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Aim: To evaluate the incidence and severity of the impairment of selected cognitive functions in patients after sudden cardiac arrest (SCA) in comparison to patients after myocardial infarction without SCA and healthy subjects and to analyze the influence of sociodemographic and clinical parameters and the duration of cardiac arrest on the presence and severity of the described disorders., Material and Methods: The study group comprised 30 cardiac arrest survivors, the reference group comprised 31 survivors of myocardial infarction without cardiac arrest, and the control group comprised 30 healthy subjects. The Mini-Mental State Examination (MMSE), the Digit Span test from the Wechsler Adult Intelligence Scale, Lauretta Bender's Visual-Motor Gestalt Test, and the Benton Visual Retention Test (BVRT) were used to assess the presence of cognitive impairment. An original questionnaire developed by the author was used for overall mental state assessment., Results: The Bender test demonstrated a significant difference in the presence and severity of visual-motor skills between the study group and the control group, while BVRT and MMSE revealed increased incidence of cognitive impairment in the study group. The Bender and BVRT (D/D)/SS (version D, method D, scaled score) scales indicated cognitive impairment in 53.3% of these patients, while the BVRT (C/A)/SS test indicated cognitive impairment in 40%. For the reference group, the values were 32.3% and 12.9%, respectively. No correlation was found between the severity of cognitive impairment and the duration of cardiac arrest., Conclusions: Impairment of visual-motor skills, short-term visual memory, concentration, and visual-motor coordination occurs much more frequently and is more severe in individuals after SCA than in healthy individuals. Impairment of memory trace storage and recall after delay occurs more frequently in patients after SCA than in patients after myocardial infarction without cardiac arrest and in healthy individuals. SCA duration did not have any influence on the severity of the described disorders.

In the last decades a few new physical methods based on the electromagnetic head stimulation were subjected to the clinical research. To them belong:--vagus nerve stimulation (VNS),--magnetic seizure therapy/magnetoconvulsive therapy (MST/MCT),--deep stimulation of the brain (DBS) and--transcranial direct current stimulation (tDCS). The paper presents a description of mentioned techniques (nature, advantages, defects, restrictions), which were compared to the applied electroconvulsive treatment ECT, earlier described transcranial magnetic stimulation TMS and the pharmacotherapy (the basis of the psychiatric treatment).

Objectives: The aim of the study was to assess the incidence of depression and anxiety symptoms in patients after cardiac arrest (SCA) in relation to patients with a history of myocardial infarction without SCA and in healthy individuals. The analysis of the impact of selected socio-demographic and clinical parameters and duration of SCA on the presence and severity of depression and anxiety symptoms in different groups was also performed., Methods: The study involved 30 patients after SCA and 31 patients with a history of myocardial infarction without SCA. The control group consisted of 30 healthy subjects. To assess the mental state, a specially developed questionnaire was used, while the presence and severity of the symptoms were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HAM-A)., Results: Statistically, a significantly higher average level of depression and a higher incidence of anxiety was demonstrated in patients after a sudden cardiac arrest (study group) and after myocardial infarction (reference group) compared with the control group. There were no statistically significant differences in the incidence of anxiety between the study and reference groups. No impact of the duration of cardiac arrest on the incidence of depression and anxiety symptoms in the study group was observed., Conclusions: In the group of people with a history of cardiac arrest, the most common mental disorder is depression. Anxiety and depression are significantly more frequent in patients with a history of SCA than in healthy individuals. There were no differences in the incidence and severity of depression symptoms in patients after SCA compared to patients after myocardial infarction without SCA. The described socio-demographic parameters and clinical characteristics had no impact on the symptoms of depression and anxiety in the investigated groups.

Electroconvulsive therapy (ECT) is an important method of biological treatment in serious psychic disturbances. Similarly to drug therapy it is marked by a determined schematics of applying including the list of indications, contraindications, procedures of the performance, as well as the list of adverse invents. Applying defined schemas allows for minimizing the risk and influences the final effectiveness of therapy.

