subjects in Group 1 significantly more frequently confirmed the history of a hereditary predisposition to alcohol dependence, suicidal ideation, suicide attempts and self-harm.

Discussion: The obtained results closely correspond to the data available in the literature.

Conclusions: An assessment of exposure to various forms of childhood abuse appears to be an indispensable element of collecting medical history of people with alcohol dependence.

Open access
Diagnosis and Construction of Speech Coherence Disorders in Schizophasia

Abstract

Introduction: Language disorders defined as schizophasia are one of the key symptoms of schizophrenia, especially in the disorganized form of this psychosis, which is reflected in the description of “loose associations” as one of the core negative symptoms according to P. E. Bleuler. At present, the disruption of text at the level of discourse coherence and syntactic impoverishment at the sentence level are regarded as the linguistic basis of schizophasia. The most often applied tool for clinical assessment of schizophasia is the Scale for the Assessment of Thought, Language, and Communication (TLC) devised by N. Andreasen.

Objective: The paper presents language samples of patients suffering from schizophrenia with a high intensity of schizophasia, but above all, text samples created by speech therapy students, which were supposed to simulate the language pathology of the sick. The aim of the study was to compare these two corps of the text in order to assess how classes on schizophasia affect the understanding of specific language phenomena in the field of text coherence disorders, such as derailment, incoherence, distractible speech, loss of goal.

Material:

1. Text body obtained from two patients suffering from schizophrenia with a high level of schizophasia.

2. Corpus of the text constructed by two students of speech therapy, during academic classes on schizophasia.

Results: This study presents specimens of speech by schizophrenic patients with a high intensity of schizophasia, but first of all text specimens authored by logopedics students, which were intended to simulate the language pathology of patients suffering from schizophasia.

Conclusions: The essence of schizophasic language disorders is apparently the disorders of text coherence at the pragmatic, semantic and syntactic levels. The presented schizophasic utterances constructed by logopedics students are very similar to genuine specimens of schizophasic speech – they are proof of the understanding of what schizophasia is. We may hope that the presentation of language disorders from the texts spoken by patients with schizophrenia, and then the attempt to construct analogous utterances, is conducive to better understanding of the essence of schizophasia, i.e. the disruption of text at the level of building the whole utterance but also at the sentence (phrase) level in the form of syntactic impoverishment.

Open access
The Impact of Emotional Intelligence Level on The Depression Vulnerability

Abstract

Introduction: Recently the issue of emotional intelligence has become a widespread theme of discussion. This review paper is made a contribution to this debate. Discovering of effective predictive and protective factors for depression would have far-reaching consequences for society, science and economy.

Material and Methods: To investigate this issue, we searched articles available in the Google Scholar and PudMed databases under the following terms: emotional intelligence, depression, emotional intelligence and depression for the years 1999-2019. Accessible literature allowed to show basic information of emotional intelligence, detect a system of relationships between emotional intelligence level and depression, and present recommendations.

Results and Discussion: The result of this analysis is a statement that all components of emotional intelligence can be a defense against depression. People with high abilities in regulation their own emotions have large social support, what protect them against depression. The capable managing one’s own and others’ emotions create large and deep interpersonal relationships, what provide more emotional support and tangible assistance during everyday challenges. Stressful life events are among the most powerful predictors of depression, and high level of emotional intelligence enable to cope with them more effectively.

Conclusions: The present text will constitute an impulse to explore this theme more. Moreover, there is a recommendation for researchers to create more effective and simplified tests for examining the level of emotional intelligence in case of spreading them much more and use them in a routine psychiatric practice. A confirmation of the title hypothesis can stand a key to struggle with depression.

Open access
The influence of metacognitive training on the improvement of working memory in children with ADHD

Abstract

The purpose of the study is to check whether the memory will be strengthened after three months of metacognitive training using such mnemonic techniques as Mind Maps and Sketchnoting in children diagnosed with ADHD. According to the most recent, the Fifth Edition of The Diagnostic and Statistical Manual of Mental Disorders, working memory plays a key role both in the symptoms of ADHD and in secondary problems such as: learning disorders, professional or social difficulties.

Method: 45 schoolchildren took part in the experimental study (M=1,42; SD = 10,41;). .Each child had a diagnosed psychomotor overexcitability and attention disorders. The participants were randomly qualified into three groups: the first group was tested for the effect of Mind Maps; the second group, for the effect of Sketchnoting while the third group was assigned the role of a control group. All of the groups were administered The Deferred Naming Test before and after the training. This assessment method belongs to the PU-1 Set of Diagnostic Tests.

Results: The working memory improved in each of the three groups. The smallest number of errors were made by the children in the group with Mind Maps, while the biggest number of errors were made by the children in the control group.

