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Zawód psychoonkologa w Polsce nie jest dostatecznie uregulowany prawnie. Aktualnie, według rozporządzenia Ministra Zdrowia w sprawie świadczeń gwarantowanych z zakresu leczenia szpitalnego, psychoonkolog to osoba z wyższym wykształceniem medycznym, tj. absolwent uczelni medycznej, np. lekarz czy pielęgniarka, którzy spełnili dodatkowy warunek ukończenia studiów podyplomowych z psychoonkologii. Jest zatem widoczne, że pozostająca w mocy definicja legalna zawodu psychoonkologa jest niespójna z regulacją tego zawodu obowiązującą od 2018 r., a wynikającą z obwieszczeniu tego samego ministra w systemie Polskiej Ramy Kwalifikacji (PRK). PRK zawęża bowiem grono osób mogących uzyskać kwalifikację z zakresu diagnostyki i pomocy psychoonkologicznej wyłącznie do psychologów i lekarzy psychiatrów, ograniczając tym samym grupę osób uprawnionych do wykonywania zawodu psychoonkologa. Dodatkowy problem prawny wynika z istotnych różnic w charakterze zawodów lekarza i psychologa, z uwagi na nieobowiązywanie w praktyce, mimo formalnego pozostawania w mocy, ustawy o zawodzie psychologa. Nie można wreszcie pomijać okoliczności, że oprócz dwóch wzajemnie sprzecznych regulacji zawodu psychoonkologa na gruncie wskazanych wyżej przepisów (Rozporządzenie MZ i PRK), istnieje jeszcze w Polsce trzecia droga uzyskiwania tzw. certyfikatu psychoonkologa nadawanego przez Polskie Towarzystwo Psychoonkologiczne (PTPO). Obecnie osoby certyfikowane w ramach tej procedury, a poza psychologami i lekarzami certyfikat uzyskiwali też przedstawiciele innych profesji, np. pielęgniarki czy zatrudnieni w hospicjach duchowni, w większości nie będą mogli formalnie wykonywać tego zawodu, ponieważ ustawodawca nie przewidział uznania certyfikatów nadawanych przez PTPO za równoważne z uzyskaniem kwalifikacji psychoonkologicznej w kontekście wskazanych wyżej przepisów.

Introduction: Psychometric properties of the Self-evaluation of Negative Symptoms (SNS) in subjects with the deficit subtype of schizophrenia (SCZ-D) have not been investigated so far. This study had the following aims: (1) to assess psychometric properties of SNS in subjects with SCZ-D and (2) to explore the usefulness of SNS, in comparison with other clinical characteristics, in screening for SCZ-D. Methods: Participants were 82 stable outpatients with schizophrenia, including 40 individuals with SCZ-D and 42 individuals with the non-deficit subtype (SCZ-ND). Results: Internal consistency was acceptable-to-good in both groups. Factor analysis revealed two dimensions (apathy and emotional). There were significant positive correlations of the SNS total score with the subscore of negative symptoms from the Positive and Negative Syndrome Scale (PANSS) and significant negative correlations with scores of the Social and Occupational Functioning Assessment Scale (SOFAS) in both groups, indicating good convergent validity. The following measures were found to be appropriate screening tools for differentiating SCZ-D and SCZ-ND (p < 0.001): the SNS total score (area under the curve [AUC]: 0.849, cut-off ≥16, sensitivity: 80.0%, specificity: 78.6%), the PANSS subscore of negative symptoms (AUC: 0.868, cut-off ≥11, sensitivity: 90.0%, specificity: 78.6%), and the SOFAS (AUC: 0.779, cut-off ≤59, sensitivity: 69.2%, specificity: 82.5%). Also, adding the SOFAS (cut-off ≤59) to the SNS (cut-off: ≥16) further improved sensitivity and specificity (AUC: 0.898, p < 0.001, sensitivity = 87.5%, specificity = 82.2%). Cognitive performance and age of psychosis onset were not found to be suitable measures for differentiating SCZ-D and SCZ-ND. Conclusion: The present findings indicate that the SNS has good psychometric properties in subjects with SCZ-D and those with SCZ-ND. Moreover, the SNS, the PANSS, and the SOFAS might be used as screening tools for SCZ-D.

Objective:The pathogenesis of schizophrenia is multidimensional and intensively studied. The gut–brain axis disturbances might play a significant role in the development of schizophrenia.Methods:We compared the gut microbiota of 53 individuals with schizophrenia and 58 healthy controls, using the 16S rRNA sequencing method. Individuals with schizophrenia were assessed using the following scales: the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, the Social and Occupational Functioning Assessment Scale and the Repeatable Battery for the Assessment of Neuropsychological Status.Results:No significant between-group differences in α-diversity measures were observed. Increased abundance of Lactobacillales (order level), Bacilli (class level) and Actinobacteriota (phylum level) were found in individuals with schizophrenia regardless of potential confounding factors, and using two independent analytical approaches (the distance-based redundancy analysis and the generalised linear model analysis). Additionally, significant correlations between various bacterial taxa (the Bacteroidia class, the Actinobacteriota phylum, the Bacteroidota phylum, the Coriobacteriales order and the Coriobacteria class) and clinical manifestation (the severity of negative symptoms, performance of language abilities, social and occupational functioning) were observed.Conclusions:The present study indicates that gut microbiota alterations are present in European patients with schizophrenia. The abundance of certain bacterial taxa might be associated with the severity of negative symptoms, cognitive performance and general functioning. Nonetheless, additional studies are needed before the translation of our results into clinical practice.

