Polyethylene glycol hypersensitivity, patient outcomes in a 7-year retrospective study.

BACKGROUND: Immediate IgE-mediated hypersensitivity reactions to polyethylene glycol (PEG) are rare. Our understanding of PEG hypersensitivity is limited. OBJECTIVE: To evaluate the clinical characteristics and investigation outcomes of the largest cohort of patients with PEG allergy reported. METHODS: A total of 44 patients investigated for suspected PEG allergy across 4 United Kingdom tertiary allergy centers between October 2013 and December 2020 were studied. Clinical characteristics, index reaction, and approaches to and outcomes of allergy investigations were analyzed. RESULTS: PEG hypersensitivity was confirmed in 42 of 44 cases. Macrogol laxatives were the most common index drugs reported (23%), followed by depo-medroxyprogesterone (19%), oral penicillin V (10%), and depo-methylprednisolone (10%). In general, 61% experienced grade III anaphylaxis. Intradermal testing (IDT) increased the diagnostic sensitivity from 51% to 85%. Five patients experienced systemic reactions during IDT. Of the 5 patients, 2 were skin prick test positive to a high molecular weight PEG. Three patients with negative skin test results had positive drug provocation test results. Seven patients with PEG allergy reported tolerance to H1-antihistamines containing PEG. Administration of messenger RNA COVID-19 or Oxford/AstraZeneca COVID-19 vaccines was tolerated in all 16 patients to whom they were administered. CONCLUSION: PEG hypersensitivity is an uncommon cause of drug-induced anaphylaxis. Four index drugs accounted for two-thirds of the cases, and reactions to these drugs should prompt PEG hypersensitivity investigations. PEG IDT increases diagnostic yield. The role of skin prick test with higher molecular weight PEGs requires further attention. Further studies are required to understand PEG thresholds and PEG equivalent doses of various administration routes. COVID-19 vaccines were tolerated by all exposed.

CRUSE® -An innovative mobile application for patient monitoring and management in chronic spontaneous urticaria.

BACKGROUND: Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user-friendly platform to complete patient-reported outcome measures (PROMs) on their mobile devices. CRUSE® , the Chronic Urticaria Self Evaluation app, aims to address this unmet need. METHODS: CRUSE® was developed by an international steering committee of urticaria specialists. Priorities for the app based on recent findings in CSU were defined to allow patients to track and record their symptoms and medication use over time and send photographs. The CRUSE® app collects patient data such as age, sex, disease onset, triggers, medication, and CSU characteristics that can be sent securely to physicians, providing real-time insights. Additionally, CRUSE® contains PROMs to assess disease activity and control, which are individualised to patient profiles and clinical manifestations. RESULTS: CRUSE® was launched in Germany in March 2022 and is now available for free in 17 countries. It is adapted to the local language and displays a country-specific list of available urticaria medications. English and Ukrainian versions are available worldwide. From July 2022 to June 2023, 25,710 observations were documented by 2540 users; 72.7% were females, with a mean age of 39.6 years. At baseline, 93.7% and 51.3% of users had wheals and angioedema, respectively. Second-generation antihistamines were used in 74.0% of days. CONCLUSIONS: The initial data from CRUSE® show the wide use and utility of effectively tracking patients' disease activity and control, paving the way for personalised CSU management.

Vitamin B12 Hypersensitivity: A Retrospective Multicenter Study.

