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Purpose Investigation of the longitudinal effect of schizophrenia on changes in various brain-metabolite levels and their relationships with cognitive deficits that have not been fully explained yet. Methods Five years subsequent to their first examination for their first episode of schizophrenia, eleven patients from an original group of 30 were reexamined. Their cognitive functions were assessed with the Wisconsin Card Sorting Test. Magnetic resonance imaging and proton magnetic resonance spectroscopy were performed on a 1.5 T scanner. Voxels of 8 cm3 were positioned in the left frontal lobe, left temporal lobe, and the left thalamus. The study had a naturalistic design, and patients were treated with various antipsychotics. Results No significant statistical differences between the baseline and follow-up in N-acetylaspartate (NAA:creatine plus phosphocreatine [Cr] and NAA/H2O) levels were observed in any region of interest. We found a significant statistical correlation between 5-year difference in frontal NAA/Cr levels and duration of the last antipsychotic treatment in this period (R=0.908, P=0.012). We found a trend (P=0.068) toward lower choline-containing compounds (Cho/Cr ratio) in the temporal lobe over 5 years and a trend (P=0.079) in higher glutamate-glutamine- GABA (Glx/H2O) levels in the left thalamus. The patients showed social and clinical improvement at follow-up examination, and there were no changes in Wisconsin Card Sorting Test results. Conclusion The observed tendency toward decline in choline ratio might have been due to decreased temporal cell density or impaired neuron-membrane or myelin functions. A tendency for higher Glx levels suggest the involvement of thalamus dysfunction in the chronic schizophrenia process. The lack of NAA decrease might have been due to effective antipsychotic treatment. Further longitudinal studies on large patient groups are required to confirm these metabolic changes in schizophrenia.

Background Interactions between the digestive system and the brain functions have become in recent years an important field of psychiatric research. These multidirectional interactions take place in the so called microbiota-gut-brain axis and emerging scientific data indicate to the significant role of microbiota in the modulation of the central nervous system (CNS) including affective and cognitive functions. Objective An assessment of psychobiotic and immunomodulatory effects of probiotic bacteria Lactobacillus Plantarum 299v (LP299v) by measuring affective, cognitive functions and biochemical parameters in patients with MDD undergoing treatment with selective serotonin reuptake inhibitors (SSRI). Design Seventy nine patients with MDD were randomized and allocated to a double-blind, placebo-controlled trial. Participants received either a SSRI with the probiotic LP299v (n = 40) for a period of 8 weeks or a SSRI with the placebo of the probiotic (n = 39) for the same period. The severity of psychiatric symptoms was assessed using Hamilton Depression Rating Scale (HAM-D 17), Symptom Checklist (SCL-90) and Perceived Stress Scale (PSS-10). Cognitive functions were assessed using the Attention and Perceptivity Test (APT), Stroop Test parts A and B, Ruff Figural Fluency Test (RFFT), Trail Making Test (TMT) Parts A and B and the California Verbal Learning Test (CVLT). Biochemical parameters such as tryptophan (TRP), kynurenine (KYN), kynurenic acid (KYNA), 3-hydroxykynurenine (3HKYN), anthranilic acid (AA), 3-hydroxy anthranilic acid (3HAA), tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), interleukin 1-beta (IL-1b) and cortisol plasma concentrations were measured. Results Sixty participants finished the study and were analyzed: 30 participants in the LP299v group and 30 participants in the placebo group. There was an improvement in APT and in CVLT total recall of trials 1–5 in the LP299v group compared with the placebo between baseline and after 8 weeks of intervention. There was a significant decrease in KYN concentration in the LP299v group compared to the placebo group. We also observed significant increase in 3HKYN:KYN ratio in the LP299v group compared with the placebo group. Additionally, Repeated Measures ANOVA revealed a significant effect of interaction of Treatment x time for AA concentration. However, results of post hoc analysis did not reach statistical significance in neither probiotic nor placebo group. There were no significant changes of TNF-α, IL-6 and IL-1b and cortisol concentrations in neither probiotic nor placebo groups. Conclusions Augmentation of SSRI treatment with probiotic bacteria Lactobacillus Plantarum 299v improved cognitive performance and decreased KYN concentration in MDD patients. Decreased KYN concentration could contribute to the improvement of cognitive functions in the LP299v group compared to the placebo group. To our knowledge results of this study are the first evidence of improvement of cognitive functions in MDD patients due to probiotic bacteria and this is the first evidence of decreased KYN concentration in MDD patients due to probiotic bacteria.