The aim of the article is to examine differences in the quality of life (the psychophysical, psychosocial, personal, and metaphysical spheres) as well as gratitude, meaning in life and positive orientation to life between diocesan and religious seminarians and secular students. The influence of religiosity on quality of life and subjective well-being is the subject of numerous studies, but seminarians (i.e. people preparing to be priests) have rarely been included in them. The present research was carried out for the first time with a group of diocesan and religious seminarians in Poland and secular students. The study involved 296 participants—98 diocesan seminarians, 96 religious seminarians and 102 secular students in the control group. Results showed significant differences in the quality of life. Religious and diocesan seminarians scored higher than the control group members in the psychophysical, personal, psychosocial and metaphysical spheres. In addition, in terms of gratitude, and the presence of meaning in life, religious and diocesan seminarians achieved higher scores than the control group but lower scores in searching for the meaning in life. There were no significant differences between diocesan and religious seminarians except that only diocesan seminarians obtained significantly higher scores on positive orientation to life than the control group. Overall, results support the idea that seminarians have higher quality of life and subjective well-being than secular students. Research implications are discussed.

Aims and objectives To establish the predictive utility of specific social support domains for emotional well-being in cancer caregivers, six months after their partner's cancer diagnosis. Background In cancer caregivers, social support has been consistently related to anxiety and depression. There is little information, however, about the predictive utility of specific social support domains for psychological well-being in the first six months after a partner's cancer diagnosis. Design Longitudinal research study. Methods Sixty-seven caregivers of recently diagnosed cancer patients were recruited from the Reina Sofia University Hospital in Cordoba (Spain). Participants completed a set of questionnaires including the Berlin Social Support Scale (BSSS), the Hospital Anxiety and Depression Scale (HADS) and a socio-demographic questionnaire. Data were collected at two time points: T1 (30-45 days after diagnosis) and T2 (180-200 days after). TRIPOD checklist was used. Results Most of the caregivers were female (65%) and the partner of the patient (58%), with an average age of 51.63 years (SD = 13.25). Statistical differences were observed between the two assessment points for the social support domains of perceived emotional support, satisfaction with support and protective buffering. Logistic regression analysis showed that less physical and sports activity, more support seeking and less informational support received at T1 predicted anxiety at T2, while less perceived available support predicted depression. Conclusions Accurate information and support from other members of the community and the promotion of physical and sports routines for cancer caregivers may help to alleviate symptoms of anxiety and depression in the first months after a partner's cancer diagnosis. Relevance to clinical practice Clinicians must pay attention to the social support needs and physical activity of caregivers in the first days after diagnosis, in order to prevent anxiety and depression.

Aim of the study: To get acquainted with the opinions of Polish doctors about selected economic, ethical and utilitarian aspects of the doctor–patient relationship in the context of the financing of medical services. Method: Online questionnaire with instructions and invitations to participate in the study, sent via a medical portal. Answers were received from 264 physicians, including 177 women and 87 men, aged between 24 and 67. The differences in sex, age, length of service, place of employment, specialisation and the type of funding were analysed. Results: Male physicians working in hospitals are more willing to make decisions based on simple economic calculations. The study showed age-related differences in professional motivation, willingness to make sacrifices for patients, distrust towards patients, ethical issues, willingness to depend on economic balance and willingness to refuse treatment in order to protect the doctor’s personal interests. The type of specialisation differentiated the group in terms of satisfaction with earnings and sense of professional prestige, the degree of distrust towards patients, attitudes to medical records, and readiness to refuse economically unprofitable procedures. The lowest satisfaction with earnings and the lowest sense of professional prestige were declared by psychiatrists. In addition, 77% of the participants did not attribute significant importance to medical standards. Conclusions: Polish doctors are a heterogeneous group in terms of professional motivation, professional prestige and declared attitudes towards patients, which should be taken into account in the organisation of medical services and training of physicians. Changing social and economic conditions influence the development of attitudes that are less focused on the interests of the patient, as indicated by the age-related differences among the surveyed physicians. The low level of importance assigned by doctors to medical standards can have a negative impact on the effectiveness of standardisation of medical services in Poland.

Cognitive deficits are widely observed in patients with psychosis and represent one of most important determinants of functional outcomes. It has been shown that patients with psychosis prefer maladaptive coping strategies over active coping styles. However, it remains unknown whether cognitive impairments are related to coping styles in psychotic disorders. Therefore, the aim of this study was to assess whether cognitive deficits observed in patients with first-episode psychosis (FEP) might impact the use of specific coping strategies. We recruited 40 FEP patients and 35 healthy controls. In our study, FEP patients were more likely to use maladaptive coping styles after adjustment for education level and medication effects. The use of maladaptive coping strategies was associated with greater impairments of visuospatial/constructional abilities and language skills in FEP patients. In addition, lower odds of using adaptive coping were related to higher levels of depressive symptoms in the group of patients. Adaptive coping was associated with better global cognitive performance in healthy controls. Our results indicate that cognitive impairments, especially worse performance of visuospatial/constructional abilities and language skills, might be related to the preference of maladaptive coping strategies. Lower odds of using adaptive coping styles might be associated with more severe depressive symptomatology. This study was funded from science budget resources granted for the years 2016-2019 (the Iuventus Plus grant awarded by the Ministry of Science and Higher Education, grant number: IP2015 052474). Scopus

Aim Caregivers of cancer patients are at high risk of experiencing impairments in terms of anxiety, depression and quality of life. This study examines the mediation capacity that perceived emotional support can have after diagnosis and six months later between depression and anxiety after diagnosis and quality of life in informal caregivers of cancer patients. Design A sample of 67 informal caregivers of cancer patients was used. This study is longitudinal, ex post facto prospective, with convenience sampling. Methods Participants completed the Medical Outcomes Study 36‐Item Short Form (SF‐36), the Hospital Anxiety and Depression Scale (HADS) and the Berlin Social Support Scale (BSSS) and a sociodemographic questionnaire. Data were collected between March 2017 and November 2018. Results Spearman's correlation analysis showed that anxiety, depression and perceived emotional support were related to quality of life. The mediation analysis showed that the relationship between depression after diagnosis and quality of life six months later was mediated by perceived emotional support.

