Colostrinin (a naturally occurring, proline-rich, polypeptide mixture) in the treatment of Alzheimer's disease.

This study was designed to confirm or negate findings from earlier trials demonstrating that Colostrinin, a novel compound derived from ewes' colostrum, has potential in the treatment of mild or moderate Alzheimer's Disease (AD). 105 patients were recruited from six psychiatric centres in Poland. The trial consisted of a 15 week double-blind phase comparing Colostrinin with placebo, followed by a second 15 week open labelled phase when all patients received Colostrinin. The dosage of Colostrinin was 100 microg on alternate days for three weeks followed by two weeks drug-free. This cycle was repeated three times for each phase. The primary outcome measures used were Alzheimer's Disease Assessment Scale-cognitive portion (ADAS-cog) and Clinical Global Impression of Change (CGIC). Secondary outcome measures were Instrumental Activities of Daily Living (IADL); Mini-Mental State Examination (MMSE); ADAS-non cognitive test (ADAS-non cog); and overall Patient Response. The main outcome measures were assessed at week 15 when active was compared with placebo but all parameters were evaluated at baseline, week 15 and week 30. Two separate statistical analyses were undertaken, a Full Sample Analysis (FSA) in which all missing values were replaced with the worst result observed and a Valid for Efficacy (VFE) analysis in which those patients who had serious protocol violations were excluded. This resulted in 14 patients being excluded from the VFE-analysis. The FSA analysis at week 15 showed a stabilizing effect of Colostrinin on cognitive function in ADAS-cog (p = 0.02) and on daily function in IADL (p = 0.02). The overall patient response was also in favour of the active (p = 0.03). Patients graded as mild on entry also showed a superior response of ADAS-cog compared with more advanced cases (p = 0.01). Evidence from this study indicates an early beneficial effect on cognitive symptoms and daily function. Colostrinin has potential value in the treatment AD.

[The issue of cults in psychiatry]. / Zagadnienie sekt w psychiatrii.

The cult indoctrination, mechanisms operating within sects, manipulation techniques and the role of the leader are presented in the article. Authors discuss personality features and situational factors leading to cult-entering and psychopathological effects on cult members. There are also the basics of brainwashing and its efficiency included, followed by the psychiatrists and families position in diagnosing and therapy of cultists.

[Medical student curriculum in psychiatry in Poland]. / Szkolenie przeddyplomowe w psychiatrii w Polsce.

The author describes present medical student curricula in psychiatry in Polish medical schools based on the questionnaire sent to all the lecturers of the subject in Poland. The questionnaire contained questions concerning the schedule of lectures, seminars and classes (the list of topics) as well as the number of hours of the forms of activities like interpersonal training, discussion groups, internship, etc. We also asked on which year of studies the course in psychiatry took place. The questionnaire included our request to describe the level of integration of psychiatry and other pre-clinical and clinical subjects as well as to enclose a recommended reading list (handbooks and other items of literature). The last question dealt with the problem of assessment of lectures and classes by students. The results of the questionnaire reveal great differences in the curricula of psychiatry in various schools in Poland. The differences lie both in the courses and the number of hours devoted to teaching psychiatry (in most schools it was 120 hours or less). In 7 schools students learn psychiatry in the 6th i.e. the last year of their studies. In 2 schools lectures in psychiatry are given in the th year. In Kraków and Gdansk the courses in psychiatry consist of 150 and 160 hours respectively. The author proposes unification of the curricula in psychiatry concerning both the number of hours of classes and lectures, and topics as well as introducing the diagnostic and classifying criteria ICD-10 (WHO) since Poland is going to join EU.

[Psychiatry at the turn of the 20th and 21st centuries]. / Psychiatria na przelomie XX i XXI stulecia.

The author makes an attempt at considering the most important achievements in psychiatry which have taken place in the global scale during the passing century, and the direction taken up by the development of global psychiatry in the coming century. The 20th century was characterised not only by the impressive development of science, thanks to which completely new possibilities opened up for global psychiatry, but also by the presence of extreme events that took place as a result of false ideologies such as fascism and communism. In the 20th century concepts like homicide, holocaust, the extermination of the mentally ill, experiments on people that are prohibited by the ethics of medicine and the elementary rules of humanity, etc. The paper includes the achievements of diagnosis and therapy of psychiatric disorders and the latest organisational solutions as well as the perspectives for further development of psychiatry. The author also implies the aims that psychiatry has to take up due to the numerous threats from our civilization: the technical-technological development, pollution of the natural environment, the negative changes in human values, the rising brutality in interhuman relations due to racial, national and religious conflicts and terrorism, the disappearing feeling of being safe in society, vision of hunger and poverty in many countries on a few continents, the danger of an epidemic outbreak of new unknown diseases caused by viral mutations, or genetics--the possible negative effects of genetic engineering (cloning of humans), etc. The author tries to define the role of psychiatry in preventing the threats of civilization.

