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The aim of the study was to present the increasingly alarming phenomenon of completed suicide in adolescents and young adults. The material analysed had been drawn from the records of post-mortem examinations conducted by the Institute of Forensic Medicine in Kraków. The analysis covered cases of completed suicide committed by 15-30 years old inhabitants of Kraków or its environs between the September 2002 and the September 2003. The group of subjects analysed comprised 47 individuals (9 females and 38 males); 57.4% of these had resided in a big city (Kraków), and the remaining 42.6%--in villages or little towns near Kraków. The data regarding cases of completed suicide were compared with the data regarding suicide attempts by self-intoxication in the period under consideration, extracted from the documentation of the Department of Clinical Toxicology in Kraków. The latter data encompassed 233 cases of suicide attempts by individuals ranging in age from 15 to 29 years, with females constituting 62.2% of these, and males--37.8%. 65% of the attempters had been residents of Kraków. The analysis of the data from the Institute of Forensic Medicine revealed that nearly half of the suicide victims concerned had been treated for mental disorders, mainly depression and addictive disorders. The occurrence of suicide attempts prior to the fatal act was established in the case of 17 subjects (18.5%). Over half of the subjects (48.9%) committed suicide by hanging themselves, 17%--by falling from a height, 8.6%--by drowning, and 19.1%--by self-intoxication with medicaments. 77.2% of the subjects committed suicide at home. In the case of 23 subjects (48.9%), the post-mortem examination revealed the presence of alcohol. The analysis of the cases of suicide attempts by self-intoxication revealed a significant percentage of depressive disorders (26%)--of high occurrence especially in the case of females, whereas alcohol addiction was the predominant diagnosis in the case of males. Furthermore, the majority of the attempters exhibited situational reactions or personality disorders. Suicide attempts constitute an essential part of the issue of suicide in adolescents and young adults and require further research. What attracts notice, is a high percentage of males among suicide victims, and a high percentage of suicide victims with earlier suicide attempts. The results of the study should be taken into consideration in suicide prevention in groups especially endangered by the risk of completed suicide, such as adolescents and young adults after suicide attempts.

Social competence were analysed using the origin Polish Questionnaire of Social Competence questionnaire (KKS). The competence gained during the life span are dependent on age, temperament, personality and partially on intelligence. There were 66 drug users (22 females, and 44 males) from methadone maintenance treatment programme conducted in Rydygier's Hospital. Social Exposure Scale, Scale of Assertiveness, Scale of Direct Interpersonal Contacts separately as well as the sum of information were used for estimation of the competence. The patient age at narcotic initiation, duration of being in methadone substitution programme, means of support were a statistically significant factors. A significant differences between two group as regard the psychopathology the drug abuse alone or coincidence with psychiatric diagnosis were also noted.

The aim of the study was the evaluation of the changes in nutritional habits of opiates dependent persons during 4 years of attendance in methadone maintenance treatment conducted by the Department of Toxicology of CMUJ in Kraków. These criteria were fulfilled by 30 persons (23 males and 7 females). They were examined before the methadone treatment and after 4 years of treatment. During Initial and final examinations for each of examined person the 24-hour recall had been performed three times. The information about daily supply of main nutrients (proteins, fats, fatty acids, carbohydrates, dietary fibre, cholesterol), minerals (calcium, iron, phosphorus, zinc, sodium) and vitamins (vitamin A, B1, B2, niacin, C) were obtained. The results were compared with daily norms (N) recommended on the safe level of intake. The normal range was established on the level +/-10% of normal values (+/-10% N). The changes between the results of following examinations were tested by using the t-student test. After 4 years of methadone treatment an increase in energy, vitamins, minerals and main nutritional ingredients intake was noted in women group. In men group a decrease in energy, proteins and carbohydrates intake was noted and fats intake, mainly unsaturated fatty acids, was increased. Vitamins were consumed in lower amounts and among minerals lower consumption in case of iron and sodium was noticed. In comparison with the recommended values in the initial examination in women group too low intake concerned fibre and vit. A, B,, calcium, iron, zinc and magnesium was noticed. In group of men too low intake (below recommended values) of energy, carbohydrates, fiber, vit. B1, B2, C, niacin, calcium and magnesium was noticed. After 4 years of methadone maintenance treatment in group of women too low intake only of vit. B1 and iron was noticed. In group of men it concerned vit. B1, B2, C, niacin and minerals such as calcium, iron, magnesium and zinc.