Aim of the studyTo answer the question of what significance psychotherapists attach to failure.Subject or material and methodsThe study group included 100 psychotherapists. A qualitative method (open questions) and a quantitative method (Self Confrontation Method by Hubert Hermans) were used. An analysis of psychotherapists' comprehension and experience of failure, and an analysis of emotions felt when succeeding or failing in psychotherapy were performed.Results94% of psychotherapists declared that they experienced failures in the course of their professional work. The failures were accompanied by particularly negative emotions and were quantitatively and qualitatively different from the emotions felt when a patient's therapy was completed successfully. A failure was most frequently (76 out of 100 psychotherapists) perceived as premature termination of treatment by the patient where therapy cessation was attributed in 70% of cases to factors within the patient's control. Psychotherapists evaluated their competences highly - they claimed to possess qualities predisposing them to an average success rate of 73%. They rated their job satisfaction at the level of 80%. 61% of psychotherapists discussed their failures at counselling supervision meetings.DiscussionA tendency to preserve one's self-esteem and to strengthen one's self displayed by psychotherapists is evident in the process of analysing previously committed mistakes.ConclusionsPsychotherapists experience failures and they are most frequently inclined to attribute them to factors within patients' control.

Interactions between the digestive system, brain functions and immunoglobulin G (IgG) mediated immunity against food antigens became recently a topic of growing interest in psychiatry research. Psychological stress can activate hypothalamic-pituitary-adrenal axis (HPA) with subsequent hypercortisolemia. It can also influence intestinal permeability and dynamics of IgG response. Major depression can by accompanied either by activation of inflammatory response or by immune suppression (e.g. decreased antibody production) where hypercortisolemia is a significant immune modulator. The aim of our study was to assess IgG immune response against 44 food products in depressed patients and controls along with markers of psychological stress, inflammation, psychometric and dietary parameters. Serum IgG concentrations against 44 food antigens, plasma cortisol, TNF-α, IL-6, IL-1b concentrations were measured and psychometric parameters were evaluated using Hamilton Depression Rating (HAM-D 17), Perceived Stress (PSS-10), and Symptom Checklist (SCL-90) scales in 34 depressed patients and 29 controls. Dietary parameters such as frequency of exposure to food antigens, appetite and weight change were assessed. There was a significantly lower IgG concentration against dairy in depressed patients compared to controls (post hoc p

Cel pracyNarodzenie dziecka stanowi ważne wydarzenie w życiu kobiety oraz w diadzie małżeńskiej/partnerskiej. Zmiany, które zachodzą wymagają przeorganizowania dotychczasowych stylów radzenia sobie i rozwinięcia nowych sposobów adaptacji, co nie zawsze przebiega łagodnie. W niniejszym badaniu oceniano, w jakim stopniu rozwinięcie objawów depresji poporodowej u kobiet jest związane z ich satysfakcją w zakresie funkcjonowania relacji.MetodaBadaniem objęto 100 kobiet w pierwszym miesiącu po porodzie. Ankietowane udzieliły odpowiedzi na temat danych socjodemograficznych oraz wypełniły kwestionariusze dotyczące depresji poporodowej (Postpartum Depression Screening Scale) i jakości relacji małżeńskiej/partnerskiej (Kwestionariusz Dobranego Małżeństwa).WynikiWystąpił statystycznie istotny związek pomiędzy poziomem doświadczania depresji poporodowej a jakością relacji w związku. Większe nasilenie objawów depresji poporodowej (kłopoty ze snem/jedzeniem, niepokój/niepewność, wahania nastroju, chaos psychiczny, poczucie utraty własnego JA, poczucie winy/wstydu, myśli samobójcze) występowało u osób mniej zadowolonych ze swego związku, to jest takich, które doświadczały mniejszego poczucia intymności, samorealizacji i podobieństwa oraz większego poczucia rozczarowania. Kobiety, które deklarowały większe zadowolenie ze swego związku, ujawniały jednocześnie lepsze samopoczucie psychiczne po narodzeniu dziecka. Nie zaobserwowano związku pomiędzy występowaniem objawów depresji poporodowej a zmiennymi socjodemograficznymi (wiek, wykształcenie, miejsce zamieszkania) i zmiennymi związanymi z historią położniczą kobiety (liczba dzieci, liczba ciąż, występowanie poronień, planowanie ciąży, wcześniejsze występowanie depresji, rodzaj porodu, stan dziecka po porodzie, sposób karmienia).WnioskiU pacjentek niezadowolonych z jakości relacji w związku obserwowano większe nasilenie objawów depresyjnych po porodzie. Większe zadowolenie ze związku deklarowały kobiety żyjące w związkach formalnych.