Altered methylation of the FKBP5 gene has been observed in various mental disorders and attributed to the effects of adverse childhood experiences (ACEs). However, the level of FKBP5 methylation has not been investigated in patients with psychotic disorders. Therefore, in this study we aimed to determine the FKBP5 methylation in patients with psychosis and controls, taking into account the effects of ACEs. Participants were 85 patients with psychotic disorders, including first-episode psychosis (FEP) patients and acutely relapsed schizophrenia (SCZ-AR) patients, as well as 56 controls. The level of four CpG sites at the FKBP5 gene was determined in the peripheral blood leukocytes using pyrosequencing. After controlling for potential confounding factors, the level of FKBP5 methylation at one out of four tested CpG sites was significantly lower in FEP patients compared to other groups of participants. Significant main effects of parental antipathy and sexual abuse on the level of FKBP5 methylation were observed at the differentially methylated CpG site. Participants reporting this category of ACEs had significantly lower levels of FKBP5 methylation at this CpG site. Lower levels of FKBP5 methylation were associated with better cognitive performance and higher functional capacity in patients with psychosis. In controls, lower methylation of FKBP5 was related to worse performance of immediate memory and language skills. Our findings suggest that hypomethylation of the FKBP5 appears at early stages of psychosis and might be associated with a history of ACEs as well as less severe clinical manifestation.

Background: The aim of this study was to describe the correlations between the psychosocial burden on male caregivers and their perception of social support, as well as distress, anxiety, and depression among their partners in the first six months after a cancer diagnosis. Methods: A cross-sectional, longitudinal and observational study was conducted on a group of 61 couples, with the use of Zarit Burden Interview (ZBI), Caregiver Burden Scale (CBS), Berlín Social Support Scales (BSSS), Hospital Anxiety and Depression Scale (HADS) and Distress Thermometer (DT). Statistical analysis was performed using Statistica v.13. Results: A strong positive correlation between the ZBI and CBS, as well as between support-seeking and the emotional involvement of male partners, was documented. The negative correlation between the lack of instrumental support and a much greater burden on caregivers, in emotional, social, and family life was documented. The level of distress, anxiety, and depression, as well as family problems reported by female patients, were positively correlated with the male caregiver′s burden. A demographic analysis showed significant relationships between the number of offspring and the negative health indicators of patients and their partners. Implications: The obtained results encourage deeper reflection on the need to improve the availability of instrumental support for male caregivers and support for families with an oncological ill parent in caring for minor children, and to maintain the social activity of the caregiver.

Progress in medical science has allowed the discovery of many factors affecting the pathogenesis of bipolar disorder, and among the most recent research directions are found regenerative and inflammatory processes. The role of regenerative processes remains particularly poorly explored, but available data encourage further research, which may explain the pathogenesis of bipolar disorder (BD). The aim of this study was to evaluate the mobilization of stem cells into peripheral blood, in patients with bipolar disorder during stable phase, not treated with lithium salts. The study included 30 unrelated individuals with the diagnosis of bipolar disorder, with disease duration of at least 10 years, not treated with lithium salts for at least five years prior to the study. The control group consisted of 30 healthy subjects, matched for age, sex, body mass index (BMI), origin, socio-demographic factors and nicotine use. Blood samples underwent cytometric analyses to assess concentrations of: Very Small Embryonic Like (VSEL) CD34+, VSEL AC133+, HSC CD34+, HSC AC133+. There were no significant differences in stem cell levels between patients with BD and healthy controls. However, the level of VSEL cells AC133 + was significantly higher in type I BD patients compared to healthy controls. Our results indicate a disturbance in regenerative processes in patients with bipolar disorder.

The new area of research in psychiatric disorders is concerned with abnormal regeneration processes. The role of brain neurogenesis has been studied for decades. New discoveries, concerned with the pluripotency of VSEL cells and the role of factors involved in stem cell trafficking in peripheral blood create hope that it will be possible to develop a better understanding of the processes of neuroregeneration/neurodegeneration. There is an ongoing research investigating concentrations of: sphingosine -1-phosphate, SDF-1, elements of complement cascade, and stem cells in peripheral blood, including their possible connection to psychiatric disorders. Collected data, suggesting an abnormal course of regeneration processes in psychiatric disorders, raises hope of finding new potential markers of psychosis and anxiety disorders.

Background: In contrast to the reality of clinical practice, in which psychotherapy and pharmacotherapy are frequently combined, the attitudes of psychotherapists towards the use of pharmacotherapy in conjunction with psychotherapy have to date been rarely studied. Method: A special questionnaire was designed for the purpose of the study. An electronic format allowing for anonymous online responses was sent to psychotherapists from two selected mental health institutions in Warsaw. The results were analysed statistically. Results: One hundred six psychotherapists returned a completed questionnaire. They were classified into three groups depending on the length of psychotherapeutic practice as well as into groups of cognitive-behavioural, psychodynamic/psychoanalytic and systemic/integrative psychotherapists. Although cognitive-behavioural therapists do not treat more patients than therapists of other modalities, they encounter significantly more patients who receive medications (p = 0.001) and the number of their patients receiving combined treatment is increasing during psychotherapy. The highest knowledge of drug names was reported in the group of psychodynamic/psychoanalytic therapists. Integrative and systemic therapists more often declared their positive attitude towards combining psychotherapy with pharmacotherapy (Chi-squared test, χ2; p = 0.04). Psychotherapists declaring a neutral attitude towards pharmacotherapy – regardless of the therapeutic modality – had generally more patients in therapy than therapists by whom the use of drugs in the course of psychotherapy was perceived positively or negatively (p

