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Open access

Paulina Wróbel-Knybel, Michał Flis, Rafał Dubiel and Hanna Karakuła-Juchnowicz

Abstract

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.

Open access

Aleksandra Iwanicka, Joanna Iwanicka and Anna Urbańska

Abstract

The aim of the article is to point out to the specificity and difficulties an expert psychologist faces while producing a court expertise in family and guardianship cases. Such a diagnosis is prepared at the request of a family court. The questions asked by the court in family and guardianship cases determine the range and aim of diagnosis including the type of examined case. Having considered the court’s questions, a psychologist formulates hypotheses and operationalizes variables. This article will present the main areas of problems which arise while developing opinions in family and guardianship cases. The two main issues will be discussed: the range of an expert psychologist’s competences in the light of the court’s expectations frequently exceeding an expert’s capabilities and the impact of the choice of research methods on the quality of an opinion issued to obtain the final ruling in the court case.

Open access

Małgorzata Futyma-Jędrzejewska, Ewelina Drzał and Hanna Karakuła-Juchnowicz

Summary

Pregnancy, childbirth and motherhood are new situations for women and require adjustment. Women suffering from schizophrenia require special attention due to the course of the disease. Physiological changes that occur in the body during pregnancy may be unacceptable for women suffering from schizophrenia. They may delusively deny the existence of the pregnancy, lead an unhealthy lifestyle (stimulants, poor diet, lack of gynaecological check-ups), which in turn causes an increased risk of complications. In the research conducted so far, it has been proven that three kinds of complications are associated with schizophrenia: complications concerning pregnancy itself (bleeding, diabetes, Rh-incompatibility, pre-eclampsia), intrauterine growth restriction (low birth weight, congenital malformations, small head circumference) and complications regarding labour (uterine atony, asphyxia, emergency Caesarean section). The course of the labour itself in this specific group of patients has not yet been sufficiently examined. It has also been proven that perinatal complications are one of the factors determining an increased risk of schizophrenia.

Open access

Aneta Perzyńska-Starkiewicz

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

S. M. Yasir Arafat

Abstract

Objectives

There has been a plethora of studies conducted on different aspects of parenting and how it affects children. However, assessment of parenting style and dimension is untouched in Bangladesh. The Parenting Style and Dimension Questionnaire (PSDQ) is a self-reporting questionnaire responded by parents regarding their parenting practices, which assesses the three categories of parenting styles, namely, authoritative, authoritarian, and permissive. It was aimed to adapt and validate PSDQ in Bangla which is the mother tongue of the people of Bangladesh.

Methods

The validation study was conducted from January 2017 to June 2018 in three schools of Dhaka city with the self-reporting semi-structured Bangla version of PSDQ. The adaptation of PSDQ to Bangla was performed according to the state-of-the-art procedure of forward–backward translation. Parents having children aged 6–16 years were approached through schools to participate in the study. Data were collected from 349 parents and analyzed using Statistical Package for the Social Science version 16.0 software.

Results

Cronbach’s alpha of PSDQ Bangla was 0.84, which signifies a good internal consistency. Cronbach’s alpha of authoritative domain was 0.95, authoritarian domain 0.88, and permissive domain 0.78. A total of three factors were extracted using exploratory factor analysis with varimax rotation after discarding four items that had poor correlation and factor loading values. The three extracted factors were authoritative, authoritarian, and permissive; these are similar with the initial three dimensions of PSDQ.

Conclusions

Current study resulted in PSDQ Bangla, which retains 35 items in 3 domains with distribution of 20 items in authoritative domain, 9 items in authoritarian domain, and 6 items in permissive domain. The 35-item PSDQ Bangla can be a psychometrically reliable and valid tool to use in clinical setting of psychiatric practices in Bangladesh, especially to deal with child psychiatric disorders.

