35, 5

Rola neuropeptydu Y w lęku            731
Role of neuropeptide Y in anxiety   731
Robert Krysiak, Ewa Obuchowicz, Zbigniew Stanisław Herman
Neuropeptide Y (NPY), one of the most abundant peptides in the mammalian brain, is implicated in the control of many physiological processes. It is also suggested the involvement of NPY in several neuropsychiatric illnesses. This review summarizes the present knowledge concerning the role of NPY in anxiety and discusses probable sites and receptors involved in the anxiolytic-like effect of NPY as well as interactions between the NPY and corticotropin-releasing factor (CRF) systems. The possible role of the NPY system in human psychopathological conditions associated with anxiety is also reviewed. Based on our data, we suggest that the NPY system is involved in antianxiety effects of diazepam and buspirone.

Profil objawów zaburzenia depresyjnego i lękowego mieszanego   743
Symptoms profile of mixed anxiety and depressive disorder             743
Krzysztof Małyszczak, Sławomir Sidorowicz, Tomasz Łaczmański
The paper describes symptoms of mixed depressive and anxiety disorder (ICD-10). The study was carried out in three medical dispensaries: two psychiatric (42 persons) and one primary care (62 persons). Patients with or without anxiety and depressive symptoms were included. Exclusion criteria was: psychoactive substance abuse, physical diseases affecting mental state, and mental disorders other than anxiety or mood disorders. A total of 104 patients (65 women and 39 men in mean age of 41.1 years) were inquired with General Health Questionnaire (GHQ-30), Global Assessment of Functioning (GAF) and diagnostic questionnaire based on Schedules for Clinical Assessment in Neuropsychiatry, Version 2.0.
There was no pattern of symptoms specific for mixed disorder that could be a basis for operational criteria. The most frequent were symptoms of generalised anxiety disorder (GAD), depression and dysthymia. The most specific symptoms, selected using discriminant analysis were: (1) difficulty in concentrating, (2) feeling mentally tense, (3) feeling of hopelessness or despair, (4) shortening of breath, (5) lowered mood, (6) feeling dizzy, unsteady, faint, or light headed; (7) early waking up, (8) nightmares, (9) dry mouth, (10) hot flushes or cold chills, (11) frequent tearfulness. The results contribute to the concep that mixed depression and anxiety disorder is closely related to generalised anxiety disorder (GAD).

Lęk i depresja u chorych na astmę oskrzelową   755
Anxiety and depression in bronchial asthma       755
Karina Badura, Zenon Brzoza, Piotr Gorczyca, Jerzy Matysiakiewicz, Robert T. Hese, Barbara Rogala
The aim of the study was to establish the frequency and follow the clinical course of depression and anxiety in patients with bronchial asthma. 57 patients (37 atopic and 20 nonatopic) with mild and moderate bronchial asthma and 53 subjects matched for age and sex as control groups were included in the study. The following questionnaires: Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Scale (HADS) were used to evaluate anxiety and mood state. The level and prevalence of anxiety and depression were significantly higher in both groups of asthmatics in comparison to healthy subjects. Symptoms were mild and moderate. Nonatopic patients were more depressed and anxious than atopics.

Zaburzenia depresyjno-lękowe u kobiet po histerektomii – przegląd piśmiennictwa    763
Anxiety-depressive disorders in women after hysterectomy. Literature reviev                 763
Katarzyna Marek, Agata Dimter, Mirosława Jawor, Dominika Dudek
In the common opinion amongst woman, the surgical removal of the uterus and ovaries can be a cause of limited physical and sexual activity and heve an effect on their attractiveness. The majority of women after hysterectomy can be permanently depressed and can also show symptoms of mixed anxiety-depressiva disorder. The review of literature allows for an assumption that the topic of anxiety and depression should not be underrated, by treating it as an exaggerated theme, as some researchers do. By considering the research quoted in this paper the collected directions of diagnostic and therapeutic procedures undertaken by the psychiatrist and psychologist can be used before the planned operation. Special consideration must be given to patients who have a history of affective disorders or sexual abuse. Pharmacotherapy and psychotherapy should applied in order to prevent post-operative affective disorders.

