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In 2024, we observe the fortieth anniversary of the publication, where, for the first time, the term of Seasonal Affective Disorder (SAD) was used. Presently, SAD is regarded as a special category of mood disorder. In the American Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V), the seasonality makes a specifier, "with seasonal pattern", both for recurrent depression or Major Depressive Disorder (MDD), and for Bipolar Disorder (BD). The most spectacular phenomenon among SAD is winter depression. Its symptomatology is mostly similar to atypical depression, characterized by excessive sleepiness and carbohydrate craving. SAD can pertain up to one fifth of persons with MDD or BD and is more frequent in women. SAD can be considered as an extreme expression of the central nervous system (CNS) changes related to circannual rhythm of lighting. The seasonal changes of the CNS function apply to the secretion of melatonin, the neurotransmitters dopamine and serotonin and the hypothalamic-pituitary-adrenal axis. In the circadian and circannual processes, a significant role is played by so-called "clock genes". SAD may be a legacy of Homo neanderthalensis. In winter depression, the therapeutic effect is obtained by an exposition to bright light (bright light therapy -- BLT) as well as to blue light or using the method of dawn simulation. The therapeutic effect of phototherapy has also been ascertained in non-seasonal depression. As a counterpoint to this mechanism, promising trials have been undertaken in manic states by light restriction using blue light blocking glasses. [ABSTRACT FROM AUTHOR]

The Polish standard of treatment with racemic ketamine for patients with depressive disorders was developed by a Working Group appointed by the National Consultant in the field of psychiatry. Despite the wide range of available medications, as many as one-third of depressed patients do not respond to standard antidepressant treatment, raising the need for an ongoing search for new effective and safe therapies. In recent years, the possible role of overactivity of the glutamatergic system in the etiopathogenesis of depression has again attracted the attention of many experts. The possibility of using substances with a modulating effect on the glutamatergic system in the treatment of depressive disorders has been postulated, among others, the long-known anesthetic ketamine, which is a noncompetitive NMDA receptor antagonist. This paper summarizes the results of studies on the efficacy and safety of racemic ketamine (administered intravenously) in the treatment of patients with depressive symptoms in the course of both unipolar and bipolar affective disorder, and, meeting the expectations of many practicing psychiatrists wishing to broaden the range of therapies offered to their patients, presents recommendations on indications, contraindications, precautions and the treatment regimen itself with intravenous ketamine for patients with mood disorders. [ABSTRACT FROM AUTHOR]

Consciousness is most frequently defined as a subjective experience of mental processes. The phenomenon of consciousness has always been a subject of great interest in various fields of science, including psychiatry, and the most prominent scientists have engaged in research on it. The studies performed in recent years have brought about novel data on the evolutionary and neurobiological attributes of this phenomenon. In the first part of the article, the evolutionary concepts of consciousness are presented, going back to the beginnings of life on our planet. They are proposed by such illustrious scientists as Joseph LeDoux, Daniel Dennett, António Damásio, and Arthur Reber. Each of them presents the issue of consciousness in the context of evolution slightly differently. However, there are many similarities concerning the development of the nervous system and mental life. The second part discusses the novel research on the cognitive and neurobiological components of consciousness. Among many researchers of this issue, we chose the achievements of two British authors such as Chris Frith and Anil Seth. The neuroanatomical and perceptive aspects of both the level and context of consciousness are provided. Besides presenting the contemporary evolutionary and neurobiological concepts of consciousness, the article aims to bring closer the profiles of the prominent researchers of neuroscience mentioned here. This term can be translated into Polish as "neuronauka", although our country's most frequently used name is "neurobiologia." [ABSTRACT FROM AUTHOR]

Bipolar affective illness (bipolar disorder - BD), also known as manic-depressive illness, is characterized by periodic opposite states of mood, activity, and motivation (mania and depression), sometimes of extreme intensity. The development and maintenance of such states in evolution can betoken a possibility of their adaptive character, enabling adaptation to an unfavorable external situation (depression) and a mobilization to using resources when available (mania). In the article, the main focus is put on the evolutionary aspect of "bipolarity" and manic/hypomanic states. Molecular-genetic studies show that in evolution, the genes connected with a predisposition to BD have been conserved. In the paper, the evolutionary adaptive concepts connected with the functioning of Homo sapiens during the middle and late Pleistocene periods were discussed as well as the "mismatch" theories associated with not befitting brain functioning to contemporary conditions. The benefits of mania and hypomania, also in the context of their link to depression were delineated, indicating their relationship to the increase in reproductive success. They result from such features of mania/hypomania as increased exploratory, psychomotor and sexual activity, and prompt risk-taking. The reproductive success can be connected with hyperthymic and cyclothymic temperaments, most frequently occurring in subjects with BD. The hyperthymic temperament often leads to increased social status and a tendency to leadership, and the cyclothymic temperament can increase creativity. Examples of the relationship between manic/hypomanic states and the phenomenon of emigration as well as the advancement of American society are provided. [ABSTRACT FROM AUTHOR]

