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Carbamazepine (CBZ) is an anticonvulsant drug, widely used also in various disorders like neuropathic pain, bipolar affective disorder, resistant schizophrenia, and trigeminal neuralgia. Appropriate analytical procedures are necessary to monitor, detect and quantify CBZ in pharmaceutical formulations and biological samples. The search for new methods for drug determination is one of the most important challenges of modern scientific research. It is important to study the chromatographic conditions of CBZ analysis, which is necessary for the further development of efficient drug determination methods. In this work, retention, peak symmetry, and system efficiency of CBZ on Polar RP and Phenyl-Hexyl stationary phases were investigated. Various mobile phases containing methanol (MeOH) and/or acetonitrile (ACN) as organic modifiers, acetate buffer, and the addition of diethylamine (DEA) were applied. Different chromatographic systems were compared to obtain satisfying retention, peak shape, and system efficiency. The most optimal chromatographic system with Polar RP column was applied for the determination of CBZ in pharmaceutical formulations, human serum, and saliva by the high-performance liquid chromatography with diode array detection (HPLC-DAD) method. Solid-phase extraction (SPE) method was applied for sample preparation prior to chromatographic analysis. The proposed method was validated for linearity, selectivity, precision, and accuracy. Confirmation of the presence of CBZ and its main metabolites in biological samples obtained from patients was performed using the ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method.

Introduction: SARS-CoV-2 infection might be presented in many various specific and non-specific manifest and symptoms from different systems. Also, the psychotic symptoms are documented but the explanation for their pathophysiology remains debatable and a complex matter. The main objective of this paper is to present cases of patients without a history of psychiatric disorders who developed the first episode of psychosis during the SARS-CoV-2 infection. Material and methods: Two cases of not-related patients with no previous psychiatric history developed psychotic episodes during COVID-19 infection. In both cases chronologically first they experienced symptoms of infection, secondly, delusions and psychomotor agitation that required psychiatric hospitalization. Full remission was observed after antipsychotic treatment in both cases. Results: Even though the pathophysiology of the post-COVID-19 psychiatric symptoms remains unclear, some reports that indicate associations between the infection and the onset of such symptoms. The infection itself, by the induction of cytokine storm followed by the excessive release of pro-inflammatory cytokines, is considered to stimulate the potential onset of the psychosis, however, other factors such as medications used during treatment (with a particular emphasis on glucocorticosteroids) or psychological factors should be considered as well. Conclusions: Patients infected with SARS-CoV-2 might develop serious psychotic episodes even without a prior psychiatric history. Besides, psychiatric symptoms might be the first the even the only manifestations associated with the active SARSCoV-2 infection which seems to be very challenging especially in cases of rapid psychotic episodes without any clear respiratory symptoms.

Introduction: Lifestyle is often a decisive factor influencing both, somatic health and mental health. The aim of the study was to evaluate the quality of life, sleep quality and general mental health of nursing students. Material and method: The study used the diagnostic survey method. The study was cross-sectional. A questionnaire was used, which was made available to the respondents via the Internet. The survey included the demographic questionnaire, the Fantastic Life Inventory, the Pittsburgh Sleep Quality Questionnaire (PSQI) and the General Health Questionnaire (GHQ-30). A total number of 165 nursing students (151 female and 14 male), aged from 19 to 53, participated in the study. All calculations were made using version 24 of the SPSS statistical package. Results: The general mental health of students, as measured by the GHQ-30 scale, was quite good – the mean score on the GHQ30 scale – M = 9.21 (SD = 7.80). The average lifestyle quality index in the Fantastic Life Inventory Scale (M = 34.99; SD = 6.19) indicated a high quality of lifestyle. As many as 81% (N = 134) of the respondents followed the principles of rational nutrition and consumed a balanced diet, 92% (N = 152) did not abuse alcohol, 86% (N = 142) did not smoke, 93% (N = 154) had never used other psychoactive substances. However, 57% (N = 94) of respondents did not undertake physical activity or undertook it on an insufficient level. Most of the subjects experienced sleep disturbances, the most common being difficulty falling asleep – 78.8% (N = 130), and waking up during the night or early in the morning – 70.3% (N = 116). Conclusions: The quality of lifestyle and general mental health of the respondents was good. A significant influence of the quality of life on the occurrence of mental health disorders has been demonstrated.

Cel pracyW ostatnich latach wzrosła liczba badań potwierdzających zmiany kompozycji mikrobioty jelitowej u pacjentów z zaburzeniami odżywiania (ED). Jak dotąd, nie przeprowadzono kompleksowej analizy określającej dysfunkcje bariery jelitowej i zmiany ekosystemu jelitowego u pacjentów z jadłowstrętem psychicznym (AN). Celem przeglądu systematycznego było określenie: 1) różnic pomiędzy pacjentami z AN a osobami zdrowymi (HC) w składzie mikrobioty jelitowej i markerach związanych z barierą jelitową, 2. Związku między mikrośrodowiskiem jelit a zmiennymi związanymi ze stanem zdrowia pacjentów z AN.MetodaDokonano przeglądu piśmiennictwa (bazy danych PubMed / Embase / ClinicalTrials) do 30 września 2020 w poszukiwaniu badań opisujących mikrobiom jelitowy i markery integralności bariery jelitową u pacjentów z AN.WynikiSześć badań dotyczących ekosystemu jelitowego zostało zakwalifikowanych do przeglądu, z czego trzy prace opisywały również markery bariery jelitowej. Spośród pięciu badań analizujących różnorodność mikrobioty, cztery z nich wykazały różnice między pacjentami z AN a osobami zdrowymi (HC). Badania potwierdziły istnienie nieprawidłowych wartości stężeń markerów integralności bariery jelitowej pacjentów z anoreksją.WnioskiPrzeprowadzony przegląd systematyczny potwierdza zmiany w ekosystemie jelitowym pacjentów z zaburzeniami odżywiania, jednak bez uzyskania konsensusu co do charakterystycznego dla AN wzorca mikrobioty. Uszkodzenie integralności bariery jelitowej w tej grupie chorych wymaga potwierdzenia w dalszych badaniach.

Despite the vaccine against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) being reported to be safe and effective, the unwillingness to vaccinate and doubts are still common. The aim of this international study was to assess the major reasons for the unwillingness to vaccinate in a group of students from Poland (n = 1202), Bangladesh (n = 1586), India (n = 484), Mexico (n = 234), Egypt (n = 566), Philippines (n = 2076), Pakistan (n = 506), Vietnam (n = 98) and China (n = 503). We conducted an online cross-sectional study that aimed to assess (1) the percentage of vaccinated and unvaccinated students and (2) the reasons associated with willingness/unwillingness to the vaccine. The study included 7255 respondents from 9 countries with a mean age of 21.85 ± 3.66 years. Only 22.11% (n = 1604) of students were vaccinated. However, the majority (69.25%, n = 5025) expressed a willingness to be vaccinated. More willing to vaccinate were students in informal relationships who worked mentally, used psychological/psychiatric services before the pandemic, and studied medicine. There are cultural differences regarding the reasons associated with the unwillingness to vaccinate, but some ‘universal’ might be distinguished that apply to the whole group.