Objective: To present Erwin Ringel's theory of the presuicidal syndrome as an instrument for the assessment of suicidal risk., Method: The literature regarding the presuicidal syndrome was reviewed., Results: As it is evident from the research and works by Ringel, and also from the works by other classics of suicidological literature, such as Farberow, Poldinger, Schneidmann, Beck, and B6hme, the discovery of the presuicidal syndrome has opened up new vistas for the therapy of suicidal tendencies. The knowledge of the nature of the presuicidal syndrome indicates that a specific "anti-suicide" therapy has to be applied. The principal aims of such a therapy include the removal of the patient's feeling of alienation by the creation of a good doctor-patient relationship, the creation of the conditions enabling the patient to vent his/her aggression verbally, the removal of the presuicidal narrowing of the patient's consciousness by the reinforcement of the effective, positive behaviour, and the stimulation of the patient's imagination towards the formulation of new aims in life., Conclusion: The concept of the presuicidal syndrome, although somewhat forgotten, still can enhance the understanding of the psychopathology of suicide, contribute to the effective identification of individuals endangered by the occurrence of suicidal tendencies, and contribute to the increase in the effectiveness of the therapy required. Finally, the present authors suggest that the presuicidal syndrome, as a special multifactor psychopathological phenomenon, should be recognized as a diagnostic unit, thus filling in the present gap in the classifications of mental illnesses.

The aim of the work was to present the characteristics of suicide attempts, distinguished on the basis of the scores in the Suicidal Intent Scale questionnaire (SIS), created by Aaron Beck, professor of psychiatry from Philadelphia. The group examined comprised 238 patients (63 males and 175 females) hospitalised in the Department of Clinical Toxicology CMUJ in Kraków in the years 2000-2001, after a suicidal self-intoxication with xenobiotics. The examination was conducted by means of the Suicidal Intent Scale (SIS)--a psychological test created by Aaron Beck. In the case of about 65% of the patients examined, their suicide attempts most frequently were acts of impulsive behaviour, rarely planned for longer than three hours before the realization and usually made in another person's presence or in a situation in which another person's intervention was highly probable. Such attempts had the character of "a cry for help", and were aimed at effecting some change or at manipulating the environment. Nevertheless, the patients acted in a conviction that their act was a serious attempt at ending life, and, most frequently, they maintained such opinions during the examination. On the other hand, they rarely expressed further suicidal intents, and more frequently accepted the fact that their lives had been saved. By contrast, the remaining 35% of the patients examined had attempted suicide with the evident intention to kill themselves; they had taken full precautions against being discovered and had planned suicide carefully to eliminate the smallest possibility of intervention. In the majority of cases, they still maintained the wish to die after the attempt. As the results of the examination indicate, the Suicidal Intent Scale, and, especially, the Precautions subscale, point at the important aspect of suicidal intentions, which, being of vital importance for the diagnostic purposes and suicide prevention, requires further investigation.

The aim of the study was to estimate the risk factors for eventual suicide in the case of individuals hospitalised for a suicide attempts (or attempted suicide). The group examined comprised 238 patients, who, in the years 2000-2001, were hospitalised in the Department of Clinical Toxicology CM UJ in Kraków for suicidal self-intoxication with medical drugs. The group consisted of 63 males and 175 females ranging in age from 17 to 79 years (the mean age was 36 years). The instruments applied in the examination included a structured interview and a set of psychological tests; complementary information was obtained from the patients' case histories. In the year 2005, on the basis of the data from the Institute of Forensic Medicine in Kraków, it was established that 10 of the patients under consideration--6 females, and 4 males--had eventually committed suicide within the period concerned. The retrospective analysis of the case of each of these 10 individuals revealed that the majority of them had been treated psychiatrically for depression or alcoholic addiction, had experienced parental or marital bereavement, or had experienced serious financial difficulties. The subjects' case histories informed also about the cases of suicidal death in the families of several subjects. As should be pointed out, the results of psychological tests obtained earlier by the 10 subjects concerned did not unequivocally indicated high endangerment by the risk of eventually committing suicide. Finally, it is necessary to observe that alcoholism and depression were the most frequently diagnosed mental disorders in the case of the male suicides. In the case of the female suicides, the results of the analysis reveal a variety of psychological, psychiatric and socio-demographic factors that, eventually, could lead to suicide.