COVID-19 pandemics reactivated interest in the relationship between mental diseases and infectious factors. In this narrative review, such association for tuberculosis, syphilis, toxoplasmosis, influenza, and COVID-19 was discussed. A connection between tuberculosis and melancholia was postulated for several centuries. In the 1950s, an anti-tuberculosis drug, iproniazid, was found to exert an antidepressant effect. In the 20th century, it was demonstrated that psychiatric disturbances connected with syphilis can be treated by an inoculation of malaria, which initiated immunotherapy. Increased frequency of Toxoplasma gondii infections in psychiatric illnesses was found and higher risk of the illnesses following the infection in pregnancy. A more frequent incidence of schizophrenia in persons born during the influenza pandemic in the second half of the 20th century was evidenced. Mental disturbances can result from an ancient infection of the human genome by retroviruses. Infection during pregnancy can increase their risk in later life. Pathogenic can be also an infection in adult life. COVID-19 causes significant early and late consequences for mental health. Two-year pandemics observation brought data on the therapeutic action of psychotropic drugs on SARS-CoV-2. Despite previous data on the antiviral action of lithium, a significant effect of this ion of the prevalence and course on the COVID-19 was not confirmed. [ABSTRACT FROM AUTHOR]

Lithium is a drug of choice as a mood-stabilizer for the maintenance treatment of bipolar disorder (BD). The prophylactic efficacy of lithium can be determined by genetic factors, partially related to a predisposition to bipolar disorder. In the field of psychiatric genetics, the first decade of the 21st century was dominated by the "candidate gene" research. In this paper, the studies on candidate genes associated with lithium prophylaxis performed at the Poznan University of Medical Sciences in 2005-2018 are presented. During this time, the polymorphisms of multiple genes have been investigated, many of which are also associated with a predisposition to bipolar disorder. The associations with lithium prophylactic efficacy were found for the polymorphisms in 5HTT, ACP1, ARNTL, BDNF, COMT, DRD1, FKBP5, FYN, GLCC, NR3C1, and TIM genes, but not those in 5HT2A, 5HT2C, DRD2, DRD3, DRD4, GRIN2B, GSK-3P, MMP-9, and NTRK2 genes. The polymorphism of the GSK-3P gene was found to be associated with the kidney side-effects occurring during lithium therapy. Possible roles for these genes in both the mechanism of lithium prophylactic efficacy and pathogenesis of bipolar disorder were discussed. [ABSTRACT FROM AUTHOR]

Aim. The efficacy of vortioxetine in major depressive disorder has been evaluated in many studies. However, there is a lack of studies assessing vortioxetine in bipolar depression. Material and method. In 60 patients with bipolar depression, vortioxetine 10-20 mg daily was added to current mood stabilizing medication during 24-week, naturalistic, openlabel study. The most frequent mood stabilizers were lamotrigine, quetiapine, olanzapine, and valproates. The therapeutic efficacy was evaluated by the Clinical Global Impression - Improvement (CGI-I) and Clinical Global Impression - Severity (CGI-S) scales. Patients were classified as responding to vortioxetine when they achieved 1 or 2 points on the CGI-I scale at any stage of observation. The criterion of remission was defined as score 1 at the CGI-S. Results. 73% of all patients (44/60) responded to vortioxetine and 52% (31/60) achieved clinical remission of depressive symptoms (in mean 8.97 ± 4.05 weeks). There were no significant associations between vortioxetine response/remission rates and: (1) the dose, (2) BD type, (3) clinical stage, (4) presence of rapid cycling, (5) history of psychotic symptoms, analyzed depressive symptoms, and (6) concomitantly used mood stabilizer. 4 patients (6.7%) stopped treatment due to adverse effects (nausea), and 7 patients (11.7%) discontinued treatment due to the phase switch. 14 patients (23%) experienced a loss of vortioxetine effectiveness after the initial response or remission. Conclusions. The results indicate relatively high rates of response and remission during 24-week treatment in depressed bipolar patients receiving vortioxetine concomitantly with a mood stabilizer. This may indicate that vortioxetine added to a mood stabilizer may constitute an efficient and well tolerated therapeutic option in bipolar depression. [ABSTRACT FROM AUTHOR]