Introduction: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Its prevalence tends to increase worldwide. Untreated sleep apnea is associated with a higher risk of metabolic diseases, cardiovascular diseases, stroke, road accidents, and death, but also it is suggested that it increases the risk of mental disorders. Method: The literature review was based on a search of articles on Medline, Pubmed, and Google Scholar from 2003 to 2021 using the keywords: obstructive sleep apnea; mental disorders; cognitive functions; affective disorders; depression; bipolar disorder; schizophrenia; psychotic disorders. The analysis included original studies, meta-analysis, and review articles. Discussion: The result obtained from researches published so far does not allow for drawing unequivocal conclusions. There is a lot of bias present in study protocols and inclusion/exclusion criteria. Nonetheless, it seems that some disorders have a better proven correlation with OSA. Cognitive impairment, depression, and anxiety disorders are linked to OSA not only in terms of the overlapping of symptoms but also of a causal relationship. Psychotic disorders and bipolar disorders connections with OSA are confirmed, but they are not yet well understood. All correlations are found to be possibly bidirectional. Conclusion: 1. Multiple lines of evidence increasingly point towards a bidirectional connection between OSA and mental disorders, and the cause and effect relationship between these two groups of disorders requires further research. 2. Due to reports of an increased risk of OSA with antipsychotic drugs, caution should be exercised when initiating therapy with this type of drug in patients with known risk factors for it. 3. Screening for OSA in psychiatric patients should be introduced as OSA can increase cognitive impairment, affective, and psychotic symptoms.

Summary Introduction: There is an ongoing debate as to whether the use of selective serotonin reuptake inhibitors (SSRIs) by pregnant women increases the risk of developing autism spectrum disorders (ASD) in the offspring. Aim: The aim of the study was to 1) present, based on a case report, the potential factors that may affect the development of ASD in a child, 2) review the literature on the risk of ASD in the case of using SSRIs by a pregnant woman. Case report: The case report concerns a child of a 33-year-old patient, previously treated for an episode of depression at the age of 23. At the beginning of the 15th week of planned pregnancy, when she was 28 years old, sleep disturbances were observed. Over the next few weeks, she gradually developed a full-blown depressive syndrome which required the use of sertraline. The child was born through a natural delivery, a healthy boy, who was diagnosed with ASD at the age of 2.5 years, which was the trigger for the development of the third episode of depression in the patient. Conclusions: The results of the research indicate that SSRIs can penetrate the placental barrier, influencing the processes of serotoninergic transmission in the fetus, disrupting neurodevelopmental processes. On the other hand, a higher risk of ASD development in children of depressed mothers who do not use pharmacotherapy was confirmed, compared to the general population and in the case of the occurrence of depressive episodes in mother in the past and in relation to the male fetuses. The greater risk of ASD in children of mothers who take SSRIs may not only be associated with the medication itself but also with the presence of depression and the probable common genetic basis for both disorders. In each case, other risk factors for the development of ASD should also be taken into consideration, e.g. vitamin D3 deficiencies, unsaturated fatty acids, oxytocin levels, the presence of intestinal dysbiosis.

Introduction: The study aims to present 1) a case report of an 18-year-old female patient with borderline personality disorder (BPD) 2) the diagnostic and treatment difficulties in BPD patients. Materials and methods: The review of the literature from the years 1953-2020 searched from PubMed, Google Scholar, and Web of Science databases. Discussion: Patient, 18-years old, hospitalized five times for psychiatric care, presenting self-injurious behaviours, hurting herself within forearms. A patient attempted suicide eight times. She is living with her divorced parents. The patient’s father has a new partner with whom he has children. The patient used marijuana and she was experiencing psychotic symptoms under its influence. She smokes 10 cigarettes per day and drinks alcohol once a week since she was 16 years old. Psychiatric problems appeared when the patient started learning in high school. Conclusions: 1. Borderline personality disorder (BPD) is a serious psychiatric condition of a difficult diagnosis that should be differentiated with many other psychiatric disorders such as an atypical or subclinical course of psychosis, affective disorders, or dissocial personality. 2. A therapeutic process of a person with BPD is based on psychotherapy and personalized treatment strategies, whereas, pharmacological treatment plays only a supporting role during BPD treatment.

Introduction: Cotard’s syndrome (CS) is a rare set of psychopathological symptoms, the main symptom of which is nihilistic delusions concerning the negation of the existence of internal organs or the entire body Aim, material and methodology: The aim of the study is to present a case of a patient treated for postpartum depression who developed Cotard’s syndrome. The patient’s symptoms began immediately after her daughter. The clinical picture was dominated by anxiety and apathy, nihilistic delusions about the atrophy of the urethra and other lower abdominal organs, and olfactory hallucinations - she could smell rot. Discussion: The available literature on Cotard’s Syndrome does not allow us to indicate a certain reason for its development. Perhaps the birth of the first child - the woman doubted herself as a mother, she was afraid that she would hurt the cause of the disorders observed and described by us was transient ischemia of the CNS during delivery. Conclusions: Cotard’s syndrome can develop in the course of many mental and somatoform disorders. The described case is, to our knowledge, the first description of Cotard’s Syndrome in the deprivation period. Difficulties in establishing the etiopathogenesis and pathophysiology of Cotard’s Syndrome translate into therapeutic problems. It has been suggested that the treatment of the underlying disorder on the basis of which CS is developed remains the most effective method of therapy.

Introduction: Manganese has a role in the membrane transport systems, synthesis of protein, vitamin C, and vitamins B, catalysis of hematopoiesis, regulation of the endocrine, immune system, blood sugar, reproduction, digestion, and blood coagulation. Furthermore, the level of manganese concentrations in human body appears to affect the occurrence of schizophrenia. The aim of this study was to search for relationships between the manganese level and the onset of schizophrenia. Material and methods: A descriptive review was performed based on a literature search on Medline and Google scholar from 2003 to 2020, using keywords: schizophrenia, manganese, Mn. The included studies were meta-analyses, case-control studies, and cohort studies that examined differences in manganese concentrations in patients with schizophrenia and healthy controls. Result: Eight studies were selected for the review, with one reporting elevated levels of manganese, two showing no significant differences, and the rest including two meta-analyses stating lower manganese concentrations in patients with schizophrenia in comparison with controls. Conclusion: In most of the researched studies, manganese concentrations in patients with schizophrenia were lower than in control groups, but not all of them reached the same conclusions. The relationship between manganese levels and schizophrenia must be further investigated.

