Anal dyspareunia - biological and psychosocial correlates of painful anal intercourses in population. / Dyspareunia analna ­ biologiczne i psychospoleczne korelaty bolesnych kontaktów analnych w populacji.

Anodyspareunia (anal dyspareunia) is a phenomenon related to the passive side's feeling of pain or discomfort in anal sex when attempting or completely penetrating the anus. This dysfunction was first described in 1998 by Rosser's team investigating its biopsychosocial correlates in a sample of men who had sex with men. The work is theoretical in nature and is an attempt to integrate the current knowledge on the phenomenon of anodyspareunia. It presents attempts to define the phenomenon and data on its prevalence, possible reasons for its occurrence and further research directions. The analyzed studies show that although the occurrence of anodyspareunia is influenced by both physiological factors (e.g., lack of lubrication, oral or manual stimulation of the anus prior to penetration) and psychological factors, the latter seem to play a decisive role in the experience of pain. Not all people who practice anal sex report pain associated with it, which may lead to the perception of anal dyspareunia.

Long-term forensic psychiatric inpatient treatment - review of the selected literature and the analysis of data from the medium secured forensic psychiatry unit. / Wieloletnie detencje psychiatryczne ­ przeglad wybranego pismiennictwa i analiza danych z oddzialu psychiatrii sadowej o wzmocnionym stopniu zabezpieczenia.

OBJECTIVES: The aim of this study was to perform an analysis of the risk factors of long-term psychiatric detention, defined as a stay in forensic institution exceeding respectively 60 and 84 months, based on data obtained from 150 patients from medium secure forensic psychiatry unit. The discussion was preceded by an analysis of the available literature in this field. The sociodemographic factors, the course of the mental disorder, the characteristic of committed criminal acts, aggressive or self-destructive behavior and the clinical characteristic of the illness in the last 6 months of psychiatric detention were analyzed. METHODS: A pilot study was based on a retrospective analysis of data from medical records and psychiatric experts' opinions of a cross-sectional nature. Due to the variables' characteristic, the Student's t-tests, Spearman's correlation and the Kruskal-Wallis rank ANOVA were used. RESULTS: Risk of long-term hospitalization significantly correlated with factors related to the course of the last 6 months of inpatient treatment, including the mental state of patients, the occurrence of aggressive behaviors and the response to pharmacological treatment. There was no significant effect of demographic factors or coexisting addiction to alcohol and psychoactive substances. The risk of long-term psychiatric detention increased with the duration of the illness. There were no correlations with the age of the patients at the time of admission nor number of detentions. The nature of the diagnosis was also not found to be a risk factor. CONCLUSIONS: Our study is the first systematic attempt to assess the risk factors of long-term psychiatric detention in a group of patients of forensic psychiatry centers in Poland. We hope that the presented results will rise a discussion on the shape of psychiatric care in Poland and encourage further research in this area, as well as they will contribute to the optimization of the treatment process.

Clinical and Psychosocial Characteristics of Adolescent Pediatric Patients Hospitalized after Different Types of Suicidal Behaviors-A Preliminary Study.

The objective of this study was to examine the clinical characteristics of adolescents hospitalized after a suicide attempt or instrumental suicide-related behavior. Participants included thirty-six adolescents from the pediatric unit of a Polish hospital who made a nonfatal suicide attempt (SAA) or engaged in instrumental suicide-related behavior (IBA), as well as a general population sample (GPS). Psychosocial features were measured using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), the Social and Occupational Functioning Assessment Scale (SOFAS), the Suicide Behaviors Questionnaire-Revised (SBQ-R), the Psychache Scale (TPS), the State-Trait Anxiety Inventory (STAI), the Center of Epidemiological Studies Depression Scale for Children (CES-DC), and the Prodromal Questionnaire (PQ-16). The SAA group scored significantly higher than the IBA group and the GPS in modules related to irritability and anhedonia, voice hallucinations and delusions, suicidal acts, thoughts and ideation, and medical lethality. Additionally, the SAA scored higher on the SBQ-R and PQ-16 compared to the IBA group and the GPS. Although anxiety, mental pain, and depressive symptoms could not independently distinguish between the SAA and IBA groups, psychotic symptoms were more frequently present within the SAA group. The above symptoms may be important to consider when screening for suicide risk in the general population.

Knowing when to stop: Aberrant precision and evidence accumulation in schizophrenia.

Predictive coding and active inference formulations of the dysconnection hypothesis suggest that subjects with schizophrenia (SZ) hold unduly precise prior beliefs to compensate for a failure of sensory attenuation. This implies that SZ subjects should both initiate responses prematurely during evidence-accumulation tasks and fail to inhibit their responses at long stop-signal delays. SZ and healthy control subjects were asked to report the timing of billiards-ball collisions and were occasionally required to withhold their responses. SZ subjects showed larger temporal estimation errors, which were associated with premature responses and decreased response inhibition. To account for these effects, we used hierarchical (Bayesian) drift-diffusion models (HDDM) and model selection procedures to adjudicate among four hypotheses. HDDM revealed that the precision of prior beliefs (i.e., starting point) rather than increased sensory precision (i.e., drift rate) drove premature responses and impaired response inhibition in patients with SZ. From the perspective of active inference, we suggest that premature predictions in SZ are responses that, heuristically, are traded off against accuracy to ensure action execution. On the basis of previous work, we suggest that the right insular cortex might mediate this trade-off.