BACKGROUND: Vitamin B12 (Vit B12) deficiency affects approximately 20% of those above the age of 60 years in the United Kingdom and United States. If untreated, it leads to detrimental health outcomes. OBJECTIVE: To investigate a cohort of patients with Vit B12 hypersensitivity (VB12H) referred to 3 UK allergy centers and design a pathway for the investigation of VB12H. METHODS: A total of 29 patients seen between 2014 and 2022 underwent skin prick testing (1 mg/mL) with cyanocobalamin (CC) and hydroxycobalamin (HC) and intradermal testing (0.1 and 0.01 mg/mL). Patients with negative skin tests underwent a Vit B12 drug provocation test (DPT) with either the index or the alternative drug. RESULTS: Of 29 patients, 18 (62%) presented with immediate VB12H. Eight experienced anaphylaxis (4 to HC and 4 to CC) and had positive skin tests to the index drug. One patient reacted to oral and 7 patients to injectable Vit B12. Seven patients sensitized to one form of Vit B12-tolerated DPT with an alternative Vit B12. One patient with immediate VB12H reacted to polyethylene glycol (PEG) in oral cobalamin. Of 29 patients, 8 presented with delayed hypersensitivity reaction; 4 patients tolerated the intramuscular index formulation, whereas 2 patients tolerated the per oral formulation. One patient presented with symptoms consistent with symmetrical drug-related intertriginous and flexural exanthema. Three patients were referred because of cobalt allergy. CONCLUSION: Confirmed VB12H is rare. We propose a comprehensive evaluation protocol that includes Vit B12 skin tests and considers PEG allergy in patients presenting with VB12H.

The Genetic Background of Abnormalities in Metabolic Pathways of Phosphoinositides and Their Linkage with the Myotubular Myopathies, Neurodegenerative Disorders, and Carcinogenesis.

Myo-inositol belongs to one of the sugar alcohol groups known as cyclitols. Phosphatidylinositols are one of the derivatives of Myo-inositol, and constitute important mediators in many intracellular processes such as cell growth, cell differentiation, receptor recycling, cytoskeletal organization, and membrane fusion. They also have even more functions that are essential for cell survival. Mutations in genes encoding phosphatidylinositols and their derivatives can lead to many disorders. This review aims to perform an in-depth analysis of these connections. Many authors emphasize the significant influence of phosphatidylinositols and phosphatidylinositols' phosphates in the pathogenesis of myotubular myopathies, neurodegenerative disorders, carcinogenesis, and other less frequently observed diseases. In our review, we have focused on three of the most often mentioned groups of disorders. Inositols are the topic of many studies, and yet, there are no clear results of successful clinical trials. Analysis of the available literature gives promising results and shows that further research is still needed.

Immediate hypnosis effects and outcome predictors in chronic nociplastic pain.

This study used data from a randomized controlled trial on the efficacy of hypnosis with analgesic suggestions relative to hypnosis with nonspecific suggestions to explore two areas. The first was the immediate effects of each hypnosis session and their relevance to the treatment induced change in pain intensity. The second was the identification of variables associated with the beneficial effects of hypnosis treatment in the form of reducing pain intensity and pain quality. The predictive value of the initial treatment response, hypnotizability, and the dichotomous variable of pain medication use were examined. Both interventions resulted in similar significant reductions in pain intensity after each session, but without a cumulative effect. The initial response correlated positively and moderately with pain intensity decreases induced by the complete hypnosis treatment. There was only a weak association between hypnotizability and pain quality improvement. Only participants not taking pain medications achieved a meaningful reduction in pain outcomes. Each hypnosis session results in an immediate reduction in chronic nociplastic pain intensity, and a fruitful first session may be a positive signal to continue therapy. Even patients with low hypnotizability can obtain beneficial outcomes. Pain medication use may become a new predictor in hypnosis research, as significant decreases in pain intensity and pain quality occurred only in the absence of pharmacotherapy. However, the results of this study require confirmation in further research with longer treatment periods.

Pain and Its Management in Patients Referred to a Geriatric Outpatient Clinic.

(1) Background: A major problem affecting geriatric patients is pain. In addition to pain, a significant problem of old age is dementia and depression, which can hinder the diagnosis and treatment of pain. The aim of this study was to analyse the prevalence of pain in patients treated in a geriatric outpatient clinic and the treatment used. (2) Methods: The analysis was based on the records of 937 patients who visited the Geriatric Outpatient Clinic in Dobre Miasto between 2015 and 2020. Based on records containing data dating back to their first visit to the hospital, patients' experiences of pain, the presence of depressive symptoms and dementia, and the pharmacological treatment used for pain (analgesics and coanalgesics) were analysed. (3) Results: Pain complaints were reported by 311 patients (33.2% of the study group), 76% of the complaints were from females. The mean age of the patients was 78 years (SD = 8.45). At least one analgesic drug was taken by 107 patients (34.4%). The most commonly used analgesics were opioids (63 patients, 58.87%), especially tramadol. Of the potential coanalgesics, the largest number of patients used an antidepressant. (4) Conclusions: Despite the widespread prevalence of pain among the elderly, only about one-third of them were taking pain medication, mainly in the form of weak opioids. Patients with symptoms of dementia were found to report pain less frequently.