[Against abuse of methodology in psychiatry]. / Przeciw naduzywaniu metodologii w psychiatrii.

The author argues with methodological requirements of scientific research in psychiatry especially as far as the estimation of the value of new psychotropic drugs is concerned. Periodical withdrawal of the drugs and double blind placebo controlled challenge in endogenous depression and psychosis as well as in pediatric psychiatry and psychogeriatry are considered to be inadmissible. The author warns against the possibility of judicial claim in case of fatal complications in psychiatric patients. The abuse of methodology has been named "methodologization of psychiatry" as compared to the discredited term "politicalization of psychiatry".

[Problems of psychogeriatrics]. / Problemy psychogeriatrii.

The author discusses the present state and needs of psychogeriatry in Poland. He considers the situation within the period of 33 years, which, in his opinion, has not been distinctly improved in spite of growth of old age disorders and various psycho-social threats connected with economical difficulties. The author discusses shortly the diagnostic criteria as well as the state of research on etiopathogenesis and treatment of the Alzheimer's disease.

[Dependence on serum cortisol level or the severity of intellectual impairment in primary degenerative dementias]. / Zaleznosc miedzy poziomem kortyzolu w osoczu a stopniem uposledzenia intelektualnego w zespolach otepiennych pierwotnie zwyrodnieniowych.

Basal serum cortisol level was measured in patients with primary degenerative dementia. The diagnosis of primary degenerative dementia was made by the DSM-III-R criteria, and the severity of dementia was measured by use the Rosen et. al. scale. Additionally, the presence of depressive and paraphrenia syndromes was evaluated. The Hamilton scale was used for the evaluation of depression severity. Cortisol level was measured by radioimmune assay. Sixty three patients, 39 female and 24 male, were evaluated. The mean age for women was 69.54 and for men 71 years. Patients were divided into 3 groups: I--simple dementia, II--dementia with depression, III--dementia with paraphrenia. Positive correlation was found between basal cortisol level and the severity of dementia only in group I. Mean cortisol level in patients from group II and III was significantly different than in group I. Among female patients with depression the negative correlation between cortisol level and severity of dementia was found; no other correlations were proved. No correlation was found between the cortisol level and severity of dementia in Hamilton's scale.

[Changes in thyroid function in primary degenerative dementia processes]. / Veränderungen der Schilddrüsenfunktion bei primär degenerativen Demenzprozessen.

To overcome diagnostic uncertainties in early phases of Alzheimer's disease (pre-senile dementia), the analysis of T-3 and T-4 concentration can be usefully employed. Arising out of the localisation neuropathological findings in Alzheimer type dementia, it could be that hormonal findings perform a useful function as indicators of a change in neurotransmitter activity in this disease.

[Epidemiology and psychopathology of epileptics in Bydgoszca Province registered between 1976 and 1980]. / Untersuchungen zur Epidemiologie und Psychopathologie der zwischen 1976 und 1980 in der Woiwodschaft Bydgoszcz registrierten Epileptiker.

In the years 1976-1980, the province of Bydgoszcz had a total of 2635 registered epileptics, or 0.37% of the entire population, over the age of 16. From these, 200 patients were randomly selected, and between 1983 and 1985 a complats clinical follow-up investigation was carried out. Among the most frequent mental disorders found were postparoxysmal twilight state (19.5%) and affective psychoses (11%), among the chronic disorders, dementia of varying intensity (26.5%). In contrast with previous investigations the present investigation made it possible to determine with precision the cause of epileptic attacks. The ratio was 61% to 31%.

[The etio-epigenetic nosographic system as an illustration of multiaxial diagnosis in psychiatry]. / Das ätioepigenetische nosographishe System als Illustration zur multiaxialen Diagnostik in des Psychiatrie.

Basing on earlier work done by Essen-Möller in Sweden, Leme Lopez in Brazil, and Tadeusz Bilikiewicz in Poland, a survey is presented of the development of the concepts known an etioepigenetic psychiatric nosography. The significance of these systems in the classification of mental disorders is illustrated by examples. The etioepigenetic system involves three axes of development methods of the complex structure of the psyche. The first axis embraoes the genotypic period, the second the effects of etioepigenetic factors, and the third the formation of psychopathologic (neurotic or psychiatric) syndromes.