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Biomedical subjects

A Kiejna

Publications and source records attributed to A Kiejna.

At least 19 recordsLinked to original sources
PubMed2007

Social disability in different mental disorders.

OBJECTIVE: To assess the social disability of people with different psychiatric disorders. METHODS: Cross-site survey in five psychiatric hospitals (Dresden, Wrocław, London, Michalovce and Prague). Working-aged patients diagnosed (ICD-10) with schizophrenia and related disorders (F2), affective disorders (F3), anxiety disorders (F4), eating disorders (F5) and personality disorders (F6), were assessed at admission (n=969) and 3 months after discharge (n=753) using the Brief Psychiatric Rating Scale and the Groningen Social Disability Schedule. The main outcome measure was Interviewer-rated social disability. RESULTS: During acute episodes patients with personality, eating and schizophrenic disorders functioned less effectively than those with affective or anxiety disorders. After controlling for age and severity of psychopathology, there was no significant effect of the diagnosis (during remission), sex, education and history of disorder on disability. Site, employment and partnership were significant factors for the level of social disability in both measure points. CONCLUSION: Severity of psychopathological symptoms, not the diagnosis of a mental disorder, was the most significant factor in determining the level of social functioning, particularly during the remission period. Site, employment and partnership appeared as significant factors influencing the level of social disability.

Adult↗
PubMed2004

Pathways to psychiatric care and reform of the public health care system in Poland.

OBJECTIVE: - Since 01.01.1999 a reform of the health care system in Poland has been realised based on the general health insurance act. We attempt to use the pathway method, especially measuring of time intervals along pathways, as a way of making accessibility to mental health services operational. METHOD: - In a period of 2 months all patients aged 15 and over who had not sought care from any public or private psychiatric service during the previous 365 days, were interviewed by psychiatrists, using the Polish version of the WHO Encounter Form. RESULTS: - A total of 228 patients were seen. The study reveals that the median interval between first seeing a primary care giver and arrival at a mental health service was 12 weeks, which is much longer than all other European centres in previous studies. CONCLUSION: - Making use of the pathway method and, in particular, median interval analysis between the onset of the mental health problem and seeing mental health professionals (MHPs) has shown practically limited access of patients, with a new episode of care to psychiatric services in both epidemiological catchment areas. This method seems to be a simple and inexpensive way of monitoring the accessibility to MHP in the period of health care reform.

Adolescent↗
PubMedDate not supplied

[Factorial structure of Hamilton Anxiety Rating Scale].

Among subjects suffering from anxiety disorders, mixed anxiety-depression and dysthymia (DSM III R), severity of disease has been assessed in six centres, using the Hamilton Anxiety Rating Scale. Results from two centres have been rejected because of major difference in comparison with the other centres, in which there were no statistically relevant difference. Resting on 90 subjects' rates, the analysis of factorial structure and factor reliability has been conducted with the principal components method and varimax rotation. Four factors have been extracted: somatization, psychic anxiety, somatic anxiety and psychic depression. The rotated factors accounted from 13% to 19% of the total variance (all four--60%). Unlike many previous investigators, we found that psychic factors of depression and anxiety are clearly separated, what must be due to heterogeneity of the group. The factorial structure in case of a homogenic group could be reduced to two factors: somatization and psychic anxiety or depression--depending on cases selection. Results explain the ability of Hamilton Anxiety Rating Scale to assess severity of anxiety as well as depressive state, and point out that the scale is not diagnostic.

Adult↗
PubMedDate not supplied

[Trichotillomania].

Trichotillomania is the recurrent pulling out of one's own hair, which results in noticeable hair loss, classified in DSM IV and ICD 10 as an impulse control disorder. Trichotillomania can occur as an isolated symptom or may be associated with affective disorders, schizophrenia, substance abuse, borderline personality, obsessive-compulsive disorder. Its onset is usually in childhood and females are more affected than males.

Child↗
PubMedDate not supplied

[The diagnostic questionnaires and their use in epidemiological studies in psychiatry].

The paper presents diagnostic instruments employed in psychiatric; brief history of their development with regard to their importance for progress in psychiatric epidemiology, the characteristic of the most important diagnostic questionnaire (Present State Examination--PSE, Composite International Diagnostic Interview--CIDI, Schedules for Clinical Assessment In Neuropsychiatry--SCAN, Structured Clinical Interview for DSM IV--SCID, Schedule for Affective Disorders and Schizophrenia--SADS, Diagnostic Interview Schedule--DIS). It also describes some features that should be considered while choosing a proper instrument for a given study. The authors call attention to some differences between instruments, e.g., those related to the structure of the questionnaire, involving diagnostic categories, the sort of information that an instrument allows to collect, competence of interviewers and their training, and also population for which the instrument is assigned. Presenting advantages and disadvantages of instruments, the authors emphasize that there is no best instrument. The choice of questionnaire depends, first of all, on the purpose of the study and the funds that the researches have at their disposal.