Apple metabolism under oxidative stress affects plant cell wall structure and mechanical properties.

Several studies have shown beneficial effects of short exposure to oxidative stress on stored fruit, such as better preservation, increased firmness, preservation of polyphenolic compounds, and reduced risk of postharvest disorders such as bitter pit and superficial scald in apples. In this study the effect of short-term oxidative stress conditions on the physiology of apple fruit was investigated. Apple fruit of three cultivars were exposed to hypoxic storage conditions of various lengths to induce anaerobiosis. The response of apple fruit to short-term oxidative stress was evaluated by means of cell wall immunolabeling and atomic force microscopy. In addition, the antioxidant capacity and antioxidative activity of apple peels was assessed. Through various techniques, it was shown that short-term oxidative stress conditions promote specific enzymatic activity that induces changes in the cell wall of apple fruit cells. Exposure to short-term stress resulted in the remodeling of cell wall pectic polysaccharides, observed as an increase in the size and complexity of extracted oxalate pectin. Structural changes in the cell wall were followed by an increase in Young's modulus (compressive stiffness of a solid material, expressed as the relationship between stress and axial strain) of the cell wall material. The data presented in this paper show in a novel way how storage under short-term oxidative stress modifies the cell wall of apple fruit at the molecular level.

Central psychological symptoms from a network analysis of patients with anxiety, somatoform or personality disorders before psychotherapy.

BACKGROUND: Cross-sectional network analysis examines the relationships between symptoms to explain how they constitute disorders. Up to now, research focuses mostly on depression, posttraumatic stress disorder, and rarely assesses larger networks of various symptoms measured with instruments independent of classifications. Studies on large groups of psychotherapy patients are also rare. METHODS: Analyzing triangulated maximally filtered graph (TMFG) networks of 62 psychological symptoms reported by 4616 consecutive nonpsychotic adults in 1980-2015. RESULTS: Case-dropping and nonparametric bootstrap proved the accuracy, stability and reliability of networks in patients' sex-, age-, and time of visit divided subgroups. Feeling that others are prejudiced against the patient was the most central symptom, followed by catastrophic fears, feeling inferior and underestimated. Sadness, panic, and sex-related complaints were less central than we expected. All analysed symptoms were connected, and we found only small sex-related differences between subsamples' networks. No differences were observed for time of visit and age of patients. LIMITATION: Analyses were cross-sectional and retrospective, not allowing examination of directionality or causality. Further, data are at the between-person level; thus, it is unknown whether the network remains constant for any person over time. One self-report checklist and building binary network method may bias results. Our results indicate how symptoms co-occured before psychotherapy, not longitudinally. Our sample included public university hospital patients, all White-Europeans, predominantly females and university students. CONCLUSIONS: Hostile projection, catastrophic fears, feeling inferior and underestimated were the most important psychological phenomena reported before psychotherapy. Exploring these symptoms would possibly lead to enhancement of treatments.

What are we afraid of when we fear for our health? The symptom context of hypochondriacal complaints. / Czego sie boimy bojac sie o swoje zdrowie? Kontekst objawowy skarg hipochondrycznych.

