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Introduction: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women at the reproductive age. In 2018, the European Society of Human Reproduction and Embryology (ESHRE) developed and published new accurate recommendations for the diagnosis and management of women with PCOS. In this work, a separate chapter is devoted to the quality of life and mental disorders in patients with polycystic ovary syndrome. Material and Methods: This article provides an overview of the literature regarding mental disorders associated with PCOS with the focus on the ESHRE recommendations. Conclusion: The medical staff and patients should be aware of the negative impact of polycystic ovary syndrome on the quality of life, coexistence of depression, anxiety, psychosexual and eating disorders.

Summary Objective: The aim of the study was to determine differences in the range of socio-demographic variables, selected clinical variables, temperament and character traits, coping with stress strategies and the level of aggression in alcohol addicts with or without a history of suicide attempt(s). Methods: The study involved 90 people addicted to alcohol, treated in inpatient alcohol dependence treatment program. In order to collect data on socio - demographic variables and selected clinical variables, a self-made questionnaire was used. The severity of alcohol dependence was verified using the MAST and SADD scales. Characteristics of temperament and character were examined with the TCI questionnaire. The BPAQ and COPE questionnaires were used to examine the level of aggression and styles of coping with stress. Results:Out of 90 subjects with alcohol dependence syndrom, 20% had attempted suicide in the past. The respondents with a history of suicide attempts were statistically significantly younger, were characterized by a younger age of alcohol drinking initiation and the initiation of regular alcohol drinking, and a greater severity of alcohol dependence in the MAST and SADD scales. A significantly larger percentage of respondents who had attempted suicide inflicted self-injury in the past, used other psychoactive substances as well as hypnotics and sedatives. The subjects with a suicide attempt in the interview obtained statistically significantly higher scores in terms of the level of aggression, harm avoidance and self-directedness, and more often used the style of coping with stress based on avoidance and accepting the situation. Conclusions: The obtained results correspond with data available in the literature and may provide a foundation for theoretical models explaining the phenomenon of suicidal behavior in alcohol addicts as well as for suicide prevention programs in this group of patients.

Cel pracy Celem pracy jest analiza przypadku wulowdynii współwystępującej z depresją. Metoda Analiza dokumentacji medycznej oraz przypadku klinicznego. Wyniki 45-letnia kobieta została przyjęta do kliniki z powodu dokuczliwego bólu sromu z towarzyszącymi objawami zespołu depresyjnego, nieustępującego po duloksetynie w maksymalnej tolerowanej dawce 60 mg/d. Pacjentka od 11 lat cierpi na nawracające bóle w zakresie sromu lub okolicy skroni i żuchwy z towarzyszącą depresją. W przeszłości dwukrotnie podjęła próbę samobójczą. Pierwotnie rozpoznawano u niej wulowodynię, następnie kilkukrotnie hospitalizowana psychiatrycznie z rozpoznaniami klinicznymi ze spektrum zaburzeń nastroju. Ból i objawy zespołu depresyjnego ustępowały po lekach przeciwdepresyjnych: klomipraminie, escitalopramie, wenlafaksynie. Analiza historii choroby, przeprowadzone badanie ginekologiczne potwierdziło występowanie u pacjentki wulwodynii. Remisję w zakresie bólu i objawów afektywnych osiągnięto jednoczasowo po włączeniu do leczenia gabapentyny w dawce 900 mg/d. Ostatecznie u pacjentki rozpoznano wulwodynię i zaburzenia depresyjne nawracające. Postawienie takiej diagnozy byłoby jednak w pełni uprawnione, gdyby w przyszłości wystąpił u niej epizod depresyjny niezwiązany z bólem. Wnioski 1. Wulwodynia często współwystępuje z zaburzeniami depresyjnymi. 2. Zaburzenia depresyjne mogą stanowić czynnik ryzyka zachorowania na wulowodynię, jak również pojawiać się wtórnie do dolegliwości bólowych. 3. Rozpowszechnienie innych funkcjonalnych syndromów bólowych takich jak fibromialgia, zespół skroniowo-żuchowowy u pacjentek z wulwodynią jest większe niż w ogólnej populacji kobiet. 4. Ryzyko samobójstwa w wulwodynii, podobnie jak w innych przewlekłych syndromach bólowych jest relatywnie wysokie, szczególnie w sytuacji współwystępowania objawów depresyjnych.