Open access

Jenny Hufenreuter, Josephine Otto and Michael Linden

Abstract

Objectives

Training, treatment and quality assurance in occupational therapy need guidelines and manuals. Two manuals and corresponding manual adherence checklists were developed for resistance- and regeneration-oriented treatment strategies, which are standard in occupational therapy. The hypothesis is that occupational therapists can apply different treatments and that this can be measured.

Methods

In a psychiatric-psychosomatic rehabilitation hospital, 108 patients were randomly assigned to the regeneration group and 113 to the resistance group. Patients were asked to indicate on a manual adherence checklist which interventions they had experienced during treatment. Additionally, a convenience sample of 124 patients who had not participated in the special groups but only in routine occupational therapy was interviewed at the end of the hospital stay.

Results

Resistance-oriented interventions were significantly more often reported in the resistance group and regeneration-oriented intervention was reported in the regeneration group.

Conclusions

The study demonstrates that the occupational therapy can be standardised according to treatment manuals and that protocol adherence can be ascertained, similar to that in other psychotherapies. This is important for training, practice, research and quality control, as manual guided and monitored treatment allows transparency in regard to what should and what has been done in therapy.

Open access

Niku Dhillon and Reinhard Heun

Abstract

Objectives

Clozapine is an effective antipsychotic medication licenced for the management of treatment resistant schizophrenia. Due to its non-selective pharmacology, it has a broad range of side effects. Nocturnal enuresis secondary to the use of clozapine has been documented in the literature but may be overlooked, the link between drug and symptom being clinically unnoticed. Patients may not mention urinary symptoms due to supervening psychosis, co-existing symptomatology, embarrassment or shame. By raising awareness of the phenomenon, early recognition and patient support may improve compliance with clozapine medication, and consecutively, overall mental health. Consequently, this systematic review investigates the prevalence of nocturnal enuresis secondary to clozapine use.

Methods

A literature search on clozapine and nocturnal enuresis was used to identify the relevant papers. Papers providing the prevalence data on Clozapine associated nocturnal enuresis were selected for data extraction.

Results

47 papers were initially identified. Eight papers focused on the prevalence of clozapine associated nocturnal enuresis (CANE). Point prevalence (nocturnal enuresis at the time of assessment), 1-month prevalence and episode prevalence (nocturnal enuresis since beginning of clozapine) were given. Papers included patients with schizophrenia, schizoaffective disorder, bipolar affective disorder and psychotic depression, taking clozapine medication. The prevalence of CANE ranged from 10–42%. Point prevalence was 21–27%, 1-month prevalence was 10–39% and episode prevalence was 15–42%. Clozapine was more likely to cause nocturnal enuresis compared to other psychotropic medication.

Conclusion

The prevalence of CANE may be greater than previously thought. However, in order to determine an accurate prevalence of clozapine associated nocturnal enuresis, larger studies with strict inclusion criteria, common definition of diagnosis and prevalence are required. By establishing an accurate prevalence, physician awareness can be improved, and patients can becounselled on the risk of developing the side effect, thus improving early identification and reducing discontinuation rates.

Open access

Aneta Gerhant, Ewa Krzewicka-Romaniuk, Dagna Siedlecka, Magdalena Derewianka-Polak and Marcin Olajossy