Transcranial magnetic stimulation (TMS) is one of new techniques of the physical treatment in psychiatry. Its advantage is painlessness, so as lack of invasiveness and evoking a convulsive effect. The technique of TMS was introduced into the clinical practice in 1985--originally as a diagnostic method in neurology. Later TMS became a valuable tool in the basic research in neurophysiology and neuropsychology, so as in clinical examinations. In 1994 the first papers on TMS application in therapy of depression and schizophrenia were published. The research on the therapeutic TMS effectiveness encounters certain problems and restrictions: difficulties in determining a place of the stimulation, lack of the possibility of the selection of optimal parameters for the stimulation, problem in guarantying optimal conditions for the double-blind study, etc. During the last two decades TMS was applied in therapy of mood disorders and psychoses more on the principle of consuetude, than confirmations of the evident effectiveness. However recently a group of European experts presented the study, in which they regarded TMS as the effective method in therapy of depression and schizophrenia--presenting conditions to the optimal stimulation.

Unlabelled: AIM : The aim of the research is the analysis of psychiatric consultations conducted in the multi-disciplinary hospital, establishing the cause of the consultations according to ICD-10 and the analysis of psychiatric consultations regarding their number on particular wards., Methods: Retrospective analysis of medical documentation concerning given consultations in the multidisciplinary hospital in Tarnowskie Góry in the years 2002-2010 has been conducted. In the statistics studies Shapiro-Wilk test, Kruskal-Wallis test, Mann-Whitney U test, Chi-square test of independence and the others have been used., Results: In the analyzed years, 3,672 consultations have been done, the mean age of the consulted patients has been 46.9 years. Taking into consideration the sex of the consulted patients, 41.99% of them were female and 58.01% were male. The main diagnoses of all consultations present as follows: F00-F09: 18.82%, F10-F19: 29.58%, F20-F29: 17.70%, F30-F39: 10.29%, F40-F48: 13.83%, F50-F59: 0.16%, F60-F69: 3.21%, F70-F79: 1.77%, F80-F89: 0%, F90-F98: 1.01%, other: 3.62%. The consultations most often have taken place on the following wards: Hospital Admitting Department (13.21%), Hospital Emergency Service (6.97%), Surgery Department (8.42%), Internal Medicine Department (6.51%), Neurology Department (4.82%)., Conclusions: The most frequent causes of consultation were addictions, the next were organic and psychotic disorders, neurotic and affective disorders. Consultations most often have taken place at the Hospital Admitting Department/Hospital Emergency Service, Surgery Department, Internal Medicine Department and Neurology Department.

Electroconvulsive therapy (ECT) is a former physical therapy method in psychiatry which is applicable up till today in relation to its high effectiveness and the safety. Centuries of applying nonconvulsive methods of the electric stimulation preceded introducing this method into the clinical practice. ECT is arousing a lot of controversies; populous myths are connected with its applying--that demands explanations. Numerous biological mechanisms explaining the clinical efficacy of ECT action are well-known.

Background: There has been noticed a systematic growth of using psychoactive substance (SP) in last years. The co-occurrence of mental and physical disorders related to substance abuse of treated patients is more often a serious problem to medical services. Dual diagnosis (DD) is a clinical term referring to co-morbidity or the co-occurrence in the same individual of a psychoactive substance use disorder and another psychiatric disorder. The aim of the study is to investigate the prevalence of dual diagnosis in patients with diagnosis of substance use disorder hospitalized in years 1994-2005, to assess the kind of co-morbid mental disorders and the course of treatment in three groups: patients with DD, with diagnosis of mental disorder without substance use and with diagnosis related to substance use., Methods: The retrospective study of 4 349 case records of patients hospitalized in the department of psychiatry in years 1994-2005. Out of this number two groups of patients were separated: persons abusing or dependent on SP (n = 825) and patients with dual diagnosis (n = 362). The control group (n = 200) was created among patients with mental disorders and without SP abuse. Socio-demographic factors, number and the length of hospitalizations, aggressive behaviours, suicide attempts, discharges from hospital on demand were analyzed. In the DD group there was an attempt to evaluate the relation between substance use disorders and co-occuring mental disorders performed., Results: The frequency of DD among all patients hospitalized in the studied period of time was 8.3%, whereas among patients abusing SP was 30.5%. This study demonstrates that patients with the DD are statistically longer hospitalized, discharged from hospitals at their own request and more often need treatment in hospitals, statistically more often try to commit suicide and perform aggressive behavior. Mental disorders were substantially often secondary to substance related disorders in the DD group. There was proved that patients mainly abused alcohol and the most frequent mental disorder were mood (affective) disorders.