Purpose. Modern neuroimaging techniques allow investigating brain structures and substances involved in the pathophysiology of mental disorders, trying to find new markers of these disorders. To better understanding of the pathophysiology and differential diagnosis of schizophrenia and bipolar disorder, this study was conducted to assess the neurochemical alterations in the frontal and temporal lobes in hospitalized patients with schizophrenia and bipolar disorder. Methods. Twenty-one subjects with schizophrenia (paranoid and differentiated types), 16 subjects with bipolar I disorder (manic, depressive, and mixed episode), and 20 healthy subjects were studied. Magnetic resonance (MR) imaging and proton resonance magnetic spectroscopy (1H MRS) were performed on a 1.5 T scanner. Voxels of 8 cm3 were positioned in the left frontal and left temporal lobes. Results. Glx/H2O (GABA, glutamine, and glutamate/nonsuppressed water signal) ratios were significantly increased in the left temporal lobe in schizophrenia, but not in bipolar disorder, compared with controls. Cho/H2O (choline/nonsuppressed water signal) ratios in the left frontal lobe had a tendency to increase in bipolar disorder and schizophrenia, relative to controls. A lower temporal lobe NAA/H2O ratio in mixed than in manic and depressive episode of bipolar patients was also found. No other significant differences were found among three studied groups as regards NAA, Cr, and mI ratios. Conclusions. Our results partially confirm the role of a glutamatergic system in schizophrenia, however, only in a temporal lobe. We also point to the importance of the choline-containing compounds (marker of cellular density) in the frontal lobe of patients suffering from bipolar disorder and schizophrenia. We also found the deleterious effect of mixed bipolar episode on the integrity and functioning of the temporal lobe. Glutamatergic left temporal spectroscopic changes may potentially help in differential diagnosis of schizophrenia from bipolar disorder.

Assessment of functioning of the marriages applying for marital therapy.The research included 44 marriages: 22 of them were qualified for the marital therapy and 22 constituted a control group - were not taking part in therapy. Participants evaluated themselves and their relation using: SCORE-15 (Systematic Clinical Outcome and Routine Evaluation), UMACL (UWIST Mood Adjective Check List), KKM (Marriage Communication Questionnaire).Marriages applying for the therapy, when compared with control group, showed worse general functioning, lower adaptability, more disrupted communication and were overwhelmed by difficulties in higher degree. The lower level of engagement and support, as well as the higher level of depreciating behavior were present in their communication. In this group the lower mood expressed in lower degree of Hedonic Tone and higher degree of Tense Arousal was also recorded.The specific functioning of marriages in crisis applying for the marital therapy is an important indication for the family therapists, in respect to their interventions during therapy process. When working with couples, it is important to consider their difficulties in communication, the tendency to depreciating each other, the lower mood and estimating the therapy as helpful and needful with simultaneous devaluating of their own styles of coping.

The aim of the study was to investigate the influence of familial alcohol abuse, depressive symptoms and the quality of life on MAST score in schizophrenic patients, dependent from alcohol. Material and methods. 61 patients with dual diagnosis and 60 with single diagnosis of schizophrenia performed MAST In two groups with clinical scales, depressive symptoms and the quality of life were assessed.Significant correlates of higher MAST scores were family history of alcohol abuse and earlier onset of alcoholism. Dissatisfaction with the quality of life was correlated with higher MAST scores but only in dependent from alcohol female schizophrenic patients.Symptoms of depression accompanying alcohol dependence did not influence MAST score.

Background BMI (body mass index) can be misleading regarding the level of adiposity in a normal-weight individual. Recently, a bioelectrical impedance analysis (BIA) method was developed that can measure body composition variables. The main objectives of this study were to use BIA to compare the body composition variables between chronic non-diabetic schizophrenic patients with normal weight and healthy individuals. The secondary objective was to compare the nutritional pattern of schizophrenia patients with that of matched healthy subjects, and to identify possible relationships between the content of different components of their diet and visceral adiposity. Methods The subjects were 52 normal-weight patients (33 males and 19 females) diagnosed with schizophrenia based on the DSM-IV and 45 (23 males and 22 females) BMI- matched controls. The patients had been receiving atypical or typical antipsychotic agents for at least one year before enrollment into the study but continuously for 3 months preceding the study and were psychiatrically stable. Body fat (kg), percent (%) body fat, fat-free mass, VAT (visceral adipose tissue) and SAT (subcutaneous adipose tissue) were measured using the bioelectrical impedance analysis (BIA) method. Daily food rations (DFR) were quantitatively evaluated by a 24-h dietary recall method covering 3 days preceding the examination. Results In normal-weight patients schizophrenia was significantly linked with higher VAT, VAT/SAT ratio and lower fat- free mass. Men had over 5 times and women over 2 times as much VAT as BMI matched groups. In women with schizophrenia and in their controls, the amount of magnesium, niacin and vitamin B6 in their diet inversely correlated with VAT, while in men lower zinc and vitamin C intake was related to higher visceral adiposity. Conclusions Our study has shown that normal-weight patients with chronic schizophrenia have higher levels of visceral fat (VAT) than controls but similar volume of subcutaneous adipose tissue (SAT). Although no clear conclusion can be made regarding cause-and-effect relationships between the dietary content of food served to our patients and visceral obesity, we suggest that schizophrenia diet should be further investigated as a possible factor related to this type of obesity.