Abstract

Objective: The aim of the study was to determine differences in the range of socio-demographic variables, selected clinical variables, temperament and character traits, coping with stress strategies and the level of aggression in alcohol addicts with or without a history of suicide attempt(s). Methods: The study involved 90 people addicted to alcohol, treated in inpatient alcohol dependence treatment program. In order to collect data on socio - demographic variables and selected clinical variables, a self-made questionnaire was used. The severity of alcohol dependence was verified using the MAST and SADD scales. Characteristics of temperament and character were examined with the TCI questionnaire. The BPAQ and COPE questionnaires were used to examine the level of aggression and styles of coping with stress. Results: Out of 90 subjects with alcohol dependence syndrom, 20% had attempted suicide in the past. The respondents with a history of suicide attempts were statistically significantly younger, were characterized by a younger age of alcohol drinking initiation and the initiation of regular alcohol drinking, and a greater severity of alcohol dependence in the MAST and SADD scales. A significantly larger percentage of respondents who had attempted suicide inflicted self-injury in the past, used other psychoactive substances as well as hypnotics and sedatives. The subjects with a suicide attempt in the interview obtained statistically significantly higher scores in terms of the level of aggression, harm avoidance and self-directedness, and more often used the style of coping with stress based on avoidance and accepting the situation. Conclusions: The obtained results correspond with data available in the literature and may provide a foundation for theoretical models explaining the phenomenon of suicidal behavior in alcohol addicts as well as for suicide prevention programs in this group of patients.

Open access

Reinhard Heun

Abstract

Obsessive compulsive disorder (OCD) is a severe, often long-term mental disorder. It may be independent from, or comorbid with other mental disorders, especially depression and anxiety disorders. Suicidal thoughts, ideations and ruminations are prevalent in subjects with OCD, but it is not yet clear if the incidences of attempted and completed suicides have increased in comparison with the general population and with other psychiatric disorders.

Methods

We conducted a systematic literature search on the incidence of suicide attempts and completed suicides in subjects with OCD. Search terms for Pubmed and Medline were OCD and suicide. We selected papers providing follow-up data on the incidence of attempted and completed suicide in OCD.

Results

404 papers were initially identified. Only 8 papers covering six studies provided prospective data on attempted or completed suicide over a defined period in subjects with OCD, four studies included control subjects. Two studies providing follow-up data were limited to high-risk samples and did not provide enough data on the incidence of suicide in comparison with the general population. The conclusion that there is an increased risk of attempted and completed suicides in OCD can only be based on one large Swedish National Registry sample with an up to 44 year follow up. Psychiatric comorbidity is the most relevant risk factor for suicide.

Conclusions

Even though some studies report an increased incidence of attempted and completed suicides in OCD patients from selected high risk samples, the evidence from population based studies is mostly based on one large Swedish study. More long-term studies in the general population with a reduced risk of subject attrition are needed. Using a clear definition and assessment of suicidal behaviour and a common time-frame would improve the comparability of future studies.

Open access

Giuseppe Carrà, Giulia Brambilla, Manuela Caslini, Francesca Parma, Alessandro Chinello, Francesco Bartoli, Cristina Crocamo, Luigi Zappa and Costanza Papagno

Abstract

Objectives

Since evidence on executive control among women with Anorexia or Bulimia Nervosa (AN/BN) are somehow inconclusive, we aimed to explore whether performance in set-shifting in AN/BN might be influenced by Facial Emotion Recognition (FER).

Methods

We randomly recruited women with a diagnosis of AN or BN, from an Eating Disorders Outpatient Clinic in Italy, as well as healthy controls (HCs). We evaluated with established tools: diagnosis (Eating Disorder Examination- EDE-17.0), executive control (Intra-Extra Dimensional Set Shift-IED) and FER (Ekman 60 Faces Test-EK-60F). Univariate distributions by diagnostic subgroups were assessed on sociodemographic and clinical variables, which were selected for subsequent multiple linear regression analyses.

Results

Women with AN performed significantly worse than HCs on IED adjusted total errors. HCs scored significantly better than AN and BN on EK-60F fear subscale. Although IED set shifting was associated (p = 0.008) with AN, after controlling for age, EK-60F fear subscale, alexithymia and depression (i.e., clinically relevant covariates identified a priori from the literature, or associated with AN/BN at univariate level), this association could not be confirmed.

Conclusions

Impaired executive control may not be a distinctive feature in women with AN, since several clinical characteristics, including fear recognition ability, are likely to have an important role. This has significant implications for relevant interventions in AN, which should aim at also improving socio-emotional processing.