Conclusion: Mind Maps can be an important complement to other forms of therapeutic treatment for children with ADHD diagnosis. Regular use of this tool in education or therapy strengthens the memory. The improvement of this executive function can be substantial in learning to write and read (memorization of the correct shapes of letters), remembering and recalling from memory the rules agreed with the child or better time orientation.

Open access
Mental and behavioral disorders in the population of homeless patients admitted to hospital emergency departments

Abstract

The aim of the study is to identify the most common mental and behavioral disorders diagnosed in homeless patients admitted to hospital emergency departments and to identify performed medical procedures including diagnostic and therapeutic measures in this range.

Material and Method:Data from information systems of three hospitals concerning stays of homeless people in ED in Bydgoszcz in 2013-2015 were analyzed. As any as 3133 stays were identified. The data was compiled using the Microsoft Excel spreadsheet and Statistica 10 statistical software package.

Results: Diagnoses in the category of mental disorders and behavioral disorders constituted 23.3% of diagnoses made in the studied population, of which two thirds were psychiatric disorders and behavioral disorders caused by alcohol use. Specific personality disorders (5.84%), schizophrenia (3.82%), and mild mental retardation (2.24%) were diagnosed in patients. One tenth of all the ICD-9 procedures performed were the procedures of the category 94- Procedures related to mental condition

Conclusions: Mental and behavioral disorders are one of the main reasons for admission of homeless people to hospital emergency departments. Most diseases is diagnosed in facilities where psychiatric consultation is possible, as well as where the number of procedures related to mental condition performed is the highest. Homeless patients suffering from mental and behavioral disorders are rarely admitted to hospital wards for hospitalization. Psychiatric care for homeless patients admitted to emergency departments is an ad hoc intervention and depends on the availability of a psychiatrist. Providing homeless patients with access to a psychiatric diagnosis at ED level would affect the quality of psychiatric care and would contribute to the improvement of mental health of homeless people.

Open access
Wendigo Psychosis

Abstract

Introduction: Wendigo psychosis is considered an endemic psychiatric disorder associated with culture. It manifests through compulsive, strong attacks of cannibalistic behaviors. It mainly concerns Algonquian: Cree tribes and people living in the Northern Ojibwa area.

Material and methods: In our article, we have collected available publications on Wendigo’s psychosis. This area included Internet databases: PubMed and Google Scholar, from the first reports on the disease to the latest information. Due to culture-bound syndromes and the rarity of occurrence in the present time at work, we focused not only on symptoms, treatment or diagnosis, but also on historical and ethnographic features.

Discussion: The first remarks on this disorder derive from the Powhatan dictionary which was used by the Algonquian tribe. In the 1960s there were 70 cases of the disease, but the available epidemiologic data is poor. There are many legends about the mythical creature Wendigo and its likeness is repeatedly used in popular culture. Most of the symptoms exhibited by those suffering from this dysfunction is related to famine and chronic loneliness, e.g. apathy, neurosis.

Summary: The treatment of the psychosis in the past was based on folk beliefs, as well as homicide. Modern medicine offers a wide spectrum of antipsychotic drugs whose use is focused on the elimination of side effects. Pharmacotherapy consists in administering to the sick drugs from the group of benzodiazepines or antipsychotic agents of both the first and the second generation.

Open access
Disease perception and coping strategies for stress in Polish patients with various mental disorders

Abstract

Introduction: Nowadays more and more people struggle with mental problems associated with fast pace of life and overpowering stress. Individuals affected by mental disorders frequently apply ineffective methods of coping with stress, and their attitudes towards the disease in fact strengthen the psychopathological symptoms. The purpose of the present study was to compare disease perception and coping strategies for stress in Polish patients with various types of mental disorders.

Material and Methods: The study involved 123 patients with depressive disorders, anxiety disorders, schizophrenia, alcohol related disorders, subjects detained due to psychoactive substance-induced psychotic disorders and amnestic syndromes, staying at Mental Healthcare Centre. Measurements of the variables were carried out using COPE Inventory and Disease Perception Questionnaire.

Results: The type of mental disorder differentiated the group with respect to the use of strategies aimed at seeking instrumental and emotional support, planning, positive reinterpretation, focus on emotions and substance use. There are significant differences between patients in the approach to illness as a task, weakness and threat.

Conclusions: The results show that the type of mental disorder is important in the context of the strategies used for coping with stress and the patients' approach to their condition.