The aim of the presented study was the assessment some socio-demographic factors of alcohol dependent patients more times hospitalized in Department of Toxicology in Kraków in the years 1999-2004. The repeatedly hospitalization of 334 patients (298 men and 36 women), aged from 17 to 71 years (mean 45.1 years) due the alcohol problem on the basis of clinic documentation were established. The following socio-demographics traits were taken in analysis: age, sex, marital status, place of living, education, kind of jobs, employment and others sources of money. The patients were admitted from 2 or more 29 times during 6 years. Medical history of addiction of mentioned patients was from 1 to 40 years, mean 25 years. 43.7% persons live single and 53.6% was married. The most patients live in Kraków (80%) and others near the town. The education of them: 15.0% ended high school, 28.7% "medium", 30.5% "low professional" and elementary school--13.8% of them. This factor was similar like regional data. Amount mentioned persons 25.8% worked for salary, 11.7% had own business, and 25.4% was retired, and 29.0% was unemployed. This last factor was worse liked similar from mentioned region. The kind of jobs of persons on the aspect of "social safety" was described. Among the mentioned chronic alcohol addicted persons about 18.8% of them with machines in traffic was worked (bus drivers i.e.) and 7.5% described persons in special jobs was worked (policemen, physician i.e.). The authors were suggested that mentioned factors due health services cost in Poland and propose integration of treatment of alcohol-addicted patients.

The aim of the present paper was to examine the effect of substitution methadone treatment on the frequency of DNA lesions using a micronuclear and a sister chromatid exchange tests. The material under study were lymphocyte cultures from peripheral blood, collected 3 times at 3-month intervals from 24 patients. The obtained results may suggest that methadone treatment combined with a change in lifestyle significantly reduces the risk of genome lesions.

The aim of the presented study was the assessment of somatic and psychiatric disorders in alcohol addicted patients, treated in the Department of Clinical Toxicology detoxification unit in Kraków in 2002 year. The total number of 443 patients (377 men and 66 women) were considered for the research. More than 50% patients were hospitalized repeatedly (2 or more times) due to alcohol problems. Medical history as well as detail medical examination and diagnostic evaluation revealed the concomitance with alcohol disease different somatic illnesses and psychiatric disorders. In 194 patients (43.8%) the alcoholic liver damage was diagnosed, frequently (in 5.2% patients) with chronic pancreatitis. Only 22 patients (5%) were infected with hepatitis virus type B. Diabetes type 2 and different cardiovascular disorders were present in almost one third of patients. In the past 55 patients (12.4%) have had severe head trauma, and 51 (11.3%) were treated because multiorgan trauma. Psychiatric examination revealed in 102 patients (23%) affective disorders, and in 92 (20.7%) personality disturbances. The presented data should be a ground for discussion about treatment model alcohol dependency in Poland.

The aim of the study was to present the phenomenon of suicide attempts by self-poisoning in a group of females and males ranging in age from 15 to 29 years, and treated in the Department of Clinical Toxicology Jagiellonian University College of Medicine in Kraków in the years 2000-2002. The group analyzed comprised of 1117 patients, 629 (69.1%) women and 425 (38.1%) men. In the female group, teenagers under 19 constituted 48.9%, whereas young females ranging in age from 20 to 29 years--51.1%. In the male patients group teenagers under 19 constituted 29.4%, the young men (20-29 years of age)--70.6%. The group was analyzed from the point of view of demographic, clinical and social factors such as gender, age, level of education, marital status and occupation (if applicable), the course of self-poisoning and kind of toxic substance involved. In the majority of cases, self-poisoning had been caused by taking one type of medicines, and less frequently by taking mixed-type medicines or by simultaneously taking medicines and ethanol. The most typical drugs used in the attempts included benzodiazepines, phenothiazines, nonsteroidal antiinflammatory and antiepileptic drugs. The assessment of the poisoning severity based on the PSS classification, indicates the predominance of the minor and moderate poisoning. Up to 50% of subjects suffered from mental disorders--most frequently from affective disorders, neurotic disorders, and personality disorders. As an essential part of the problem of suicidal behaviors in teenagers and young adults, suicide attempts among young population require an in-depth analysis. The scale of the problem indicates the necessity of initiating appropriate preventive actions and organizing appropriate psychological and psychiatric care.

