[Dissociative fugue in a maternity ward patient--a case report]. / Fuga dysocjacyjna u pacjentki oddzialu polozniczego--studium przypadku.

AIM: To pay attention to the role of stress connected with delivery, obstetric history, as to the pathologies in the infant as predictors of dissociative disturbances in the patient of the maternity ward. METHOD: The case analysis. CASE DESCRIPTION: The thirty-year-old woman with secondary education, married and employed had left the maternity ward with her baby unnoticed on the fourth day after giving birth. The patient didn't remember this fact after finding her and the infant by the police. The patient had no genetic predisposition in her history and had suffered head injury in her childhood. Her mother lost two of her siblings (miscarriage and early death of infant). The patient miscarried her first pregnancy, and then she had waited several years for the baby. The second pregnancy was at risk, the labor was premature and the infant was born with palatoschisis. In the maternity ward, the patient had difficulties with feeding the baby. She experienced fear about the baby's life, as well as the feeling of being neglected by the staff. In the psychiatry ward, the patient did not reveal any symptoms of mental illness. A memory gap covered the period of her flight. She had shown interest in her child and was motivated to nurse him by herself. The tendency to use immature defence mechanisms (denial and suppression), as well as mild cognitive dysfunctions were observed in psychological testing. Dissociative fugue was diagnosed. CONCLUSIONS: The interaction of past and present traumatic experiences with cognitive dysfunctions and immature defence mechanisms could influence the patient's ability to cope with fear about the child negatively. It led consequently to dissociative loss of memory with disintegration of perception, identity, and conscious control over the behaviour in the fugue. The case shows a need for early diagnosing and providing psychological support to patients of the maternity ward, especially those laden with multiple stress factors.

[MORS--the stationary model centre of sociopsychiatric rehabilitation for youths--the program and evaluation]. / Modelowy Osrodek Rehabilitacji Socjopsychiatrycznej dla mlodziezy--MORS--program i badania ewaluacyjne.

INTRODUCTION: The psychosocial consequences of psychosis in the youth are educational negligence's, poor peer relations and difficulties in achieving life independency. MORS--the Stationary Model Centre of Sociopsychiatric Rehabilitation was created for overcoming these problems. AIM: To present the programme of rehabilitation and its effects in MORS. METHOD: The evaluation was performed in 18 of the 26 young persons being admitted to MORS in the years 2006-2008. Structured Questionnaires of past history for the staff and clients, the SOC-29 and KIDscreen -52 scales were used. RESULTS: A significant number of young people from incomplete families, and/or families burdened with parental mental health problems was noticeable. The best effects were achieved in compensating for educational negligence's, and improving the social and life skills. The self estimation of health and life satisfaction was lower in the youth clients on discharge from MORS than in the general population. CONCLUSIONS: According to retrospective evaluation, the stationary programme of psychosocial rehabilitation in MORS seems to be effective in youths with psychotic disorders and difficulties in social functioning. Further development, and prospective evaluation of that programme would be valuable. Social support in local communities for the youth being discharged from MORS is needed.