With help of informatics technology it is possible to simulate various physiological processes in virtual models of biological structures. In a created realistic model of the human head we made some comparative investigations over physical phenomena accompanying the electroconvulsive treatment ECT and transcranial magnetic stimulation TMS--two methods with confirmed (ECT) or presumable (TMS) antidepressant efficacy. The present investigations are a continuation of the earlier conducted study in the simple spherical model of the head. Investigations confirmed, that magnetic stimulation TMS generates a considerably weaker current flow in the brain than it is present in electroconvulsive technique. Applying of such weak stimulation in modus,,at haphazard", i.e. on the brain area which does not need to be metabolically disturbed in this patient--cannot cause an antidepressant effect at all. The results of the investigations explain not only the safety of the magnetic method, but the weak effectiveness of this method. The authors propose some methods for improvement of TMS efficacy.

Background: The aim of this prospective study was to verify whether magnetostimulation with weak variable magnetic fields with low value of induction could enhance the effects of pharmacological therapy in drug-resistant depression., Materials and Methods: Thirty patients, 26 women and 4 men, with drug-resistant depression were enrolled in the study. The subjects from Group No. I (14 patients) were given fluvoxamine and treated with weak variable magnetic field using the VIOFOR JPS device; the subjects from Group No. II (16 patients) were also given fluvoxamine but they were treated with the VIOFOR JPS device in placebo mode. Changes in depressive symptoms were estimated with the 21-point Hamilton Depression Scale (HDRS), Montgomery-Asberg Depression Scale (MADRS) and Beck Depression Inventory (BDI) questionnaire., Results: After 15 days of treatment highly significant differences were revealed between the patients treated with magnetic field and the patients treated with placebo: the final HDRS score was 53% of the initial value for the group receiving combined treatment, and 86% in the placebo group (p<0.001); for MADRS score the values were 51% and 88% (p<0.001), respectively, and for BDI 60% and 87% (p<0.001). Thus, the average effect of placebo applied with fluvoxamine was a ca. 15% reduction of symptoms, while the concurrent application of magnetic field and SSRI treatment resulted in a 40-50% improvement., Conclusion: Our study indicates that adding a two-week low-induction variable magnetic field stimulation to a classical pharmacologic therapy reduces the intensity of symptoms in patients with drug-resistant depressive disorders., (Copyright 2009 Elsevier B.V. All rights reserved.)

The deep brain stimulation DBS is the newest physical method of the treatment of depressive disorders. When applying of this technique in neurological illnesses (e.g., Parkinson's disease), mood changes were observed. In 2005, Helen Mayberg et al. used DBS in the therapy of the depression for the first time. Stimulating electrodes were placed in Brodmann areas 25. In the period of some past years, only about 30-40 patients with refractory depression have undergone DBS treatment. Numerous problems connected with applying DBS in patients with psychiatric disorders are described in the paper.

Since 1999, attempts have been made in the application of a new technique called magnetic seizure therapy (MST) or magnetic convulsion therapy (MCT) in the treatment of depressive disorder--as an alternative to electroconvulsive treatment. The technique of rapid rate transcranial magnetic stimulation (rTMS) is used to evoke intentional and repeated magnetoconvulsive seizures, though it requires the use of stimulation parameters practically inaccessible in commercially available rTMS magnetic stimulators. Magnetic convulsion therapy has been tested on monkeys as well as humans. A decisive majority of studies carried out both on animals and humans addressed the issue of safety of the MST method and confirmed that the side-effects (mostly of a cognitive nature) which occurred after magnetic seizures were weaker than those observed after electroconvulsive seizures. An analysis of available sources, however, does not confirm any proven antidepressant action of the MST technique. No experimental investigations have been carried out on animal models of depression. Clinical effectiveness had been confirmed in merely a few (perhaps three) patients with depression. The authors submit the results of the hitherto conducted studies on MST to critical analysis, particularly in the aspect of their antidepressant efficacy.