Aim. Comparison of the frequency of childhood traumatic events between a group of patients with bipolar disorder (BD), borderline personality disorder (BPD) and healthy persons. Methods. The study included 35 patients (10 male, 25 female) with BD, hospitalized in the Department of Adult Psychiatry in Poznań, the Neuropsychiatric Hospital in Kościan and the Medical Centre in Milicz, as well as 35 patients (9 male, 26 female) with BPD under the care of the Józef Babinski Hospital in Kraków. Seventy-one healthy persons (22 male, 49 female) constituted a control group. The Polish version of the Childhood Trauma Questionnaire (CTQ) was used. Results. In both clinical groups, no gender differences as to the CTQ indexes were found. Patients from both groups had more frequent childhood trauma compared with control subjects. Patients with BPD showed significantly higher CTQ indexes than those with BD. Conclusions. The obtained results indicate significantly more frequent experience of traumatic events in childhood in patients with BPD compared with BD. This is discussed in the context of the pathogenesis and treatment of both conditions. It is probable that in BPD childhood trauma plays the biggest role among all psychiatric disturbances. [ABSTRACT FROM AUTHOR]

The contemporary clinical idea of bipolar affective disorder (BD) has been shaped as an aftermath of Emil Kraepelin's thought named "manisch-depressives Irresein", put forward in 1899, with essential modifications during the last half-century. A current paradigm for the etiopathogenesis of BD postulates the emergence of the illness as a result of an interaction between genetic and epigenetic factors with environmental influences. The most important for the molecular genetics of BD were the analyses of so-called candidate genes and genome-wide association studies (GWAS). The genetic BD profile includes many genes predisposing to other psychiatric disorders. Epigenetic disturbances constitute a mediating mechanism for the influence of environmental factors in the early period of life. Some neurobiological concepts of BD have a pharmacological origin, resulting from the mechanisms of the drugs used in the illness. They include catecholamine, cation transport, and purinergic theories. Such concepts as the neuroplasticity disturbances, "inflammatory" theory, and stress axis dysfunction resulted as an extrapolation of the initial pathogenetic hypotheses of depression. New pathogenetic theories of BD include the disturbances of biological rhythms and mitochondrial and oxidative stress dysfunctions. In BD there are abnormalities of the functions of the brain structures, in particular, the so-called anterior limbic system. Pathogenetic environmental influences include factors operating in pregnancy, early childhood trauma, stressful events in later life as well as seasonal and climatic factors. Both the pathogenesis and the course of BD are presently perceived in a developmental context, reflected by the staging concepts of the illness. [ABSTRACT FROM AUTHOR]

In 2021, one-hundred and ten years passed since a Swiss psychiatrist, Eugen Bleuler, introduced a term 'schizophrenia', denoting one of the most severe and stigmatizing psychiatric illnesses. Presently, it is known that the etiopathogenesis of schizophrenia is multifactorial, and a neurodevelopmental theory has been the most important pathogenic concept for more than 30 years. The theory postulates an interaction between genetic predisposition and environmental factors. In recent years, mainly thanks to employing the genome-wide association studies (GWASs), many molecular-genetic processes increasing a predisposition to schizophrenia have been identified. In the article, the role of pregnancy and perinatal period for risk of developing schizophrenia was considered. In patients with schizophrenia, as early as in childhood and adolescence, the disturbances of brain development occur, reflected, among others, by an impairment of cognitive functions. Childhood trauma makes a risk factor for developing schizophrenia and a less favorable course of the illness. The arising of the first psychotic episode is boosted by socio-environmental factors (e.g., migration, urbanicity) and psychoactive substance use, both increasing dopaminergic activity of the brain. In the paper, contemporary knowledge on the pathogenesis of psychotic and deficit symptoms and disturbances of cognitive functions was presented. This was done concerning the neurotransmitters' changes and genetic and neuroimaging studies, with emerging therapeutic implications. At the end of the article, a current position of schizophrenia in the context of dichotomic division of mental disturbances put forward by Emil Kraepelin in 1899 was discussed. [ABSTRACT FROM AUTHOR]

