[Dual diagnosis in psychoactive substance abusing or dependent persons]. / Podwójna diagnoza u osób uzaleznionych lub szkodliwie uzywajacych substancji psychoaktywnych.

BACKGROUND: There has been noticed a systematic growth of using psychoactive substance (SP) in last years. The co-occurrence of mental and physical disorders related to substance abuse of treated patients is more often a serious problem to medical services. Dual diagnosis (DD) is a clinical term referring to co-morbidity or the co-occurrence in the same individual of a psychoactive substance use disorder and another psychiatric disorder. The aim of the study is to investigate the prevalence of dual diagnosis in patients with diagnosis of substance use disorder hospitalized in years 1994-2005, to assess the kind of co-morbid mental disorders and the course of treatment in three groups: patients with DD, with diagnosis of mental disorder without substance use and with diagnosis related to substance use. METHODS: The retrospective study of 4 349 case records of patients hospitalized in the department of psychiatry in years 1994-2005. Out of this number two groups of patients were separated: persons abusing or dependent on SP (n = 825) and patients with dual diagnosis (n = 362). The control group (n = 200) was created among patients with mental disorders and without SP abuse. Socio-demographic factors, number and the length of hospitalizations, aggressive behaviours, suicide attempts, discharges from hospital on demand were analyzed. In the DD group there was an attempt to evaluate the relation between substance use disorders and co-occuring mental disorders performed. RESULTS: The frequency of DD among all patients hospitalized in the studied period of time was 8.3%, whereas among patients abusing SP was 30.5%. This study demonstrates that patients with the DD are statistically longer hospitalized, discharged from hospitals at their own request and more often need treatment in hospitals, statistically more often try to commit suicide and perform aggressive behavior. Mental disorders were substantially often secondary to substance related disorders in the DD group. There was proved that patients mainly abused alcohol and the most frequent mental disorder were mood (affective) disorders.

Therapeutic efficacy assessment of weak variable magnetic fields with low value of induction in patients with drug-resistant depression.

BACKGROUND: The aim of this prospective study was to verify whether magnetostimulation with weak variable magnetic fields with low value of induction could enhance the effects of pharmacological therapy in drug-resistant depression. MATERIALS AND METHODS: Thirty patients, 26 women and 4 men, with drug-resistant depression were enrolled in the study. The subjects from Group No. I (14 patients) were given fluvoxamine and treated with weak variable magnetic field using the VIOFOR JPS device; the subjects from Group No. II (16 patients) were also given fluvoxamine but they were treated with the VIOFOR JPS device in placebo mode. Changes in depressive symptoms were estimated with the 21-point Hamilton Depression Scale (HDRS), Montgomery-Asberg Depression Scale (MADRS) and Beck Depression Inventory (BDI) questionnaire. RESULTS: After 15 days of treatment highly significant differences were revealed between the patients treated with magnetic field and the patients treated with placebo: the final HDRS score was 53% of the initial value for the group receiving combined treatment, and 86% in the placebo group (p<0.001); for MADRS score the values were 51% and 88% (p<0.001), respectively, and for BDI 60% and 87% (p<0.001). Thus, the average effect of placebo applied with fluvoxamine was a ca. 15% reduction of symptoms, while the concurrent application of magnetic field and SSRI treatment resulted in a 40-50% improvement. CONCLUSION: Our study indicates that adding a two-week low-induction variable magnetic field stimulation to a classical pharmacologic therapy reduces the intensity of symptoms in patients with drug-resistant depressive disorders.

[A case of ketamine dependence]. / Przypadek pacjenta uzaleznionego od ketaminy.

Ketamine is a rapid-acting anaesthetic agent which has been used for over 40 years. It is an antagonist of N-methyl-D-aspartate (NMDA) receptors and agonist of mu and sigma opiate receptors. Ketamine acts through inhibition of sensory parts in the brain and stimulation of the limbic system and optic thalamus. The most common psychiatric disorders observed after the use of ketamine are: psychomotor agitation, hallucinations, status of stupor, consciousness disorders. There are observed cases of non-medical use of ketamine since the sixties of the 20th century. The authors describe the case of a 52 year old man who has been addicted to ketamine for 15 years. The patient was admitted to hospital to observe and treat the withdrawal syndrome as an effect of abrupt discontinuation of a chronically abused substance. On the ground of medical examinations, standard tests, anamnesis and hospital observation, ketamine dependence syndrome of a person with personality disorders was recognized. There was no somatic symptoms of withdrawal syndrome observed. The patient complained of sleep disorders and anxiety. Diazepam, carbamazepine and vitamins was used during treatment. The patient was motivated to stop using ketamine. This case and the described symptoms were compared with others articles.

[Sense of coherence in alcohol dependent males treated in departments of alcohol detoxication and rehabilitation--initial report]. / Poczucie koherencji u mezczyzn uzaleznionych od alkoholu leczonych w oddzialach detoksykacyjnym i rehabilitacji odwykowej--doniesienie wstepne.

The aim of this study was a comparison of the sense of coherence in the group of alcohol dependent male patients, with and without selecting psychosocial effects of alcoholism. The examined group consisted of 55 males treated in departments of alcohol detoxication and rehabilitation in Mental Hospital in Toszek. The SOC--29 scale by Antonovsky was used in order to estimate the sense of coherence and specific questionnaire was used to show selecting psychosocial effects of alcoholism. SOC level was significantly higher in the group of men without psychosocial consequences of alcohol dependence.

[The comparative studies of therapeutic results in patients with psychotic refractory depression treated with selected antidepressants and unilateral ECT]. / Porównanie wyniku terapeutycznego u pacjentów z lekooporna, psychotyczna depresja leczonych wybranymi lekami przeciwdepresyjnymi i jednostronnymi wstrzasami elektrycznymi.

Out of 14 patients with severe, refractory, psychotic depression-7 patients were treated by UECT and the rest with amitriptyline or mianserin. Remission and improvement were recorded in 6 patients after a course of UECT but in none treated with antidepressants.