The aim of this study was the assessment of disorders after chronic intake of psychoactive drugs, like marijuana, amphetamine, ecstasy, cocaine and opiates. In 2002 in the Department of Clinical Toxicology detoxification unit were treated 117 chronic drug abusers. The 76 of them use the opiates predominantly, the next 41 persons (35 men, 6 women), were heavy abusers of psychostimulant drugs. In opiate abusers typical withdrawal signs and symptoms were observed. In the group of psychostimulants users, the mean time of marijuana use was 6 years, amphetamine--5 years. The cocaine was used rarely. Among 25 persons (61%) from these group the withdrawal syndrome were established. The excitation of neurovegetative system, depression, or psychomotor effects were observed. We concluded the necessity of estimation of neurobiological changes after using of psychostimulants and that more controlled research might uncover a clinically diagnosable withdrawal syndrome in human psychostimulants users.

Sex and the age structure have been for decades the crucial factors determining the dimensions of suicide. In the literature of the subject, it is possible to find different interpretations concerning the widely known facts of larger effectiveness of suicide among males. Females, on the other hand, exhibit suicidal behaviour and suicide attempts several times bigger than the number of completed suicides. In comparison with wide literature dealing with the problematic of completed suicide, the number of publications concerning suicide attempts is, both in foreign and in Polish literature rather scarce. That is why the present authors have undertaken the analysis of suicide attempts by subjects hospitalized in the Department of Clinical Toxicology Jagiellonian University College of Medicine in Krakow in the years 2000-2002. On the basis of the medical documentation, 2757 cases of attempted suicide through self-intoxication by subjects undergoing treatment in the toxicological department. In the period concerned, the number of hospitalizations after suicide attempts increased from 856 cases in the year 2000 to 971 cases in 2001, and subsequently slightly decreased to 930 cases in 2002. The highest indicator of suicide attempts through self-intoxication has been observed among adolescents and young adults. In the absolute values, within the span of the years in question, there is a substantial predominance of suicide attempts undertaken by adults ranging in age from 20 and 50. On the contrary, in the oldest age group (over 60), the number of suicide attempts through self-intoxication was in the years concerned the lowest. In contrast with completed suicide, where the proportion of males to females is 4:1, in the group examined, females constituted 50% of subjects after suicide attempts. The number of females after suicide attempts in the consecutive years analysed was higher among adolescents and young women under 30. Despite drawbacks in data gathering, there is convincing testimony indicating that suicide is the result of number of complex risk factors. Sex and the age structure belong to non-modifiable factors, and thus emphasis should be put on the importance of the gathering of relevant data and on further research into the factor of sex and age structure in suicide attempts and completed suicide.

The aim of the study was to analyze seasonality and temporal fluctuations in suicide attempts by persons living in Krakow and hospitalized in the Department of Clinical Toxicology CMUJ in the years 2000-2002. The research focussed on the frequency of suicide attempts in relation to the time of the day, day of the week, and month of the year. Temporal fluctuations in the frequency of suicide attempts have been assessed on the basis of the data from medical documentation concerning 2757 suicide attempts by individuals ranging in age from 14 to 90 years. The group consisted of 1607 females and 1150 males. According to the results of the research, seasonality and temporal fluctuations in the frequency of suicide attempts is different for males and females. In the case of the males examined, no dependence between the frequency of suicide attempts and a particular month or season has been observed. In the case of females, on the contrary, the data indicate the existence of a seasonal pattern with the peak in the spring (or early part of the summer), and in the autumn--in October and November. In males, the peak day for attempted suicide was Monday, whereas in females--Sunday and Monday. As regards the time of the day, both the results of the present research and data collected by WHO/EURO indicate that suicide attempts occurred most frequently in the evening, late in the evening or in the early part the night. In conclusion, it has been emphasized that the majority of suicide attempts, especially by females, occurs late in the evening or early in the night. This finding seems to be of particular importance for suicide prevention--it can contribute to the increase in the effectiveness of the organization of work in the Crisis Intervention Centres and make therapists and patients' families aware of the existence of periods of an increased suicide risk. The research has been conducted owing to the cooperation between the department of Clinical Toxicology, CMUJ and the Department of Adult Clinical Psychiatry, CMUJ in Kraków. The results obtained, together with the results of the research conducted by the centres participating in WHO/EURO are vital for suicide prevention and treatment.

