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The position of selective mutism disorder – SM – has been modified in the last edition of the classification of mental disorders DSM-5. It was removed from “Disorders of childhood and adolescence” and placed in “Anxiety disorders”. This caused two important changes in the interpretation of the symptoms of selective mutism. It highlighted anxious etiology of the disorder and also open the possibility to diagnose selective mutism in adults as a special category of anxiety disorders. The aim of this study was to present three different cases concerning the diagnostic difficulties of selective mutism (the child, the teenager and the persons who became adult during our observation) regarding current views on SM. In this study we presented the current view on the etiology, course and available therapies for selective mutism. Owing to updating the clinical knowledge about SM and describing three cases, we highlighted the controversies around the diagnosis and treatment of this disorder. Selective mutism might be a preliminary diagnosis, often leading to the diagnosis of other disorders of diverse etiology and course. Among the psychiatric aspects of the disorder, the ‘anxiety component’ of SM is crucial. In individuals with selective mutism, developmental disorders, social cognition and neurocognition deficits or dysfunctions of auditory processing often coexist. The severity and the type of comorbidities may determine the future course of the illness and the final effects of the therapy.

The aim of this study was to investigate and compare total mercury (Hg), selenium (Se), and Se:Hg molar ratios in fish muscles (phytophages n=3; benthophages n=32; predators n=5) and semiaquatic carnivores, including piscivores (the European otter n=8, the feral American mink n=7) and the omnivorous raccoon (n=37) from a riverine European ecosystem in a Se-deficient area. The Hg concentration in fish reached 0.337μg/g dry weight, dw (0.084μg/g wet weight, ww). We found significant differences among Hg levels in tested vertebrate groups (predators vs benthophages: 0.893 vs 0.281μg/g; piscivores vs omnivores: 6.085 vs 0.566μg/g dw). Fish groups did not differ in Se concentrations, with a mean value of 0.653μg/g dw. Significant differences were revealed between Se levels in piscivorous and omnivorous carnivores (0.360 vs 0.786μg/g dw, respectively). Fish Se:Hg molar ratio values were2.2. Benthophages had higher the ratio than predators but similar to phytophages. Among carnivores, piscivores had much lower the ratio than raccoon (0.14 vs 3.75) but raccoon and fish medians did not significantly differ. We found almost two times higher Se levels in fish and raccoons compared to piscivores, possibly resulting from lower fish Se digestibility by piscivores in contrast to higher absorption of plant Se by many fish and omnivorous raccoons. Considering that a tissue Se:Hg molar ratio1 may be connected with a Hg toxicity potential increase, we assume that piscivores in Se-deficient area are in worse situation and more exposed to Hg than fish and omnivores.

The raccoon (Procyon lotor) carnivore native to North America is a fast spreading, invasive species in the Europe now. At the moment, the highest population occupies areas near the German-Polish border. The data on the occurrence of Cryptosporidium spp. and microsporidia in raccoons is limited to North America's territory and is totally lacking in the case of their introduction to Europe. Therefore, the objective of this study was to investigate the occurrence of microparasites, i.e., Cryptosporidium spp. and microsporidia in the introduced raccoons obtained from localities in Poland and Germany. A PCR-based approach that permitted genetic characterization via sequence analysis was applied to raccoon fecal samples (n = 49), collected during 2012-2014. All fecal samples were simultaneously tested with the use of genetic markers, and DNA of microsporidia and Cryptosporidium spp. was detected among the examined raccoons. The results of our research confirmed the presence of Cryptosporidium skunk genotype and Enterocytozoon bieneusi NCF2 genotype. The results suggest a possible role of raccoons in the contamination of the environment, including urban areas, with pathogens of zoonotic significance as well as their role in the transmission and introduction of new genotypes of microparasites in the areas where P. lotor has not been observed yet. To our knowledge, there has been no literature data on the above genotypes detected previously in humans or animals from the examined study sites so far.

Acanthocephalan larvae were found during parasitological sections in intestines of four out of 84 individuals of raccoon (Procyon lotor L.) from eastern Czech Republic. They were identified as cystacanths of Polymorphus minutus (Goeze, 1782). Because water birds are the proper hosts of this parasite, this record is among the rare ones. For this reason we present the morphological description, biometric data and photographs of the parasites, as well as a discussion of similar cases reported in the literature.