Aim: The prospective analysis of sense of coherence (SOC) and health-related quality of life (HRQOL) correlations in breast cancer survivors in the first year after surgery and the evaluation of the prognostic value of SOC for HRQOL. Method: Thirty-nine women aged from 34 to 68 years (mean = 55.92, standard deviation, SD = 8.84) completed the following surveys: the core European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and the supplement BR23 for HRQOL, and the Life Orientation Questionnaire, SOC-29 for SOC. Data were collected twice: once in the third month after breast surgery (t1: sociodemographic, SOC and HRQOL), and once nine months later (t2: HRQOL). Results: The mean SOC was 141.13 (SD 24.17). The average global health status and overall quality of life (GHS/QOL) was 59.82 (SD 23.47) in t1 and 55.36 (SD 22.93) in t2. A significant decrease in cognitive functioning and an increase in the severity of breast symptoms between t1 and t2 were reported. The results showed several positive correlations between SOC and functional scales of EORTC QOL questionnaires, suggesting the predictive value of meaningfulness for cognitive and emotional functioning of breast cancer survivors. Conclusion: The data obtained give a new insight into the issue of adaptation to cancer and suggest that sense of coherence may play a role in cognitive and emotional functioning in the first year of cancer treatment. Implications for psychosocial care providers: The results suggest the need for active screening and management of cognitive impairments and emotional problems as well as for breast-related symptoms in the first year of cancer therapy. All psychosocial interventions that can empower generalised resistance resources, which are mediated by SOC, may be recommended for better HRQOL in breast cancer survivors.

Introduction and objectives Surgical treatment due to brest cancer have an impact on women sexuality. There is a need for research about effective indications for sexology consultation in women after such treatment. The aim of this study is to determine the indications for sexology consultation in women after surgical treatment for breast cancer. Material and methods We tested 42 women patients diagnosed with breast cancer who had undergone mastectomy 3 months before the study. 3 months after the surgery the women were surveyed using the Polish version of FSFI assessing sexual functioning in women. The result of PL-FSFI were compared with the control group. Results It was found that the mean score of PL-FSFI in the study group 3 months after the surgery was 13.33 points (score range: 1.2-31.7; median 8.3 points) with a statistically significant difference in terms of areas: desire, arousal, lubrication and orgasm in favour of the control group. The total score of PL-FSFI was significantly lower in women after mastectomy than in women after breast-conserving surgery. It has been shown that sexually active women in whom the surgery concerned the right breast (on the side of the dominant hand) scored lower on the scale "sexual functioning" of QLQ-BR-23 than women with surgery of the left breast, with this difference being statistically significant. There was a statistically significant correlation between the baseline performance status on the Zubrod scale and the scales: desire, lubrication and satisfaction of PL-FSFI. Living in a small town proved to be statistically significant for predicting a lower risk of sexual dysfunction among the surveyed women. Conclusions The women who underwent surgery due to breast cancer had a higher risk of sexual dysfunction compared to the general population. Higher risk of sexual dysfunction especially concerns women after mastectomy, those who underwent breast surgery on the side of the dominant hand, and those with a worse preoperative overall level of functioning of > = 1 point on the Zubrod scale. A lower risk of disorders was observed in women living in smaller towns. The above factors indicate the advisability for sexology consultation in women with breast cancer.

In this paper we examined whether stem cells and factors responsible for their movement may serve as new biological markers of anxiety disorders. The study was carried out on a group of 30 patients diagnosed with panic disorder (examined before and after treatment), compared to 30 healthy individuals forming the control group. We examined the number of circulating HSCs (hematopoetic stem cells) (Lin−/CD45 +/CD34 +) and HSCs (Lin−/CD45 +/AC133 +), the number of circulating VSELs (very small embryonic-like stem cells) (Lin−/CD45−/CD34 +) and VSELs (Lin−/CD45−/AC133 +), as well as the concentration of complement components: C3a, C5a and C5b-9, SDF-1 (stromal derived factor) and S1P (sphingosine-1-phosphate). Significantly lower levels of HSCs (Lin−/CD45 +/AC133 +) have been demonstrated in the patient group compared to the control group both before and after treatment. The level of VSELs (Lin−/CD45−/CD133 +) was significantly lower in the patient group before treatment as compared to the patient group after treatment. The levels of factors responsible for stem cell movement were significantly lower in the patient group compared to the control group before and after treatment. It was concluded that the study of stem cells and factors associated with their movement can be useful in the diagnostics of panic disorder, as well as differentiating between psychotic and anxiety disorders.

Cel pracyW artykule analizie poddano jakość życia kobiet z rakiem piersi, ze szczególnym uwzględnieniem wskaźników satysfakcji seksualnej, perspektyw na przyszłość oraz obrazu ciała w zależności od zastosowanej metody leczenia operacyjnego.MetodaDo badania zakwalifikowano 42 kobiety w wieku 35 do 70 lat, 3 miesiące po przebytym leczeniu chirurgicznym z powodu wczesnego raka piersi, poddanych chemioterapii uzupełniającej. Jako narzędzia badawcze zastosowano dwa kwestionariusze EORTC: QLQ-C30 i BR23 oraz kwestionariusz funkcji seksualnych: PL-FSFI.WynikiNie wykazano istotnej różnicy w zakresie ogólnej jakości życia w zależności od rodzaju zabiegu chirurgicznego. Największe dolegliwości w zakresie dolegliwości miejscowych zgłaszały chore pooddane operacji oszczędzającej (=BCT) z limfadenektomią pachową. U kobiet poddanych mastektomii wykazano wyższy poziom funkcjonowania poznawczego, natomiast większe nasilenie systemowych objawów ubocznych w porównaniu do pacjentek po BCT. Chore u których zabieg dotyczył piersi prawej raportowały więcej problemów w funkcjonowaniu seksualnym (p=0,034). W analizie regresji wielorakiej wykazano dodatnią korelację zmiennej funkcjonowanie emocjonalne z oceną przyszłych perspektyw (p=0,01) oraz oceną obrazu ciała (p=0,007).WnioskiRodzaj techniki operacyjnej nie wpływa na ogólną jakość życia oraz na satysfakcję seksualną operowanych kobiet. Problemy z pamięcią i koncentracją uwagi nie korelują bezpośrednio z nasileniem objawów ubocznych leczenia i jako takie wymagają niezależnej diagnostyki. U pacjentek, u których zabieg dotyczył piersi po stronie ręki prawej (dominującej) należy rozważyć potrzebę konsultacji seksuologicznej. Kobiety z rakiem piersi, u których obserwuje się zaburzenia emocjonalne w okresie 3 miesięcy po zabiegu operacyjnym posiadają zwiększone ryzyko zaburzeń w obrazie ciała jak i w ocenie przyszłych perspektyw.

