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Aneta Perzyńska-Starkiewicz

Abstract

This article reminisces about the life and career of Jan Mazurkiewicz, one of the most outstanding Polish psychiatrists – the author of Psychophysiological Theory, an original conception of mental disease based on the theory of evolution and dissolution of the nervous system developed by the Englishneurologist John Hughlings Jackson. Professor Jan Mazurkiewicz was an active organizer of psychiatric care. He was co-founder and director of hospitals in Kochanówka and Kobierzyn. He held the rank of Associate Professor at the John Casimir University in Lviv and the position of Professor at the Jagiellonian University in Cracow. From 1919 until his death in 1947, Professor Jan Mazurkiewicz was the head of the Department of Psychiatry at the University of Warsaw. For twenty three years, starting from 1924, he was the president of the Polish Psychiatric Association. The Mazurkiewicz's Psychopathological Theory provides a natural model of development of the highest psychic functions. Damage to a higher evolutionary level of the nervous system leads to the activation of the previously suppressed lower levels, transformed by the pathogen into psychopathological symptoms. Mazurkiewicz's scientific thought was adopted and developed by his student andthen, collaborator, Professor Mieczysław Kaczyński, who was later to become the head of the Department of Psychiatry in Lublin. This work discusses the research conducted at Lublin's Department of Psychiatry which expands on Mazurkiewicz's theory

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

Aneta Perzyńska-Starkiewicz

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

Rafał Dubiel, Adam Perzyński, Ida Kłębukowska, Aneta Perzyńska-Starkiewicz, Iwona Chmiel-Perzyńska and Marcin Olajossy

Abstract

The paper describes a patient, who has been consulted and hospitalized multiple times, due to dermatological lesions on his face. We will present his medical history and describe circumstances leading to the final diagnosis of factitious disorder. In the theoretical part we will try to answer the question, whether the extreme severity of the factitious disorders can, at some point, reach the level of delusions.

Open access

Anna Urbańska, Agnieszka Lis, Mateusz Sołowiej, Aneta Perzyńska-Starkiewicz, Diana Szymczuk and Marcin Olajossy

Abstract

Purpose: A case of schizophrenia with coexisting obsessive-compulsive symptoms is reported.

Case: The frequency of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) occurrence among patients suffering from schizophrenia is considerably higher in comparison to general population. The results of some studies show that schizo-obsessive disorder is characterized by higher intensity of negative and depressive symptoms. Patients with comorbid schizophrenia and obsessive-compulsive disorder show greater level of social dysfunction and they exhibit suicidal behaviours more often than patients diagnosed with schizophrenia. We present a 33-year-old female with obsessive-compulsive symptoms with onset in her early teens with no satisfactory response to treatment, in spite of her good intellect and insight into illness and cooperation.

Comment: There is some evidence suggesting that patients with “schizo-obsessive disorder” have a worse prognosis compared to the group of patients suffering only from schizophrenia, but the effect of OCD on schizophrenia symptom profile is unclear.