Biomedical subjects

Janusz Rybakowski

Publications and source records attributed to Janusz Rybakowski.

At least 19 recordsLinked to original sources

PubMed2005

No association of the brain-derived neurotrophic factor (BDNF) gene C-270T polymorphism with schizophrenia.

Brain-derived neurotrophic factor (BDNF) regulates a variety of neuromodulatory processes during development, as well as in adulthood. It has been proposed as a risk factor for schizophrenia. We have investigated a possible association between schizophrenia and the C-270T polymorphism in the brain-derived neurotrophic factor (BDNF) gene in 397 schizophrenic patients and 380 control subjects. The diagnosis of schizophrenia was made for each patient by at least two psychiatrists, using DSM-IV and ICD-10 criteria in structured clinical interviews for DSM-IV Axis I disorders (SCID). No association was found between schizophrenia and the analyzed polymorphism, for either genotype or allele distribution (for genotype: p=0.513, for alleles: p=0.812). Differences were not statistically significant when analyzed separately by sex. For males, the differences for genotype distribution and allele frequency were p=0.078 and p=0.162 respectively and for females: p=0.441 and p=0.315. Thus, our data indicate that variations in the BDNF gene are unlikely to be an important factor in susceptibility to schizophrenia.

Adult↗

PubMed2005

Maintenance treatment of bipolar disorders.

Conventional antipsychotic drugs, although efficacious in the treatment of mania, have not demonstrated a significant usefulness in the maintenance treatment of bipolar disorder. This has primarily been due to a tendency to induce depressive symptoms and depressive recurrences in this group of patients in the course of long-term administration. However, the picture has changed following the introduction of second-generation antipsychotics. These drugs have pro-depressant properties (if any) that are much weaker than conventional antipsychotics. Furthermore, their tolerability, especially in long-term treatment, is more favorable compared to classical antipsychotics. Clinical observations of the action profile of second-generation antipsychotic drugs in the treatment of schizophrenia have pointed to a possibility of these agents possessing mood-stabilizing properties. The first such suggestion was made by Zarate (1995) in connection with clozapine. The prevention of manic and depressive recurrences in bipolar disorder is a hallmark of the definition of mood-stabilizers.

Antidepressive Agents, Second-Generation↗

PubMed2004

[The quality of life of diabetic patients--literature review].

The knowledge concerning the influence of psychosocial factors on the functioning of patients with diabetes seems still insufficient. In the article, the scales measuring global quality of life and the effect of the illness on the quality of life, as well as the results of studies on quality of life of diabetic patients are presented. Improvement of quality of life may have both medical and economic consequences.

Clinical Trials as Topic↗

PubMed2004

[Symptoms and treatment of depression in patients with diabetes].

The prevalence of depression in patients with diabetes may be as high as 30%. Results of studies point to insufficient diagnosis and treatment of depression in diabetic patients. Guidelines for diagnosis and treatment of depression occurring in diabetic patients are presented.

Antidepressive Agents↗

PubMed2003

Association analysis of serotonin 2A receptor gene T102c polymorphism and schizophrenia.

The serotonin neurotransmitter has been associated with the pathogenesis of mood disorders and schizophrenia. Serotonin receptors genes may therefore be candidate genes for the study of the genetics of these disorders. In this study, patients with schizophrenia (n=235) and controls (n=344) were analysed to determine the correlation between the 5HT(2A) receptor gene T102C polymorphism and schizophrenia. No association was found between the studied polymorphism and schizophrenia (p=0.854 for alleles and p=0.945 for genotypes). Results were also not significant when analysed by gender (for male p=0.861-allele frequency and p=0.467-genotype frequency, for female p=0.857-allele frequency and p=0.833-genotype frequency). Subgroups with regard to schizophrenia subtypes, age of onset and clinical course of schizophrenia were analysed with negative results.

Adult↗

PubMed2002

A polymorphism of the norepinephrine transporter gene in bipolar disorder and schizophrenia: lack of association.

Norepinephrine is one of the neurotransmitters which has been implicated in the pathogenesis of mood disorders and schizophrenia. The norepinephrine transporter (NET) gene may be a candidate gene for the study of the genetics of these disorders. In this study, 198 patients with schizophrenia and 100 patients with bipolar disorder were analysed for a silent mutation 1287 A/G, located in the coding region (exon 9) of the NET gene, to determine the association between this polymorphism of the NET gene and bipolar disorder or schizophrenia. No association was found between the studied polymorphism of the NET gene and either bipolar disorder or schizophrenia.