The niacin skin flush test (NSFT) is a simple method used to assess the content of fatty acids in cell membranes and is a possible indicator of factors hidden behind various outcomes in patients. The purpose of this paper is to determine the potential usefulness of NSFT in mental disorder diagnostics along with the determination of factors that may affect its results. The authors reviewed articles from 1977 onwards, focusing on the history, variety of methodologies, influencing factors, and proposed mechanisms underlying its performance. Research indicated that NSFT could be applicable in early intervention, staging in psychiatry, and the search for new therapeutic methods and drugs based on the mechanisms of NSFT action. The NSFT can contribute to defining an individualized diet for patients and prevent the development of damaging disease effects at an early stage. There is promising evidence for supplementation with polyunsaturated fatty acids, which have a beneficial influence on the metabolic profile and are effective even in the subclinical phase of the disease. NSFT can contribute to the new classification of diseases and a better understanding of certain mental disorders’ pathophysiology. However, there is a need to establish a validated method for assessing the NSFT results.

Pro/antioxidant imbalance has been reported in schizophrenia (SZ). However, the results of studies are inconsistent and usually do not include other factors that are highly affected by oxidative stress (OS).This cross-sectional study aimed to determine the serum levels of OS markers and their potential connection with schizophrenia. The total sample comprised 147: 98 individuals with SZ −47 first-episode (FS) and 49 chronic patients (CS)—and 49 healthy individuals (HC) as a control group. The examination included clinical variables and serum levels of antioxidants and oxidative damage products. The significant changes were observed in concentrations of all examined markers, without any specific direction of the pro/antioxidant balance shift between SZ and HC. In the regression model adjusted for cofounders, catalase: OR = 0.81 (95%CI: 0.74–0.88); glutathione peroxidase: OR = 1.06 (95%CI: 1.02–1.10); total antioxidant capacity: OR = 0.85 (95%CI: 0.75–0.98); oxidative stress index: OR = 1.25 (95%CI: 1.03–1.52); ferric reducing ability of plasma: OR = 0.79 (95%CI: 0.69–0.89); advanced glycation end products: OR = 1.03 (95%CI: 1.01–1.04); and advanced oxidation protein products (AOPP): OR = 1.05 (95%CI: 1.03–1.07) turned out to be significant predictors of schizophrenia. In the multiple stepwise regression model, pro/antioxidant status and their interaction with the duration of illness-related factors affected schizophrenia symptoms: positive symptoms (FRAPxKYN), negative (DITYR, FRAP, CAT), general (KYN), and over-all psychopathology (KYNxNFK). The results confirm differences in serum levels of oxidative biomarkers between SZ patients and healthy individuals. The pro/antioxidant status could be considered a predictor of schizophrenia and the factor affects patients' symptom severity.

To allow better diagnosis and management of psychiatric illnesses, the use of easily accessible biomarkers are proposed. Therefore, recognition of some diseases by a set of related pathogenesis biomarkers is a promising approach. The study aims to assess the usefulness of examining oxidative stress (OS) in schizophrenia as a potential biomarker of illness using the commonly used data mining decision tree method. The study group was comprised of 147 participants: 98 patients with schizophrenia (SZ group), and the control group (n = 49; HC). The patients with schizophrenia were divided into two groups: first-episode schizophrenia (n = 49; FS) and chronic schizophrenia (n = 49; CS). The assessment included the following biomarkers in sera of patients: catalase (CAT), glutathione peroxidase (GPx), superoxide dismutase-1 (SOD-1), glutathione reductase (GR), reduced glutathione (GSH), total antioxidant capacity (TAC), ferric reducing ability of plasma (FRAP), advanced glycation end products (AGEs), advanced oxidation protein products (AOPP), dityrosine (DITYR), kynurenine (KYN), N-formylkynurenine (NFK), tryptophan (TRY), total oxidant status (TOS), nitric oxide (NO) and total protein. Maximum accuracy (89.36%) for distinguishing SZ from HC was attained with TOS and GPx (cut-off points: 392.70 and 15.33). For differentiating between FS and CS, the most promising were KYN, AOPP, TAC and NO (100%; cut-off points: 721.20, 0.55, 64.76 and 2.59). To distinguish FS from HC, maximum accuracy was found for GSH and TOS (100%; cut-off points: 859.96 and 0.31), and in order to distinguish CS from HC, the most promising were GSH and TOS (100%; cut-off points: 0.26 and 343.28). Using redox biomarkers would be the most promising approach for discriminating patients with schizophrenia from healthy individuals and, in the future, could be used as an add-on marker to diagnose and/or respond to treatment.

Choices regarding coping strategies during the COVID-19 pandemic outbreak may imply the development as well as the severity of emotional disorders. The aim of this web-based cross-sectional study was to: (1) assess the coping strategies for stress in a population of Polish students and (2) evaluate the impact of those strategies on the severity of depression, stress, and anxiety symptoms during the COVID-19 lockdown. To evaluate emotional distress, we used the DASS-21 scale and coping strategies Brief-COPE Inventory. The study included 2172 respondents (73% female, 27% male) with a mean age of 22.1 ± 2.2. Students more frequently chose stress coping strategies belonging to the ‘approach’ coping strategies (M = 29.60 ± 6.89) compared to ‘avoidant’ coping strategies (M = 22.82 ± 5.78). The intensification of distress in women caused a turn to religion (p = 0.001), while men used substances (p < 0.001) and a sense of humor (p < 0.001). Medical students coped best with emotional distress, which is very encouraging for their future profession. The highest level of DASS total score was associated with the usage of avoidant coping strategies, prior use of psychiatric or psychological support, and loneliness. Planning interventions to prevent emotional disorders in students requires the identification of factors contributing to increased emotional distress.

