Models of activity in the narratives of people with schizophrenia. / Wzorce aktywnosci w narracjach osób chorych na schizofrenie.

OBJECTIVES: This article presents an analysis of the narratives of people with schizophrenia from the perspective of descriptions of activities. The goal is to look for changes in activity models under the influence of a psychotic crisis experience. METHODS: Three fragments of auto-narratives concerning periods: prior to illness, during illness and during remission periods, were compared. These were created after psychotic crisis. The narratives of 26 people with schizophrenia about their lives and self-perception during the aforementioned periods made up the research material. Linguistics textual analysis was conducted, distinguishing the determinants of six selected models of activity relating to sense of agency and intentionality of action. Frequency analysis and multivariable methods were applied to compare the relative frequency of their occurrence in narratives. RESULTS: Descriptions of activities during the illness are more strongly saturated with models of an extrinsic control site, impersonal control over action, avoidance, individual actions, states in comparison to the remission period, and in particular, descriptions of activity prior to the illness. CONCLUSIONS: The results of analysis of schizophrenia patients' narratives indicate a decreased sense of agency related to experiencing states of disorder (subjectively defined). This motivational deficit also concerns remission periods after the active phase of the illness, though to a lesser extent. Analysis of motivational models reveals differences of descriptions of own activity, indicating alterations in auto-narration and narrative identity under the influence of a psychotic crisis in a retrospective approach. These changes pertain to deep layers hidden in the relationship between the form of the narrative and its content. They indicate other images of oneself (self-positions or self-narrative voices) as a healthy, sick and in remission person - especially in terms of the perception of their own agency.

Monitoring the treatment outcome in endometrial cancer patients by CEA and TATI.

An attempt was made to compare the usefulness of determining markers carcinoembryonic antigen (CEA) and tumor-associated trypsin inhibitor (TATI) in endometrial cancer patients in whom recurrence or distant metastasis was diagnosed in observation after treatment. The study included 316 patients aged 32-81, average age of 61 years, SD = 8.72, with diagnosed endometrial cancer, treated between 1994 and 1995 at the Oncology Center in Warsaw and then under observation from 4 months to 17 years after completion of treatment. The levels of the markers TATI and CEA were assessed from the first five serum samples taken during postoperative radiotherapy and in the initial period of observation after completed treatment. Receiver operating characteristic (ROC) curves were generated, determining the sensitivity and specificity of both CEA and TATI in patients who experienced treatment failure, i.e., recurrence and distant metastasis. Assessing the sensitivity of the marker CEA, it was found that if in the third sample, i.e., during radiation therapy, the marker level increased by more than 20 % compared with the first sample, then recurrence of cancer occurred during the observation period in 75.9 % of patients and metastatic occurred in 69.7 % of patients. In the evaluation of the marker TATI, it was found that if the level of TATI between the first and the third sample increases by 10.6 % from the initial level, then in 84.4 % (sensitivity) of cases, this means the occurrence of cancer recurrence and in 75.7 % (sensitivity) of cases, the occurrence of metastasis. The specificity of both markers is low and not useful diagnostically.

Tumor-associated trypsin inhibitor in patients with endometrial cancer.

AIM: The aim of the study was to look for prognostic factors of metastasis or recurrence in patients with endometrial cancer. METHODS: Tumor-associated trypsin inhibitor (TATI) concentrations were measured in serum of 317 patients with endometrial cancer. The assay was done 7 times in each patient, from the moment of diagnosis until the start of follow-up after the completion of treatment. Observation of patients after treatment lasted from 0 to 16 years. RESULTS: The TATI levels in patients with adverse prognostic factors accumulated in the first 3 assays and then decreased to zero. Mean TATI concentrations were significantly higher in patients with clinically advanced disease (stage IIIB) than patients at stage I (Kruskal-Wallis p = 0.0446). An increase in the concentration by more than 10.6% in the first 3 assays was significantly correlated with disease relapse (Mann-Whitney Z = -6.06653, p = 0.00000) and local or distant recurrence (Mann-Whitney Z = -4.97475, p = 0.000001). A significant increase in the TATI level in the first 3 tests also occurred in patients who died during the study period (Kruskal Wallis p<0.001). In our series of patients with endometrial cancer, TATI proved to be a sensitive indicator of disease recurrence and distant metastasis, with a sensitivity of 84.4% and 75.7%, respectively. CONCLUSIONS: TATI seems to behave as a prognostic factor in certain subgroups of patients with endometrial cancer.

[Sense of coherence and ways of coping in the relationship with brother or sister in healthy siblings of mentally ill persons]. / Poczucie koherencji i sposoby radzenia sobie ze stresem w relacji z bratem lub siostra u zdrowego rodzenstwa osób chorych psychicznie.