Ketamine is a rapid-acting anaesthetic agent which has been used for over 40 years. It is an antagonist of N-methyl-D-aspartate (NMDA) receptors and agonist of mu and sigma opiate receptors. Ketamine acts through inhibition of sensory parts in the brain and stimulation of the limbic system and optic thalamus. The most common psychiatric disorders observed after the use of ketamine are: psychomotor agitation, hallucinations, status of stupor, consciousness disorders. There are observed cases of non-medical use of ketamine since the sixties of the 20th century. The authors describe the case of a 52 year old man who has been addicted to ketamine for 15 years. The patient was admitted to hospital to observe and treat the withdrawal syndrome as an effect of abrupt discontinuation of a chronically abused substance. On the ground of medical examinations, standard tests, anamnesis and hospital observation, ketamine dependence syndrome of a person with personality disorders was recognized. There was no somatic symptoms of withdrawal syndrome observed. The patient complained of sleep disorders and anxiety. Diazepam, carbamazepine and vitamins was used during treatment. The patient was motivated to stop using ketamine. This case and the described symptoms were compared with others articles.

Unlabelled: Total hip replacement is one of the most successful orthopaedic interventions in improving considerably the patients' performance, nevertheless some patients demonstrate declined functional ability following an operation. Such condition is not a consequence of medical illness or the surgery itself but might rather be associated with mental status. The authors conduct an investigation concerning the relation between some psychological and psychiatric factors and their influence on health-related quality of life in patients after total hip replacement., Methods: Into the study group we included 102 subjects undergoing total hip replacement (59 female, 43 male). In all subjects we measured depression (Beck Depression Inventory - BDI), anxiety (State and Trait Anxiety Inventory - STAI), sense of coherence (SOC-29), personality traits (Eysenck Personality Inventory - EPI) and health related quality of life (SF-36)., Results: The postoperative values of the PCS and the MCS for the whole group of patients correlated negatively with the SOC values (p=0.04 and p=0.03 respectively). Neuroticism (EPI) and anxiety as a trait (STAI) were also associated with postoperative performance, both in mental (p=0.03 and p=0.008 respectively) and physical (p=0.005 and p=0.04 respectively terms)., Conclusion: Total hip replacement improves significantly the patient's health-related quality of life at 6months after surgery, what is influenced by sense of coherence, neuroticism and anxiety as a trait. Above mentioned factors should be taken into account when rehabilitation and social readaptation processes are planned.

Continuation and maintenance electroconvulsive therapy (ECT) is used to reduce the risk for relapse and recurrence of affective disorders and schizophrenic disorders. Despite the potential value of these ECT schedules, both are relatively neglected in clinical practice. This article reviews the recent research on the subject. Although most of the research are small open studies and case reports, continuation and maintenance ECT does emerge as a safe and effective treatment for relapse and recurrence-prone patients who have responded to the basic course of ECT.

2008 brings the 70th anniversary of the first electroconvulsive treatment, which was applied in a Psychiatric Clinic of Rome and introduced a new physical therapy to the clinical practice. The electroconvulsive therapy (ECT)--remains as the only method from the earlier therapies practised in the era preceding modem pharmacotherapy. It survived to the present times despite some difficulties. The ECT is a safe and extremely effective method for the treatment of severe affective disorders and psychoses. The paper presents the development of ECT and others convulsive techniques in a historical context.

The aim of this study was to determine the characteristics of ECT practice in Polish Psychiatric Clinics in 2005. A questionnaire was sent to all Polish psychiatric hospitals that performed electroconvulsive therapy in 2005. Altogether 450 patients (0.22% of the general number of psychiatric inpatients in 2005 and 0.72% of the inpatients of hospitals where electroconvulsive therapy was performed) were treated with ECT in Poland in 2005. The rate of ECT use in Poland is the lowest in the Central--East European region.

