Deep brain stimulation of anterior nucleus and centromedian nucleus of thalamus in treatment for drug-resistant epilepsy.

INTRODUCTION: Drug-resistant epilepsy (DRE) remains poorly-controlled in c.33% of patients, and up to 50% of patients suffering from DRE are deemed not to be suitable candidates for resective surgery. For these patients, deep brain stimulation (DBS) may constitute the last resort in the treatment of DRE. STATE OF THE ART: We undertook a systematic review of the current literature on DBS efficacy and the safety of two thalamic nuclei-anterior nucleus of the thalamus (ANT) and the centromedian nucleus of the thalamus in the management of patients with DRE. A search using two electronic databases, the Medical Literature, Analysis, and Retrieval System on-line (MEDLINE) and the Cochrane Central Register of Controlled Trials (CEN-TRAL) was conducted. CLINICAL IMPLICATIONS: We found 30 articles related to ANT DBS and 13 articles related to CMN DBS which were further analysed. Based on the clinical research articles, we found a mean seizure frequency reduction for both thalamic nuclei. For ANT DBS, the mean seizure frequency reduction ranged from 48% to 75%, and for CMN DBS from 46.7% to 91%. The responder rate (defined as at least 50% reduction in seizure frequency) was reported to be 53.2-75% for patients after ANT DBS and 50-90% for patients after CMN DBS. FUTURE DIRECTIONS: ANT and CMN DBS appear to be safe and efficacious treatments, particularly in patients with refractory partial seizures and primary generalised seizures. ANT DBS reduces most effectively seizures originating in the temporal and frontal lobes. CMN DBS reduces mostly primary generalised tonic-clonic and atypical absences and atonic seizures. Seizures related to Lennox-Gastaut syndrome respond very favourably to CMN DBS.

Feelings of loneliness and meaning in life in subjects with Asperger's syndrome: a pilot study.

Subjects with Asperger's syndrome without intellectual disabilities have significant difficulties in establishing social relationships despite their IQ being within the normal range. One of the effects of social deficit is depression. The question arises whether loneliness and dimensions of meaning in life correlate with the severity of depression and whether the average severity of depression, loneliness and dimensions of meaning in life differentiate the following groups: people with Asperger's syndrome and depression, people with Asperger's syndrome without depression, people with depression without Asperger's syndrome and healthy subjects. The study was conducted on a total of 170 people, including: 43 people with Asperger's syndrome and depression, 41 people with Asperger's syndrome without depression, 40 people with depression without Asperger's syndrome and 46 healthy people (without Asperger's syndrome and without depression). All were administered a demographic survey, Beck Depression Inventory II (BDI-II), De Jong Gierveld Loneliness Scale, Life Attitude Profile-Revised. Asperger's syndrome and depressive episodes were diagnosed on the basis of ICD-10 research criteria still applicable in Poland. In the group with Asperger's syndrome and depression the highest levels of loneliness and the lowest values of the dimensions of the sense of meaning in life, except for the acceptance of death, were observed. This result was significantly different from the results obtained in the other study groups. Both in people with Asperger's syndrome without depression and in people with depression without Asperger's syndrome, the values of the dimensions of the sense of meaning in life and the level of loneliness differ significantly from the results obtained in the control group. The BDI-II scores correlated positively with the loneliness values and negatively with the sense of meaning in life values in all groups. The results indicate that both suffering from depression and having Asperger's syndrome are associated with an increased sense of loneliness and a reduced sense of meaning in life. People with Asperger's syndrome and depression have the highest values of loneliness and the lowest values of dimensions of the sense of meaning of life compared to the other groups studied. The limitation of the work is the deliberate selection of groups, because it would be interesting to answer the question whether Asperger's syndrome is a risk factor for depression in the population.

THE FEELING OF LONELINESS IN SOMATIC DISEASES AND MENTAL DISORDERS AS A NEW CHALLENGE OF MODERN MEDICINE.