Objective. The study is the second part of the literature review on hyponatremia in patients with diagnosed mental disorders. This article focuses on psychogenic polydipsia as, along with the SIADH, one of the two most common causes of hyponatremia in the mentioned group of patients. Method: The literature review was based on searching the Medline, the Google Scholar and the Ebsco databases in Polish and English by entering the following phrases: psychogenic polydipsia, the psychosis – intermittent hyponatremia – polydipsia syndrome, water intoxication. Discussion: Psychogenic polydipsia occurs in up to 25% of patients treated for mental disorders. It most frequently concerns patients with schizophrenia. 30% of patients with psychogenic polydipsia suffer from hyponatremia with or without symptoms of water intoxication. In the etiology of psychogenic polydipsia, the influence of dopaminergic and noradrenergic neurotransmission has been considered, as well as angiotensin, which is claimed to have dipsogenic properties. In order to reduce the severity of the disorder, attempts have been made to administer the following groups of medications: β-blockers, opioid receptor antagonists, angiotensin convertase inhibitors and angiotensin receptor antagonists. Other methods include replacing classic antipsychotic drugs with clozapine. There are also reports of a reduced severity of polydipsia with hyponatremia after introducing risperidone and olanzapine. Preventing episodes of water intoxication in patients with psychogenic polydipsia requires the monitoring of their body weight and a suitable reduction of fluid intake by them. Results: Mentally ill patients, especially those with chronic schizophrenia, should be monitored for psychogenic polydipsia and the concomitant hyponatremia.

Introduction. Hyponatremia is an important part of psychiatric practice. In order to analyze its causes and symptoms, the literature on hyponatremia in psychiatric patients has been reviewed. The work has been divided into two separate manuscripts. In the first one the authors discuss the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and hyponatremia occurring with the use of psychotropic drugs (antidepressants, antipsychotics, normotimics), while the second paper discusses research on psychogenic polydipsia. The causes of hyponatremia in patients treated in psychiatric wards include: water intoxication associated with polydipsia, somatic comorbidities, side effect of internal medicine and psychiatric drugs. The most common mechanism leading in these cases to hyponatremia is the syndrome of inappropriate secretion of vasopressin (SIADH). The SIADH syndrome is a group of symptoms, first described in 1967 by Schwartz and Bartter in The American Journal of Medicine, which results from the hypersecretion of antidiuretic hormone, also called vasopressin, which causes patients to develop normovolemic hyponatremia. The phenomenon of drug-induced hyponatremia in psychiatric practice is generally observed with the use of antidepressants, antipsychotics and anti-epileptic drugs (used in psychiatry as normotimic drugs). Aim and method. The first manuscript includes a review of literature on the syndrome of inappropriate secretion of vasopressin (SIADH) and hyponatremia occurring after the use of psychotropic drugs, and is divided into two subsections: 1. The syndrome of inappropriate secretion of vasopressin (SIADH), 2. Hyponatremia and psychotropic drugs (antidepressants, antipsychotics, normotimics). Conclusion. In the view of the reviewed literature it is extremely important to control the natremia level during pharmacotherapy using the above mentioned drugs, especially in the initial period of therapy.

The objective of the study was to assess the level of patients' need for information about the planned gynecologic surgery. Material and Methods. The number of 173 patients preparing to undergo planned gynecological procedure were qualified for the study. The participation in the survey was entirely voluntary. Each patient was asked to fulfill the survey conducted using the Amsterdam Preoperative Anxiety and Information Scale- APAIS that enables the estimation of the patient’s need for surgery-related information. Furthermore patients’ clinical and demographic data was collected. Results were analyzed using appropriate statistical tools: the Shapiro-Wilk W-test (for distribution of the studied parameters) and the Mann-Whitney U-test (for comparing two independent groups). P value less than 0.05 was considered statistically significant. Results. It was shown that premenopausal women have a greater need for information about the planned surgery than postmenopausal patients (p0.05). Conclusions. The high level of the need for information about the planned surgery characterizes premenopausal patients and those operated for the first time.