OBJECTIVES: To identify the set of symptoms most frequently co-occurring with hypochondriacal complaints in patients with neurotic or personality disorders. METHODS: Nonparametric Spearman rank correlations between the variables of symptom checklist "O" describing hypochondriacal symptoms and other symptoms were analyzed. To increase the reliability of the results, the analyses were performed independently in two groups: 3,929 patients before admission to a day hospital in the years 1980-2002 (group A) and 3,190 patients before admission in the years 2004-2015 (group B). RESULTS: For selected groups of patients, lists of correlation coefficients were obtained showing the most important (strongest) and statistically significant associations between five hypochondriacal symptoms and somatization symptoms coming from the muscular system, breathlessness, symptoms coming from the cardiovascular system, anxiety symptoms, and compulsive thoughts without specific content. CONCLUSIONS: The multidimensional nature of hypochondriacal complaints and their association with somatization symptoms similar to infection or inflammation were confirmed. Apart from the fears about patient's own health, fears about close relatives are also an important symptom, to which clinical attention should be paid.

Usefulness of controlled breathing in psychiatry. A review of recent findings. Part 1 - Eastern approach. / Uzytecznosc technik kontrolowanego oddychania w psychiatrii. Przeglad badan z ostatnich lat. Czesc 1 ­ tradycje Wschodu.

The topic of this review is the clinical usefulness of techniques involving controlled breathing, based on Eastern traditions, aimed at restoring autonomic balance in psychiatry. Although these techniques have a long tradition as "relaxation methods", they gain additional meaning in the context of prolonged stress resulting from the ongoing COVID-19 pandemic. This review, however, is not limited to the pandemic; it also focuses on recent findings regarding clinical populations and provides basic information on the biological mechanisms of respiration and related markers (respiratory rate - RR and heart rate variability - HRV) and their use as effect indicators in research on the population of patients with mental disorders. On the basis of the available data from empirical studies and previous systematic and narrative reviews, it is possible to indicate the possible benefits of using techniques based on controlled breathing as a complementary method in the treatment of a number of mental health disorders. Possible side effects associated with the proposed techniques are also discussed.

The Efficacy of Hypnotic Analgesic Suggestions in Chronic Nociplastic Pain: A Randomized Controlled Trial.

This blinded study evaluated the relative efficacy of three hypnosis sessions in 60 patients with chronic nociplastic pain allocated randomly to one of two conditions: hypnosis with analgesic suggestions, or hypnosis with nonspecific suggestions. Pain intensity, pain quality, and pain interference as outcome measures were assessed before and after treatment. A mixed-design analysis of the variance model showed no significant differences between groups. According to the adjusted model, large effect size improvements in pain intensity and pain quality emerged for both conditions but were only meaningful for patients not taking pain medications. Analgesic suggestions may not play a primary role in beneficial outcomes of hypnosis at the beginning of chronic pain management since both interventions demonstrated similar positive effects. Future studies should investigate the efficacy of the hypnosis components over longer treatment periods.

Network analysis of body-related complaints in patients with neurotic or personality disorders referred to psychotherapy.

Background: Psychopathology theory and clinical practice require the most complex knowledge about patients' complaints. In patients seeking for psychotherapy, body-related symptoms often complicate treatment. Aim: This study aimed at examining connections between body-related symptoms, and identification of symptoms which may be responsible for emergency and sustaining of anxiety, somatoform and personality disorders with the use of network analysis. Methods: In our retrospective research we used data from a sample of 4616 patients of the Department of Psychotherapy, University Hospital in Cracow, diagnosed with anxiety, somatoform or personality disorders. We constructed the Triangulated Maximally Filtered Graph (TMFG) networks of 44 somatoform symptoms endorsed in the symptom checklist "O" (SCL-O) and identified the most central symptoms within the network for all patients and in subgroups of women vs. men, older vs. younger, and diagnosed in 1980-2000 vs. 2000-2015. We used bootstrap to determine the accuracy and stability of five networks' parameters: strength, expected influence, eigenvector, bridge strength and hybrid centrality. Results: The most central symptoms within the overall network, and in six subnetworks were dyspnea and migratory pains. We identified some gender-related differences, but no differences were observed for the age and time of diagnosis. Conclusions: Self-reported dyspnea and migratory pains are potential important targets for treatment procedures.

Oral Cavity Clinical Evaluation in Psychiatric Patients with Eating Disorders: A Case-Control Study.