Objective: The aim of this study was to examine the association between the Taq 1A polymorphism of the ANKK1 gene in homogeneous subgroups of patients with alcohol dependence syndrome divided according to Lesch’s typology.Material/Methods: DNA was provided from alcohol-dependent (AD) patients (n = 373) and healthy control subjects (n = 168), all of Polish descent. The history of alcoholism was obtained using the Polish version of the SSAGA (Semi-Structured Assessment for the Genetics of Alcoholism). Samples were genotyped using the PCR method.Results: We found no association between alcohol dependence and ANKK1 Taq 1A polymorphism.Conclusions:Lesch’s typology is a clinical consequence of the disease, and its phenotypic description is too complex for simple genetic analysis.

Cel pracyCelem badania była weryfikacja nastepujących hipotez: 1. Czy kobiety, które przeszły chirurgiczne leczenie raka piersi różnią się od zdrowych kobiet sposobem doświadczania własnego ciała (Ja cielesne)? 2. Czy technika chirurgiczna (mastektomia vs zabieg oszczędzający pierś) różnicuje grupę operowanych kobiet pod względem doświadczanie ciała po operacji? 3. Czy zmienne demograficzne, BMI, rozmiar biustu i ocena blizny różnicują grupę badanych kobiet pod względem doświadczenia cielesności po operacji?MetodaW celu zbadania sposobu doświadczania swojego ciała przez kobiety po operacji piersi zastosowano Kwestionariusz Ja cielesne (J-C) autorstwa Beaty Miruckiej (2005). Analizie poddano wyniki kwestionariusza uzyskane od 50 kobiet. Wyniki porównano z grupą kontrolną kobiet zdrowych. Analizę statystyczną przeprowadzono z zastosowaniem pakietu IBM SPSS Statistics, wersja 24, z jednoczynnikową analizą wariancji (ANOVA).WynikiIstotne różnice uzyskano pomiędzy całą grupą kobiet po operacji piersi, niezależnie od techniki operacyjnej i grupą kontrolną w trzech aspektach kwestionariusza J-C: akceptacja ciała, manifestowanie kobiecości i doświadczanie intymności.WnioskiOperacyjne leczenie raka piersi pozostaje w istotnym związku ze sposobem przeżywania swojego ciała, wyrażonym w trzech wymiarach Ja cielesnego badanych kobiet.

Introduction: The immune system is undoubtedly involved in the pathogenesis of various psychiatric disorders, such as schizophrenia, bipolar disorder, or depression. Although its role is not fully understood, it appears that this area of research can help to understand the etiology of mental illness. One of the components of the human immune system is the complement system, which forms a part of the innate immune response. Physiologically, except for its essential protective role, it is a vital element in the regeneration processes, including neurogenesis. To date, few studies have tried to clarify the role of the complement cascade in mental disorders. Materials and Methods: We evaluated concentrations of C3a, C5a, and C5b-9 complement cascade components in the peripheral blood of 30 patients suffering from bipolar disorder (BD) for at least 10 years, in euthymia, who were not treated with lithium salts. In addition, we divided our study sample into BD type I (BD-I, 22 persons), and BD type II (BD-II, 8 patients). The control group consisted of 30 healthy volunteers matched for age, sex, BMI, and smoking habits. Results: Compared to healthy controls, BD patients had elevated concentrations of all the investigated components. Furthermore, in patients with BD-II, we observed higher concentrations of C5b-9 as compared to patients with BD-I. However, there was a significant effect of BD diagnosis only on the levels of C3a and C5a but not on the level of C5b-9 after adjustment for potential confounding factors. Conclusions: Increased concentrations of components C3a and C5a of the complement system in the investigated group as compared to healthy controls suggest involvement of the complement cascade in the pathogenesis of BD, and provides further evidence of immune system dysregulation in BD patients.

OBJECTIVE Analysis of the relationship between the body self (BS) and the sense of coherence (SOC) in women after breast surgery due to cancer in comparison with a control group. METHODS A cross-sectional study in a group of 78 women using the body-self questionnaire (BS-Q), and the life orientation questionnaire (SOC-29). Statistics based on the IBM SPSS v.25. RESULTS Multivariate analysis of variance (MANOVA) has shown significant differences based on groups in experiencing intimacy, manifesting femininity, body acceptance, and manageability. In particular, manifesting femininity and body acceptance showed a big effect size (0.30

Accumulating evidence indicates that stress plays an important role in the development of psychotic disorders. Recent studies have revealed that patients with first-episode psychosis (FEP) present systemic biological dysregulations related to stress-exposure in terms of elevated allostatic load (AL) index. However, the mechanisms underlying this observation remain unknown. Therefore, in this study we aimed to investigate the AL index with respect to stress coping strategies in 36 FEP patients and 31 matched controls. We found significantly higher AL index in FEP patients compared to controls after co-varying for potential confounding factors. Patients with FEP were less likely to use active and task-focused coping. Lower odds of using these coping styles, planning as well as positive reinterpretation and growth were related to higher AL index in FEP patients, but not in controls. Depressive symptoms were associated with lower likelihood of using task-focused coping as well as positive reinterpretation and growth. Additionally, depressive symptoms were related to higher AL index. Finally, depressive symptoms mediated the effects of task-focused coping as well as positive reinterpretation and growth on the AL index. Our results confirm systemic biological dysregulation indexed as AL in FEP patients. Lower odds of using active coping styles might contribute to higher AL index via the mediating effect of depressive symptoms in patients with FEP. Longitudinal studies are required to establish causal inferences between coping styles, depressive symptoms and the AL index in early psychosis.

