Multiple-Monitored Electroconvulsive Therapy (MMECT) - does it really just belong in psychiatry's past? A case report. / Wielokrotne monitorowane zabiegi elektrowstrzasowe (MMECT) ­ czy na pewno wylacznie domena historii psychiatrii? Opis przypadku.

Electroconvulsive therapy has been a method used in psychiatry since 1938 and despite its rather turbulent history, it is still the most effective method of treating severe mental disorders. Despite its high efficiency and good safety profile, patients with catatonia usually require a large number of treatments. It entails a long hospitalization time and the necessity to repeatedly induce general anesthesia. In 1966, Blachly proposed to induce more than one seizure during a single anesthesia. According to this method, the patient was to be constantly monitored (ECG, EEG) during a series of electroconvulsions, which consisted of two to even eight treatments. For simplicity, the method is called multiple-monitored ECT (MMECT). The work is based on the medical history of a patient diagnosed with catatonic schizophrenia. Due to the insufficient effect of single treatments, we decided to use the MMECT method, which was performed in series of three treatments, twice a week. Thanks to the therapy, catatonic symptoms remitted. Studies in various patient populations have shown that MMECT reduces hospitalization time, the duration of acute symptoms, and the patient's total exposure to anesthetics and muscle relaxants. As the above case shows, MMECT can potentially be considered as a safe treatment alternative in patients that require a large number of treatments, resistant to standard forms of therapy.

Correlation between Selected Clinical Symptoms and Severity of Aggression, Impulsiveness and Their Selected Behavioral Manifestations in Patients with Polycystic Ovary Syndrome Phenotype A.

Previous studies on aggressiveness and impulsiveness in women with polycystic ovary syndrome (PCOS) are ambiguous. Furthermore, no biochemical or clinical factors related to these variables have been definitively confirmed. The aim of the study was to clarify whether, in women with phenotype A of PCOS, variables such as body mass index and clinical and biochemical hyperandrogenism have an impact on either the intensity of impulsivity or aggression or on other selected behavioral manifestations of these variables. The study included 95 patients diagnosed with PCOS phenotype A. The criterion for recruitment into the study group and the control group was body mass index. The study was conducted with the use of a closed-format questionnaire and calibrated clinical scales. Higher body mass index (BMI) values in women with PCOS phenotype A are associated with poor eating habits. The severity of impulsivity and aggression syndrome, as well as the tendency to engage in risky sexual behavior and patterns of alcohol consumption among patients diagnosed with PCOS phenotype A, are not dependent on BMI. The severity of impulsiveness and the syndrome of aggression in women with phenotype A PCOS are not associated with clinical symptoms of hyperandrogenism or with androgen levels.

Volunteers' psychological condition during the war in Ukraine - a survey. / Kondycja psychiczna wolontariuszy w trakcie wojny w Ukrainie ­ badanie ankietowe.

OBJECTIVES: Our goal was to fill a literature gap regarding the impact of volunteering on volunteers' mental health. METHODS: Using social media platform "Facebook" volunteers were asked to fill in a self-developed research questionnaire concerning their well-being. The link to the survey remained open from April to May 2022. Overall, 867 participants' responses were analyzed, 703 were included. Respondents were divided into three groups according to how volunteering had affected their well-being. Subsequently two groups were extracted: volunteers operating in Ukraine and those hosting refugees at home. In each of these groups impact of volunteering on volunteers' well-being was examined. RESULTS: 45.10% of participants reported volunteering has positively affected their overall well-being, in 35.56% it had no impact and in 19.35% affected them negatively. Somatic symptoms of anxiety manifested in 11.10% and were more severe in 8.25%. 14.10% of participants reported a greater need of using psychoactive substances. Among volunteers who hosted refugees 52.23% felt increased tension and irritability. 18% of volunteers operating in Ukraine reported a need to see a psychiatrist or a psychologist. CONCLUSIONS: Impact of volunteering on one's mental well-being ranged from positive to detrimental. Initial mood had significant impact on mental well-being after volunteering. The phenomenon of indirect trauma among non-professional volunteers is not sufficiently explored yet and requires further research.

Malignant complications of masturbation - a case study. / Zlosliwe nastepstwa masturbacji - opis przypadku.