The aim of the paper to reflect on the meaning of the sense of loneliness caused by illness. The work is a selective narrative review with particular emphasis on attempts to define the feeling of loneliness, as well as the results of own research. The problem of loneliness affects not only patients, but also their families and caregivers. As it follows from the literature review, the issue of loneliness has been much better studied in mental disorders than in somatic diseases. In addition, the analysed research shows that the presence of the disease is the main variable determining the feeling of loneliness in the population of people in late adulthood. The feeling of loneliness turns out to be a key element of the psychosocial aspect of any disease. Therefore, it would be necessary to consider in the future how this adverse psychosocial phenomenon could be prevented.

The Association between Personality Factors and Metabolic Parameters among Patients with Non-Alcoholic-Fatty Liver Disease and Type 2 Diabetes Mellitus-A Cross-Sectional Study.

BACKGROUND: The increasing prevalence of type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) states a serious problem for public health. The introduction of effective methods of treatment and prevention is crucial to avoid complications of these diseases. Among them, we can specify psychological factors that affect everyday life and determine the patient's attitude towards therapy, and what follows, their compliance in treatment. The literature indicates these connections in various ways; in our study, we extend this view to include a broader perspective of human personality. OBJECTIVE: We decided to investigate the associations between personality factors and metabolic parameters in patients with NAFLD and T2DM in order to better understand the patient's approach to the treatment of a chronic disease, such as those mentioned, and to establish the basis for further research implementing psychological interventions in the treatment of NAFLD and T2DM. METHODS: One hundred participants with NAFLD and T2DM underwent blood tests and anthropometric measures. Each of them was asked to complete five questionnaires evaluating their personality properties. RESULTS: We revealed that a rise in body mass index is related to a fall in the emotional intelligence factor of utilizing emotions, and a rise in emotional perception. The decrease in task-oriented coping style and a rise in emotion-oriented coping style are associated with a waist-hip ratio increase. The increase in fasting plasma glucose is predicted by a decrease in task-oriented coping style score. A fall in social diversion coping style score is associated with a high-density lipoprotein increase; in turn, a triglycerides increase is connected with a decline in rhythmicity score. CONCLUSIONS: The personality factors are in relationship in the management of NAFLD and T2DM. They affect a patient's approach to treatment, which is very important, because we know lifestyle and dietary interventions are an important part of the treatment of these diseases. The compliance manifests by lifestyle modifications, taking medications regularly, measuring blood glucose, and inspection visits in outpatients' clinics are a large part of a diabetic's life. Future studies introducing psychological intervention to improve, e.g., coping styles or rhythmicity are needed to implement new methods of patient management.

Type 2 Diabetes Mellitus, Non-Alcoholic Fatty Liver Disease, and Metabolic Repercussions: The Vicious Cycle and Its Interplay with Inflammation.

The prevalence of metabolic-related disorders, such as non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (DM2), has been increasing. Therefore, developing improved methods for the prevention, treatment, and detection of these two conditions is also necessary. In this study, our primary focus was on examining the role of chronic inflammation as a potential link in the pathogenesis of these diseases and their interconnections. A comprehensive search of the PubMed database using keywords such as "non-alcoholic fatty liver disease", "type 2 diabetes mellitus", "chronic inflammation", "pathogenesis", and "progression" yielded 177 relevant papers for our analysis. The findings of our study revealed intricate relationships between the pathogenesis of NAFLD and DM2, emphasizing the crucial role of inflammatory processes. These connections involve various molecular functions, including altered signaling pathways, patterns of gene methylation, the expression of related peptides, and up- and downregulation of several genes. Our study is a foundational platform for future research into the intricate relationship between NAFLD and DM2, allowing for a better understanding of the underlying mechanisms and the potential for introducing new treatment standards.

Comparing chronic obstructive pulmonary disease and depressive disorder in terms of inflammation-related biomarkers.