AIM: The aim of the present study was to investigate sense of coherence in healthy siblings of persons suffering from schizophrenia as well as their ways of coping in the relationship with ill brother or sister. METHODS: 40 healthy brothers and sisters of persons with ICD- 10 diagnosis of F20 to F29 participated in the present study. Orientation to Life Scale (SOC- 29) was used to assess sense of coherence and Ways of Coping with Stress questionnaire (SRSS) was used to examine stress coping strategies. RESULTS: Mean global score of siblings of persons with schizophrenia was 111 points. Subjects used coping strategies focused on problem significantly more often than those focused on emotions. CONCLUSIONS: Therapeutic work with healthy siblings should focus on strengthening sense of personal competence, development of personal resources and different ways of coping with stress, investigation of emotions that healthy siblings experience in the relationship with ill brother or sister as well as supporting the process of accepting changes in the relationship with the ill sibling.

[The perception of authorship in schizophrenia - the analysis of activity patterns in autonarrations]. / Postrzeganie wlasnego sprawstwa przez osoby chore na schizofrenie - analiza wzorców aktywnosci w autonarracjach.

AIM: The paper presents the study of narrations of schizophrenic patients focused on the description of activities characteristics. The aim is to answer the question of how experiencing of psychotic crisis influences the perception of their authorship. Do the inherent characteristics of the activity differ with reference to the period of life which they relate to: the time before getting sick, or after falling ill with schizophrenia? METHODS: The material consisted of narrations of 26 people with schizophrenia about their life prior to the illness and after the psychotic crisis. Linguistic categories that make up the patterns of activity have been distinguished. The frequency of the occurrence was compared in both narrations. RESULTS: Self-descriptions after falling ill are more saturated with patterns of avoidance, motivation internally localized connected with attempts of coping with the disease and externally localized action control connected with a decreased sense of authorship in relation to experiencing symptoms and reduction of social competence. CONCLUSIONS: The change of self-image after psychotic experience concerns the deeper planes of narrative, i.e. the patterns of activity hidden in connection between the content and narrative form. The research showed the decrease of the sense of agency associated with the disease experience.

[Sociodemographic and clinical profile of patients with dual diagnosis living in Warsaw district Mokotow in comparison with participants in other European countries--results of the international, multicentre research project ISADORA]. / Profil spoleczno-demograficzny i kliniczny pacjentów z podwójna diagnoza mieszkajacych w warszawskiej dzielnicy mokotów na tle badanych w innych miastach europejskich--wyniki wieloosrodkowego, miedzynarodowego programu badawczego ISADORA.

AIM: The aim of the present study was to compare socio-demographic and clinical profile of the inpatients with dual diagnosis in Warsaw with the profile of inpatients treated in other European centres. METHOD: 50 patients consecutively admitted in Warsaw were included in the study; total number of patients recruited from 7 European centers was 352. Recruitment was conducted in general inpatient psychiatric departments and specialized dual diagnosis inpatient wards. Data was collected during single interview with the use of M.I.N.I and EuropAsi questionnaires. RESULTS: Both in Warsaw and overall study population males constituted almost 2/3 of the group. Patients in Warsaw were more frequently living with relatives or other close persons as well as remained in intimate relationships in comparison to patients from other study sites. Depression was the most common diagnosis in Warsaw and it was significantly more often found it this center than in Tampere. Moreover, patients in the Warsaw group were significantly less frequently diagnosed with cannabis use disorder and more frequently - with tranquillizers use disorder. CONCLUSIONS: The differences among sites regarding socio- demographic and clinical profiles of dual diagnosis patients were due to both socio-cultural factors (e.g. psychoactive substances accessibility) and the research methodology.

[The comparison of self image before and after the psychotic crisis --the analysis of schizophrenic patients' narration]. / Porównanie obrazu siebie przed i po wystapieniu kryzysu psychotycznego poprzez analize narracji osób chorych na schizofrenie.

AIM: The aim of this study was to show the influence of schizophrenia on the individual system of meanings--the way in which the persons describe themselves and their life story. In order to achieve this goal, the analysis of narration of patients suffering from schizophrenia was conducted. METHOD: We examined 20 patients suffering from schizophrenia. We interviewed the patients with a structured narrative questionnaire. The persons described their life and themselves--in the time before and after the psychotic crisis. The interviews were analysed according to different literary methods and the knowledge of formal linguistics. The demographic variables and the clinical state of patients were also controlled. RESULTS: Persons suffering from schizophrenia used more positive attributes and less negative attributes while describing themselves before illness. They reported more positive episodes from their life, before the psychotic crisis. CONCLUSIONS: The psychotic crisis causes the dramatic decrease of self esteem and breakdown of the life story. The patients described themselves and their life in negative, pessimistic optics. The trauma of mental illness is reflected in narration by breakdown of "good story" about the person and her/his life. This change of self image concerns the persons who both cooperate in psychotherapy and are critical to illness.

[Sense of coherence and coping styles among parents of adult children with schizophrenia]. / Poczucie koherencji i style radzenia sobie ze stresem wsród rodziców doroslych dzieci z rozpoznaniem schizofrenii.