We present a case of a 32-years-old female patient diagnosed with paranoid schizophrenia for many years who has developed neuroleptic malignant syndrome (NMS) as a result of long-acting antipsychotic's injection. Since the initial ineffectiveness of benzodiazepines, the course of electroconvulsive therapy (ECT) has been carried out. In spite of the initial promising response to ECT 3 weeks after the admission her somatic and mental state deteriorated greatly, that was hardly explicable solely by the potential loss of effectiveness of ECT or laboratory tests. Diagnostics extended with imaging tests and gynecological examination revealed the connective tissue-covered cap of a popular multivitamin supplement in patient's vagina. During the following deepened interview, she admitted that in fact 6 months ago a piece had gotten stuck while masturbating. However due to the sense of shame and subjective lack of disturbing symptoms she had left it unsaid. One month after the evacuation of the foreign body she has been discharged from the hospital remaining the full remission. The presented case shows that inflammation in the body can complicate catatonia and NMS, causing a non-specific course and difficulties in diagnosis and treatment. In some patients, the inflammatory process may be caused by a foreign body located in various natural orifices in the body. It appears significant in the group of psychiatric patients. Once again it highlights the tremendous role of meticulously conducted interview including the patient's autoerotic life.

Persistent delusional disorder with delusions of poverty - a case study. / Uporczywe zaburzenia urojeniowe o typie zubozenia ­ opis przypadku.

We present a case study of a patient who was hospitalized with the initial diagnosis of psychotic depression with predominant delusions of poverty. During his hospital stay despite antidepressant and antipsychotic treatment with 150 mg of sertraline and 20 mg of olanzapine per day, no symptomatic improvement was achieved. Besides, the psychotic features have risen to the fore along with inadequately vaguely expressed affective component. What drew attention was the coherence and permanence of delusional judgements, which, albeit variable in expression, always concerned one theme - the belief of an inevitable bankruptcy. The whole clinical picture, both with the objectifying interview defining the order of emerging symptoms, was suggestive and the verification of diagnosis was made. Persistent delusional disorder with delusions of poverty with subsequent mood disorder was diagnosed. The treatment with 275 mg of clozapine per day was started and we observed a slow gradual withdrawal of psychosis as well as a total normalization of the affective range. The case illustrates the importance of differential diagnosis of mental states in which psychotic features coexist with affective symptoms. It is helpful to determine the sequence of the symptoms development. It should be noted that although the ICD-10 classification distinguishes exclusively 7 subtypes of persistent delusional disorder, in the clinical practice we can encounter other thematic areas of psychosis. It brings substantial therapeutic and prognostic implications.

Association Study of the SLC1A2 (rs4354668), SLC6A9 (rs2486001), and SLC6A5 (rs2000959) Polymorphisms in Major Depressive Disorder.

The membrane excitatory amino acid transporter 2 (EAAT2), encoded by SLC1A2, is responsible for the uptake and redistribution of synaptic glutamate. Glycine modulates excitatory neurotransmission. The clearance of synaptic glycine is performed by glycine transporters encoded by SLC6A9 and SLC6A5. Higher synaptic glycine and glutamate levels could enhance the activation of NMDA receptors and counteract the hypofunction of glutamate neurotransmission described in major depressive disorder (MDD). The aim of the study was to assess whether polymorphisms of SCL1A2 (rs4354668), SCL6A5 (rs2000959), and SCL6A9 (rs2486001) play a role in the development of MDD and its clinical picture in the Polish population. The study group consisted of 161 unrelated Caucasian patients with MDD and 462 healthy unrelated individuals for control. Polymorphisms were genotyped with PCR-RLFP assay. We observed that the frequency of genotype CC and allele C of the SLC1A2 polymorphism rs4354668 was twice as high in the MDD group as in control. Such differences were not detected in SLC6A5 and SLC6A9 polymorphisms. No statistically significant association of the studied SNPs (Single Nucleotide Polymorphisms) on clinical variables of the MDD was observed. The current study indicates an association of polymorphism rs4354668 in SCL1A2 with depression occurrence in the Polish population; however, further studies with larger samples should be performed to clarify these findings.