[Symptoms profile of mixed anxiety and depressive disorder]. / Profil objawów zaburzenia depresyjnego i lekowego mieszanego.

The paper describes symptoms of mixed depressive and anxiety disorder (ICD-10). The study was carried out in three medical dispensaries: two psychiatric (42 persons) and one primary care (62 persons). Patients with or without anxiety and depressive symptoms were included. Exclusion criteria was: psychoactive substance abuse, physical diseases affecting mental state, and mental disorders other than anxiety or mood disorders. A total of 104 patients (65 women and 39 men in mean age of 41.1 years) were inquired with General Health Questionnaire (GHQ-30), Global Assessment of Functioning (GAF) and diagnostic questionnaire based on Schedules for Clinical Assessment in Neuropsychiatry, Version 2.0. There was no pattern of symptoms specific for mixed disorder that could be a basis for operational criteria. The most frequent were symptoms of generalised anxiety disorder (GAD), depression and dysthymia. The most specific symptoms, selected using discriminant analysis were: (1) difficulty in concentrating, (2) feeling mentally tense, (3) feeling of hopelessness or despair, (4) shortening of breath, (5) lowered mood, (6) feeling dizzy, unsteady, faint, or light headed; (7) early waking up, (8) nightmares, (9) dry mouth, (10) hot flushes or cold chills, (11) frequent tearfulness. The results contribute to the concept that mixed depression and anxiety disorder is closely related to generalised anxiety disorder (GAD).

[Psychopathology of violent behavior in mental disorders]. / Zachowania gwaltowne w zaburzeniach psychicznych.

The frequency of violent behaviour in mental hospitals has been increasing in recent years. A number of factors may be responsible. Violent and dangerous patients are sent to hospitals, quite often against their will. This may lead to conflicts and assaults against the staff members. There are many factors, both in present situation and in biography, conductive to violent behaviour: unfavourable experiences in childhood (neglect, cruelty, sexual exploitation), psychopathic structure of premorbid personality, frustrations, and eventually deformations of world perception caused by psychotic symptoms. Various mental disorders may lead to the violent behaviour, but it is most frequently observed in exacerbation of paranoid schizophrenia, in young males, particularly in cases with systemized delusions, emotional turmoil and anger. Introduction of a person (nurse, physician, family member, other patient) into psychotic world may also lead to the attack. In particular cases it is difficult to foresee violent behaviour, but some indicators are known. There are very few investigations on the role of the staff in violent behaviour of patients. The danger may be brought by criticism, refusal and rejection, compulsory drug administration, undue limitations of the patient's liberty, or the opposite--no reaction to violations of institutional regulations. Psychopathology of the staff may also encourage the violent behaviour: inability to solve the transference and countertransference, reaction formation and denial are the most important. Fear exaggerates the feeling of danger and induces the staff members to avoid the patient, diminishing the possibility of influence and control of the patient's disturbed behaviour. Recurrent violent behaviour may be connected with brain pathology, so the modern diagnostic procedures may be indicated in such cases.

The reversibility of CT brain changes in alcohol dependence.

Control CT assessments of the brain of 15 alcohol dependent patients who showed an improvement in their clinical state were performed after a mean of 16 months. A partial decrease of the widening of cerebral sulci and the third ventrical was noticed. Also, the neuroradiological pictures of the vermis and cerebellum were seen to improve in most patients.

[Analysis of the reversibility of CT brain changes in alcohol dependent patient]. / Badania odwracalnosci zmian obrazu tomokomputerowego mózgowia chorych z zespolem uzaleznienia od alkoholu.

Control CT assessments of the brain of 15 alcohol dependent patients who showed an improvement in their clinical state were performed after a mean of 16 months. A partial decrease of the widening of cerebral sulci and the third ventrical was noticed. Also, the neuroradiological pictures of the vermis and cerebellum were seen to improve in most patients.

Clinical trial of hemodialysis in chronic schizophrenia.

The hemodialysis program was carried out in four male chronic schizophrenic patients hospitalized 3--12 months in the Psychiatric Clinic, Medical University, Wroclaw. The diagnosis was made independently by three psychiatrists. The disease lasted 5 to 26 years. The clinical assessment of mental and physical state followed each dialysis. The BPRS, CGI and Wing's Ward Behavior Scale were filled. Eleven to 20 dialyses were conducted once a week (two patients) or twice weekly (two patients). Neuroleptics were withdrawn. A short period of slight, unspecific improvement was followed by a deterioration in all cases, which made it necessary to put the patients back on neuroleptics. At the end of the dialysis program none of the patients improved. Further research on the efficacy of dialysis in chronic schizophrenia should be made before the final assessment of its value.