Effect of Disturbances of Zinc and Copper on the Physical and Mental Health Status of Patients with Alcohol Dependence.

The concentrations of copper and zinc in the tissues of alcohol-addicted people can significantly correlate with the variables describing their mental state. Studies on the homeostasis of zinc in alcohol-dependent patients have often been characterized by low hypozincemia detection. This may be caused by a low content of zinc in blood serum (1%) compared to the average zinc level in the body. Unfortunately, most authors have identified extracellular zinc in their studies. In the available literature, data on the level of copper in patients suffering from alcohol dependence are inconsistent. Our study included 100 alcohol-addicted patients (the study group) and 50 healthy subjects (the control group). Mental state was measured using appropriate psychometric scales. We used inductively coupled plasma mass spectrometry (ICP-MS) to determine copper and zinc content. Our results confirm the purposefulness of the use of zinc concentration in erythrocytes as a diagnostic parameter for low zinc status in alcohol-dependent patients. Alcohol-dependent patients with reduced concentrations of zinc in erythrocytes/copper in blood plasma differed significantly from alcohol-dependent patients with normal concentrations in terms of clinical parameters. With regard to zinc in blood plasma and copper in erythrocytes, this situation has not been found. The clinical symptoms of hypozincemia and copper deficiency in patients addicted to alcohol usually relate to disorders in central nervous system functioning, and they result in a decreased quality of physical and mental life.

[MSLT: an objective method of assessment of excessive sleepiness]. / MSLT--obiektywna metoda oceny nadmiernej sennosci.

Excessive daytime sleepiness is a serious medical problem. It appears against patient will, when he performs normal day activities. It significantly disturbes daily functioning and may be a cause of a serious accidents. Approximately 5% of the general population suffers from excessive daytime sleepiness. The most common cause of daytime sleepiness is sleep deprivation. It is also a symptom of many disorders and may be an effect of taking many drugs, especially sedative ones. Investigation continued in the seventies by W. Dement and M. Carscadon resulted in preparation of MSLT which became the most widely used, objective method of the assessment of excessive sleepiness. It has been quickly used in diagnosis of narcolepsy, obstructive sleep apnea, idiopathic hypersomnia, periodic limb movements, circadian rhythms disorders, insomnia investigations, clinical assessment of many drugs. However equipment requirements are not that complicated, but investigator knowledge and experience are the limitations of the method. We described the protocol of the test including EEG procedures, patient preparation, interpretation of the results and normal values. Indications for MSLT in the diagnosis of sleep disorders were outlined with the special emphasis on narcolepsy.

[To cast a spell on reality. On actions of Soviet authorities in connection with the 6th Congress of the World Psychiatric Association at Honolulu]. / Zaklinanie rzeczywistosci. O dzialaniach wladz sowieckich w zwiazku z VI Kongresem WPA w Honolulu.

At the 6th Congress of the World Psychiatric Association, held at Honolulu in August 1977, its participants accepted by acclamation a--so called--"Hawaiian Declaration" and a Resolution of the Royal College of Psychiatrists. The Declaration condemned all kinds of abuse in psychiatry, and the Resolution condemned the abuses in the Soviet psychiatry in particular. The Congress of Honolulu carried out, at last, the action initiated at the Congress of Mexico City six years earlier. But by then there was a lack of courage yet to take these measures, and the counter-action of the Soviet authorities proved to be effective. Aware of the fact that this time the pressure to condemn the misuses practiced in the Soviet psychiatry would be ever stronger, the KGB and the Ministry of Health of the USSR began their "preparations" for the next Congress as early as in 1976. This article describes the tactics of action promoted by the Soviet authorities in order to prevent the condemnation. The Author made a proper use of some documents that he had recovered at the Moscow "Centre for Storing the Contemporary Archives".

[Community specialized social help services for patients with mental disorders: one year experience]. / Specjalistyczne uslugi opiekuncze dla osób z zaburzeniami psychicznymi--roczne doswiadczenia.

This article describes one year's experiences of Foundation of Supporting Psychiatric Department Medical Academy of Warsaw in care of patients with mental disorders in two districts of Warsaw. The service was provided for open group of about 70-80 patients with the diagnosis of schizophrenia and depressive disorder recurrent. Introducing of this type of care resulted in reducing of the number of patient admitted to the hospital and in shortening of the mean hospitalization time. Moreover, last but not least, improved patient's life quality. The article contains also care reports illustrations successes and defeats in this type of care.