Aim: The aim of this study was to assess the mental status and sociodemographic data and their influence on the quality of life in patients after total hip replacement., Methods: SF-36, Soc-29, HADS, MPI, sociodemographic questionnaire were given to a cohort of 48 subjects who participated in this study (28 female, 20 male), with age range of 54-70 (mean 56). Questionnaires were administered to subjects two weeks before surgery and three months after surgery., Results: Patients after total hip replacement showed significant improvement in health-related quality of life in the summary scale of PCS and MCS and HADS-D and HADS-A. There were no significant differences in SOC and MPI. The postoperative values of the PCS and the MCS for the whole group of patients correlated positively with the SOC values. Neuroticism (MPI) was also associated with the postoperative functioning in the mental and physical dimensions. Older patients had more likely to have worse score in MCS and PCS before and after surgery., Conclusions: Total hip replacement significantly improves patient health and well-being at three months after surgery. Sense of coherence, neurotism and old age influence quality of life.

The aim of this paper was to explain the idea of cardiac syndrome X, particularly the association between emotional disturbances, somatoform disorder and syndrome X. Cardiac syndrome X is defined by the presence of angina-like chest pain, a positive response to stress testing and angiographically normal coronary arteriogram. It has been shown to occur in approximately 20 - 30 percent of angina patients undergoing cardiac catheterization. Most of the patients with normal angiograms are women especially in perimenopausal age. Syndrome X patients reported more depression, anxiety and somatic concerns than positive angiographic patients. They have high scores on psychological inventories that measure anxiety and depression, and are very prone to somatization. They have better prognosis with death from cardiac causes than patients with coronary heart disease. With regard to female chest pain patients, somatoform disorder can be assumed. At the present time, there is no common agreement on the exact cause of the symptoms associated with syndrome X.

Aim: The aim of this study was to evaluate the influence of sociodemographic and clinical factors on symptoms of depression in 90 female patients awaiting coronarography., Method: The factor dividing the patients into two groups: those without significant atheromatosis - 48 women and those with coronary atheromatosis - 42 women, was the result of invasive diagnostics of coronary heart disease. BDI (Beck Depression Inventory), HAM-D (Hamilton Depression Rating Scale) and sociodemographic and clinical data questionnaire were used in the study., Results: It was proved that there was a connection between the appearance of increased parameters of depression and more frequent number of annual visits in the Primary Care or Cardiologic Clinic, higher level of depressiveness and anxiety, fear of obtaining information applying to the necessity of coronarography, lack of hormonal replacement therapy and of support from other people. Additionally, it was noticed that the intensity of symptoms were higher for those less educated, those waiting shorter for coronarography and those with hypertension. There were no statistically significant differences in the estimation of depressive states in both groups, neither in prevalence, nor in the intensity., Conclusion: Patients with increased parameters of depression need special therapies and multidisciplinary care.

Objective. To assess the score of SOC (sense of coherence), BDI (Beck Depression Scale), STAI ( State and Trait Anxiety Inventory) in three examined groups and correlation of SOC score with sociodemographic data, anxiety and depression. Methods. The SOC, BDI, STAI questionnaires were given to 51 patients after limb amputation, 65 patients after vertebral surgery because of chronic back pain and 40 persons in the control group. Results. Patients after limb amputation achieved the same level of SOC score as the control group. Patients who had higher results on the SOC score rarely suffered from phantom pain. Patients after spine surgery had a lower level on the SOC score than the control group. A lower score of SOC was observed in older, unemployed, poorer educated, subjects taking medicine, who did not report improvement after operation. Patients after limb amputation and patients after spinal surgery were more depressed and anxious than healthy people. Conclusion. Patients with higher SOC results, in both examined groups, were less depressed and anxious.

Objective. The study investigated health-related quality of life in relation to mental status (anxiety and depression) and demographic factors in patients before and after total hip replacement due to osteoarthrosis. Methods. The SF-36, HADS, socio-demographic data questionnaire was delivered to a group of 184 subjects (108 females, 76 males) at the mean age at the time of surgery of 59 years. Questionnaires were delivered to the subjects 2 weeks before the surgery and 6 months after the operation (by mail). Results. Patients after hip replacement showed significant improvement in health-related quality of life in most domains of SF-36 score and summary scale of PCS (Physical Component Summary Scale) and MCS (Mental Component Summary Scale). They also showed improvement in mental status. Elderly patients were more likely to show worse score in MCS and PCS before and after surgery. BMI (body mass index) was correlated only with preoperative PCS. Mental status was associated with postoperative PCS and MCS. Patients who were satisfied with the results of the surgery showed higher PCS and MCS score. Conclusion. Hip replacement surgery brings significant improvement to the quality of life. Age and mental status of those patients influence markedly their postoperative performance.