Cel pracyCelem naukowym badania było poszukiwanie grup osób uzależnionych od alkoholu różniących się nasileniem przemocy fizycznej, emocjonalnej i seksualnej w dzieciństwie a następnie poszukiwanie zmiennych osobowościowych różnicujących te grupyMetodaBadaniem objęto 90 osób uzależnionych od alkoholu. Zastosowano następujące metody kwestionariuszowe: Kwestionariusz Temperamentu i Charakteru (TCI), Inwentarz do Pomiaru Radzenia Sobie ze Stresem (COPE), Kwestionariusz Agresji Buss i Perry (BPAQ), Arkusz Samopoznania Cattella oraz Inwentarz Wczesnej Traumy (ETI).WynikiWyodrębniono dwie grupy osób uzależnionych od alkoholu: grupę 1 z wysokimi indeksami nadużyć fizycznych, emocjonalnych i seksualnych w dzieciństwie oraz grupę 2 z niskimi. Badani z grupy 1 osiągali istotnie statystycznie wyższe wyniki niż badani z grupy 2 w zakresie następujących skal temperamentu kwestionariusza TCI: NS, HA oraz niższe w skalach charakteru: SD, C2, C4. Badani z grupy 1 istotnie częściej niż badani z grupy 2 posługiwali się unikowym stylem radzenia sobie ze stresem, rzadziej wykorzystywali styl zadaniowy, oraz osiągali istotnie statystycznie wyższe wyniki w zakresie niepokoju ogólnego, jawnego, ukrytego, poziomu agresji, agresji fizycznej, wrogości i gniewu.WnioskiWiększe nasilenie przemocy fizycznej, emocjonalnej i seksualnej w dzieciństwie u osób uzależnionych od alkoholu wiąże się tymi cechy osobowości, które wydają się być kluczowe dla podtrzymania abstynencji oraz jakości współpracy w terapii.

Aim: The objective was to analyze the case of postpartum depression complicated with extended suicide attempt. Method: The analysis of clinical case and medical history. Results: In 25-year-old patient, two weeks after childbirth, postpartum depression episode occurred. In the further course of illness psychotic symptoms (delusions, mood disorders), suicidal and infanticide thoughts emerged. Four weeks after childbirth, the patient killed her baby and took an unsuccessful suicidal attempt. Based on medical records, several risk factors of postpartum depression were identified: 1. obstetric and child-related risk factors: Caesarean section, premature birth, obstetric complications during pregnancy, infant’s difficult temper, difficulties related to breastfeeding; 2. psychological risk factors: baby blues, high anxiety level during pregnancy, high level of stress related to child care. Conclusions: Psychoeducation of women during pregnancy, including their families, is an extremely crucial element of postpartum depression prevention. It is also necessary to raise awareness among healthcare professionals who have frequent contact with mothers after childbirth: midwives, gynaecologists and paediatricians.

BackgroundThe problem of coping with stress is an important one in the context of development and persistence of alcohol dependence. In the literature to date very little attention has been paid to coping patterns construed as a configuration of specific coping styles, particularly as regards the functioning of addicted individuals. The aim of the study was to verify whether individuals with alcohol dependence characterized by different coping patterns differ with respect to the severity of psychopathological symptoms, defense mechanisms and time perspectives.MethodsParticipants were given a battery of psychological tests—Coping Inventory for Stresfull Situations (CISS), Defense Style Questionnaire (DSQ 40), Syndrom Checklist (SCL-90) and Short Zimbardo Time Perspective Inventory (SZPTI-PL). The sample comprised 112 individuals with alcohol dependence, aged 20 to 63 years old, the average age was 37.86; 78 percent were men. There were identified three sub-groups of individuals characterized by a distinctive patterns of coping with stress —“emotional-avoidant”, “task oriented” and a “mixed one”.ResultsIndividuals with the predominant emotional-avoidant coping pattern are characterized by significantly higher severity of psychopathological symptoms, less mature defense mechanisms and past time perspectives. Subjects reliant on task-oriented coping pattern were characterized by the highest level of adaptation and the most constructive way of functioning in the face of difficulties.ConclusionIt is worth regarding the examination of patterns of coping as an indispensable element of collecting medical history from alcohol dependent individuals.

Infantile autism is a neurodevelopmental disorder characterized by impairments in communication, reciprocal social interaction and restricted repetitive behaviors or interests. Although the cause of these disorders is not yet known, studies strongly suggest a genetic basis with a complex mode of inheritance. The etiopathogenetic processes of autism are extremely complex, which is reflected in the varying course and its symptomatology. Trajectories of brain development and volumes of its structures are aberrant in autistic patients. It is suggested that disturbances in sertotoninergic, gabaergic, glutaminergic, cholinergic and dopaminergic neurotransmission can be responsible for symptoms of autism as well as can disturb the development of the young brain. The objective of this article is to present the results of reasearch on neuroanatomical, neurochemical and genetic aspects of autism.