The raccoon (Procyon lotor) is a North American carnivore introduced to Europe in the 20th Century. Raccoons are believed to be the potential hosts of many parasites, or to be involved in their transmission to other animals. Nematodes of the genus Trichinella can infect many carnivorous and omnivorous animals worldwide. The aim of the present study was to determine the occurrence of Trichinella spp. infection in raccoons in Central Europe. Muscle samples were collected from various regions of Poland, the Czech Republic and Germany during the years 2012-2016. The larvae of Trichinella spp. were detected in 11 raccoons, and these were identified as T. spiralis and T. pseudospiralis by multiplex PCR (89.9% and 9.1%, respectively). No mixed infection was observed. This is the first report describing the occurrence of T. spiralis and T. pseudospiralis in P. lotor in Central Europe. Our findings also show that the raccoon population acts as a reservoir of Trichinella pseudospiralis.

CelDotychczas opisano kilka przypadków psychoz indukowanych stosowaniem cytrynianu klomifenu, używanego w celu stymulacji owulacji. Jednak dane dotyczące rozpowszechnienia objawów psychotycznych wśród kobiet leczonych z powodu niepłodności są niejednoznaczne. Nadal niewiele wiadomo na temat ewentualnych psychiatrycznych powikłań preparatów farmakologicznych stosowanych w technikach rozrodu wspomaganego. Prezentujemy przypadek pacjentki, u której w przebiegu drugiej z kolei procedury zapłodnienia pozaustrojowego rozwinęły się przemijające objawy psychotyczne. Wnioski płynące z przeglądu piśmiennictwa (przeprowadzonego w oparciu o zasoby bazy danych Medline) sugerują, że dotychczas nie opisywano przypadków występowania psychozy »okołostymulacyjnej« w przebiegu procedur zapłodnienia pozaustrojowego z zastosowaniem cytrynianu klomifenu i bromokryptyny. Autorzy niniejszej pracy nie ograniczyli się do omówienia tego rzadkiego zjawiska klinicznego, ale również pokusili się o podsumowanie obecnego stanu wiedzy na temat zależności pomiędzy strategiami farmakoterapeutycznymi stosowanymi w ramach procedur zapłodnienia pozaustrojowego, a ryzykiem rozwoju zaburzeń psychotycznych.MetodaOpis przypadkuWyniki-WnioskiPrawdopodobnym mechanizmem wyzwalającym objawy psychotyczne w opisywanym przypadku było zastosowanie w celu indukcji owulacji-cytrynianu klomifenu w skojarzeniu z bromokryptyną stosowaną w przebiegu przewlekłej hiperprolaktynemii . Terapia skojarzona cytrynianem klomifenu oraz bromokryptyną może stanowić farmakologiczny model hiperdopaminergii wraz z indukowaniem niefizjologicznych wahań poziomu estrogenów w osoczu. Powyższy schemat leczenia może warunkować zwiększenie podatności do rozwoju objawów psychotycznych. Zaś wpływ takiej terapii należy rozważyć w razie wystąpienia ewentualnych powikłań psychotycznych u pacjentek poddawanych technikom rozrodu wspomaganego.

Aim of the studyThe present work aimed to assess the association between cognitive functions, the lifetime occurrence of psychotic symptoms, and reported adverse effects of antipsychotic treatments in patients with bipolar disorders.Subject or material and methodsIn the present work, 44 bipolar disorder inpatients hospitalized in the Affective Disorders Unit of the Institute of Psychiatry and Neurology in Warsaw, were investigated. All of them met the criteria of remission and were prepared for release from the hospital unit. Twenty-two patients were hospitalized in the manic stage of the illness, and 22 were in the depressive stage of illness. Both groups were assessed using adequate psychiatric rating scales (HDRS or YMRS and CAMRS) and neuropsychological tests (WCST, TMT, Stroop Test and Verbal Fluency Test).ResultsPatients who had a prior history of psychotic symptoms had poorer verbal functioning in comparison to subjects without such a history. However, individuals hospitalized in the manic state of disease, and who reported more adverse events after antipsychotic medication during the whole course of illness, had worse results in some parameters of executive function measurements in the WCST test, namely occurring in a greater percentage of nonperseverative errors and a lower number of completed categories.DiscussionGenerally the results confirm findings according to which, patients with the history of psychosis performe worse on neurocognitive tasks. However, the nature of dysfunctions found, generates questions about its relations with the experience of psychosis and antipsychotic treatment.ConclusionsDifferent aspects of cognitive dysfunctions may be related to the experience of psychosis and antipsychotic treatment in patients with bipolar disorders.