Cel pracyCelem pracy było: 1. zaprezentowanie użytecznych w kontekście teorii integracji społecznej wskaźników ekonomicznych, socjodemograficznych i innych wskaźników związanych ze zjawiskiem samobójstw oraz 2. wskazanie nowych wskaźników mogących mieć szczególne znaczenie we współczesnych warunkach polskich.Materiał i metodyDokonano narracyjnego przeglądu piśmiennictwa poświęconego socjologicznemu podłożu samobójstw, przeszukując internetowe bazy danych MEDLINE/PubMed, PsycINFO, Google Scholar z użyciem słów kluczy: suicide, suicide risk factors, Durkheim’s theory of suicide, integration and disintegration of society, sociodemographic factors, economic factors, religion, oraz określając deskryptory czasowe: 2000–2017.WynikiW aspekcie integracji rodzinnej przedstawiono związki wskaźników rozwodów, małżeństw, dzietności i udziału kobiet w rynku pracy z ryzykiem samobójstw; w aspekcie gospodarczym uwzględniono stopę bezrobocia, produkt krajowy brutto per capita, wskaźnik nierówności społecznej Giniego oraz wskaźniki dobrobytu społecznego; w aspekcie społecznym: wskaźniki jakości systemu opieki zdrowotnej, wskaźnik spożycia alkoholu per capita oraz wskaźnik migracji. Biorąc pod uwagę aspekt religii, analizie poddano związki parametrów religijności konwencjonalnej, współczynnika Gallupa oraz odsetka książek o tematyce religijnej z ryzykiem samobójstw. Specyfikę polskich warunków uwzględnia Indeks Zrównoważonego Rozwoju w aspekcie ekonomicznym oraz wskaźniki dominicantes i communicantes w wymiarze religijnym.WnioskiDokonany przegląd istotnych wskaźników z punktu widzenia teorii dezintegracji społecznej może mieć praktyczną wartość w ocenie ryzyka samobójstw zarówno przy planowaniu programów zapobiegania samobójstwom, jak i dla klinicystów pracujących w obszarze ochrony zdrowia psychicznego.

Introduction: Warfarin has been considered as a “gold standard” in the prevention and treatment of thromboembolic events since 1954. Since the introduction of direct oral anticoagulants in the last few years (NOAC-Non-Vitamin K antagonist Oral Anticoagulants) prescriptions volume for apixaban, edoxaban, dabigatran and rivaroxaban have been gradually surpassing warfarin. The benefits include: anticoagulation from day one, fixed daily dosing, elimination for the need of international normalised ratio (INR) monitoring, fewer interactions with food and co-administered medicines with reduced risk of bleeding and better overall life quality. Objectives: Assessing evidence for the safe use of Non-vitamin K Oral Anticoagulants (NOAC) with Selective Serotonin Reuptake Inhibitors (SSRI) and Serotonin and Noradrenaline Reuptake Inhibitors (SNRI). Method: Review of literature published between 2014 and 2016 was made using the key words: Selective Serotonin Reuptake Inhibitor, Serotonin and Noradrenaline Reuptake Inhibitors, apixaban, dabigatran, edoxaban, rivaroxaban, bleeding, interaction, depression with time description from 2014 to 2018. Evidence within the literature was then compared with guidelines from the National Institute for Health and Care Excellence (UK), British National Formulary (UK), Clinical Excellence Commission (Australia), Thrombophilia and Anticoagulation Clinic (USA) and Summaries of Product Characteristics (SPC). Results: 1. Serotonin plays a critical role in maintaining homeostasis. Use of SSRI/SNRI compromises its platelet reuptake increasing risk of bleeding. 2. Increased tolerability and safety of NOAC over Warfarin, although caution is advised when NOAC is used with SSRI/SNRI with less evidence suggesting pharmacodynamic interactions. 3. It is not recommended to use NOAC with strong CYP and P-gp inhibitors. Conclusions: With limited literature evidence, caution is advised when co-prescribed NOACs with SSRI/SNRI, especially with other cofactors and interacting medicines further increasing risk of bleeding.

The coronavirus disease 2019 (COVID-19) pandemic has a significant impact on both physical and mental health. The aim of this cross-sectional study was to (1) evaluate depression, anxiety, and stress levels among students from Polish universities during the first weeks of the COVID-19 pandemic and (2) assess the risk factors of the higher intensity of emotional distress. We conducted an online survey using the Depression, Anxiety, and Stress Scale-21 (DASS-21) to assess well-being. The study included 2172 respondents (73% female, 27% male) with a mean age of 22.1 ± 2.2. Moderate to extremely severe scores of depression, anxiety, and stress were reported by 43.4%, 27.3%, and 41.0% of the respondents, respectively. Higher scores of DASS-21 were related to female sex (odds ratio (OR) = 3.01), studying sciences (OR = 2.04), co-residence with the roommates (OR = 1.25), suffering from a mental disorder (OR = 5.88), loneliness (OR = 293.30), the usage of psychiatric support before pandemic (OR = 8.06), poor economic situation (OR = 13.49), and the lower scores were found for being currently employed (OR = 0.4). This study highlights an urgent need for (1) crisis-oriented psychological and psychiatric support for students during the outbreak of the COVID-19 pandemic and (2) preparing appropriate psychological interventions to improve the mental health of students for a possible similar situation in the future.

Schizophrenia is a heterogeneous disorder without a fully elucidated etiology and mechanisms. One likely explanation for the development of schizophrenia is low-grade inflammation, possibly caused by processes in the gastrointestinal tract related to gluten sensitivity. The aims of this study were to: (1) compare levels of markers of gluten sensitivity, inflammation and gut permeability, and (2) determine associations between gluten sensitivity, inflammation, and intestinal permeability in patients with first-episode/chronic (FS/CS) schizophrenia and healthy individuals (HC). The total sample comprised 162 individuals (52 FS; 50 CS, and 60 HC). The examination included clinical variables, nutritional assessment, and serum concentrations of: high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), soluble CD14 (sCD14), anti-Saccharomyces cerevisiae antibody (ASCA), antigliadin antibodies (AGA) IgA/IgG, antibodies against tissue transglutaminase 2 (anti-tTG) IgA, anti-deamidated gliadin peptides (anti-DGP) IgG. A significant difference between groups was found in sCD14, ASCA, hs-CRP, IL-6 and AGA IgA levels. AGA IgG/IgA levels were higher in the FS (11.54%; 30.77%) and CS (26%; 20%) groups compared to HC. The association between intestinal permeability and inflammation in the schizophrenic patients only was noted. The risk for developing schizophrenia was odds ratio (OR) = 4.35 (95% confidence interval (CI 1.23–15.39) for AGA IgA and 3.08 (95% CI 1.19–7.99) for positive AGA IgG. Inflammation and food hypersensitivity reactions initiated by increased intestinal permeability may contribute to the pathophysiology of schizophrenia. The immune response to gluten in FS differs from that found in CS.

A growing body of evidence confirms abnormal fatty acid (FAs) metabolism in the pathophysiology of schizophrenia. Omega-3 polyunsaturated fatty acids (PUFAs) are endogenous ligands of the G protein-coupled receptors, which have anti-inflammatory properties and are a therapeutic target in many diseases. No clinical studies are concerned with the role of the GPR120 signaling pathway in schizophrenia. The aim of the study was to determine the differences in PUFA nutritional status and metabolism between patients with schizophrenia (SZ group) and healthy individuals (HC group). The study included 80 participants (40 in the SZ group, 40 in the HC group). There were no differences in serum GPR120 and PUFA concentrations and PUFA intake between the examined groups. In the HC group, there was a relationship between FAs in serum and GPR120 concentration (p &lt, 0.05): &alpha, linolenic acid (ALA) (R = &minus, 0.46), docosahexaenoic acid (DHA) (R = &minus, 0.54), omega-3 PUFAs (R = &minus, 0.41), arachidonic acid (AA) (R = &minus, 0.44). In the SZ group, FA serum concentration was not related to GPR120 (p &gt, 0.05). In the HC group, ALA and DHA serum concentrations were independently associated with GPR120 (p &lt, 0.05) in the model adjusted for eicosapentaenoic acid (EPA) and accounted for 38.59% of GPR120 variability (p &lt, 0.05). Our results indicate different metabolisms of FAs in schizophrenia. It is possible that the diminished anti-inflammatory response could be a component connecting GPR120 insensitivity with schizophrenia.