Adult↗

PubMed2002

[Neurobiological aspects of psychotherapy theory and practice].

Psychological processes of learning may lead to biological changes in brain synapses, as was shown by Eric Kandel, Nobel laureate for 2000. Factors connected with learning (for instance, psychotherapeutic procedures) can modify the expression of genes occurring in brain cells. Current neurobiological research make it possible to explain some theoretical concepts and mechanisms of action of psychotherapy on the ground of basic medical sciences. Experimental and clinical studies point to a prominent role for early untoward life experiences in brain development and vulnerability for psychiatric disturbances. Neuroimaging studies demonstrated the existence of unconscious processes in both cognitive and emotional functions. In several studies, changes in brain function or in the biology of whole organism were measured, under the influence of psychotherapy. It was found that in such illnesses as depression or obsessive-compulsive disorder, similar changes in brain functions, as measured with neuroimaging methods, were observed either after pharmacotherapy or psychotherapy. The attempts have been also made to interpret psychotherapeutic mechanisms in the light of current concepts of memory processes, functioning of brain circuits or neurobiological theories of character and temperament.

History, 20th Century↗

PubMed2002

[Psychiatric complications of glucocorticoid treatment].

In the article, clinical symptoms of psychiatric complications occurring during treatment with glucocorticoids were described, and therapeutic guidelines were suggested. Psychiatric symptoms are observed in approximately 25% of patients receiving glucocorticoid therapy. Depression, mania and mixed states are the most frequent, psychotic symptoms and cognitive impairments (including delirium) are but less frequent. Associations between clinical factors (i.e. age, sex, past psychiatric story, medical condition, the dose of glucocorticoids) and the frequency and the severity of psychiatric complications were discussed. When psychiatric disturbances occur, the reduction or discontinuation of glucocorticoids should be taken into account. Treatment of psychiatric symptoms is needed when psychiatric disorder is severe or the patient is suicidal or agitated. In such cases the use of neuroleptics, antidepressants, normothymic and other drugs, as well as electroconvulsive therapy was discussed. The outcome is generally good, the majority of patients make a good recovery, over 90% of patients restored to health within 6 weeks of the onset of treatment.

Bipolar Disorder↗

PubMed2002

Borna Disease Virus--reactive antibodies in Polish psychiatric patients.

BACKGROUND: It has been proposed that the Borna Disease Virus (BDV) plays a role in the etiopathogenesis of psychiatric disorders. We assessed BDV seropositivity in Polish psychiatric patients and healthy controls, and the relationship between seropositivity and selected diagnostic and clinical variables. MATERIAL/METHODS: Serum samples from 946 psychiatric patients with different diagnoses (ICD-10) and 407 psychiatrically healthy controls were assayed. The ECLIA method was used, which enables the assessment of two anti-BDV antibodies: anti-p24 and anti p-40. Data were also collected on diagnosis, age, age at onset, and place of residence. RESULTS: Only anti-p24 antibodies were found. The seropositivity rates were: 2.4% and 1.0%, respectively, in patients and controls (p=0.1). A significant difference between patients and controls was observed in mental retardation and affective-anxiety spectrum disorders. Seropositivity did not show any association with demographic variables, but it was elevated in patients with recent onset of disease vs. remote onset of disease (10.2% vs. 1.6%; p=0.0003). CONCLUSIONS: Significantly higher anti-BDV seropositivity was found in Polish psychiatric patients with affective-anxiety spectrum disorders and mental retardation than in controls. The association between recent onset disorders and higher anti-BDV response, in the light of recent reports on circulating immune complexes of BDV antigens and antibodies, warrants further studies on the longitudinal course of humoral response to BDV.

Adult↗

PubMedDate not supplied

[Studies of cerebral blood flow in metabolism in depression using positron emission tomography (PET)].

Investigations of cerebral blood flow and metabolism provide interesting data concerning specific brain regions involved in depression. The objective of this paper is to present to Polish readers results of studies using PET in patients with depression. Provocation of transient sadness in healthy subjects during clinical experiments was associated with increase of metabolism in limbic and paralimbic regions and decreased metabolism in dorsolateral prefrontal cortex. During depression metabolism of dorsolateral prefrontal cortex (DLPF) was decreased but metabolism of subgenual cingulate was increased. After recovery, normalisation of metabolism, that is increase in DLPF was observed in patients treated with antidepressive drugs as well as psychotherapy. These data point to the role of frontal-thalamic-limbic circuits in regulation of emotions and pathogenesis of depression.