Epidemiologic Methods↗
PubMedDate not supplied

[Clomipramine in the treatment of obsessive-compulsive disorder. An open 8-week trial].

Among many drugs used for treatment of obsessive-compulsive disorder clomipramine is still considered as model drug though serotoninergic mechanism is common for many antidepressants. The study was carried out in order to assess the potential and dynamic of antiobsessive and anticompulsive efficacy of clomipramine used in normal therapeutic doses during eight week trial. The study was carried out with the help of Asta Medica company and trade name of the used drug was Hydiphen. The severity of obsessive-compulsive disorder was evaluated at the moment of inclusion to the study and then once every week. The obsessive-compulsive scale Y-BOCS was employed. 27 patietnts (16 women and 11 men) at aged 18-64, from different mental health care centers in Poland participated in this study. The study was completed by 67% of patients--due to lack of therapeutical effect the treatment of others patients was stopped. Among the patients who responded well to clomipramine therapy, improvement was observed after the first week and then the dynamic of improvement decreased after 4 weeks. During the 7th week the drug reached its maximal efficacy level with statistically significant reduction in scores of Y-BOCS scale. The range of therapeutic doses was 75-250 mg. In this range no seriouse adverse events were observed and some of mild ones that occurred at the beginning of the therapy diminished during the next week.

Adolescent↗
PubMedDate not supplied

[Frame of mind among Polish population in research carried out by the Central Statistical Office: initial analysis].

The authors are going to estimate the prevalence poor frame of mind and neurosis among Polish adult people, and try to appoint the relationships between psychiatric disorders and gender, age, civil status, education and maintenance. The questionnaire contains questions about quality of sleep, possibility to fix one's attention on acting, inner tension, self-confidence. Almost 1/4 of women and 18% of men have poor frame of mind. We find very strong and important relationships between neurosis and the poor frame of mind. There were no differences in mental state between people living in towns and villages. The unemployed and the cripples have worse psychological condition than working men. People who are divorced and widowed have statistically more often poor frame of mind and neurosis than the married. We also found a major correlation between poor frame of mind and neurosis and education. Low education is connected with poor psychological condition.

Adolescent↗
PubMedDate not supplied

[An estimate of family doctor's knowledge of diagnosis and treatment of depression and anxiety disorders].

Depression is more widespread than hypertension. Nevertheless, physicians specialized in family medicine did not have knowledge necessary to diagnose and treat depression and anxiety disorders. Only six persons out of fifty five who filled in the questionnaire could recognize depression correctly (ICD-10 criteria). Doctors knew antidepressant drugs, but they did not know therapeutic doses. We can try to explain this situation through doctor's pre and postgraduate education.

Adult↗
PubMedDate not supplied

[Pharmacokinetics of second generation antidepressants].

This paper presents the pharmacokinetic properties of newer second generation antidepressants, with an emphasis on the main metabolic pathways of drugs and metabolites as well as their effects on the cytochrome P450 enzymes. Except for Milnacipran all newer antidepressants are biotransformed in the presence of at least one cytochrome P450 izoenzyme. Drugs and their metabolites may be the substrates or inhibitors of cytochromes P450. The knowledge of drugs' metabolic pathways as well as the knowledge of substrates and inhibitors of izoenzymes assists in choice of a proper drug and its dose. It is particularly important in case of polypharmacotherapy when there is a high risk of adverse events. It is also important to remember about genetic polymorphism of some cytochrome P450 izoenzymes (CYP2D6, CYP2C19) that underlies the marked inpatient variability in drug metabolism.

Antidepressive Agents, Second-Generation↗
PubMedDate not supplied

[The influence of whole body cryotherapy on mental health].

The paper presents a little known issue about the influence of wholebody cryotherapy on mental health. Observations of patients' behaviour after passing the cryogenic chamber leads to an interesting hypothesis. Short exposition to extreme cold has doubtless a profitable influence on man's frame of mind. Immediately after passing the cryogenic chamber, apart from the well known analgetic effect, we detect changes in patients' mental state such as improvement of mood, deep relaxation, freshening up, consolation, euphoria. This unusual state lasts for a long time after ending the cycle of cryotherapy. Different mechanisms of this effect are considered. New possibilities of this method have been presented. Durability of such an advantageous phenomenon are investigated in our research centre in Wrocław.

Cryotherapy↗