Central neurocytoma (CN), first described in 1982 by Hassoun and colleagues, is a rare tumor accounting for 0.25% to 0.5% of all tumors of the central nervous system. The tumor is a neoplasm of neuroepithelial origin, with intermediate malignancy (WHO grade II), detectable with both computed tomography and magnetic resonance imaging. Complete excision of the tumor gives favorable long-term results, with infrequent recurrences and/or metastases. Only 3 previous cases in which CN presented with co-occurring psychotic symptoms were found in the PubMed database. This report presents the case of a 27-year-old patient with paranoid syndrome without neurological symptoms, in whom magnetic resonance imaging confirmed a large intracranial tumor located predominantly in the right lateral ventricle and third ventricle reaching down to the hypothalamus. Resection of the tumor (histopathologically a CN) resulted in complete remission of the psychotic symptoms. This case supports the need for neuroimaging in all patients with first-episode psychosis because of the possibility of neurologically silent brain tumors. Quick diagnosis in such cases is crucial for the selection of treatment methods and prognosis.

G protein-coupled receptors (GPCRs) constitute a family of transmembrane proteins that mediate many cellular processes. GPR120/FFAR4, a receptor from this family that is activated by fatty acids, has received considerable attention recently. This paper presents a literature review concerning the role of GPR120 and its mechanism of action in animal and human studies as well as the potential use of GPR120 for the treatment of chronic diseases. Two electronic databases – Medline and Google Scholar – were searched for available studies addressing the review topic that were written in English and published from 2000 to June 2017. The following key terms were used in the search: GPR120, FFA4, GPR120 agonist, PUFAs, EPA, DHA, adipocyte, obesity, hyperlipidemia, inflammation, cancer, diabetes, insulin resistance, taste, atherogenesis, hepatis, central nervous system. In humans, GPR120 expression is expressed in macrophages, eosinophils, and adipose tissue, in cells of the tongue, liver, lungs, small and large intestine, gastric mucosa, and pancreas, in the central nervous system and placental microvilli. Medium- and long-chain fatty acids act as ligands for the receptor. Through the internalization of beta-arrestin-2 complex and the inhibition of NF-κB, GPR120 mediates the activation of the cell’s anti-inflammatory mechanisms. The receptor is also involved in the maturation of adipocytes, the modulation of insulin signalling pathways, the regulation of glucose metabolism, and the secretion of intestinal hormones. GPR120 is a promising target for the treatment of numerous diseases, whose pathophysiology is associated with low-grade inflammation. As a result of intensive searches, a likely group of synthetic agonists of the receptor was determined with potential therapeutic applications in conditions such as obesity, impaired carbohydrate metabolism, inflammatory bowel diseases, cancer, mental disorders.

StreszczenieSkala EASE jest listą objawów do częściowo ustrukturalizowanego fenomenologicznego badania subiektywnych lub empirycznych nieprawidłowości (anomalii), które można uznać za zaburzenia podstawowej, „minimalnej” samoświadomości. EASE opracowana została na podstawie samoopisów otrzymanych od pacjentów chorujących na zaburzenia ze spektrum schizofrenii. Skala ma duże znaczenie dla opisu, diagnozy oraz diagnozy różnicowej zaburzeń ze spektrum schizofrenii. Prezentowana wersja zawiera istotne szczegółowe kwestie dotyczące zbierania wywiadu oraz opisy objawów psychopatologicznych (Podręcznik), arkusz wyników (Aneks A), listę pozostałych pozycji Skali stosowanych w czasie wywiadu (Aneks B) oraz porównawczą listę pozycji EASE/BSABS (Bonner Skala für die Beurteilung von Basissymptomen, Bońska Skala do Oceny Objawów Podstawowych) (Aneks C).

More and more evidence confirms the theory that the intake of cereal products containing gluten may play an important role in the pathogenesis of many diseases. There are also premises indicating the relationship between the so-called gluten-related diseases and the development and course of mental disorders, including schizophrenia. The aim of this article is to review the literature on the potential relationship between the consumption of gluten and schizophrenia, considering the etiopathogenesis and the role of gluten-free diet in the treatment of schizophrenia. Methods: There were analysed available research papers in PubMed and Google Scholar with the key words: schizophrenia, gluten- related disorders, allergy to grain products, celiac disease, microbiota, immune system, exorphins and time span: 1960-2016 . Conclusions: Existing research results indicate a possible relationship between diet rich in grain products with high gluten content and the occurrence or exacerbation of schizophrenia symptoms. However, further studies are necessary to: 1) identify groups of patients for whom the consumption of cereal products (gluten) is associated with a particular risk of schizophrenia exacerbation, 2) determine the mechanisms relating the consumption of gluten with the mental state of schizophrenic patients, 3) get the possible benefits of implementing gluten-free diet in patients with schizophrenia.

Ω-3 unsaturated fatty acids are compounds belonging to the group of essential fatty acids (EFAs). The history of the discovery of EFAs dates back to the 1930s of the twentieth century, however, growing interest in ω-3 EFAs in the context of mental health has been observed since the year 2000. In view of their multidirectional action, these compounds are a promising form of adjunctive therapy of many illnesses, including psychiatric disorders. The present article aims to review the literature on the clinical applicability of ω-3 EFAs in treating schizophrenia. We present the results of preclinical studies in this area and the mechanisms of ω-3 EFAs action discussed by the authors. The randomized controlled trials (RCTs) evaluating the possibility of using ω-3 EFAs in schizophrenia are characterized in detail. The results of the tests are not clear, which may result from the methodological diversity of interventions made. Ω-3 EFAs seem to be a promising form of adjunctive therapy of schizophrenia. Further research is needed, which will allow for defining groups of patients in which intervention will bring the expected results.