Cerebrovascular Circulation↗

PubMedDate not supplied

[Long-term lithium prophylaxis in the bipolar affective disorder].

The purpose of the study was to evaluate the efficacy of lithium prophylaxis in patients with bipolar affective disorder and to determine clinical differences between lithium responders and non-responders. Clinical and demographic data of 103 patients treated with lithium for at least 10 years were analysed. 24 patients had no episodes on lithium (excellent responders--ER), in 48--at least 50% reduction of episode index (number of episodes/year) was observed, and the remaining 31 did not benefit from lithium treatment. Duration of illness before lithium introduction was significantly longer in lithium non-responders. Lithium responders had significantly higher episode index before lithium. Percentage of excellent responders diminished during treatment. The trend toward higher lithium plasma level in excellent responders was observed. Non-responders had significantly more depressions during first year of lithium prophylaxis. Depressive episodes during first year of treatment may be a predictor of non-response.

Adult↗

PubMedDate not supplied

[Factors connected with the effect of risperidone on psychopathological symptoms and working memory in schizophrenia].

The aim of the study was to assess the impact of some clinical factors such as family history of psychiatric illness, obstetric complications and duration of the illness on the effect of treatment with risperidone on psychopathological symptoms and deficits of working memory in patients with schizophrenia. The study involved 50 patients with schizophrenia, aged 16-50 years (mean 28 years), with duration of the illness 1-15 years (mean 4 years). The clinical and neuropsychological evaluation was performed before and after 3 months of risperidone treatment in dose 2-6 mg (mean 4.2 mg/day). Before treatment, a significantly higher intensity of psychopathological symptoms and of some cognitive dysfunctions was found in schizophrenic patients with family history of psychiatric illness and in those with a history of obstetric complications. After 3 months of risperidone treatment, no difference in the intensity of psychopathological symptoms or the performance on neuropsychological tests was observed among these groups. Patients with longer duration of the illness had less improvement in positive symptoms. The results of this study show that treatment with risperidone may lead to better compensation of psychopathology and of neuropsychological deficits originating in genetic predisposition and obstetric complications. Better effect of risperidone on psychotic symptoms is likely with the administration of the drug early in the course of the illness.

Adolescent↗

PubMedDate not supplied

[The effect of sertraline on cognitive functions in patients with obsessive-compulsive disorder].

The aim of this study was to assess the effect of sertraline on psychopathological symptoms and cognitive functions and in patients with obsessive compulsive disorder (OCD). The investigated group consisted of 25 patients with OCD (12 male, 13 female) aged 17-47 (mean 29 +/- 9) years, duration of illness was 1-15 (mean 4 +/- 2) years. After treatment with sertraline, a significant improvement in OCD symptoms measured by YBOCS and in neuropsychological "frontal" tests were observed. Little correlation was found between the effect of sertraline on OCD symptoms and on cognitive dysfunctions. This may suggest that these two effects may be connected with different pharmacological properties of the drug. The effect of sertraline on OCD symptoms, similarly like other drugs inhibiting serotonin transporter (clomipramine, other SSRI) is associated with its influence on serotonergic system. On the other hand, the effect of sertraline on dopaminergic neurotransmission may be related to its favorable action on cognitive functions connected with the activity of frontal lobe.

Adolescent↗

PubMedDate not supplied

[Second generation antipsychotics: similarities and differences].

Second generation antipsychotics share some similarities but display also differences in their action. The pharmacological profile as well as the clinical efficacy and tolerability of these drugs currently on the market in Poland have been described. The analysis of their properties reveals distinct differences between the drugs. Those differences underline the value of the medications in the treatment of psychotic disorders. The differences allow tailoring the antipsychotic therapy to the individual needs of each single patient. Such a possibility to use the pharmacological agents according to the needs of the patient makes an important feature of the second generation drugs. At the same time it indicates that obvious differences in action exist inside the group.

Antipsychotic Agents↗

PubMedDate not supplied

[Clinical picture and treatment of subsequent depressive episodes--results of Polish multicenter study].