On October 1, 2003, the Act on social pension of June 27, 2003, came into force. Social pensions are granted to individuals who are of age and totally unable to work due to somatic deficiencies that have occurred mainly before coming of age (18 years of life). The most important element of the new law is the fact that while assessing the right for the benefit it is not important when the complete inability to work occurred, but that it resulted from somatic deficiency which occurred in the period mentioned above. This kind of solution, however, differs greatly from what was included in the former school-pupil's pension, in the family pension, or in the right to earlier retirement pension of employees having children requiring constant care. Although in all the solutions the premise entitling the individual to receive appropriate benefits was and still is the occurrence of disorders causing complete disability to work (the former second group of disability), in all the former legal solutions, the complete inability to work had to occur in the periods determined by an appropriate law or regulation. Yet, in the case of social pension, it is only an enigmatic malfunction of the organism, which is not defined anywhere and in any way, that has to occur in the periods determined by the regulations. It seems that the law on social pension requires urgent modification.

Traditionally, we distinguish three forms of psychoorganic syndrome: 1) oligophrenic, 2) characteropathic, and 3) dementive. According to ICD-10 classification, these disorders should be defined by more modern terms: 1) mental impairment (F7x), 2) personality disorders and behaviors caused by brain injury or brain malfunction (F07), and 3) various forms of dementia (from F00 to F04), respectively. To assess the level of intellectual aptitude, i.e., to confirm the existence of possible intellectual deficits, we can use various neuro-psychological instruments. The most important instrument here is the Wechsler scale, whose results allow for distinguishing six intellectual levels below mental norms. To assess the judicial importance of particular intellectual deficits, the experts should refer to the former Government Ordinance on the rights to earlier retirement benefits of employees having children who require constant care, of May 15, 1989. According to the above mentioned Ordinance, it is only at least moderate mental impairment that may be the sole basis for deciding about the former second disability group (now: complete inability to work). In the case of slight impairment - such a decision may be issued only if the impairment occurs together with other serious disorders severely impairing organism functioning. In other words, slight mental impairment can justify the certification of mere partial inability to work. Following this line of thought, we must say that lesser intellectual deficits, such as borderline cases or intelligence below average, should not be formally the premises of judicial value. It seems sensible to issue similar guidelines also in the case of dementive syndromes, that is, secondary intellectual deficits occurring at mature or old age.

Aim: The aim of this study was to assess the score of HADS and the correlation with sociodemographic factors and personality traits in patients after limb amputation., Method: 45 patients after limb amputation due to atherosclerosis and 30 persons from a control group participated in the study. HADS Scale and the Maudsley Personality Inventory created by Eysenck were used in the study. Socidemographic data were collected by means of the Sociodemographic data questionnaire., Results: In comparison to the control group, patients after limb amputation achieved a higher score in HADS-A and HADS-D and in the N scale of the Maudsley Personality Inventory. Higher levels of anxiety and depression were noticed in patients suffering from phantom limb pain and in patients with neurotic personality traits., Conclusion: Patients after limb amputation need multidisciplinary care because of higher levels of anxiety and depression (especially patients with phantom limb pain and those with neurotic personality traits).

Aim: To compare personality types in patients after vertebral surgery., Method: 74 patients after vertebral surgery were examined with the MPI. 22 patients were operated because of injury. 52 patients were operated because of chronic pain back. The control group consisted of 20 healthy people. Maudsley Personality Inventory created by Eysenck, was used to study personality types., Results: There were no differences in personality types between patients suffering from chronic back pain and patients operated because of injury. Statistically, a significantly higher score in the N scale was noticed in the group with chronic back pain in comparison to patients operated because of injury and in comparison to the control group., Conclusions: A higher score in the N scale observed in patients suffering from chronic back pain, may suggest a specific personality type of those patients. Higher level of neuroticism may create some difficulties in the acceptation of the illness and adaptation process. It is necessary to take special psychological care of those patients.

