Prevalence and risk factors of depressive episodes among student population in Wroclaw - epidemiological study results. / Rozpowszechnienie i czynniki ryzyka epizodów depresji wsród wroclawskiej mlodziezy akademickiej - wyniki badania epidemiologicznego.

OBJECTIVES: The aim of this study was to identify risk factors and estimate prevalence of depressive episodes among Wroclaw's universities students. METHODS: Polish adaptation of the Composite International Diagnostic Interview (CIDI) was implemented to gather epidemiological data from 370 students of public universities in Wroclaw. Proportional stratified sampling was performed to obtain distinct, independent strata representing sex, year of study and educational profiles. Randomisation was ensured by recruitment procedures. RESULTS: Prevalence of depressive episodes among students in Wroclaw is high - 14.7% throughout life, 9.8% within 12 months prior to the interview. High prevalence of severe and moderate depressive episodes seems to be worrisome (respectively 5.1% and 6.6% throughout life, 3.8% and 3.9% within 12 months prior to the study). Year of study, profile and lack of partner relationship remain risk factor for depression. CONCLUSIONS: High prevalence of depressive episodes indicates the need for prevention and therapy based on epidemiological data and tailored to the students' needs. Depression among students requires further epidemiological studies.

Childhood adversity as a moderator of the relationship between emotional reactivity and the occurrence of anxiety and depression in a non-clinical group.

AIM: The research is an attempt to confirm the role of emotional reactivity and childhood adversity in the development of anxiety and depression as well as to determine the scope of interaction between these two factors. MATERIAL AND METHODS: 430 participants were included in the study. The intensity of emotional reactivity was determined using the FCZ-KT Questionnaire developed by Zawadzki and Strelau. The occurrence of childhood adversity was measured using the Hardt Childhood Questionnaire. The occurrence of anxiety and depression was measured using the structured interview WHO-CIDI 3.0. The relationship between variables was analysed using the logistic regression model. RESULTS: A moderating role of the level of childhood adversity on the relationship of emotional reactivity and the occurrence of anxiety and depression was observed. In the group with high levels of adversity, no such relationship was observed for either of the two disorders. For low and medium levels of the moderator, different relationships for anxiety and depression were found. CONCLUSIONS: The obtained results are only partially explained within the temperamental risk factor model. A different pattern of relationships between the intensity of the temperamental trait and the occurrence of anxiety and depression depending on the amount of reported adversity may result from the cumulative effect of the negative consequences of this type of experience.

["Epidemiology of mental disorders and access to mental health care. EZOP - Poland" - research methodology]. / "Epidemiologia zaburzen psychiatrycznych i dostepnosc psychiatrycznej opieki zdrowotnej. EZOP - Polska" - metodologia badania.

AIM: Since the second half of the twentieth century, with the development of structured diagnostic tools, population based studies on epidemiology of mental disorders are carried out. A special role is played by World Mental Health Survey Initiative which brings together a group of countries from different continents in order to carry out research projects according to standard methodology using the Composite International Diagnostic Interview. Polish EZOP study, which was conducted in accordance with the guidelines of WMH joined that group. The project was implemented under the Norwegian Financial Mechanism and the Financial Mechanism of the European Economic Area. Its aim was to estimate the prevalence of mental disorders in the Polish population of adults, assess the distance to mental disorders and to obtain knowledge about the perception of psychiatric disorders and treatment. METHODS: The research tool was the Polish version of CIDI-WHO ver.3.0., which was developed for the project. The study was performed in accordance with the guidelines of WMH (cognitive interviews, interviewers training, standardization of field procedures) using electronic version of CIDI questionnaire (CAPI) within the 2-stages procedure in randomly selected representative sample of the Polish population aged 18-64. The quality of the study was systematically controlled and reported by MB SMG/KRC, and completed data (10,081 interviews) were sent to the Department-Centre of Monitoring and Analyses of Population Health NIPH-NIH. After the initial analysis data were sent to the analytical center of WMH, which applied additional cleaning tools and added new variables representing psychiatric diagnoses in DSM-IV and ICD-10.