Introduction: Chronic obstructive pulmonary disease (COPD) is characterized by the presence of depressive symptoms. Methods: Cytokine and deiodinase iodothyronines (DIOs) levels were evaluated in COPD patients and patients diagnosed with depressive disorder and control individuals. using enzyme-linked immunosorbent assays. Results: Interleukin 1ß (IL-1ß), and tumor necrosis factor-α (TNF-α) levels were higher in COPD and depression patients than in control individuals. DIO2 were significantly lower in COPD and recurrent depressive disorder (rDD) patients than in controls. Conclusions: Changes in the levels of IL-1ß, TNF-α and DIO2 in COPD patients may explain the presence of depression in COPD patients.

The Relationship between Selected Factors (Temperament, Bipolar Traits, Sleep Quality, Severity of Addiction) and Depressive Symptoms in Alcohol-Dependent Men.

Clinical and epidemiological studies have demonstrated a relationship between alcohol addiction and mood disorders. Alcohol-dependent patients with depression tend to demonstrate clinically more severe manic symptoms, which complicates the process of diagnosis and therapy. However, the predictors indicating the risk of mood disorders in addicted patients remain unclear. The aim of the study was to examine the relationship between personal dispositions, bipolar traits, depth of addiction, quality of sleep, and depressive symptoms in alcohol-dependent men. The study group comprised 70 men (age M = 46.06, SD = 11.29) diagnosed with alcohol addiction. The participants completed a battery of questionnaires: BDI, HCL-32, PSQI, EPQ-R and MAST. The results were tested using Pearson's correlation quotient and general linear model. The findings indicate that some of the studied patients are likely to have mood disorders of clinically significant severity. High neuroticism and poor sleep quality are independent predictors of depressive symptoms in alcohol-dependent patients. Among the components of sleep quality, problems with falling asleep and waking up at night appear to be most strongly associated with depressive symptoms. The intensity of depressive symptoms may relate to the intensity of certain bipolar features, such as risk-taking activity and irritability. High neuroticism and poor sleep quality are independent predictors of depressive symptoms in the studied group.

The Structure of Temperament in Caregivers of Patients with Schizophrenia.

The onset of schizophrenia symptoms usually occurs in early youth. As a result, the parents of these patients usually become their caregivers. The role of a caregiver for a person with schizophrenia is a considerable mental and physical burden. Therefore, an interesting issue is what motivates these people to take up this challenge. It is probable that, apart from the moral imperative or kinship, the factor determining this decision is the personality structure of the caregiver. The aim of our study was to compare the structure of temperament (according to the model of temperament as formal characteristics of behavior developed by Jan Strelau) in caregivers of young adults (age 18-25 years) with schizophrenia with the structure of temperament of parents of healthy young adults still living in the family home under their care. The study group consisted of 64 people (51 women), who were taking care of young adults (aged 18-25 years) with schizophrenia, while the control group (53 people, 42 women) consisted of parents of healthy adults still living in the family home. Both groups were asked to complete a questionnaire of the authors' own design on their demographic data as well as The Formal Characteristics of Behavior-Temperament Inventory to assess the temperament traits. The results were given in the number of points obtained on average in each dimension. Both groups did not differ in terms of size and age, with women predominating. Caregivers of young adults with schizophrenia had higher values of briskness (43.22 ± 4.45 vs. 42.90 ± 3.98, p = 0.032), emotional reactivity (46.02 ± 4.39 vs. 41.01 ± 3.12, p = 0.012) and activity level (44.01.89 ± 4.15 vs. 37.59 ± 4.77, p = 0.022) compared to the control group. The remaining dimensions of temperament: perseverance, sensory sensitivity, rhythmicity, and endurance did not differentiate between the two groups. The temperament structure of caregivers of young people with schizophrenia differs from the temperament structure of caregivers of healthy adults. Caregivers of sick people have higher values of briskness, emotional reactivity, and activity level compared to the control group.

The feeling of loneliness and the sense of meaning in life in patients with various levels of bronchial asthma control.