Zaburzenia depresyjno-lękowe u kobiet po histerektomii – badania własne   771
Anxiety-depressive disorder in women after hysterectomy. Own study              771
Mirosława Jawor, Agata Dimter, Katarzyna Marek, Dominika Dudek, Andrzej Wojtyś, Aleksandra Szproch
Hysterectomy is a surgical procedure that significantly affects the quality in which the operated person views herself, lowers self-esteem and brings about changes in the quality of life. The results of the presented study show the necessity of a more accurate and specific dealing with the problem of affective disorders and anxiety states in women who have undergone such an operation.
The course of the post-operative period and the return of the patients to full health are largely affected by their psychological state and the quality of life they experience. A successful (in a medical sense) surgical procedure is not a guarantee of the bringing back health in a holistic sense.
The results of studies and clinical observations show that half of the group of women operated suffer from anxiety-depressive disorders as a cause of the operation, and a quarter of all those operated require specialist help.
No psychological preparation for the operation, absence of closest people in the decision making before the operation, lack of knowledge on the surgical operational-span, lacking psychological aid after the operation – all these can significantly affect the rehabilitation and the process of regaining the social functions.
It appears vital to introduce a psychological programme and special care taking of the women who declare having symptoms which appear to lead to the development of depressive disorders. The appearance of depressive symptoms post-operatively as well as the earlier presence of affective disorder symptoms can be prognostic in the further development of the disorder.
The early diagnosis of the affective disorder and the higher level of anxiety in women post-hysterectomy and the fast application of appropriate treatment can inhibit further symptom elevation and persistence.
Catamnestic studies on women post-hysterectomy due to non-oncologic causes will allow seeing the dynamics of the changes in the affective disorders at different time intervals from the operation.

Ocena bezpośrednich zmian funkcji poznawczych u pacjentów poddanych chirurgicznej rewaskularyzacji wieńcowej przeprowadzonej w hipotermii i normotermii    781
Assessment of short-term neuropsychologic changes after normothermic versus hypothermic coronary artery bypass grafting    781
Renata Górna, Wojciech Kustrzycki, Andrzej Kiejna, Joanna Rymaszewska
Background: Coronary artery bypass grafting (CABG) is one of the main methods of treatment of coronary artery disease. Neuropsychological testing is a sensitive method for quantitative assessment of cognitive dysfunctioning following cardiopulmonary bypass. The aim of the present clinical study was to evaluate the neuropsychologic changes in CABG patients, operated with normothermic or hypothermic cardiopulmonary bypass (CPB).
Methods: Neuropsychological changes were assessed in 33 first-time CABG patients before and 3-10 days after surgery. Patients underwent CABG with hypothermic (Gr. H, n=17) or normothermic (Gr. N, n=16) CPB with standard anesthesia. Neuropsychological performance was assessed using a well-established battery of 10 tests. A neuropsychological test battery includes: Digit Span- subtest of WAIS-R (PL), the Trail Making Test, Raven Test, Benton, Bourdon, Verbal Fluency (F,A,S), Turm von Hanoi, Rey Auditory Verbal Learning Test, Supermarket, WAIS-R (PL) Digit Symbol- subtest of WAIS-R (PL). All patients completed the test for perception, attention, immediate and delayed verbal and visual memory, visual and verbal learning, problem-solving strategies, abstraction, recognition, word fluency, visual- motor coordination and psychomotor speed. For comparison, the incidence of decline using the 1,5 standard deviation (at least in 2 tests) also was calculated.
Results: Comparing the reliable change and SD methods, statistically significant differences in the incidence of decline were observed in 6 of the 10 neuropsychological measures. Patients’ scores showed a significant deterioration  in concentration of attention, immediate verbal memory, psychomotor speed, visuoconstructive tasks and verbal learning. Neuropsychological deficits were found in 66,7% of patients after surgery. Post-operative deficits were not associated with the method  used (normothermia or hypothermia).

Przypadek depresji u pacjentki z chorobą niedokrwienną serca          797
An episode of depression in a patient with coronary artery disease   797
Dominika Dudek, Dariusz Dudek, Andrzej Zięba
An episode of depression in a patient with Ischaemic Heart Disease is presented. The patient had undergone coronary angioplasty with optimal results. The clinical picture of the depressive disorder consisted mainly of chest pain complaints in the cardiac area, which made the diagnosis all the more difficult. The application of antidepressive treatment caused the depressive symptoms together with the chest pain to disappear. A therapeutic success was achieved owing to the good co-operation between the invasive cardiologist and the psychiatrist.