Current treatment of major depressive disorder (MDD) often does not achieve full remission of symptoms. Therefore, new forms of treatment and/or adjunct therapy are needed. Evidence has confirmed the modulation of the gut–brain–microbiota axis as a promising approach in MDD patients. The overall purpose of the SANGUT study—a 12-week, randomized, double-blind, and placebo-controlled Study Evaluating the Effect of Probiotic Supplementation on the Mental Status, Inflammation, and Intestinal Barrier in Major Depressive Disorder Patients Using Gluten-free or Gluten-containing Diet — is to determine the effect of interventions focused on the gut-brain-microbiota axis in a group of MDD patients. A total of 120 outpatients will be equally allocated into one of four groups: (1) probiotic supplementation+gluten-free diet group (PRO-GFD), (2) placebo supplementation+ gluten-free diet group (PLA-GFD), (3) probiotic supplementation+ gluten containing diet group (PRO-GD), and (4) placebo supplementation+gluten containing diet group (PLA-GD). PRO groups will receive a mixture of psychobiotics (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175), and GFD groups will follow a gluten-free diet. The intervention will last 12 weeks. The primary outcome measure is change in wellbeing, whereas the secondary outcome measures include physiological parameters. Microbiota and its metabolites have the potential to influence CNS function. Probiotics may restore the eubiosis within the gut while a gluten-free diet, via changes in the microbiota profile and modulation of intestinal permeability, may alter the activity of microbiota-gut-brain axis previously found to be associated with the pathophysiology of depression. It is also noteworthy that microbiota being able to digest gluten may play a role in formation of peptides with different immunogenic capacities. Thus, the combination of a gluten-free diet and probiotic supplementation may inhibit the immune-inflammatory cascade in MDD course and improve both psychiatric and gut barrier-associated traits. NCT03877393 .

Pomimo ponad 100-letniej historii badań nad schizofrenią, jej etiologia nadal nie została w pełni wyjaśniona, co może wynikać ze znacznej heterogenności zarówno w zakresie jej przebiegu, jak i etiopatogenezy. Jednym z najlepiej udowodnionych mechanizmów pośredniczących w rozwoju schizofrenii są reakcje immunologiczno-zapalne, których źródła w ostatnim czasie upatruje się w zaburzeniach funkcjonowania osi jelitowo-mózgowej oraz patologicznych procesach zachodzących w jelitach. W artykule stanowiącym przegląd literatury dotyczącej tej tematyki, przedstawiono znaczenie dla rozwoju schizofrenii poszczególnych czynników mających wpływ na funkcjonowanie osi mózgowo-jelitowej, tj. 1. mikrobiomu jelitowego (mikrobioty jelitowej), 2. zespół przesiąkliwego jelita (leaky gut syndrome), 3. nadwrażliwości na antygeny pokarmowe, w tym na gluten oraz kazeinę mleka krowiego. Wyniki badań wydają się bardzo obiecujące i wskazują na możliwość uzyskania poprawy stanu klinicznego u części pacjentów z rozpoznaniem schizofrenii poprzez modyfikację diety, stosowanie probiotyków, czy też wdrożenie terapii antybiotykami z określonych grup terapeutycznych. Potrzebne są jednak dalsze badania dotyczące powiązań pomiędzy mikrobiomem jelitowym oraz funkcjonowaniem jelit, jako elementami pośredniczącymi w aktywacji układu immunologicznego, a rozwojem i dalszym przebiegiem schizofrenii.

Processing speed turns out to be the central area of research on cognition in schizophrenia. So far the relationship between this dimension and the IQ level of patients and their healthy siblings has not been investigated.To investigate the differences in cognitive speed in patients with schizophrenia and their healthy siblings, and to determine whether cognitive speed as a covariate affects differences in IQ and cognitive profiles between groups.Forty-seven inpatients diagnosed with schizophrenia according to DSM-IV (SCH) and their 36 healthy siblings (HSB) were tested with cognitive speed tasks according to Bartzokis et al. method and Wechsler Intelligence Scale. Additional control for the possible impact of antipsychotic drugs and selected demographic variables on the cognitive performance was taken into account.The siblings scored significantly higher in the cognitive speed task (p 0.01) than patients, the WAIS-R cognitive test profiles were also significantly different in two ways: between groups, and between single test results in each of the assessed groups. The interaction effect: ANOVA, F(10, 770) = 2.798, p = 0.002. Similarly, the Performance and Full Scale IQs were significantly different, at p 0.01. After controlling for cognitive speed, all significant differences no longer exist: e.g. Full Scale IQ, p = 0.459.Significant differences in cognitive speed between patients and their healthy siblings generate the differences in the cognitive profile assessed with Wechsler Intelligence Scale. Some problems of cognitive speed diagnosis and further research on the cognitive schizophrenia endophenotype were discussed.

Background: Determination of psychotropic drugs in clinical study is significant, and the establishment of methodologies for these drugs in biological matrices is essential for patients&rsquo, safety. The search for new methods for their detection is one of the most important challenges of modern scientific research. The methods for analyzing of psychotropic drugs and their metabolites in different biological samples should be based on combining a very efficient separation technique including high-performance liquid chromatography (HPLC), with a sensitive detection method and effectively sample preparation methods. Objective: Retention, peaks symmetry and system efficiency of vortioxetine on Hydro RP, Polar RP, HILIC A (with silica stationary phase), HILIC-B (with aminopropyl stationary phase), and ACE HILIC-N (with polyhydroxy stationary phase and SCX columns were investigated. Various mobile phases containing methanol or acetonitrile as organic modifiers and different additives were also applied to obtained optimal retention, peaks shape, and systems efficiency. The best chromatographic procedure was used for simultaneous analysis of vortioxetine and its metabolites in human serum, urine and saliva samples. Methods: Analysis of vortioxetine was performed in various chromatographic systems: Reversed phase (RP) systems on alkylbonded or phenyl stationary phases, hydrophilic interaction liquid chromatography (HILIC), and ion-exchange chromatography (IEC). Based on the dependence of log k vs the concentration of the organic modifier, log kw values for vortioxetine in various chromatographic systems were determined and compared with calculated log P values. Solid phase extraction (SPE) method was applied for sample pre-treatment before HPLC analysis. HPLC-QTOF-MS method was applied for confirmation of presence of vortioxetine and some its metabolites in biological samples collected from psychiatric patient. Conclusions: Differences were observed in retention parameters with a change of the applied chromatographic system. The various properties of stationary phases resulted in differences in vortioxetine retention, systems&rsquo, efficiency, and peaks&rsquo, shape. Lipophilicity parameters were also determined using different HPLC conditions. The most optimal systems were chosen for the analysis of vortioxetine in biological samples. Both serum and urine or saliva samples collected from patients treated with vortioxetine can be used for the drug determination. For the first time, vortioxetine was detected in patient's saliva. Obtained results indicate on possibility of application of saliva samples, which collection are non-invasive and painless, for determination and therapeutic drug monitoring in patients.