Bulimia nervosa and anorexia nervosa are not the only disorders the symptoms of which may be present in the oral cavity. The assessment of the clinical condition of patients with eating disorder symptoms was aimed at in this study. The study group consisted of 60 patients with diagnoses from categories F4.xx, F5x.x, and F6x.x ICD-10 (International Classification of Diseases, Tenth Revision). Patients were qualified for the study based on the answers provided in the symptom checklists "O". An adequate control group was selected. All patients underwent a dental examination, including the assessment of API (aproximal plaque index) and DMF (decayed missing filled index). Studies have shown that patients with eating disorder symptoms were more likely to have dental erosions (in total, 28.81% of cases). The correlation of erosion with the symptoms of eating disorders was demonstrated for several assessed symptoms present in the symptom checklists "O". Such correlations have not been demonstrated in terms of gingival recession presence. The level of oral hygiene in patients with eating disorders was assessed as sufficient or bad and indicates the need to initiate dental treatment in this group. It is important to correlate the treatment of the underlying mental disease with dental treatment and regular dental checkups.

Hypnotizability and psychopathology of patients with personality disorders.

Assessment of hypnotizability is useful in research and predicting the effects of hypnosis in clinical practice. There are few contemporary scientific reports examining the relationship between hypnotizability and psychopathological personality dimensions. The current study explores the connections between abnormal personality in psychiatric patients and the hypnotizability level. Fifty-five patients with anxiety and personality disorders who previously completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were invited to undergo the Elkins Hypnotizability Scale - Clinical Form (EHS-CF). The hypnotizability scores comprise a normal distribution but shifted toward low scores. Twenty-seven patients were included in the low hypnotizability (LOW) group, and 28 patients in the medium to high (MID-HIGH) group. The number of participants with high scores on the Psychopathic Deviate and Paranoia MMPI-2 clinical scales was significantly higher in the LOW than in the MID-HIGH group. Patterns of associations between hypnotizability and psychopathology differed in the two groups. The results indicate that moderate hypnotizability should be considered a normal trait that has no meaningful relationship with psychopathology, but certain dysfunctional symptoms of personality disorders may entail resistance and a defensive attitude toward the hypnotherapy, resulting in a tendency to obtain lower hypnotizability.

Amoxicillin hypersensitivity: Patient outcomes in a seven-year retrospective study.

BACKGROUND: The beta-lactam antibiotic amoxicillin and the beta-lactamase inhibitor clavulanic acid in combination with amoxicillin are known to cause both immediate- and nonimmediate-type hypersensitivity. OBJECTIVE: To characterize a large cohort of patients with a history of amoxicillin or amoxicillin-clavulanic acid hypersensitivity. METHODS: A retrospective analysis was conducted of the demographics, presentation, investigation, and management of 331 patients presenting to 1 allergy center with a history of hypersensitivity to amoxicillin or amoxicillin-clavulanic acid. RESULTS: Hypersensitivity was confirmed in 37 of 221 patients (17%) who took amoxicillin and 47 of 110 patients (43%) who took amoxicillin-clavulanic acid as the index drug. In immediate hypersensitivity, skin test results confirmed the diagnosis in 66 of 139 patients (47%). Penicillin cross-reactivity was observed in 16 of 36 patients (44%). Of the 16 patients who were cross-reactive, 13 (81%) reacted to amoxicillin-clavulanic acid as the index drug. All patients who had negative skin test results (73/139) underwent drug provocation. The negative predictive value of skin tests was 89%. In nonimmediate hypersensitivity, delayed intradermal tests confirmed diagnosis in 12 of 170 patients (7%). Of the 12 patients whose skin test results were positive, 8 (67%) presented with drug reaction with eosinophilia and systemic symptoms. All patients with a negative skin test result (158/170) underwent drug provocation. The negative predictive value of skin tests was 95%. Penicillin cross-reactivity was observed in 3 of 12 patients (25%). Ten patients were diagnosed with hypersensitivity to clavulanic acid. CONCLUSION: The negative predictive value of skin tests in both immediate and nonimmediate hypersensitivity reactions is excellent and excludes severe allergy. Nonimmediate hypersensitivity is rare. Confirmed hypersensitivity is more likely if amoxicillin-clavulanic acid is the index drug. Cross-reactivity was more common in patients presenting with immediate hypersensitivity, typically involving benzylpenicillin. A minority of patients were allergic to clavulanic acid.

