Comorbidity of substance use and mental disorders.

INTRODUCTION: Comorbidity is a term defined as the presence of two or more conditions occurring either at the same time or having a close relationship to the same individual. World Health Organization (WHO) define it as the "co-occurrence in the same individual of a psychoactive substance use disorder and another psychiatric disorder". Progressive deinstitutionalisation, despite indisputable benefits and improvement of life quality in psychiatric patients, resulted in appearance of new burdens, such as deterioration of family life. Furthermore, wide availability of alcoholic beverages and drugs in communities where the patients live, led comorbid substance abuse disorders to emerge as one of the biggest challenges in the modern psychiatry. There is a limited amount of data concerning the background of the patients with a dual diagnosis, available in the literature, and therefore our aim was to create a sociodemographic profile of such individuals. MATERIALS AND METHODS: The study was conducted among the patients treated in a drug rehabilitation centre of the Upper Silesian Association "Familia" in Gliwice, Poland using authors' own questionnaire, consisting of 75 items. The study group consisted of 9 females and 91 males (n=100), average age of the patients equalled 29.7 years (95%CI: 28.5-31 years; min/max value: 20/48 years), all the patients had an established dual diagnosis. OUTCOMES: 66% of the study group was single, with permanent residency, living with family either in city (47%) or in village (19%). Remaining 34% was spread through the other options (1-4%), with the highest percentage in "single, with permanent residency, living alone in the city" (4%). CONCLUSIONS: Obtained data, demonstrated high homogeneity among the patients with a dual diagnosis in terms of a socio-demographical profile.

Social attitude towards mentally ill in comparison to experts' opinions.

BACKGROUND: In modern psychiatry, deinstitutionalization of mentally ill became an essential part of improving state of being of those affected. Integration in community, despite obvious benefits, led to increase in social distance and rejection towards mentally ill. Social stigma affects different life domains of those afflicted, and therefore it is crucial to introduce methods to deal with it. Our objective was to assess and compare psychiatrists' and public attitudes and beliefs about mentally ill people. MATERIALS AND METHODS: Comparison of two samples, one including 107 psychiatrists and second including 708 individuals of the general population. Obtained outcomes were collated with similar studies available in literature. OUTCOMES: The psychiatrists' attitude was more positive in comparison to the general population. Both groups agree that programs raising public awareness are important, and should be intensified. 41% of general population and 13% of respondents from experts' group think of negative associations with mentally ill. CONCLUSIONS: Conception of utilizing mental health experts as the opinion leaders should be carefully thought through. Although awareness of social distance and stigma improved both among psychiatrists and general population since 2005 (Wciorka & Wciorka 2006, Lauber 2004), still there are areas that needs enhancement. Fear present in both groups, probably caused by inter allia image of mental illness in news reports (Angermeyer 2001), is one of such areas.

Evaluation of the cortisol concentrations in patients with schizophrenia.

INTRODUCTION: The hypothalamus-pituitary-adrenal axis (HPAA) plays a pivotal role in response to a range of external and internal factors often described as a "stress". Growing evidence in a literature, suggest various dysregulations of HPAA, in course of numerous mental disorders. Patients with schizophrenia and bipolar disorder seem to have elevated basal cortisol secretion, what might be caused by the diminution of glucocorticoid receptors' amount. It was of the interest if the cortisol concentrations in patients with diagnosed schizophrenia who underwent treatment, differs from healthy individuals. MATERIALS AND METHODS: Two groups of participants were included into the study. First group (study) consisted of 10 patients with diagnosed schizophrenia and control group which included 38 healthy individuals. Study was divided into two stages, first one (pilot) included only control group, and utilized cortisol concentrations measurement from saliva, blood and 24h urine sample. Second part (main study) involved both groups although focused on a salivary cortisol concentrations. RESULTS: A mean salivary cortisol concentration in patients with schizophrenia who underwent treatment was significantly lower in comparison with healthy individuals. CONCLUSIONS: Obtained results indicate that patients who underwent a treatment, and does not present notable clinical signs of schizophrenia may have moderately lowered levels of salivary cortisol. This may be a reflection of relenting psychotic symptoms as well as a direct effect of atypical antipsychotic drugs on a HPA axis activity.

Factors influencing the levels of work engagement in physicians from Poland, Serbia and Bulgaria.

INTRODUCTION: Lowered work engagement and burnout are a growing problem in recent years, especially among physicians. Cynicism, lack of energy and decreased efficacy may lead to the occurrence of severe depression. These phenomena influence almost every aspect of affected person's life, both professional and extraprofessional, and decrease its quality. The aim of our study was to evaluate the influence of family life and other factors on levels of work engagement and risk of depression. MATERIALS AND METHODS: Our study was conducted on a group of 417 physicians from Poland, Serbia and Bulgaria using a paper questionnaire. The collected data was subjected to statistical analyses using Statsoft Statistica v. 10.0 software. RESULTS: There was no significant correlation between work engagement and sex or age. The highest score on work engagement was in Serbia (m=4.41; Mann-Whitney's U test with p<0.05). The highest score of BDI was in Bulgaria (m=14.73; Mann-Whitney's U test with p<0.05). There was no significant correlation exceeding r=0.5 between UWES and SWING scales. WHI+/WHI- ratio correlates significantly with a BDI scale (Spearman's r=-0.49; p<0.05). CONCLUSIONS: Family life of physicians seem to have minor or even no influence on their work engagement and risk of burnout. The negative influence of work on family life may increase the risk of depression, and that effect is not susceptible to either positive or negative interactions of family life with work. The country with the lowest expenditure on a healthcare have also the lowest levels of work engagement.