Money matters: does the reimbursement policy for second generation antipsychotics influence the number of recorded schizophrenia patients and the burden of stigmatization?

PURPOSE: In Poland, non-compliance with the reimbursement policy for second-generation antipsychotics (SGA) manifested in prescribing SGA for patients with psychotic disorders other than schizophrenia may result in serious financial penalties. In this study, we aimed at investigating whether the implementation of the reimbursement policy for SGA contributed to increasing the number of patients with a diagnosis of schizophrenia relatively to the number of patients with a diagnosis of other psychotic disorders in outpatient clinics. METHODS: We analyzed data from Yearbooks of Mental Health that were published by the Institute of Psychiatry and Neurology, Warsaw, Poland in the years 1989­2009 registering the number of patients treated for various mental disorders in public facilities in Poland. Temporal trend analysis of the annual number of patients with a diagnosis of psychotic disorders, who were treated at outpatient clinics, was performed. RESULTS: We found a statistically significant increase in the total number of recorded schizophrenia patients treated at outpatient clinics, as well as in the number of patients treated for the first time at outpatient clinics for schizophrenia. These changes overlap with the implementation of the reimbursement policy for SGA. CONCLUSION: Our results suggest that the restricted reimbursement policy for SGA altered the diagnosing process in Poland. It seems that these alterations may have serious social consequences. Given that a diagnosis of schizophrenia is more stigmatizing than a diagnosis of other psychotic disorders, it might be assumed that schizophrenia over-diagnosing, possibly due to reimbursement reasons, add to the enormous burden associated with stigmatization.

[Psychiatric epidemiology--recent advances]. / Epidemiologia zaburzen psychicznych--dotychczasowe doswiadczenia.

The aim of this article is to review recent advances and the latest research trends in psychiatric epidemiology. Examination of mental disorders prevalence delivers important information about the mental state of society and need for professional psychiatric care. The 12 months prevalence estimates are 30% for any mental disorders. Knowledge about historical methods of data collecting helps to understand psychiatric epidemiology better. We overview few generations of research that differ in methodology. The most common difficulties observed during that kind of research will be described. Available methods of examination of mental disorders prevalence will be presented in this article. The most significant results of international WHO epidemiologic project will be discussed. We also point out future challenges for psychiatric epidemiology and predict the systemic solutions that make intercultural comparisons possible.

[Mothers' perception of their closeness-caregiving and intrusiveness toward adult sons with a diagnosis of schizophrenia or drug addiction]. / Nasilenie bliskosci i intruzyjnosci w ocenie matek synów leczacych sie z powodu schizofrenii lub uzaleznienia od narkotyków.

AIM: The aim of this study is to compare different aspects of closeness in the relation of mothers towards their adult sons suffering from schizophrenia or drug addiction. Werner and Green (1996), in analyzing the concept of"enmeshment", distinguish between two independent dimensions of closeness: 1) pathological--intrusiveness and 2) positive--closeness-caregiving. Intrusiveness refers to a high level of separation anxiety, projective mystification, emotional inter-reactivity and possessiveness. Closeness-caregiving is associated with warmth, spending time together, nurturance, physical intimacy and consistency. METHOD: Mothers were divided into three groups according to the diagnosis of their sons: 1) schizophrenia, 2) drug addiction, 3) control group. Subjects completed the California Inventory for Family Assessment. Its scales showed acceptable reliability and validity. RESULTS: Mothers perceive their interaction with drug addicted sons as less close, more aggressive and unpredictable than mothers from the control group. Unexpectedly mothers of patients with schizophrenia describe relationships with their sons in a more positive way than mothers from the control and drug addiction group (warmer, less possessive, less intense separation anxiety and less aggression). Additionally, they describe their relationships as less open and striving to avoid conflicts. CONCLUSIONS: Further studies should be conducted to verify if mothers of sons with schizophrenia describe their relations in positive terms as a result of the following: 1) self-protective bias, 2) a low level of openness or 3) good coping.