AIM: A comparison of the clinical picture and treatment results of the first depressive episode with the second and the third and further depressive recurrence. METHODS: The study was designed as a one-year, prospective, naturalistic observation of the clinical course of depression. One hundred and sixty-six psychiatrists participated in the study, performed in the years 1999-2000. Data of 179 patients with the first depressive episode, 170 patients with the second episode and 183 patients with third or further episode were included in the analysis. RESULTS: At the beginning of the observation, the groups of patients did not differ as to age, proportion of gender and intensity of depression, both global and particular symptoms. Patients with the first depressive episode were included into the study after longer duration of symptom occurrence and were more often treated with new generation antidepressants. Comparison of the course of disease revealed higher intensity of depressive symptoms, both global and particular clusters after 6 months and 12 months of treatment, and lower percentage of remission in patients with multiple episodes compared to the first episode group. The type of antidepressant was not significantly related to the efficacy of treatment. Ten patients (2%) had suicidal attempts, one (0.2%) with fatal outcome: in first episode group they were made during initial period of treatment, in multiple episodes--later in the course. CONCLUSIONS: The results obtained indicate that the course and the treatment outcome of subsequent depressive episodes are less favourable compared to the first depressive episode. Treatment recommendations for depression may be verified based on the results of the study.

Adult↗

PubMedDate not supplied

[Schizophrenia in the light of the evolutionary theories].

The aim of the article was to review the hypotheses of schizophrenia in the light of the evolutionary theory. The authors distinguished adaptationist and non-adaptationist hypotheses concerning the evolutionary underpinnings of schizophrenia. The adaptationist hypotheses are firmly based on notions of adaptation, natural selection and proximate and ultimate causes. The standard hypotheses of this sort proposed by Steven and Price as well as by Pollimeni and Reiss were discussed. Also, the other similar conceptions originated from McGuire and Troisi and proposed by David Horrobin were presented of which the latter is especially promising and worth further investigating. The non-adaptationistic authors criticised many assumptions of the adapationist program i.e. too broad use of term "adaptation" in the area of human behaviour or the very idea of proximate and ultimate causes. Unlike the adaptionists, they focus their attention on other aspects of the evolutionary processes i.e. the role of the mutation and also they are searching in a much intensive way than their opponents for verification of the hypotheses based on the empirical evidence. The theories developed by Crow and by Yeo were listed among the non-adaptationistic ones and presented.

Adaptation, Physiological↗

PubMedDate not supplied

[Safety and efficacy of olanzapine versus perphenazine in patients with schizophrenia: results of multicenter, 18-week, double-blind clinical trial].

AIM: The primary objective of the study was to evaluate the severity of extrapyramidal symptoms during treatment with olanzapine (10-20 mg) versus perphenazine (8-40 mg) using the Simpson Angus Scale (SAS). The secondary objective was to assess the safety profile and clinical efficacy of the investigated drugs. MATERIAL AND METHOD: A total of 95 patients with schizophrenia who met the criteria for DSM-IV were randomized to a double-blind, 18 week prospective comparative trail conducted in Poland. The tolerance of treatment was assessed with the use of scales: BAS, SAS and UKU. The efficacy of treatment was evaluated with BPRS, PANSS and CGOI scales. RESULTS: For olanzapine patients, the severity of extrapyramidal symptoms improved after 3 first weeks of treatment, and significantly decreased from the baseline to endpoint. Perphenazine patients showed an increase of extrapyramidal symptoms. The difference of the SAS scores change was statistically significant between olanzapine and perphenazine groups. Akathisia symptoms decreased significantly in the olanzapine group during the treatment period, whereas symptoms of akathisia increased in the perphenazine group. Statistically significant differences of mean change of BAS total score from baseline to endpoint were noted between treatment groups Treatment--emergent adverse events occurred more frequently in patients receiving perphenazine (46%), than in patients receiving olanzapine (17%). The proportion of patients complying with improvement criteria for CGI scale score was statistically greater in the olanzapine group (72.7%) than in the perphenazine group (47.9%). Results of this study showed that the tolerance profile in patients taking olanzapine is superior to perphenazine. CONCLUSIONS: Olanzapine was better tolerated than perphenazine. After olanzapine treatment more subjects fulfilled the criterion of improvement and schizophrenic symptoms were less severe than in patients treated with perphenazine.

Antipsychotic Agents↗

PubMedDate not supplied

[The role of social support on the quality of life of patients with schizophrenia].

The importance of social support for mentally ill people has been increasingly emphasized in recent years. This has resulted from studies showing that family and professional support plays an important role in preventing rehospitalizations and in improving quality of life of patients with schizophrenia. This article presents and analyses the findings of current research concerning the effectiveness of social support in rehabilitation programmes as well as highlights the problem of matching the type and quantity of social support provided to the patients' needs and to the phase of the disease.

Family Relations↗