The aim of the study was to assess the phenomenon of suicide attempt in the elderly inhabitants of Kraków. Special attention has been paid to the group of "seniors"--aged 75 years or over. The authors have analyzed all the 136 cases of suicide attempts by individuals aged over 60 years, selected from the cases of suicide attempts by self-intoxications by patients hospitalized in the Department of Clinical Toxicology, CMUJ in Kraków in the years 2000-2002. The group concerned included 45 males and 91 females. A large number of subjects (over a half of the total) ranged in age from 60 to 65 years. The group of seniors comprised 35 individuals (aged 75 years or over), including 7 males and 28 females. On the basis of the data from medical documentation, the subjects were analysed from the point of view of their health condition and in the psycho-social context. In the majority of cases the subjects are pensioners residing in Kraków, often living alone. In the case of 98% of the subjects, it was their first suicide attempt. Pharmaceuticals used for self-poisoning were most frequently psychotropic, or mixed-type drugs. The assessment of the severity of poisoning indicates that in about 20% patients poisoning was severe. 70% of the subjects suffered from depressive, reactive, or situational disorders, affective depression or organic brain disorders, often with dementive signs. A significant number of subjects suffered from hypertension, coronary artery disease, arteriosclerosis, or alimentary tract diseases. In the group of the seniors, the most conspicuous problems included serious somatic diseases (malignant diseases and chronic respiratory system diseases), depression, organic dementia, loneliness, and bad family situation. Taking into consideration the scantiness of research into attempted and completed suicide in the elderly and in the old elderly, the present authors stress the importance of the continuation of the research to prevent suicide in the aforesaid age group.

According to WHO, every year, suicide is committed by at least 1 mln people in the world. In Europe, suicide is committed by about 43 thousand people a year, most frequently by middle-aged and elderly males, and attempted by 700 thousand people. In Poland, in 2002, 5100 people committed suicide. The number of suicide attempts is probably ten times higher. The aim of the study is to investigate the current state of knowledge concerning suicidal behaviour and attempted suicide in adolescents and young adults. The literature on the subject is analysed, and special attention is paid to the issue of suicide epidemiology, risk factors, prevention and treatment. Definitions of suicidal behaviour and presuicidal syndrome are debated. In the chapter concerning treatment, Bohme's model of crisis intervention in the case of suicidal patients is discussed, and detailed indications for treatment are presented. Suicide attempts are undertaken most frequently by young people, especially by teenage girls and young women. The ratio of suicide in this age group increased significantly in the last few years. Phenomena which are of special importance for the prevention of suicide among adolescents include suicidal thoughts, attempted suicide, and completed suicide. Multicentre study into suicidal behaviour conducted by WHO indicate that the highest average yearly European coefficients of suicide attempts have been detected in young females ranging in age from 15 to 24 years. Polish and foreign literature on the subject is dominated by publications regarding completed suicide. The issue of attempted suicide is treated rather marginally, which may be due to the scantiness of reliable data concerning large populations. The past few years, however, brought a significant advancement of the research into the epidemiology, etiology, and treatment of suicidal behaviour in adolescents. It is difficult to establish linear correspondence between risk factors and suicidal behaviour. The cause is usually a combination of constitutional factors including genetic ones, earlier personal experiences, and precipitating stressful events. Paradoxically, the risk of suicide among adolescents increases in highly developed countries, where the quality of life has undergone a significant improvement. In conclusion, the authors have stressed the importance of an interdisciplinary approach to work with individuals endangered by the risk of suicide. Attention has also been drawn to the importance of personal contact and the necessity to accompany the individual in suicidal crisis from the beginning to the end of the therapy.

The study presents the results of the interdisciplinary research conducted on the basis of cooperation between the Institute of Forensic Medicine, the Department of Clinical Toxicology, and the Clinic of Psychiatry in Kraków. The aim of the research was to determine similarities and differences between attempted and completed suicide from the point of view of socio-demographic and clinical traits. The authors analysed 220 cases of completed suicide committed in Kraków and its environs in the year 2000. The material presented in the study was based on the archive data from post mortem examinations conducted in the Institute of Forensic Medicine in Kraków. The sample consisted of 177 males and 43 females ranging in age from 13 to 89 years. The mean age was 43.6 years for the entire group, 42 years for males and 50 years for females. The majority of subjects were males, either unemployed, or pensioners. A similar tendency was observed in the group of female subjects. Mental disorders and alcoholic addiction in anamnesis were discovered in a significant number of cases, both in the group of males and in the group of females. Subjects, in whom serious somatic diseases had been detected, constituted a separate group of cases. According to the archive data, in the last century, suicide was most frequently committed by hanging. Similarly, in the sample examined, in 133 cases, suicide was committed by hanging. In 37% of cases, the level of alcohol in the suicides' blood was between 0.5 and 3 or more g/L. In 2000/2001, within the analogical period of 12 months, the group of 200 patients after a suicide attempt by drug intoxication was examined in the Department of Clinical of Toxicology Jagiellonian University College of Medicine. This group included 49 males and 150 females, ranging in age from 18 to 79 years (mean age 35). The examination was conducted by means of structured investigation and medical documentation. Contrary to completed suicide, in the group of suicide attempters, females outnumbered males. Young people under thirty, living in a large city, possessing elementary or secondary education, and either unemployed, or pensioners, constituted the majority of the examined group. A significant percentage of females was divorced and lived with their children only. The majority of the examined population of suicide attempters had used alcohol during the attempt, had suffered from depression, personality or behavioural disorders, had undergone psychiatric treatment, or had had cases of suicide among their friends or relatives.