CelCelem pracy było określenie zależności miedzy fenotypem “sweetliking” pacjentów z Zespołem Zależności Alkoholowej a występowaniem określonych polimorficznych wariantów genu transportera dopaminy DAT1 i transportera serotoniny 5HTT_LPR.MetodaDo badania zrekrutowano 100 mężczyzn uzależnionych od alkoholu spełniających kryteria uzależnienia według ICD-10, wywiad dotyczący przebiegu uzależnienia zebrano przy użyciu polskiej wersji kwestionariusza SSAGA. Preferencję smaku słodkiego określono przy pomocy zestawów probówek zawierających roztwory sacharozy. Osoby preferujące najwyższe stężenie sacharozy sklasyfikowane zostały jako „sweet likers”. Materiał do badań genetycznych uzyskano z krwi żylnej, DNA wyizolowano metodą wysalania. Przeprowadzono analizę występowania polimorficznych wariantów genu transportera dopaminy DAT1 i transportera serotoniny 5HTT_LPR. Do analizy statystycznej użyto programu SPSS.WynikiW prezentowanym badaniu nie stwierdzono wpływu występowania określonych alleli polimorfizmów genu transportera dopaminy DAT1 i genu transportera serotoniny 5HTT a preferencją sacharozy u probandów. Stwierdzono natomiast statystycznie istotną zależność pomiędzy występowaniem genotypu 9/10 polimorfizmu genu transportera dopaminy DAT1 a preferencją sacharozy wśród probandów (p=,03704) Obecność tego DAT1 9/10 VNTR trzykrotnie zwiększała szansę wystąpienia cechy „sweet liking” (p=0,015, odds ratio-3,00) w grupie badanej. Wykazano również częstsze występowanie genotypu 10/10 (68,18% vs 47,92%) i 9/9 (6,82% vs 2,08%) u probandów SWL-. Obecność DAT1 10/10 VNTR u probandów ponad dwukrotnie zmniejszała szansę na wystąpienie SWL+ (p=0,051, odds ratio-0,43).WnioskiPotwierdzono związek fenotypu „sweetliking” i czynników genetycznych warunkujących funkcjonowanie układu dopaminergicznego.

Objectives Analysis and comparison of two types of motivation (autotelic and non-autotelic) which are behind the choice of medical specialisation by doctors in relation to their sense of coherence. Methods Questionnaire method was used in the study. The study included a group of 86 graduates of the Faculty of Medicine of the Jagiellonian University, who have completed postgraduate internships at the Department of Haematology and Oncology, Department of Gynaecology of the Jagiellonian University and the L. Rydygier hospital in Krakow in 2010-2012. Statistical analyses were performed using the IBM SPSS Statistics 21. The level of significance was alpha = 0.05. Results It has been shown that doctors are more frequently characterised by the autotelic type of motivation. It has also been proven that there is a relationship between the male sex of the surveyed doctors and their autotelic type of motivation. Moreover, it has been demonstrated that there is a correlation between the comprehensibility component of the sense of coherence and the male sex. It has been also demonstrated that there is a correlation between meaningfulness component of the sense of coherence and the choice of surgical specialisation. Conclusions Autotelic motivation prevails when choosing a medical specialty and this tendency is more noticeable in men than in women. The meaningfulness component of SoC plays a regulatory role in making career decisions related to the greater physical and mental pressure put on doctors. The observed differences in the types of motivation and the size of the components of the sense of coherence in groups of surveyed doctors - men and women - encourage further observations of these relationships on a larger population.

Human Papilloma Virus (HPV) infection is the most common sexually transmitted disease. Chronic HPV infection is indispensable for development of cervical intraepithelial neoplasia and cervical cancer. First data stating that HPV transmission among heterosexual partners is very common appeared in last years. The aim of this study was to estimate the HPV infection prevalence among male sexual partners of women diagnosed with subclinical HPV infection, cervical intraepithelial neoplasia and early invasive cervical cancer. The study was conducted among 289 women aged 25-60 diagnosed with CIN and cervical cancer stage IA; control group consisted of 44 women aged 28-56 HPV testing using the material from retroglandular sulcus was conducted among male sexual partners of women from the study group. Testing was performed with HC2 method. In the study group, HPV infection was stated in 218 (75.43%) women and in 6 (13.63%) in control group. HPV DNA was present in 148 (51.21%) men--sexual partners of women from the study group and only 1 (2.27%) from control group. Additionally, HPV types of high and low oncogenic potential were analyzed with regard to histological diagnosis (SPI, CIN, early invasive cervical cancer). As the analysis shows, HPV infection of male sexual partners of women diagnosed with SPI and CIN is relatively high (9.09-93.33%).

Endometriosis is a chronic disease affecting mainly women of the reproductive age. Its most common manifestations include impaired fecundity, pelvic pain, and dyschezia. Laparoscopic removal of endometriotic foci remains to be the gold standard for the treatment of endometriosis. More effective techniques of endoscopic approach—among others, laser application—are continually being developed. The aim of the study was to evaluate the efficacy of laparoscopic treatment with the use of CO2 laser ablation vs. electroablation with regard to pain complaints in the affected patients. The study included 48 women (aged 22–42) with varying degrees of endometriosis of the lesser pelvis. The Numeric Rating Scale (NRS) was used to evaluate pain intensity before the surgery in all patients, followed by either laser ablation or electroablation of the endometriotic foci. The results of the laparoscopic treatment were monitored after 3 and 6 months postoperatively. p value of 0.05 was considered to be statistically significant. Patients from both groups reported less intensive pain before/during menstruation (dysmenorrhea) 6 months postoperatively, with more distinct tendency in the electroablation group (p = 0.004) as compared to the laser ablation group (p = 0.025). Despite the initial improvement reported at the 3-month checkup (p = 0.008), 6 months postoperatively, a statistically significant increase in pain intensity was noted in both groups (p = 0.016 and p = 0.032 for CO2 laser ablation and electroablation, respectively). Both surgical methods seem to be effective only in the treatment of endometriosis-related dysmenorrhea, whereas the intensity of other pain complaints (dyspareunia, dysuria, dyschezia, pelvic pain syndrome (PPS)) has remained on the same level.