AIM: The aim of the research was an answer to the question if sense of coherence correlates with coping styles among parents looking after adult children with schizophrenia. METHODS: 50 parents (38 mothers and 12 fathers) at age 46-84 (mean: 60) were examined. SOC-29 and CISS questionnaires were used to diagnose traits of sense of coherence and coping styles. RESULTS: Coping style focused on problems was the most frequent one in the examined group. Sense of coherence and coping styles correlate among those in the investigated group. CONCLUSIONS: There is a correlation between sense of coherence and coping styles in the group of parents with adult children with schizophrenia. There is also a view of a statistical carer who is the mother aged about 60 years looking after the son aged 35 years diagnosed with schizophrenia.

[The participation of patients with schizophrenia in psychoeducation--the analysis from the patients' perspective]. / Uczestnictwo w psychoedukacji osób chorych na schizofrenie--analiza zajec z perspektywy pacjentów.

AIM: The aim of this study was to find out what the patients opinion about psychoeducation in schizophrenia is. METHOD: We examined 169 patients suffering from schizophrenia. They answered a questionnaire about demographic data, their opinion about participation in sessions, the motivation to psychoeducation and the themes of sessions. RESULTS: . 84% of the patients declared that they like psychoeducation. The main reason for participation in psychoeducation was the willingness to get more information about the illness and prevent relapses. The most important therapist attributes are: high communication abilities and appropriate knowledge. CONCLUSIONS: The patients want to get more information about the illness and obtain more knowledge how to cope with symptoms in order to improve the quality of their life. It is important for the therapists to create an emotional atmosphere which helps to understand each other. During the psychoeducation sessions the therapist should use more various means to get the patients involved in participation.

[Compliance in the treatment of schizophrenia--project ADHES (the renewed results)]. / Wspólpraca w leczeniu schizofrenii--wyniki projektu ADHES (poglebiona analiza).

AIM: The aim of this study was to analyse the level of compliance measured by patients, their families and psychiatrists. METHOD: 2009 patients who suffered from schizophrenia, 1791 members of their families and 203 psychiatrists were studied. They answered a questionnaire about the level of compliance and the factors which influence it. RESULTS: The level of compliance in schizophrenia was evaluated by psychiatrists as 48%, families--73% and patients--85%. The psychiatrists assessed that 60% of the schizophrenic patients did not have the sense of illness. 11% of the patients said that they have no benefits from pharmacotherapy. CONCLUSIONS: The level of compliance is the least in doctor's evaluation. The patients evaluation of the level of compliance was the biggest. The level of compliance was related to patients' insight, negative attitude to pharmacotherapy, cognitive deficits. Women were more cooperative with medication than men.

[Quality of life of schizophrenic patients and their caregivers--comparison]. / Porównanie jakosci zycia osób chorych na schizofrenie i ich opiekunów.

AIM: The aim of the research was to analyse the subjective quality of life of schizophrenic patients and their caretakers. METHOD: The quality of life was measured by the Polish adaptation of Mercier and Tempier's scale. We examined 50 patients and their relatives. RESULTS: The patients' quality of life was compared to the quality of life of their relatives. They evaluate the quality of life similarly. The differences between the patients and their caretakers concern the evaluations of social relations. Only several demographic characteristics influenced quality of life. CONCLUSIONS: The similarity of quality of life is based on taking similar criterions of evaluation. The satisfaction from life was decreased for patients and their carers. It can be connected with the impact of schizophrenia on the family.

[Quality of life of schizophrenia patients and health related problem solving skills--comparison between the group of patient participated in social skills training and psychoeducation group]. / Jakosc zycia chorych na schizofrenie a umiejetnosc rozwiazywania problemów zwiazanych z choroba--porównanie grup pacjentów uczestniczacych w treningu behawioralnym i psychoedukacji.

AIM: The aim of this study was to obtain answers to the following questions: 1. Are there differences in the level of knowledge among the patients divided into two groups t. i. social skills training group (SSTG) and psychoeducation group (SG)? 2. Do the differences correlate with the level of subjective quality of life (SQOL)? 3. Does the participation at two groups influence SQOL and whether this correlates with two different methods of running of rehabilitation activities such as social skills training and psychoeducation? METHOD: The group of 47 patients diagnosed with schizophrenia by DSM-IV were tested. They were divided into two groups: SSTG (24 persons) and SG (23 persons). RESULTS: The increase of knowledge in coping with schizophrenia symptoms was significant in the whole tested group but it was significantly higher in the training group. The SQOL and the level of knowledge in schizophrenia do not correlate. The level of SQOL decreased after taking part in social skills training. CONCLUSIONS: 1) The participation at any of tested rehabilitation activities causes an increase in the knowledge of coping with the problems resulting from schizophrenia. 2) The level of knowledge in schizophrenia does not directly influence SQOL. The level of SQOL significantly decreased in SSTG. It suggests that clinicians should concentrate on the stage just after the training cycle in order to support the patients by giving positive reinforcement.

[The quality of life of chronic schizophrenic patients in their own and their family's assessment]. / Jakosc zycia osób przewlekle chorych na schizofrenie w ocenie ich samych i ich rodzin.

The aim of the research was to analyse the subjective quality of life of chronic, schizophrenic patients. The patients' quality of life was compared to the evaluation of their family. They evaluate the quality of life similarly. The differences concern the relationship between the quality of life and clinical characteristics.