Sensitisation and allergic reactions to alpha-1,3-galactose in Podlasie, Poland, an area endemic for tick-borne infections.

PURPOSE: Ticks transmit several pathogens and seem implicated in the production of specific IgE antibodies to alpha-1,3-galactose (α-gal sIgE). They cause delayed and immediate allergy to mammalian meat and medication including antivenoms, vaccines and monoclonal antibodies. METHODS: We assessed the prevalence of α-gal sIgE in forest workers and healthy controls in the Podlasie voivodeship, north-eastern Poland; the relationship between α-gal sIgE and allergy to α-gal-containing products; the correlation between α-gal sIgE and anti-Borrelia burgdorferi and anti-tick-borne encephalitis virus (TBEV) antibodies; the relationship between α-gal sIgE and markers of infection with lesser-known pathogens transmitted by ticks such as Anaplasma phagocytophilum. RESULTS: Production of α-gal sIgE was closely related to tick bites. The odds ratio for detectable α-gal sIgE was 9.31 times higher among people with a history of tick bites (OR 9.3; p < .05). There was no correlation with the history of TBE, Lyme disease or human granulocytic anaplasmosis. However, serum α-gal sIgE correlated with anti-TBEV IgM antibodies in CSF. There was a strong correlation between α-gal sIgE and total IgE and sIgE to pork and beef. CONCLUSIONS: Our data support the link between I.ricinus ticks and the production of α-gal sIgE and confirm that the pathogens carried by ticks we examined for do not seem implicated in this immune response.

Complaints of dyspnea and their associations with personality traits in patients referred to psychotherapy in a day hospital.

BACKGROUND: Breathing difficulties are present in different medical conditions, yet seem to be underresearched in psychiatric patients. AIM: Assessment of prevalence of dyspnea complaints and their associations with personality traits in patients with neurotic or personality disorders referred to psychotherapy. METHODS: Retrospective chart review of medical records of 2450 patients with diagnoses F4-F6 (ICD-10). Analyses of associations between dyspnea reported in a symptom checklist SCL-O and pathological scores in the Neurotic Personality Questionnaire were carried out using univariate and multivariate regression analyses with ORs and 95%CI estimated with licensed STATISTICA 13 (StatSoftPL) software, and R version 4.1.0, RStudio version 1.4.1717 software. RESULTS: Dyspnea was reported by 46.3% women and 36.6% men (14.5% and 10.1% respectively assessed it as severely burdensome). Univariate regression analysis revealed several significant associations between reporting dyspnea or its extreme intensity and pathological scores in the NPQ. Multivariate regression analyses in women confirmed the importance of impulsiveness and exaltation for dyspnea occurrence, and feeling of being dependent on the environment, demobilization, and narcissistic attitude for its extreme intensity. In men impulsiveness, sense of being in danger, irrationality, and ponderings were associated with the presence of dyspnea, and sense of being in danger and envy with its extreme intensity. CONCLUSIONS: Complaints of dyspnea were pretty frequent. Several personality traits measured by the NPQ questionnaire were predictors of their occurrence and feeling of extreme burden.

Polycystic Ovary Syndrome: Personality and Temperamental Characteristics.

Polycystic ovary syndrome (PCOS) is a common gynaecological/endocrine disorder that affects 5%-10% of women of reproductive age. Its association with psychiatric conditions is well known. This study aimed to evaluate personality, temperamental, and stress-related characteristics among PCOS patients by comparing them with a control group. We found that PCOS patients presented more pronounced features of type D personality and had higher NEO Five-Factor Inventory (NEO FFI) scores on neuroticism and lower NEO FFI scores on openness to experience and conscientiousness. On the Polish version of the Emotionality Activity Sociability Temperament Survey (EAS-D), PCOS patients reported higher emotionality-fear and lower activity than controls. The PCOS group also had higher scores on state anxiety and trait anxiety, using the State-Trait Anxiety Inventory (STAI) and Distressed Personality Scale (DS-14) questionnaires. These findings underline the importance of a multidisciplinary approach to the care of PCOS patients.