Jadłowstręt psychiczny jest zaburzeniem psychicznym wiążącym się z bardzo poważnymi konsekwencjami dla zdrowia fizycznego i psychicznego pacjentów. Ze względu na złożony obraz kliniczny, na który składają się liczne objawy somatyczne oraz psychiczne, AN pozostaje poważnym problemem współczesnej medycyny i skłania do poszukiwań możliwych przyczyn tego schorzenia oraz nowych, skuteczniejszych metod terapii. W związku z doniesieniami z ostatnich lat podkreślającymi rolę mikrobioty jelit w regulacji masy ciała, interesująca wydaje się hipoteza, że u pacjentów z jadłowstrętem psychicznym występują istotne zaburzenia równowagi mikrobioty jelitowej, które mają swój udział w patogenezie i przebiegu choroby. Wyniki najnowszych badań sugerują, że nieprawidłowy skład mikrobioty jelit może być istotnym czynnikiem podtrzymującym wyniszczenie chorych z anoreksją. Szczegółowe analizy składu mikrobioty charakterystycznego dla jadłowstrętu psychicznego mogłyby okazać się przydatne w rozwijaniu nowych metod monitorowania i leczenia tego schorzenia. Celem niniejszego artykułu jest przedstawienie aktualnego stanu wiedzy na temat znaczenia mikrobioty jelitowej w patogenezie, przebiegu i terapii jadłowstrętu psychicznego.

There is an increasing amount of evidence which links the pathogenesis of irritable bowel syndrome (IBS) with food IgG hyperreactivity. Some authors have suggested that food IgG hyperreactivity could be also involved in the pathophysiology of major depressive disorder (MDD). The aim of this study was to compare levels of serum IgG against 39 selected food antigens between three groups of participants: patients with MDD (MDD group), patients with IBS (IBS group) and healthy controls (HC group). The study included 65 participants (22 in the MDD group, 22 in the IBS group and 21 in the HC group). Serum IgG levels were examined using enzyme-linked immunosorbent assay (ELISA). Medical records, clinical data and laboratory results were collected for the analysis. IgG food hyperreactivity (interpreted as an average of levels of IgG antibodies above 7.5 µg/mL) was detected in 28 (43%) participants, including 14 (64%) from the MDD group, ten (46%) from the IBS group and four (19%) from the HC group. We found differences between extreme IgG levels in MDD versus HC groups and in IBS versus HC groups. Patients with MDD had significantly higher serum levels of total IgG antibodies and IgG against celery, garlic and gluten compared with healthy controls. The MDD group also had higher serum IgG levels against gluten compared with the IBS group. Our results suggest dissimilarity in immune responses against food proteins between the examined groups, with the highest immunoreactivity in the MDD group. Further studies are needed to repeat and confirm these results in bigger cohorts and also examine clinical utility of IgG-based elimination diet in patients with MDD and IBS.

Depression is a complex, heterogeneous psychiatric disorder with multifactorial aetiology. Substantial evidence indicates that depressive episodes are associated not only with changes in neurotransmission in the central nervous system (CNS), but also may lead to structural changes in the brain through neuroendocrine, inflammatory, and immunological mechanisms. Among the factors deserving special attention connected with developing systematic inflammation are altered intestinal permeability, IgG food intolerance, and changes in gut microbiota.We present a possible scenario of the development of depression, linking elevated zonulin production, loosening of the tight junction barrier, an increase in permeability of the gut wall, and the passage of macromolecules, normally staying the gut, into the bloodstream, with the immuno-inflammatory cascade and induction of IgG-dependent food sensitivity. Alterations in bidirectional signaling between the gastrointestinal tract and the brain, so called “microbiota–gut–brain axis”, may be normalized by dietary immunomodulating factors, including prebiotics and probiotics. In the case of increased IgG concentrations, the implementation of an elimination–rotation diet may prove to be an effective method of reducing inflammation and, in this way, alleviating depressive symptoms.Given complexity and variety of mood disorders, it is necessary to develop improved integration models. Preliminary study results raise hope that the new methods mentioned above, i.e. psychobiotics, prebiotics, an elimination-rotation diet, may be an important addition to the psychiatrist's armamentarium as therapeutic agents improving the efficacy of the treatment for affective disorders [1–3].Disclosure of interestThe authors have not supplied their declaration of competing interest.

Depressive episodes are associated not only with changes in neurotransmission in the central nervous system, but also may lead to structural changes in the brain through neuroendocrine, inflammatory, and immunological mechanisms. The aim of this article is to present a new hypothesis connecting the inflammatory theory of depression with IgG food hypersensitivity and leaky gut syndrome. This new potential pathway that may mediate the pathogenesis of depression implies the existence of subsequent developmental stages. Overproduction of zonulin triggered, for example, by gliadin through activation of the epidermal growth factor receptor and protease-activated receptor causes loosening of the tight junction barrier and an increase in permeability of the gut wall (‘leaky gut’). This results in a process allowing larger molecules that would normally stay in the gut to cross into the bloodstream and in the induction of IgG-dependent food sensitivity. This condition causes an increased immune response and consequently induces the release of proinflammatory cytokines, which in turn may lead to the development of depressive symptoms. It seems advisable to assess the intestinal permeability using as a marker, for example, zonulin and specific IgG concentrations against selected nutritional components in patients with depression. In the case of increased IgG concentrations, the implementation of an elimination–rotation diet may prove to be an effective method of reducing inflammation. This new paradigm in the pathogenesis of depressive disorders linking leaky gut, IgG-dependent food sensitivity, inflammation, and depression is promising, but still needs further studies to confirm this theory.

IntroductionThere is an evidence indicating that women experiencing intimate partner violence (IPV) quite common suffer from anxiety and depression, but predictors and protective factors are not well known in this group of patients.AimThe aim of the study was to try to find factor that are connected with higher rates of anxiety and depressive symptoms in the group of female patients experiencing IPV.MethodThe study was conducted in six randomly selected centers of primary health care (PHCs) in Lublin province. One hundred and two female patients experiencing IPV were administered a structured questionnaire and the Hospital Anxiety and Depression Scale (HADS). The sequential models were created with using backward stepwise multiple regression to investigate potential risk and protective factors connected with higher rates of anxiety and depression symptom in the group.ResultsIn a study group, 68% in Anxiety Subscale(A) and 56% in Depression Subscale of HADS (D) had positive scores. Living in the country (P = 0.003) was connected with higher scores in HADS-A (P = 0.003) but not in HADS-D. Experiencing physical violence was connected with higher score in HADS-D (P = 0.005), but not in HADS-A. Chronic physical illness (A P = 0.013; D P = 0.015), being unemployed (A P = 0.024; B P = 0.008), and experiencing economic violence (A P < 0.001; D P = 0.001) were connected with higher stores in both Subscales of HADS. Taking financial support (A P = 0.002, D P = 0.003) was the protective factor for both kinds of symptoms.ConclusionsSocio-economic factors have stronger influence on anxiety and depressive symptoms in women experiencing IPV than demographic factors.Disclosure of interestThe authors have not supplied their declaration of competing interest.