The paper presents the current state of knowledge on lithium treatment. The history of the therapeutic application of lithium began in 1859 and its introduction to modern psychiatry took place 90 years later. Since the early 1960s, lithium became a precursor of mood-stabilizing drugs and nowadays is the drug of choice for the prevention of manic and depressive recurrences in mood disorders. It remains a valuable drug for the treatment of acute episodes of mania and depression, especially for the augmentation of antidepressant drugs in treatmentresistant depression. The factors of prophylactic efficacy of lithium in the context of the so-called excellent lithium responders and the efficacy in affective episodes were discussed. Among mood-stabilizing drugs, lithium exerts the biggest effect on preventing suicidal behaviors. It also shows antiviral (mainly against herpes viruses) and immunomodulatory activity. The evidence has recently been gathered on neuroprotective and 'antidementia' properties of lithium, which prompted its use in neurodegenerative disorders. The biochemical mechanism of lithium is associated mainly with the inhibition of glycogen synthase kinase-3 and an effect on intracellular signaling. The recommendations for managing lithium-induced adverse effects both in the early and late period of treatment as well as for lithium use in pregnancy and perinatal period were given. The necessity of overcoming negative perceptions of lithium was pointed out to increase the number of possible beneficiaries of lithium treatment. Both introduction of lithium into modern psychiatry and its therapeutic effects have been reflected in literature and art. [ABSTRACT FROM AUTHOR]

The third part of the triptych of my 50-year activity in psychiatry is about psychopharmacology. This way of treatment changed the picture of contemporary psychiatry. The introduction of neuroleptic (antipsychotic) drugs and tricyclic antidepressants in the 1950s resulted in a therapeutic revolution and contributed to the 'medicalization' of psychiatry and its therapeutic similarity to other non-surgical specialties. A discovery of prophylactic lithium activity in the 1960s initiated the mood-stabilizing drugs. During the last half-century, the most dynamic was the 1990s when most antipsychotic and antidepressant drugs of the so-called new generation were introduced. The twenty-first century marks a debut of next antidepressant and antipsychotic drugs, some of the latter having long-acting injectable preparations. An interesting event was a demonstration of the antidepressant activity of ketamine. My research domain in psychopharmacology was lithium treatment of affective illnesses. Lithium makes the topic of many papers I authored, more than 150 of them are in the PubMed database. Many clinical and research aspects related to lithium administration have been reported as first in Polish literature and some are pioneering in the world. Recently, I wrote the book Lithium -- the amazing drug in psychiatry which has also its English version. I have carried much research on antidepressant drugs, pharmacotherapy of treatment-resistant depression, and mood-stabilizing drugs for which I proposed a modern classification. I participated in European projects EUFEST and OPTIMISE on the optimization of using antipsychotic drugs in schizophrenia. I also performed much research on the antidepressant effect of ketamine and electroconvulsive therapy. [ABSTRACT FROM AUTHOR]

The last half-century, thanks to the efforts of outstanding researchers, brought about great progress in the pathogenesis and clinics of affective illnesses. The catecholamine and serotonin hypothesis delineated in the 1960s have retained significant merit. Since the 1990s, the theories have pointed on excessive immune activation and impairment of neuroplasticity under stress. Since the 1970s, a systematic subclassification of unipolar and bipolar affective disorder has proceeded. Epidemiological studies of the last half-century indicated a significantly higher prevalence of depression compared with previous decades. The 21st century brought evidence for a greater frequency of various forms of bipolar affective disorder. During the last 50 years, the etiopathogenesis, diagnosis and treatment of affective disorders were my favorite and fascinating clinical and research topics. This initiated in 1970 when I began my work in the Department of Psychiatry, Medical Academy in Poznan, on account of the introduction of lithium salts for the treatment of these disorders. In 1976-1977, I received a fellowship of the National Institutes of Health at the University of Pennsylvania in Philadelphia and participated in research that elucidated the mechanism of lithium transport across cell membranes. I carried out the studies on the pathogenesis of affective disorders for more than 40 years afterward. They concerned abnormalities of transport across cell membranes, the activity of stress system, excessive pro-inflammatory activation, molecular genetics, dysfunctions of cognition and neurotrophins, especially the brain-derived neurotrophic factor (BDNF). At the beginning of the 21st century, I coordinated two Polish epidemiological projects DEP-BI and TRES-DEP. For my research on bipolar disorders, I received many international awards. I am also the author of the book The faces of manic-depressive illness which had three Polish editions as well as English and Russian versions. [ABSTRACT FROM AUTHOR]