Electroconvulsive therapy (ECT) as a medical procedure of higher risk as well as a therapy evoking certain controversies requires strict obedience to the conditions of acquiring the patient's informed consent to the offered method of treatment. To acquire the patient's consent it is necessary to inform him/her about the different aspects of electroconvulsive therapy. The paper stresses that in the case of ECT therapy, the spoken information given to the patient seems insufficient. It is necessary to work out a Polish questionnaire for acquiring the patient's consent to electroconvulsive therapy and to apply it in all psychiatric institutions that carry out ECT procedures.

Unlabelled: The presence of chronic disease is a risk factor for the development of mood disturbances and panic disorders. They can influence the course of disease and effectiveness of therapy. Depression may be the cause of making light doctor's advice. Anxious patients often aggravate symptoms of the disease., Aim: To study symptoms of anxiety and depression in patients suffering from atopic eczema/dermatitis syndrome (ZAZS). Material. We studied 38 patients suffering from adequately controlled moderate ZAZS and 62 volunteers in the control group., Methods: Mental status of subjects was assessed by means of State and Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI) questionnaires., Results: ZAZS patients demonstrated higher intensity of anxiety (as a trait and as a state) than healthy subjects. Intensity and prevalence of depression in the atopic eczema/ dermatitis syndrome group was higher than in the control group., Conclusions: Patients suffering from atopic/eczema dermatitis syndrome are pre-disposed to anxiety and depression manifestation. Even adequately controlled symptoms of atopic/eczema dermatitis syndrome may be the cause of those disturbances' occurrence.

Aim: The aim of this study was to assess the score of HADS and the correlation with sociodemographic data in patients after spine surgery., Material: 40 patients after spine surgery because of low back pain and 20 persons of control group participated in the study., Methods: HADS was used in the study. Socidemographic data were collected by means of Socio-demographic data questionnaire., Results: Patients after spine surgery had worse results in HADS-A and HADS-D in comparison to control group. Men, older, worse-educated, unemployed, reporting more concomitant disease and medicine taking patients were more depressed. Anxiety correlated with age, education, tacking medicine and improvement after surgery., Conclusion: Patients after spine surgery need multidisciplinary care because of higher level of anxiety and depression.

The aim of this study was a comparison of the sense of coherence in the group of alcohol dependent male patients, with and without selecting psychosocial effects of alcoholism. The examined group consisted of 55 males treated in departments of alcohol detoxication and rehabilitation in Mental Hospital in Toszek. The SOC--29 scale by Antonovsky was used in order to estimate the sense of coherence and specific questionnaire was used to show selecting psychosocial effects of alcoholism. SOC level was significantly higher in the group of men without psychosocial consequences of alcohol dependence.

This article addresses somatoform disorders, which remain a challenging problem in contemporary psychiatry. Inadequate responses to stressors play a significant role in their development. The term "somatoform disorders" refers to illnesses that were previously termed "psychosomatic". This article defines disorders according to the ICD-10 classification while highlighting important differences between this and the DSM-IV classification. The article reviews expert opinions concerning somatoform disorders, particularly in regard to somatization, hypochondriasis and autonomic dysfunction in these conditions. Attention is drawn to the relationship between somatoform disorders and other psychiatric conditions including depression, anxiety disorders and personality disorders as well as to actual non-psychiatric illnesses. The influence of cultural background, sex and age is discussed. Difficult clinical conditions such as fibromyalgia and Münchhausen syndrome are also considered.

Aim: Preliminary results of research on the therapeutical efficacy of weak variable magnetic fields with low value of induction used as magnetostimulation in patients with depression not reacting to two consecutive, correctly applied anti-depressant pharmacological treatment are presented in the paper., Method: The examined patients (24 persons aged 18-65 years) treated with anti-depressants accessible in Poland were randomly divided into 2 groups. In 1 group (11 persons--9 women and 2 men) magnetostimulation with the use of a weak variable magnetic field with a low value of induction of 15 microT generated by the VIOFOR JPS device (Poland) lasting 12 minutes daily for 15 days was added to pharmacological therapy. Patients from 2 groups (13 persons--11 women and 2 men) were exposed to exposure with the same device. The intensity of depression was estimated with Beck's, Montgomery-Asberg's and Hamilton's scales., Results: As a result of a cycle of active magnetostimulation a distinct, statistically significant decrease of intensification of depression, both in the 7th and 15th day exposure was obtained, while in the sham-exposed group only slight, transient decrease of intensification of depression in the 7th day of sham-exposure was observed., Conclusions: It was concluded that adding magnetostimulation to pharmacological therapy results in a progressive, significant reduction of intensification of depression symptoms.