Mercury (Hg), lead (Pb) and cadmium (Cd) are involved in mammalian brain damage. However, little is known about Pb and Cd brain levels in wildlife that reflect the geochemical background. The aims of the study include the estimation of Hg, Pb and Cd concentrations, and the determination of relationships between these elements in the brains of 94 mesocarnivores. Road-killed or hunted animals were obtained from north-western Poland near the Polish-German border. The investigation covered the native Eurasian otter Lutra lutra, badger Meles meles, pine marten Martes martes, beech marten M. foina, European polecat Mustela putorius, red fox Vulpes vulpes, and alien species: feral and ranch American mink Neovison vison, raccoon Procyon lotor and raccoon dog Nyctereutes procyonoides. Depending on the diet and environmental pollution, the carnivore brains accumulated toxic metals in varying amounts. The highest median Hg levels (in mg/kg dry weight, dw) were found in the piscivorous Eurasian otter and feral mink (2.44 and 3.96), Pb in the omnivorous raccoon (0.47), while Cd in minks (~0.06). We indicated that Pb-based ammunition is a significant source of the element in scavengers from hunting area, and we also found a significant correlation between Pb and Cd levels in the fox brain. Finally, this study is the first to suggest background levels for brain Pb and Cd in mesocarnivores (

Kwetiapina jest atypowym lekiem przeciwpsychotycznym, często stosowanym w psychiatrii, w tym również objawowo do leczenia innych zaburzeń niż we wskazaniach rejestracyjnych. Jednym z zastosowań jest łagodzenie stanów klinicznych powodowanych używaniem różnych substancji psychoaktywnych. W pracy przedstawiono i omówiono doniesienia o niewłaściwym używaniu kwetiapiny, nadużywaniu, a nawet uzależnieniu psychicznym, a także o objawach zbliżonych do tak zwanego zespołu dyskontynuacji, często mylonego z zespołem abstynencyjnym występującym w przebiegu uzależnienia. Na podstawie analizy przedstawionych przypadków wykazano, że większość doniesień dotyczy mężczyzn, szczególnie nadużywających lub uzależnionych od innych, najczęściej licznych substancji psychoaktywnych, a także z zaburzeniami osobowości, często pozostających w konflikcie z prawem. Z tego względu należy pamiętać o ostrożności w przepisywaniu kwetiapiny tym osobom. W artykule dyskutowane są potencjalne mechanizmy, które mogą prowadzić do niewłaściwego używania kwetiapiny. Jest to prawdopodobnie związane z działaniem sedatywnym i przeciwlękowym co powoduje jej częste stosowanie z substancjami pobudzającymi. Również wysokie powinowactwo do receptora H 1 może powodować działanie nagradzające, podobnie jak leki przeciwhistaminowe.

Opisthorchid digenean Pseudamphistomum truncatum (Rudolphi, 1819) was isolated from liver bile ducts of the Eurasian otter (Lutra lutra) found dead in the fishing pond complex near Wrocław (Lower Silesia, SW. Poland) in March 2009. Since this is the first record of the parasite in the otter from Poland, the description, biometrical data and figure are presented.

Background The studies concerning prophylactic treatment in bipolar disorder suggest it should be introduced after the first manic episode [1]. Also early polytherapy is promoted, mainly mood stabilizers and antipsychotics. Antipsychotics are recommended in short-term use [2], but they are also used after improvement. Typical antipsychotics are effective in monotherapy in 70% of patients, like mood stabilizers.[3] The combination of antipsychotics and mood stabilizers is superior to monotherapy in rapid control of agitation.