In three articles, I discuss the 50 years of my work in psychiatry, in the formula of so-called participant observation. The first one is about schizophrenia. I present important events of the pathogenesis and diagnostics in a recent half-century and my attempts to contribute to the research. Significant for clinical description was distinguishing the positive and negative symptoms of schizophrenia. The evidence for subcortical dopaminergic hyperactivity associated with positive (psychotic) symptoms, and prefrontal dopaminergic hypoactivity, responsible for mental deficits and cognitive impairment, has been obtained. Inhibition of the dopaminergic system (blocking of dopaminergic receptors D2) is the main therapeutic mechanism of antipsychotic drugs. Neurobiological and genetic data also pointed to the role of the glutamatergic system in schizophrenia, which prompted trials of pharmacotherapy. For more than 30 years, the neurodevelopmental hypothesis of schizophrenia, assuming the interaction of genetic and environmental factors, leading to the first psychotic episode, has been the most important pathogenetic concept. In the 1990s, under my direction, neurobiological studies on schizophrenia were performed in the context of positive and negative symptoms and differences vs. mood disorders. Verification of the niacin test, a possible diagnostic aid in schizophrenia, was also made. In the recent two decades, molecular-genetic studies in schizophrenia, also using cognitive endophenotypes and eye movements, have been performed. The association of the polymorphism of various genes with schizophrenia or its endophenotype has been demonstrated, frequently, the first time in the world. In recent years, I directed a team implementing the Polish versions of new scales for the assessment of negative symptoms of schizophrenia. [ABSTRACT FROM AUTHOR]

Aim. With respect to bipolar disorder (BD), previous research have demonstrated saccadic eye movements abnormalities, manifested mainly as an increase in reaction time (latency) in both prosaccadic and antisaccadic task. So far, there were no studies related to vergence eye movements in subjects with BD. Our primary aim was to evaluate vergence tracking performance in this clinical group. Methods. 30 patients with BD in remission and 23 healthy controls were enrolled. Subjects underwent optometric examination where near point of convergence was measured by the use of Wolff Wand. Instrumented convergence measurements were performed using infrared eye tracker and dedicated vergence stimuli generator. Results. BD patients presented significantly higher average error between eyes' convergence and convergence required to fixate the target and higher number of saccadic intrusions compared with healthy controls group. Principal component analysis performed on oculometric parameters revealed differences between BD patients and healthy controls. Significant correlations between the vergence disturbances and saccadic intrusions were found. Conclusions. BD patients showed the alterations of the vergence eye movements similar to the disturbances of eye movements in the fronto-parallel plane. While the abnormalities of vergence eye movements in some mental disorders have been reported, we have for the first time objectively measured this phenomenon in BD. [ABSTRACT FROM AUTHOR]

Bipolar disorder (BD) is characterized by pathological changes in mood as well as recurring episodes of mania, hypomania, depression and mixed symptoms. In recent years, the number of BD diagnoses has risen considerably in children and adolescents. It is believed that an average rate of prevalence of bipolar spectrum disorder in the pediatric population is 1.8%, and BD type I -- 1.2%, and the prevalence of the disorder increases with the age of patients. Despite the same diagnostic criteria, there are premises that suggest that the symptoms of the disorder are present with a different frequency among children and adolescents than in adults. The most frequent manic symptom in persons with childhood-onset of the illness is thought to be irritability, and in adolescence -- hyperactivity. BD in children and adolescent population is accompanied by a high rate of comorbid psychiatric conditions. Attention deficit hyperactivity disorder and borderline personality disorder constitute particular diagnostic challenges. Early onset of BP is linked with a more severe course of the illness, worse prognosis, and a higher suicidal rate. Pharmacotherapy of BD in the pediatric population includes 1st and 2nd generation mood stabilizers, while their efficacy and safety profiles are different than in adults. The American Food and Drug Administration recommends treating manic episodes in young persons with lithium, aripiprazole, quetiapine, risperidone, olanzapine and depressive episodes with a combination therapy of olanzapine and fluoxetine. [ABSTRACT FROM AUTHOR]