Out of 14 patients with severe, refractory, psychotic depression-7 patients were treated by UECT and the rest with amitriptyline or mianserin. Remission and improvement were recorded in 6 patients after a course of UECT but in none treated with antidepressants.

The aim of the study was to establish the frequency and follow the clinical course of depression and anxiety in patients with bronchial asthma. 57 patients (37 atopic and 20 nonatopic) with mild and moderate bronchial asthma and 53 subjects matched for age and sex as control groups were included in the study. The following questionnaires: Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Scale (HADS) were used to evaluate anxiety and mood state. The level and prevalence of anxiety and depression were significantly higher in both groups of asthmatics in comparison to healthy subjects. Symptoms were mild and moderate. Nonatopic patients were more depressed and anxious than atopics.

The comparative studies of side effects in 180 patients with refractory depression treated with amitriptyline, mianserin and unilateral ECT were performed.

In 37 inpatients /27 females and 10 males, mean age--49.8 +/- +/- 10.3 years/, with the diagnosis of refractory endogenous depression, after completing a course of unilateral ECT /u-ECT/, multiple EEG examinations were performed during a year of observation. Routine EEG examinations were carried out after a washing out period of two weeks, using an 8 channel Medicor-Orion EEG device. The patients were examined before treatment and 2, 4 and 6 weeks and then 3, 6 and 12 months after the course of ECT. The mean number of ECT which the patients received during a therapeutic session was 8.4 +/- +/- 2.8. Two weeks after completing the course of U-ECT, pathologic tracings in the EEG were found in 17 patients--mainly slowing of the basic alpha activity and slow theta waves. A month after the course of U-ECT in the majority of patients--32 there was a normal EEG tracing. After 6 weeks changes in EEG were found in 2 patients. In one of them they were still present after completion of U-ECT. No significant relationship between the persistence of EEG changes and the number of U-ECT received during the last therapeutic session or the quantity of ECT treatments in the past was detected. The result of this work may support the hypothesis that changes in the biological activity of the brain after ECT therapy are reversible in nature and most probably are a reflection of functional changes in the neurons, partly connected with the therapeutic process or without any relationship with that occurring from a wide spectrum of neurochemical activity of the method of treatment.

The aim of this work was assessment of the peripheral anticholinergic effects by use of a salivary test in patients with depression on the background of affective disease, treated over four weeks in a psychiatric department by one of three methods: amitriptyline, mianserin or nondominant unilateral electroconvulsive therapy (NDULECT). There were 22 patients treated with amitriptyline, 26 mianserin and 20 by NDULECT. The degree of depression was assessed by Hamilton's scale of depression and was similar in the groups of patients compared. Also the amount of saliva excreted was similar in the material examined before treatment. Among the methods of treatment the most severe inhibition of salivation was noted in the group treated with amitriptyline, the least--after NDULECT. Mianserin reduced salivation to a small degree--taking up a middle position in the comparison of methods of treatment. Practically speaking there is a conclusion: in patients whose somatic condition contraindicates, during treatment of endogenous depression, unwanted symptoms occurring after inhibition of the cholinergic receptor, the most acceptable of the three methods would be the use of mianserin or NDULECT.

The course and results of treatment of delirium tremens in 218 patients and pre-delirium syndrome in 569 patients treated in the Psychiatric Department of the Hospital for Miners in Bytom between 1966 and 1984 was analysed. During this period there was found mitigation in the severity of the psychosis and a fall in the number of patients displaying the fully developed syndrome in relation to patients suffering from abortive forms (pre-delirium syndromes). Among the patients treated no deaths were noted. In the opinion of the authors the use of appropriate psychotropic drugs in patients with DT is only one of the many factors influencing the course of this psychosis. As important and often more important is intensive somatic treatment of patients in a severe general condition.