[Psychiatric disorders and sensory deprivation in AIDS. Case report]. / Zaburzenia psychiczne a deprywacja sensoryczna w przebiegu AIDS. Opis przypadku.

In AIDS there are several opportunistic infections that may occur. Some of them can lead to blindness (for example toxoplasmosis, CMV). It is known that psychiatric disorders can also occur in AIDS. Both situations can take place at the same time. In that case we face the diagnostic problem: Are psychiatric disorders a result of the sensoric deprivation connected with sudden blindness or organic changes in the brain caused by HIV? In our article we described the case of a 37 years old woman who had that kind of symptoms.

[HIV follow-up. New data on pathophysiology and treatment of psychiatric disturbances in the course of AIDS]. / Nadazyc za HIV. Nowe doniesienia na temat patofizjologii i leczenia zaburzen psychicznych w przebiegu AIDS.

In the article summarized here, the authors present the most important achievements in the research on pathogenesis and treatment of AIDS, with particular consideration of psychiatric disturbances occurring in the course of infection by AIDS. Since the 1 st of January 1993, a new definition of AIDS has been obligatory. This definition is based on immunological criteria (HIV seropositivity and number of limphocytes CD4 < 200/microliter). There is a considerable progress in the scope of laboratory diagnostics of the infection by HIV (a method of polimerase chain reaction has been introduced) and in the laboratory and clinical appraisal of the development of AIDS. An astonishing capability of HIV to mutation has been proved. Asymptomatic HIV carriers show about 10(6) genetically different variants of HIV, and subjects showing symptoms of AIDS may prove over 10(8) HIV variants. This extreme dynamics of HIV causes that even the subjects who are not pharmacologically treated (but who are HIV seropositive) indicate the formation of mutants resistant to medicines applied in the treatment of AIDS. The only one and relatively efficient means of treatment of AIDS is combined therapy applied from the first weeks of the infection by HIV. Professor Luc Montanier, a co-discoverer of HIV virus suggests that the most efficient therapy is that by a medicine known as 3TC, in combination with DDI or DDC and with one of the drugs named anti-proteases. This method of treatment inhibits the activity of virus protease--one of 3 enzymes indispensable for replication of HIV. Recently (at the turn of the years 1995/1996) three medicines from the anti-protease group: saquinavir, ritonavir and indinavir have been admitted to be used for treatment of AIDS by the American agency for the control of drugs and foods. FDA, in the exceptionally short time. In the article there is also a description of a concept represented by R. Price, concerning the origin of psychiatric disturbances in the course of AIDS, as well as some results of recent clinical studies on psychiatric disturbances in the course of AIDS.

[Mental disorders in the course of scleroderma: case reports]. / Zaburzenia psychiczne w przebiegu sklerodermii--opisy przypadków.

In our paper current knowledge about mental disorders in the course of autoimmunologic diseases is presented. Two such cases (catatonic syndrome and major depressive episode) are described.

[Neuropsychological disorders in patients with symptomatic AIDS treated in 1990 at the Acquired Immunodeficiency Syndrome Clinic, Medical Academy, Warsaw]. / Zaburzenia neurologiczno-psychiatryczne u chorych z pelnoobjawowym AIDS leczonych w 1990 roku w Klinice Nabytych Niedoborów Immunologicznych A.M. w Warszawie.

Material of this study consists of data collected during treatment of HIV infected patients admitted to AIDS Clinic in Warsaw. This unit, as the first in Poland, hospitalized seropositive patients with various infectious problems. Psychiatric complication of HIV infection (which needed psychotropic medication) was already observed in the first patient, who died with AIDS diagnosis (in February, 1987). In this study data concerning patients in AIDS Clinic during 1990 are presented. In this time 89 HIV seropositive patients (11 of these were women) were admitted to the clinic. Fifty two patients (10 of them were women) were IV drug abusers. Other 33 patients were homosexual (among them 4 IV drug abusers). Eight patients were out of high risk groups for HIV infection. Twelve of 89 patients were newly AIDS diagnosed. Three of them were IV drug abusers. Nine of AIDS patients (one a drug abuser) died in 1990. In six of 12 patients with AIDS diagnosis (50%) neuropsychiatric disorders were stated: depressive syndromes (n = 2), dementia syndromes with severe neurological symptoms (n = 2), delirium syndromes (n = 2). Other 3 person were IV drug abusers. In this study all above mentioned cases and their treatment are described. Our data suggest that HIV seropositive patients with psychiatric disorders need very careful diagnosis and an individual therapeutic intervention.