Objectives. Electroconvulsive therapy (ECT) is the most effective treatment for drugresistant depression. In most studies, cognitive functions including working and semantic memory showed only transient impairment after ECT. However, the deficits of episodic (autobiographical) memory were demonstrated to be long-lasting. Methods. We investigated autobiographical memory in 20 patients (8 male, 12 female), aged 21-64 years, with drug-resistant depression, treated with ECT, using the Polish adaptation of the Autobiographical Memory Interview-Short Form (AMI-SF). The assessments were performed before, immediately after 10-12 ECT sessions, and 3 months thereafter. Results. Before the ECT, the mean severity of depression was 30 ± 6 points on the 17-item Hamilton Depression Rating Scale and the treatment produced a significant clinical improvement in all patients. The indices of autobiographical memory, as assessed by the AMI-SF, were significantly lower immediately after ECT and 3 months thereafter. The impairment in autobiographical memory did not show correlation with clinical improvement and with any other clinical factors. Conclusions. The results obtained in patients with drug-resistant depression confirm that ECT treatment produces a significant impairment of autobiographical memory persisting also three months after the procedure, suggesting that it may be the most important adverse cognitive effect of the ECT. [ABSTRACT FROM AUTHOR]

Purinergic system plays a role in the regulation of many psychological processes, including mood and activity. It consists of P1 receptors, with adenosine as the agonist, and P2 receptors, activated by nucleotides (e.g., adenosine 5'-triphosphate - ATP). Propounded disturbances of uric acid in affective disorders were related to the introduction of lithium for the treatment of these disorders in the 19th and 20th century. At the beginning of the 21st century, new evidence was accumulated concerning a role of uric acid in the pathogenesis and treatment of bipolar disorder (BD). In patients with BD, higher prevalence of gout and increased concentration of uric acid have been found as well as the therapeutic activity of allopurinol, used as an adjunct to mood stabilizers, has been demonstrated in mania. In recent years, the research on the role of the purinergic system in the pathogenesis and treatment of affective disorders and schizophrenia focuses on the role of adenosine (P1) receptors and nucleotide (P2) receptors. Activation of adenosine receptors is related to an antidepressant activity. Alterations of P2 receptors are also significant for the pathogenesis of affective disorders. The role of purinergic system in schizophrenia is related to the effect of adenosine and nucleotide receptors on dopaminergic and glutamatergic neurotransmission. A lot of data indicate that schizophrenia is related to a deficit of adenosine system. Changes in the purinergic system are also significant for psychopathological symptoms of schizophrenia and for the action of antipsychotic drugs. [ABSTRACT FROM AUTHOR]

Aim. The aim of the study was to create a Polish version of the Self-evaluation of Negative Symptoms (SNS) scale, to assess its internal consistency, and to make correlations between the SNS scores and the Brief Negative Symptom Scale (BNSS) scores in the group of patients with schizophrenia. Methods. The procedure of Polish adaptation of the French-language version of the SNS scale, comprising 20 items organized in 5 subscales: asociality, blunted affect, alogia, avolition and anhedonia, was carried out. Psychometric tests were performed in 40 patients with paranoid schizophrenia (20 men and 20 women) with severity of symptoms on the Positive and Negative Syndrome Scale (PANSS) 56±16 points, receiving unchanged pharmacological treatment in the last 3 months. Results. The Polish version of the SNS scale was accepted by the author of the scale, Professor Sonia Dollfus. The reliability analysis showed high values of the Cronbach's alpha coefficient for the whole scale (0.91) and for the subscales (0.61-0.85). The SNS and its subscales showed significant correlations with the total BNSS score and with the scores of the BNSS subscales, which confirms the validity of the scale. Conclusions. A statistically significant level of consistency of the whole scale and its individual domains with the results of the clinical assessment with the BNSS, speaks for the adequacy of the self - assessment of negative symptoms by a patient with schizophrenia. Good psychometric properties of the Polish version of the SNS obtained in the study can indicate its usefulness in the research on negative symptoms conducted in Poland. [ABSTRACT FROM AUTHOR]