IntroductionAfter analysis of biological and pharmacological data, we formulated the hypothesis that the factors involved in trafficking of stem cells could be engaged in aetiology of bipolar disorder (BP).AimsIn this study, we considered the role of complement cascade proteins, stromal derived factor-1 (SDF-1), and sphingosine-1-phosphate (S1P) in long-term treated BP.MethodsA group of 30 patients with BP, without the history of lithium treatment, was examined in remission and compared with a group of 30 healthy volunteers. In peripheral blood, we have analysed the concentration of stromal derived factor-1 (SDF-1), sphingosine-1-phosphate (S1P), and some proteins of the complement cascade (C3a, C5a, C5b-9).ResultsPeripheral blood concentration of C3a, C5a, C5b-9 and SDF-1 was significantly higher in BP group compared to control group. The concentration of S1P does not distinguish BP patients from controls.ConclusionOur results suggest the possible role of the regeneration system in aetiology of BP.This work was supported by grant POIG.01.01.02-00-109/09.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The purpose of this study was to determine the relationship between sweet-liking phenotype and the variation of the gene sequence of the dopaminergic and serotonergic system.The study recruited 100 probands. The participants were interviewed for addiction (SSAGA-Semi Structured Assessment for the Genetics of Alcoholism) and assessed with the questionnaires: MMSE, Beck Depression Inventory and Hamilton Anxiety, Snaith-Hamilton Pleasure Scale. The taste was analyzed with tests to assess sensitivity to sweet taste and also smell tests were performed. Patients preferring the highest glucose volumes were called sweet likers. Statistical analyses were performed (SPSS- Statistical Package for the Social Sciences).Links between sweet liking phenotype and polymorphic variant of DAT1 gene were determined. The presence of DAT1 9/10 genotype increased three fold time sweet liking phenotype (p = 0.015, odds ratio-3.00), the presence of DAT1 10/10 decreased two fold time the chance being sweet liker (p = 0.051, odds ratio-0.43). Genotype 10/10 was significantly more common among sweet dislikers 10/10 (68.18% vs 47.92%) i 9/9 (6.82% vs 2.08%). CONCLUSIONS; A genetically significant association between the presence of 9/10 DAT1 VNTR genotype and a sweet-liking phenotype in probands was determined.

Background: The aim of the study was to determine the influence of DRD2 gene polymorphisms in exon 8 G/A (rs 6276) in the promoter region -141 C Ins/Del (rs1799732) and the influence of ANKK-1 gene Taq-1A polymorphism (rs 1800497) on the preference of increasing sucrose concentrations in men with alcohol dependence. Subjects and methods: 63 male patients with alcohol dependence were genotyped for the above polymorphisms. Their preference for increasing sucrose concentrations was tested and their taste intensity perception of sucrose solutions was assessed. The patients were tested with the 'Sniffin' Sticks' olfactory test. Results: We found a statistically significant association between some alleles of ANKK 1 gene Taq 1A polymorphisms and sucrose preference in the subjects. The A1 Taq 1A allele determined hedonistic response to the two highest concentrations of sucrose. No association was found regarding the other two polymorphisms (in the promoter region and in the exon 8 of the DRD2 gene). Conclusions: Study results suggest Taq-1A polymorphism plays a role in the preference to high concentrations of sucrose and its potential association with alcohol dependence pathogenesis.

In this study, we tested the novel hypothesis that stem cells and those factors that modulate their trafficking may be biological markers for acute psychosis. Twenty-eight subjects during their first nonaffective psychotic episode were investigated before and after antipsychotic treatment and were compared with 35 healthy controls (CG); the psychotic group (PG) was divided into "schizophrenic" (SG) and "non-schizophrenic" (NG) subgroups. We examined the number of circulating Lin(-)/CD45(-)/CD34(+) and Lin(-)/CD45(-)/CD133(+) very small embryonic-like stem cells (VSELs), which express markers of the neural lineage, and also the plasma levels of factors that modulate their trafficking: the C3a, C5a, and C5b-9 activated complement cascade components, stromal-derived factor 1, and sphingosine-1-phosphate (S1P). We found that the mean numbers of Lin(-)/CD45(-)/CD34(+) VSELs and the plasma levels of S1P prior to treatment differ between the CG and PG and that these cells express markers of neural lineage. The number of Lin(-)/CD45(-)/CD133(+) VSELs in peripheral blood differed between the SG and NG prior to treatment. Using logistic regression analysis, we found that C3a and S1P are the best predictors of risk and are potential markers for the first psychotic episode. Furthermore, in the SG, the number of circulating Lin(-)/CD45(-)/CD34(+) VSELs and the S1P plasma level are the best predictors of risk and are proposed as novel markers for the first "schizophrenic" episode of psychosis.

The alcohol dependence syndrome is a disorder with a varying course of symptoms. Nevertheless, it is possible to distinguish subgroups of patients with a similar clinical picture. The purpose of this study was to determine the relationship between the sweet liking phenotype, a subtype of alcoholism according to Lesch and/or Cloninger and gene polymorphism of the DRD2 dopaminergic system.The study recruited 63 families (parents, alcohol-addicted son). Participants were interviewed for addiction (SSAGA, AUDIT) and were examined with the following questionnaires: MMSE, Beck Depression Inventory, Hamilton Anxiety Scale, and Lesch Typology Scale. Sensitivity to the sweet taste was tested and olfactometry was done. Polymorphism of the DRD2 gene was studied in exon 8, promoter region, and TaqI A1 locus.There was no correlation between type of alcoholism and sucrose preference among alcoholics. A correlation (p = 0.048) between sweet liking in fathers and sons was found, as well as between sucrose preference in alcoholic probands and non-alcoholic fathers (p = 0.0378). Sucrose preference correlated with the TaqI A1 allele of the DRD2 gene among alcoholics (p = 0.0016). Changes in the distribution of alleles and genotypes of the TaqI DRD2 polymorphism correlated with sucrose preference among alcoholics (p = 0.008). Similar relationships were not observed for parents. There was no correlation between the hedonistic response to sucrose solutions and other polymorphisms of the DRD2 receptor gene in probands and parents.