The aim of the study was to present suicidological problems in the elderly. The investigation assessed patients treated for self-intoxication in the Department of Toxicology of Collegium Medicum, Jagiellonian University in Cracow. Medical documentation of the entire population of subjects aged over 65 and hospitalized in the years 1999-2001 was examined from the point of view of demographic and clinical factors. The examined population consisted of 68 subjects including 20 males and 48 females ranging in age from 65 to 90 years (mean age = 72.6). The majority of subjects were retired and, in many cases, lived alone. The majority of female subjects were widows living in Kraków or in small towns or villages around Kraków. A significant number of subjects had been undergoing psychiatric treatment or even repeated hospitalization prior to the suicide attempt. A significant percentage had suffered from severe somatic diseases. For 55 of the subjects (79.7%), it was the first suicide attempt, and for 14 subjects (20.3%)--a repeated one. The drugs most frequently used in the attempts were psychotropic, cardiological and mixed-type drugs. The assessment included the state of consciousness and the degree of intoxication on the subjects' admission to hospital. The mean duration of hospitalization was 13.7 days. The most frequently determined somatic diseases were hypertension (33.3%) and coronary artery decease (30.4%), atherosclerosis (15.9%) and diabetes (10.1%). In the process of a complex diagnostic and therapeutic procedure, the mental state of the patients was assessed. Depressive disorders (reactive) and endogenic depression (affective) were recognized in 51 subjects (73.9%). Organic brain disorders, often with dementive signs, were detected in 44 subjects. Schizophrenia was recognized in only a small percentage of subjects (5.8%). The description of the data indicate a close connection between depression and social factors in the case of the elderly. Therefore, an adequate treatment of depression should be give priority in programs for preventing suicide among the elderly.

That the problem of drug addiction is still growing up, so there is the necessity for widen of treatment panel for psychoactive substances abuse, especially for opiates. Because of the fact, that substituting treatment became to be popular in patients' opinion, more attention were paid on new medicine-buprenorphine. It is an agonist- antagonist of opiates' receptors. Buprenorphine has been successfully used in long-term treatment in United States and in Western Europe. Treatment with buprenorphine has been started in Poland in Toxicological Department in Kraków. This article shows outcomes of substituting treatment with buprenorphine in period from December 2000 to February 2001.

The study included 180 patients aged 18-79 (average 36) hospitalized for suicide attempts (drug intoxication) in Department of Clinical Toxicology CMUJ from March to December 2000. Examined group was composed of 49 men and 131 women. Structured investigation and medical documentation were used to estimate crucial socio-demographic risk factors of repeated suicide attempt. The following socio-demographic traits were taken into consideration in analysis: age, sex, marital status, place of living, education, employment, family background. We distinguished among patients under examinations: patients after first suicide attempt (I) and group after another suicidal attempt (II). The second group consisted of 15 men (27.8% of the total) and 39 women (72.2% of the total). Young people under 30 constituted 37.2% of the whole examined population. In population of women after repeated suicide attempt the percentage of divorced ones increased considerably (from 2.2% to 10.2%). Both in men and women after repeated suicide attempt the percentage of persons with only elementary education increased (from 34.1% to 53.7%). We observed high unemployment rate (from 26.6% to 29.6%) in both groups. Percentage of pensioners increased from 23.5% after first suicidal attempt to 33.3% after repeated suicidal attempt in men and from 25.5% to 35.9% in women. Men after repeated suicide attempt more often live with their parents, while women from the second group more often live alone with their children. It seems that some of the analysed predictors which are expression of social unadjustment may make risk factor for repeated suicidal attempts.