Neurotic symptoms profile in a day hospital patients with an anamnesis of head injury in the past. / Profil objawów nerwicowych u pacjentów dziennego oddzialu leczenia zaburzen nerwicowych z historia urazów glowy.

OBJECTIVES: The aim of the study was to assess the relationship between the occurrence of brain damage and symptoms of neurotic disorders, reported by patients of the psychotherapeutic day hospital for neurotic and personality disorders before starting treatment. METHODS: Analysis of the cooccurrence of neurotic symptoms with previous head or brain tissue damage. The trauma was reported in a structured interview (Life Questionnaire) completed before treatment in the day hospital for neurotic disorders. Illustrated with OR coefficients (odds ratios), the performed regression analyzes showed statistically significant correlations between brain damage (caused by brain trauma, stroke, etc.) and symptoms listed in the symptom checklist KO"0". RESULTS: In a group of 2,582 women and 1,347 men, some of respondents reported (in the self-completed Life Questionnaire) a previous head or brain injury. Men reported a history of trauma much more often than women (20.2% vs. 12.2%; p < 0.0005). Patients who had a history of head trauma obtained a significantly higher value of the global severity of neurotic symptoms (OWK) in the symptom checklist KO "0" than patients without head trauma. This applied to both the male and female groups. Regression analyzes showed a significant relationship between head injuries and the group of anxiety and somatoform symptoms. In both groups (men and women), ?paraneurological', dissociative, derealization, and anxiety symptoms occurred more frequently. Men more often reported difficulties in controlling the expression of emotions, muscle cramps and tension, obsessive-compulsive symptoms, skin and allergic symptoms, and symptoms of depressive disorders. Women more often reported vomiting when feeling nervous. CONCLUSIONS: Patients with a history of head injuries have a higher global severity of neurotic disorders symptoms than people without such history. Men experience head injuries more often than women, and the risk of developing symptoms of neurotic disorders is higher in men. It seems that patients with head injuries are a special group when it comes to reporting some psychopathological symptoms, especially in the group of men.

Time in the Mental Health Context: Neurotic Symptomatology, Defense Mechanisms and the Perception of Time Perspective Among Patients Diagnosed With Neurotic and Personality Disorders - A Clinical Study.

AIM: The main objective of the study is to explore relations between the time perspective, neurotic symptoms, anxiety, and defense mechanisms in the group of patients diagnosed with neurotic and personality disorders (ICD-10 groups: F4x, F60.x and F61) treated with group psychotherapy. The research is conducted on the theoretical basis of the Zimbardo and Boyd's Time Perspective Theory. METHODS: The study included 49 patients treated in the day ward for the Treatment of Neurotic Disorders and Behavioral Syndromes at the University Hospital. The measurement of the TP was performed with the Zimbardo Time Perspective Inventory. Patients also completed the State-Trait Anxiety Inventory and the Defense Style Questionnaire 40. The diagnosis was done by licensed psychiatrists and supported with the measures: Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006. RESULTS: Multiple regression analysis models showed that the four time perspectives (past negative, present fatalistic, present hedonistic, and future) are predicted in different variations by the level of anxiety state or trait and repertoire of used defense mechanisms (immature or mature). CONCLUSIONS: Considering the established bilateral correlations, change in the time perspective may constitute an important factor in the reduction of neurotic symptoms, possibly through changes in the repertoire of utilized defense mechanisms. However, there is also possible that altering neurotic symptomatology would alter time perspective. The assessment of the time perspective in patients with neurotic and personality disorders may provide useful data for the diagnosis and the monitoring of psychotherapy effectiveness. Based on the results of this study conducting further research on the role of the changes in the time perspective in the course of psychotherapy is recommended and necessary to expand the understanding of the relations observed in this study.