Open access
Dissociative identity disorder as a wide range of defense mechanisms in children with a history of early childhood trauma

Abstract

Introduction: Dissociative identity disorder, also known as multiple personality disorder, involves simultaneous manifestation of multiple alternative personalities in one human body. The disorder is still a puzzle to contemporary researchers. In comparison to the United States, where the detection rate of this disorder is growing, in Poland, it is still a niche issue, unknown to many scientists and clinicians. Rather alarmingly, this situation has remained the same for many years now.

Objective: The aim of the present study is to draw attention to the adaptive character of dissociative identity disorder as a defense mechanism in children who have experienced extremely traumatic events in early childhood. The work also sets itself the task of disseminating knowledge about multiple personality disorder in the Polish scientific community, with the hope of encouraging wider research in this area in Poland.

Material and Methods: To investigate this issue, we searched articles available in the PubMed, Google Scholar, and Polish Medical Bibliography (Polska Bibliografia Lekarska) databases for the years 1960–2018. The following search terms were used: multiple personality, dissociative identity disorder, dissociative identity disorder and children. On the basis of a meta-analysis of the available literature, we offer a general characterization of the disorder, describe its symptomatology, present several theories of its etiology and conclude it through the prism of its adaptive function.

Results and Discussion: From the analysis of the gather data, we can conclude that multiple personality disorder can be a broad variant of the child's defense mechanisms against extreme, traumatic events from childhood, which they try to cope with by creating alter personalities. Abused children create other representations of the Self to be able to rid themselves of suffering, a process that is necessary for them to survive and further develop mentally and physically.

Conclusions: There is no doubt that Polish research on this disorder is much needed. It could provide more information on the epidemiology, diagnosis, and treatment of multiple personality. In addition, a better understanding of the issue might bring us closer to the understanding of how the human mind works.

Open access
Kleptomania in a 15-year-old boy with ADHD – a case report

Abstract

Aim: The aim of the study was 1) to report the case of a 15-year-old boy who developed kleptomania symptoms during methylphenidate treatment and 2) to review the available therapeutic options for kleptomania based on a literature search of Medline and Google Scholar databases (2000–2018).

Case report: For the past seven years a 15-year-old boy had participated in counselling at a psychological counselling centre because of school problems and upbringing difficulties, and had a five-year history of psychiatric treatment for ADHD. He was admitted to the Department of Psychiatry because of recurrent stealing episodes that occurred during methylphenidate treatment. During the hospitalization, the patient did not observe the therapeutic contract – he stole items from other patients. Pharmacotheraputic and psychotherapeutic treatment resulted in a partial improvement in impulsive behaviour. At discharge, he spoke critically of his previous conduct and expressed readiness to continue treatment in an outpatient setting.

Conclusions:

  1. Kleptomania has a very negative impact on a patient's overall well-being.
  2. In the reported case, kleptomania developed during methylphenidate treatment.
  3. Kleptomania should always be taken into account as a possible cause of stealing during a psychiatric examination, to avoid stigmatization of patients as criminals.
  4. Pharmacotherapy and cognitive-behavioural psychotherapy focused on the development of strategies, which can help the patient to control the urge to steal, are important components of kleptomania treatment.

Open access
Nutritional assessment of omega-3 fatty acids intake in schizophrenia patients group

Abstract

Introduction: Schizophrenia is a chronic mental disease which significantly affects functioning and quality of life of patients. Lifestyle, including irregular eating habits, is a factor possibly intensifying symptoms of the disease and unwanted effects of pharmacotherapy. Due to positive effect on metabolic parameters demonstrated in numerous studies and participation in structure and functioning of central nervous system, omega-3 essential unsaturated fatty acids (EFAs) are the suggested form of schizophrenia cotheraphy.

Aim: The purpose of this paper was to evaluate EFAs (especially omega-3 family) consumption by individuals with schizophrenia and comparing contents of these acids in the diets of female and male patients.

Method: A study was conducted with the participation of 32 patients, recruited in the Psychiatric Outpatient Department of the Independent Public Clinical Hospital No. 1 in Lublin, with diagnosed schizophrenia. Data concerning the intake of EFAs was acquired in the course of 24-hour diet recall.

Results: Average intake of omega-3 EFAs in the examined population was 2.40 ± 2.85 g, of which only 201.6 ± 501.5 mg was constituted by EPA and DHA acids. The intake of omega-3 EFAs did not differ between men and women groups (p>0.05). Food rations of the 91% responders were characterised with the intake of EPA and DHA acids below the adequate intake level (AI).

Conclusions: Patients suffering from schizophrenia consume insufficient amounts of EPA and DHA acids. Evidence suggests that optimum intake of omega-3 EFAs could bring significant benefits for this group of patients. People suffering from schizophrenia should be attended with the care of a dietician, who will choose optimum strategy for supplying sufficient amount of nutrients in the diet.

Open access