Among the total population of 180 patients undergoing medical examination between March and December 2000, hospitalized for suicide attempts (drug intoxication) in the Department of Clinical Toxicology CM UJ in Kraków, 159 persons were examined by means of modified questionnaire of life events based on a scale elaborated by Thomas Holmes and Richard Rache. The patients were divided into 2 groups--first group comprised patients after first suicide attempt and second group consisted of those who had reattempted suicide. In regard to sex and age there were no significant differences between these two groups and the total population of 180 patients. In order to obtain the patients' subjective evaluation of the influence of their course of life on their attempting suicide, we asked the patients to select from the list of life events those that had affected their mental and physical state during of whole their life. Objectivization of life events was based on the 'units of life change' by T. Holmes and R. Rache. The sum of units of life events was 373 scores (SD +/- 200, in the range of 39-1042 units). From the total list of life events (max. score--1513) we selected the events estimated at 40 and more units of life change. Those were; marriage, divorce, separation, marital reconciliation, patient's illness, change of behavior and illness of a close relative, death of a husband/wife, child, close relative, imprisonment, pregnancy, unemployment, retirement. In the patients' subjective evaluation part, the events most frequently selected by the patients as those that had affected their mental state were: death of a close relative (56.6%), illness of a relative (40.8%), patient's illness (37.7%). A high number of patients stated events testifying to a conflict in marriage--45.7% of patients stated marital separation, and reconciliation, and 27% of patients stated unemployment as a fact that had influenced their mental state. 30.6% of these patients belonged to the first group (after first suicide attempt) and only 18.7% belonged to the second group (after repeated attempt). The authors of the study have presented a discussion over the results of the analysis and demonstrated the need for cultural adaptation of so that it can be effectively used in General Practitioners' training.

The analysis was based upon 79 patients hospitalized for suicide attempts (drug intoxication) in the Department of Clinical Toxicology CM UJ in Kraków from July to December 2000. The purpose of the study was to estimate the sense of coherence level (according to Antonovsky) as a potential suicide attempt predictor. The population of patients was divided into two groups: patients after first suicide attempt (I) and group after reattempting suicide (II). The examination was based on structure interview, analysis of medical documentation and a number of tests including SOC 29 (by Antonovsky), Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), and Beck Hopelessness Scale (HS 20). The most important psychological and independent variable measured in the study was the sense of coherence, introduced first by Aaron Antonovsky as a significant predictor of mental health. The sense of coherence (measured by SOC 29 questionnaire) comprises comprehensibility, manageability and meaningfulness. Both in foreign and in polish studies the SOC 29 level was lower in clinical groups compared to healthy people. The norm in Polish population was 139 scores in SOC 29. In the present study the average total result (men and women) was 112 scores in the group of patients after first suicide attempt, and in the group of repeated suicide attempters the average total result was even lower--only 99 scores, which makes a statistically significant difference. We also observed a statistically significant dependence between the results of SOC 20 questionnaire, the level of depression measured by Beck Depression Inventory and Hamilton Depression Scale, and the level of hopelessness measured by Beck Hopelessness Scale. The above results indicate that the sense of coherence level may make significant risk factor for repeated suicide attempt.

The study included 180 patients aged 18-79 (average 36) hospitalized for suicide attempts (drug intoxi-cations) in the Department of Clinical Toxicology CM UJ from March to December 2000. Examined group was composed of 49 men and 131 women. The following tests were used in this study: structured questionnaire, psychological tests: Beck Depression Inventory, Hamilton Depression Scale, Hopelessness Scale, Suicidal Intent Scale, Life Events Scale, SOC 29 (by Antonovsky). Besides, we used data from patients' history. The aim of our study is to analyse clinical data of suicidal attempters--after first and repeated suicidal attempts. We took into consideration the severity of coma, severity of intoxication, the kind of substances used in the attempt, the presence of alcohol, previous psychiatric treatment, cases of suicide among the patients' close friends or relatives and duration of hospitalization. Then the psychiatric diagnosis was stated. The analysis of severity of intoxication (divided into three stages: severe, moderate, and light according to the Poisoning Severity Score (PSS) indicated that in the group of repeated suicide attempters the percentage of severe intoxications was greater (9.2%) then in first time attempters. In the population of second time female attempters there is a greater percentage of persons who took neuroleptics (15.4%) compared to group first attempters (5.4%). In both groups the majority were taking anxiolytisc, sleep-inducing and mixed drugs. There was a greater percentage of persons drinking alcohol during the attempt among repeated suicidal attempters (38.8%) than among the first time attempters (26%). The percentage of persons with diagnosis of mental disease (treated in ambulatory or in hospital) is higher in the group of repeated suicide attempters (25.9%) then after first attempters (6.3%). In both groups a lot of persons had reactive depression, often associated with personality disorders, rarely endogenic depressions or psychosis. We observed that addiction to alcohol is often a problem in men who attempt suicide (I group--32.3%, II group--33.3%). The analysis of medical documentation indicated in the group of repeated suicide attempters a high percentage of people with cases of suicide among their close friends or relatives.