Dysfunkcja osi podwzgórzowo-przysadkowo-nadnerczowej u młodocianych po próbach samobójczych   803 
Dysfunction of the hypothalamic-pituitary-adrenal axis in adolescents after a suicide attempt                      803
Agnieszka Gmitrowicz, Hanna Kołodziej-Maciejewska
The subject of the research were two populations: 84 adolescents aged 14–21, after sui cidal attempts (ASA – drug overdose), never treated psychiatrically, and 30 adolescents after accidental intoxication (ACI). The objective of this research was to find whether there is a relation between the observed suicidal behaviours, psychic disorders and dysfunction of the hypothalamo – pituitary – adrenal axis. In each patient the plasma levels of cortisol and ACTH were assessed, and also the Dexamethasone Suppression Test (DST) was made.
It was found that most patients in the ASA group were females. Additionally, in this group statistically higher levels of cortisol after DST were found, comparing to the ACI group. Considering the sex of patients, the differences of serum cortisol levels were significant only in females. We found that higher cortisol levels in ASA were related to diagnosed depressive disorders (mostly in females), presence of psychosocial and environmental problems, and elevated risk level of repeated suicidal attempt.

Przeciwciała przeciwko wirusowi choroby Borna u pacjentów hospitalizowanych w szpitalach psychiatrycznych na terenach województw lubuskiego i wielkopolskiego   819
Detection of anti-Borna disease virus antibodies in patients hospitalized in psychiatric hospitals situated in the mid-western region of Poland     819
Filip Rybakowski, Kazunari Yamaguchi, Stefan Krzymiński, Franciszek Zmyślony, Jerzy Biernat, Marek Kociałkowski, Andrzej Tandeck, Barbara Trafarska, Marian Zalejski, Takashi Sawada, Tohru Naraki, Piotr Czerski, Andrzej Rajewski, Janusz K. Rybakowski
Borna Disease Virus (BDV) is single stranded RNA virus, which may infect a wide range of animal species. Manifestations of the experimental BDV infection show some resemblance to psychopathological symptoms of mental disorders in humans. Several reports suggest the higher prevalence of anti-BDV antibodies in psychiatric patients than in healthy controls. However, the seroprevalence of anti-BDV antibodies varied due to the different serological methods used in the previous studies. Electrochemiluminescence Immunoassay (ECLIA) is a recently developed, highly specific method of detecting antibodiess directed toward two BDV proteins: p24 and p40. We used the ECLIA method for the assessment of seropositivity in 946 psychiatric patients hospitalized in the psychiatric hospitals in the western part of Poland. All patients were clinically diagnosed with ICD-10 criteria. Anti-p40 antibodies have not been found in the studied sample. We found anti p-24 antibodies in 23 cases, which give the seroprevalence rate of 2.4%. This result is consistent with the outcome of Japanese population assessment, done with the same methodology. The seropositive cases did not show diagnostic specificity. We did not find statistically significant gender differences in rate of seropositivity. The seroprevalence of anti-BDV antibodies was not significantly different in patients of urban and rural residence, and in patients of different age groups. This is the first demonstration of anti-BDV antibodies in the Polish population of patients hospitalized in psychiatric hospitals.

Czynniki psychiczne w łuszczycy – przegląd piśmiennictwa   831
Psychological factors in psoriasis                                               831
Jakub Szumański, Andrzej Kokoszka
Psoriasis is an inflammatory and proliferative disease, which is seen in most classifications of psychocutaneous disorders as being mainly due to grnetic and environmental factors. Over decades of observation, physicians and patients have learned that it’s course is strongly influenced by psychological stress. Review of literature shows, however, that this relationship is multifactorial. Psoriasis itself may cause depression as a stigmatising disease. Also there is evidence that depression and anxiety disorders can be the cause of psoriasis. Because of this fact, additional treatment with psychotherapy and/or medication may be advisable and worth further exploration.

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