ABSTRACT
While critical sociologists and anthropologists of health have questioned Global Mental Health policies as postcolonial, developmental agendas, little is known on how this critique applies within the central and eastern European countries. As this article shows with the case of Poland, since the advent of capitalism and liberal democracy, the psychiatric conceptualization of depression has steadily aligned with global mental health (GMH) frameworks, amplifying pre-existing trends towards biomedical dominance in Polish psychiatry and the economic framing of mental health in policy-making. These trends are evidenced by the study of Polish Psychiatry, an official journal issued by Polish Psychiatric Association and health policy documents published since the 2010s, including statements by the Ministry of Health. Two findings are presented: first, the logic of 'closing the gap' between Poland and the West has shaped how depression prevalence data is produced and interpreted by state medical institutions and in expert psychiatric discourse; second, the reconceptualization of mental illness through its supposed economic cost has become a dominant approach to depression in Polish psychiatry and public health. Thus, in showing how the Global Mental Health agenda has permeated the specific context of Poland, promoting more individual and biomedical conceptions of mental illness, this case study enables advancing the postcolonial critique of mental health.
Subject(s)
Mental Disorders , Psychiatry , Humans , Mental Health , Poland/epidemiology , Depression/diagnosis , Depression/epidemiologyABSTRACT
OBJECTIVES: The aim of the study was to evaluate the level of cognitive and social functioning in two groups of schizophrenia patients using clinical tools, psychological tests, QEEG, and changes in the brain-derived neurotrophic factor (BDNF) activity in subjects' serum. METHODS: Randomly selected men diagnosed with schizophrenia were enrolled in the study and divided into two groups. Gr. 1 was formed by patients who did not undergo a structured rehabilitation program, while Gr. 2 was formed by patients undergoing standard rehabilitation, as provided in theprogramof the Psychiatric Rehabilitation Unit. Both groups underwent a comparative analysis of demographic parameters and based on: PANSS, AIS, GSES, and BCIS, psychological tests CTT-1, CTT-2, d2, QEEG, and changes in blood BDNF levels. To assess the effect of rehabilitation, the results obtained in both groups were compared after 12 weeks and their analysis was performed in accordance with assumptions for the experimental project. The study presents research hypotheses and pre-test and post-test comparisons of the groups, on the basis of selected research tools. RESULTS: The data obtained in measurement 1 indicate that both groups did not differ significantly in terms of: age, education, place of residence, treatment at outpatient facilities, medicines taken, and suicide attempts. Differences concerned: marital status, children, number of hospitalizations, and employment status. Furthermore, no significant differences were found for the studied groups concerning: serum levels of the brain-derived neurotrophic factor, values obtained on the PANSS, AIS, and GSES, and alpha/theta, theta/beta and theta/SMR ratios. The analyses performed in measurement 2 indicate that structured rehabilitation influences reduce negative symptoms, cause an increase in BDNF levels, cause an improvement in cognitive and social functioning and positively influence the perception speed and accuracy. CONCLUSIONS: The positive effect of structured rehabilitation influences allows to say that rehabilitation represents a necessary part of the comprehensive psychiatric treatment and should already be implemented during the first episode of the illness.