Methadone maintenance programs have effectively reduced opiate dependency and are available in many countries, also in Poland. In Kraków 50 persons were qualified to methadone maintenance treatment. Their age varied from 21 to 46 years, mean 27.8 years. Participants of the programme were mainly educated on basic technical level, unemployed, after 3 to 30 attempts of detoxification treatment. After initial observation at the Detoxification Unit of the Department of Clinical Toxicology and establishing effective daily oral dose of methadone, all patients in Outpatient Clinic of Abuse receive daily adequate dose of methadone, where in parallel, individual and group psychotherapy is used. Methadone programme which was applied seems to prove the fact, that it can significantly improve life quality of addicted patients as well as increase the level of public safety.

Authors presented the course of clinical observation of 393 acutely intoxicated patients dependent on psychoactive substances (28%) or ethanol (72%) who were discharged from the hospital at their own request before diagnosis and treatment were completed. In the first stage of detoxification the different intensity symptoms of toxic coma (25% of patients), behavioral changes-agitation and aggression (16%) and also the disturbances in consciousness accompanied by tremor and vegetative storm (15%) were observed. Authors pointed out that among others the neurobiological changes in brain reward systems of patients who discontinued diagnosis and treatment could be endangering for both the patient and the doctor. They postulate that criteria of life threatening state should by more accurately defined and the methods of full security for patient and doctors should be worked out.

The results of evaluation of health state of CNS of 114 healthy workers occupationally exposed to CS2 were demonstrated. The concentration of CS2 in the air was 0-65 mg/m3. 62 people from the control group underwent an examination in the same way--before employment and after 5 years. Psychiatric examination, psychological organic tests (Bender, Graham Kendall, Benton) and EEG record were performed. The examination results were evaluated separately and together by means of arbitrary scale of pathological changes which constituted a complex evaluation of CNS. A considerable deterioration of CNS was stated which was reflection of pathological changes of a functional type. After 5 years this complex way of evaluation of CNS in exposed workers significantly more pathological changes was evidenced then ones in the control group. In 20 exposed men who obtained the worst results in the evaluation of CNS, the head computer tomography was performed. In 60% mentioned people cortical and/or subcortical atrophy was found, described in most people to be small. At the same time it is important to state that mentioned CNS examination enables an early evaluation of functional and morphological state of CNS in people who are occupationally exposed to low concentration of CS2.

Prospective clinical studies were undertaken in 114 healthy men aged from 19 to 46 years (mean 26) occupationally exposed to CS2. The 62 men from the control group were undergoing examination in the same way before employment and after 5 years. The mean wages of the air concentration of CS2 at working posts was from 0 to 65 mg/m3. After 5 years of exposure no considerable differences were found in general medical examination with diastolic/systolic blood pressure measurement, resting ECG record and chest X ray examination. However in LAB test the lipid metabolism disturbances occurred. After 5 years the serum concentration of triglicerides and betalipoproteides of exposed workers were significantly higher than in the control group. The serum concentration of total cholesterol of both group was increased. The mentioned changes of lipid metabolism are the factors which indicate atherosclerotical changes in the man occupationally exposed to low concentration of CS2.

Fourteen patients, including 6 with viral hepatitis B and 8 with liver cirrhosis were treated with plasmapheresis for hepatic coma. Altogether 29 plasmaphereses were carried out. Complete recovery was achieved in one patient with viral hepatitis B and in 3 patients with liver cirrhosis. Plasmapheresis should be performed in patients with severe lesions to the liver. Classification of patients to the treatment should include clinical examination, biochemical and enzymatic tests, and evaluation of liver reserve with isotope hepatography. In case of the acute poisoning with hepatotoxic agents indications to plasmapheresis should be evaluated from the toxicologic point of view.