Aim. To create a Polish adaptation of the Brief Negative Symptom Scale (BNSS), to assess the internal consistency of the Polish version of the BNSS, and to make correlations between the BNSS scores and the Positive and Negative Syndrome Scale (PANSS) in the group of patients with schizophrenia. Methods. The procedure of Polish adaptation of the assessment form (Scoresheet) of the BNSS, comprising 13 items organized in 6 subscales (anhedonia, lack of proper distress, asociality, avolition, blunted affect, and alogia), as well as the Manual and the Workbook of the scale was carried out. Psychometric tests were performed in 40 patients with paranoid schizophrenia (20 men and 20 women), aged 44±13 years, with illness duration of 17±10 years, and severity of symptoms on the PANSS 56±16 points, receiving unchanged pharmacological treatment in the last three months. Results. The Polish version was accepted by the authors of the scale. The reliability analysis showed high values of the Cronbach's alpha coefficient both for the whole scale (0.97) and for individual subscales (0.74-0.93). The BNSS and its subscales showed a high significant correlation with the total PANSS score and with the PANSS negative symptom subscale, both original and modified. Conclusions. The obtained results indicate good psychometric properties of the Polish version of the BNSS and its possible usefulness in the study of negative symptoms of schizophrenia conducted in Poland. [ABSTRACT FROM AUTHOR]

This article presents recommendations of the Polish Psychiatric Association regarding approach to pregnancy loss and unsuccessful in vitro treatment of infertility. From the psychological perspective pregnancy loss and perinatal death are amongst the most stressful events in human life - carrying increased risk of developing affective, anxiety or post-traumatic stress disorders. Psychologists, physicians and the rest of the medical staff should provide integrated and individualized care which should be based on respect, empathy and expertise. The necessary phases of support for women experiencing pregnancy loss are: (1) physician providing exhaustive informational support regarding state of health, potential causes of fetal death, further approach and phases of induced labor of the fetus/pregnancy termination/procedure, (2) facilitating psychological consultation at any time and (3) providing exhaustive information on current legal standing (health insurance and labor law). Experiencing recurrent in vitro fertilization failures may result in the emotional consequences similar to those observed in miscarriages. The prolonged frustration may favor developing depressive symptoms and escalate pathological anxiety. We present basic recommendations for psychotherapy and pharmacotherapy in pregnancy loss and unsuccessful in vitro infertility treatment. [ABSTRACT FROM AUTHOR]

In the article, the recommendations of the Polish Psychiatric Association regarding pharmacological treatment of women with bipolar disorder during pregnancy and postpartum period were presented. The issue pertains to every twentieth woman wanting to get pregnant. Before planned pregnancy, it is advisable to obtain a several-month stabilization of psychiatric state, to establish treatment with one mood-stabilizing drug (except for valproate and carbamazepine) or gradual discontinuation of drugs in case of mild course of illness and lack of recurrences in recent two years. In the first trimester of pregnancy, the dose of the mood-stabilizing drug should be reduced (lithium carbonate to 500 mg/day). Depression during pregnancy can be treated with quetiapine or lamotrigine or with antidepressant drug added to a mood-stabilizing drug. Atypical antipsychotics drugs with mood-stabilizing properties can be used in case of (hypo) manic or mixed states. Following the delivery, it is advisable to introduce a moodstabilizing drug as soon as possible to prevent postpartum psychiatric disturbances. In the treatment of postpartum depression, quetiapine can be used or an antidepressant drug added to a mood-stabilizer. Considering breastfeeding, it should be remembered that the infant/maternal ratio of serum drug concentration is low for valproate, olanzapine, quetiapine, sertraline and paroxetine, and high for lithium and lamotrigine. In the case of postpartum psychosis, a hospitalization and antipsychotic treatment are needed. [ABSTRACT FROM AUTHOR]

Treatment of depressive disorders in women of childbearing age requires special attention due to the possibility of planned or unplanned pregnancy and the specificity of mood disorders associated with the perinatal period. A doctor who treats depression in a woman of childbearing age should openly discuss with the patient her sexuality and the possibility of becoming pregnant. A psychiatrist may encounter various problems, such as: a therapeutic decision regarding a woman suffering from recurrent depression who receives preventive or maintenance antidepressant medication and becomes pregnant or plans to conceive; proceedings in the case of a depressive episode in a woman who is already pregnant; proceedings in the case of postpartum depression; antidepressant treatment in the context of breastfeeding. The recommendations were prepared by the working group of the Polish Psychiatric Association based on the latest worldwide standards as well as opinions and consensus of experts. The recommendations provide general principles of therapeutic approach and include data on the safety of antidepressants. [ABSTRACT FROM AUTHOR]