The aim of the study was to analyse the correlation between body image and anxiety symptoms as well as psychological discomfort experienced by women growing up in alcoholic families.The group of 61 women (27 years old on average) was surveyed with Body Self Questionnaire and MMPI-2 personality test questionnaires and the results were measured on Scale 7 (Pt). All the participants also attended psychotherapy sessions focused on disorders resulting from growing up in families with alcohol problems.The analysis showed negative correlation (p0.05) between the results of Scale 7 (Pt) and one's body acceptance (r = -0.44), attitude to eating (r = -0.3), femininity disclosure (r = -0.28)and the experience of intimate relations (r = -0.27).The study showed that disordered body image is related to the symptoms described by Scale 7 (Pt): tendency to react with fear, worriment, stronger discomfort in social situations, fear of rejection, difficulties in interpersonal relations, poor self-confidence as well as perfectionism and tensed behaviour. A crucial factor that could improve the effectiveness of therapies for women from alcoholic families appears to be an attempt to combine the experience of oneself in physical and emotional spheres, as well as functioning cognitive schemes.

Asperger's disorder is a nosologic phenomena, that is similar to autism, and falls under the category of pervasive developmental disorders. The unknown and probably multi-factor aetiology, wide clinical picture and not completely defined and clinically relevant diagnostic criteria are the topic of discussion between investigators and clinicians. In the article presented, a single case report of a 39-year old male patient, diagnosed and treated for years due to chronic and resistant emotional and behavioural disturbances, not clearly defined psychotic symptoms and dominating dysfunctions of social involvement, may be a voice in the debate about Asperger's disorder spectrum, comorbidity in Asperger's syndrome and serve to remind the clinicians, that pervasive developmental disorders could really be diagnosed in adults.

Growing evidence indicates that it is not possible to understand carcinoma taking into account only the biological basis, without the psychological and social aspects of the disease. Contemporary psychooncology represents a holistic approach to the disease, integrating theoretical models, clinical and sociological observations as well as current scientific data. Psychooncological research concentrates on the influence of psychological factors on the risk of developing cancer (the model of "personality promoting carcinoma" and the model of "loss and depression"), on psychological processes as predictive factors in the course of an already existing illness and on psychological distress during diagnosis and treatment of the cancer.

The aim of the literature review was the problem of psychiatric complications of intensive chemo- and radiotherapy, which were used in childhood. These days most children who suffer from acute leukaemia are successfully treated. Most studies indicate cognitive dysfunctions, anxiety and mood disorders. These days a new scheme of chemo- and radiotherapy should be introduced, which should consider the mental state of the patients.

The paper focuses on such candidate gene polymorphisms that alter alcoholism-related intermediate phenotypes including: dopaminergic system polymorphic variants (DRD2 -141C Ins/Del in promoter region, exon 8 and DRD2 TaqI A and DAT 40bp VNTR genes polymorphisms) that cause predisposition to severe alcoholism (haplotype Ins/G/A2); COMT Val158Met gene polymorphism related to differences in executive cognitive function and 5-HTT gene promoter polymorphism, which alters stress response and affects anxiety and dysphoria. The transmission disequilibrium test (TDT) was used in the study. One hundred Polish families with alcohol dependence were recruited. The control subjects for the case-control study were 196 ethnically and gender matched healthy individuals. It was found that DRD2 TaqIA and DAT gene polymorphisms contained statistically significant differences in allele transmission. In the homogenous subgroups of patients with early onset and with withdrawal complications a statistically significant preferential A2 allele transmission was found in DRD2 TaqIA gene polymorphism. The alleles and genotypes distribution of the investigated polymorphisms did not differ significantly between the alcoholics and the controls in the case-control study. The results confirmed the fact that the candidate genes (DRD2 and DAT) are partially responsible for the development of alcohol dependence. The results are also in agreement with the hypothesis that there are various subtypes of alcohol dependence, which differ depending on their genetic background. Meanwhile, the currently available pharmacological therapies for alcoholism treatment are effective in some alcoholics but not for all of them. Some progress has been made in elucidating pharmacogenomic responses to drugs, particularly in the context of Clonninger and Lesch typology classification system for alcoholics.

In this paper we review previous research, suggesting a link between depressive symptoms and poor prognosis in cancer patients. The possibility, to identify an association between depressed mood and poorer outcomes and survival in haematological malignancies seems to be very interesting. We shortly describe acute leukemia, actual methods of treatment, and review important factors influencing on mood disturbances and psychosocial difficulties of haematological patients during diagnosis, chemotherapy and after bone marrow transplantation.

The psychologic characteristics of a patient treated of acute leukemia in the ward of bone-marrow transplantation at the Haematology Clinic of CM UJ in Cracow, have been presented. During chemotherapy, proceeding the bone marrow transplant, the patient developed an acute depressive episode with psychotic symptoms. Following the transplantation and discharge from the Haematology Clinic, due to the insufficiency of out-patient treatment and a marked increase of psychotic depression symptoms, the patient was hospitalised at the Depression-Treatment Ward of the Psychiatric Clinic of CM UJ in Cracow. Changes of intensity and character of the psychiatric disorder in the following stages of haematologic and psychiatric intervention are presented. Adaptive strategies considering the important theoretical models according to the authors in connection to the general problem of depressive disorders accompanying neoplasmatic disorders have been described.