ObjectivesIntellectual functioning in schizophrenia has been associated with genetic vulnerability and obstetric complications.AimsThe aim of this study was to assess:– the incidence of complications during pregnancy, labor and delivery;– the association of OCs with general intellectual ability in two groups: patients with schizophrenia and their healthy siblings.MethodsForty-two patients with schizophrenia according to DSM-IV and 43 their healthy siblings were included in the study and examined using MINI and WAIS-R. Their mothers were interviewed to gather data on OCs. The ‘midwife protocol’ of Parnas et al. was used to quantify the presence and entity of OCs.ResultsAsphyxia, mother's serious illness during pregnancy, premature delivery with weight < 2500 g, labor time > 48 h, infarcts in the placenta and eclampsia were statistically more frequent in schizophrenic group. OCs were more common in individuals with a family history. The two investigated groups were different in the following WAIS-R subtests: comprehension (P = 0.018), block design (P = 0.0001), digit symbol (P = 0.001), as well as in performance IQ and total IQ. In the patient group, correlations between OCs indexes and WAIS-R results include all intelligence quotients (verbal, performance, total IQ) and 5 WAIS-R subtests, while in the sibling group: verbal and total IQ and 2 subtests. The correlation between Vocabulary subtest and OCs was the strongest in both groups.ConclusionOCs may interact with genetic vulnerability to increase the risk of schizophrenia and have been associated with cognitive deficits in the patient group.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Human sexual function is complex and effected in many different ways by schizophrenia and the antipsychotic drugs used in its treatment. Although not extensively researched, sexual dysfunction seems to be frequent in patients with schizophrenia, especially in men. They appear, in significant part, to be a direct consequence of dopamine antagonism, combined with indirect effects due to increased serum prolactin (PRL) concentration. All of the typical antipsychotics and risperidone can cause substantial PRL elevation. Hyperprolactinemia in male schizophrenics might decrease libido, cause anorgasmia and lead to erectile dysfunction. These sexual side effects are closely associated with the patients' willingness to take antipsychotics, and can affect compliance.

During activation, blood platelets (PLT) release a number of micromolecular compounds, of which P-selectin and beta-thromboglobulin (beta-TG) are considered the major markers of the activation. The activated platelets and the released micromolecular compounds actively participate in thromboembolic disorders frequently observed in menopause. Low estrogen level in menopausal women is a common cause of depressive disorders. The aim of the study was to compare the state of PLT activation in menopausal women with and without depression. The assessment of PLT activation was based on the concentration of sP-selectin and beta-TG as serum markers of the activation.Among 65 menopausal women examined, 16 (approx. 25%) had depression. PLT activation was assessed on the basis of sP-selectin and beta-TG levels. The investigation was performed in the low-platelet citrate serum obtained from venous blood collected onto anticoagulant. The levels of beta-TG and sP-selectin were determined using the immunoenzymatic method, with ELISA Kit reagents.In all the women, both with and without depression, the levels of beta-TG and sP-selectin several times exceeded the accepted norms. The concentration of beta-TG was statistically significantly higher (p0.05) in women with depression as compared to those with no depressive disorders.Menopausal women suffering from depression show enhanced intravascular platelet activation. High beta-TG level in women with depression indicates higher risk of thromboembolic disorders in comparison with depression-free women in menopause.

In the last decade the number of patients with Lyme disease has been continuously growing worldwide including Poland. Psychiatric examinations with the help of psychometric tests were performed in the group of 77 patients with arthritis, in 20 with neuroborreliosis and 26 with erythema migrans. First evaluations started before antibiotic therapy, second 5-6 months after the treatment, third one year since the first assessment. Mental state examinations and psychometric testing revealed in majority of the patients, mainly in those suffered from neuroborreliosis and erythrema migrans evidence of various psychiatric symptomatology. The range of psychiatric presentations included: mild cognitive deficits, organic mood disorders, mild dementias, depressive and anxiety episodes with non organic etiology.

The study was undertaken to investigate, reported in earlier studies significant link, between schizophrenia, alcohol dependence and penalty. A representative sample was selected from schizophrenic patients with diagnosis of alcohol dependence hospitalized in psychiatric hospital in Choroszcz in the period of 1998-2000. They were compared with non-alcohol-abusing control patients with schizophrenia. All subjects were assessed for life-time legal problems using detailed questionnaires, family interviews and case histories. Patients with schizophrenia and alcohol dependence engaged more often in criminal activity. Personality disorders and history of head traumas might have contributed to an increase of antisocial behavior.

North-East of Poland is an area endemic for borreliosis. Psychiatric disorders, the most common for the late stage, are more and more frequent manifestations of Lyme disease. The aim of this study is to assess the incidence of different psychiatric complications and identify the spectrum of symptoms and psychopathological syndromes associated with Borrelia burgdorferi infection. Lyme disease causes a variety of psychiatric symptoms. They are less common in skin type of borreliosis manifested by skin erythema.

Lyme borreliosis is a chronic, multisystem disease, of prolong course with three consecutive stages, caused by a tick-transmitted spirochete Borrelia burgdorferi. Tick Borne Encephalitis (TBE) is neuroinfection caused by Tick Borne Encephalitis Virus (TBEV).We evaluated the occurrence of psychiatric manifestations in the early phase of borreliosis-erythema migrans and neuroboreliosis as well as in its late phase--in arthritis and in the Tick-Born Encephalitis. The aim of the study was to single out the most frequent psychiatric symptoms and psychopathological syndroms and to determine their dynamics.The study was carried out between 1999 and 2000 and comprised 174 patients of the Department of Psychiatry and Department of Infectious and Neuroinfectious Diseases of Medical Academy in Bialystok. Seventy seven patients diagnosed with arthritis, 20 with neuroborreliosis, 26 with skin manifestation-erythrema migrans and 51 with KZM participated. All subjects underwent psychiatric evaluation twice--during hospitalization and six month after discharge. Mental status examinations included general psychiatric examination and battery of scales and tests: Mini Mental State Examination, Beck Depression Inventory, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Reitan's Trail Making Test, Choynowsky Memory Scale, Symptoms Inventory and neuropsychological testing.Both in the course of TBE and Lyme borreliosis the majority of patients experienced psychiatric problems in the acute phase of disease as well as in the late phase--3, 6 months after the onset of the disease. The most common psychiatric manifestations were depressive disorders--episodes of depression or organic mood disorders, and cognitive deficits which manifest themselves as mild cognitive disorder or dementia.Psychiatric assessment is important in early stage of kzm and borreliosis but first of all after termination of acute symptomatology.