Background: Previously our team has proved bronchial asthma to be associated with a higher incidence of depression than in the healthy population, and that the severity of depression correlates with the severity of asthma symptoms. However, both, the sense of loneliness and the sense of the meaning of life have been little explored by research in the context of this disease so far.Objective: To compare loneliness and meaning of life among asthmatic patients with healthy individuals and assess the relationship of those constructs to the degree of asthma control.Methods: The level of asthma control was assessed according to the Asthma Control Test (ACT), the feeling of loneliness to the De Jong Gierveld Loneliness Scale (DJGLS), and the sense of life to Life Attitude Profile - Revised (LAP-R). Scores were compared between healthy adults and asthma patients and related to asthma control. All models were adjusted for sex and age.Results: The DJGLS score was higher among patients with asthma compared to healthy adults. All the scores measured by LAP-R except for the Existential Vacuum were higher in controls. Loneliness measured by DJGLS was negatively correlated with the degree of asthma control. Choice/Responsibleness was positively, while the Personal Meaning Index score negatively correlated with the ACT score. In the models including LAP-R and DJGLS, only loneliness was associated with asthma control.Conclusion: Loneliness is significantly related to both the development of asthma and the degree of asthma control.

The sense of loneliness and meaning in life in post-COVID convalescents-a preliminary study.

Introduction: The COVID-19 epidemic has provided opportunity to study the impact of a well-defined severe illness on the development of a depressive episode and the associated sense of loneliness and lack of meaning in life. Materials and Methods: The aim of the study was to assess the occurrence of a reactive depressive episode, the severity of depression, a sense of loneliness and meaning in life in subjects who approximately a year earlier than the date of the study had suffered from a pulmonary form of SARS-CoV-2 infection with radiologically documented interstitial lesions of the lungs, requiring and not requiring hospitalization compared to people who did not develop the disease as a result of infection with that virus. The study included 63 subjects hospitalized for pulmonary lesions, 67 not hospitalized and 60 healthy controls. The severity of depressive symptoms was measured using a Polish-language standardized version of the Beck Depression Inventory, a sense of loneliness using the De Jong Gierveld Loneliness Scale, and a sense of meaning in life using the Life Attitude Profile-Revised. Results: The frequency of depression and its severity were found to be the highest in hospitalized patients compared to those treated at home and healthy people. A significant difference in the frequency of depression and its severity between outpatients and healthy people was also observed. The feeling of loneliness turned out to be greatest in the group of hospitalized people. Also, the severity of loneliness was found to be higher in the outpatient compared to the control group. The sense of meaning in life reached its lowest level among hospitalized patients, was moderately reduced in the outpatient group, and typical of the Polish population in the control group. Discussion: Both pulmonary SARS-CoV-2 infection and hospitalization have been shown to be a risk factor for depression, increased feeling of loneliness and a reduced sense of meaning in life. The effect of trauma and the presence of depression can be the explanation for the increased sense of loneliness after the illness and the partial breakdown of the lifeline manifested by a decrease in the sense of meaning in life.

Being an adult sibling of an individual with autism spectrum disorder may be a predictor of loneliness and depression - Preliminary findings from a cross-sectional study.

Background: The aim of this study is to compare depression and loneliness among adult siblings of people on the autism spectrum, adult siblings of normotypic individuals, and adults raised alone (only child). In recent years, an increasing interest in the perspective of siblings of children diagnosed with autism has been observed, with studies among this population particularly concerned with the developmental trajectories of children and adolescents at "high risk" for ASD, rarely focusing on their mental well-being. Methods: The respondents filled out: the survey on sociodemographic data designed by the authors, Beck Depression Inventory II (BDI, measure of depression), and De Jong Gierveld Loneliness Scale (DJGLS, assessment of loneliness). Results: A rise in BDI and an increase in the DJGLS score were predicted by having a sibling diagnosed with ASD. Those effects were independent of subjects' sex, educational status, place of residence, or a number of siblings. Conclusion: The results underline a fundamental need for the development of mental hygiene programs for families where children with autism spectrum are accompanied by healthy siblings.

The Association between Depression and Perceived Stress among Parents of Autistic and Non-Autistic Children-The Role of Loneliness.

Having an autistic child significantly impairs the functioning of the family, including the wellbeing of the parents. The aim of this study was to assess whether loneliness mediates the relationship between perceived stress and the severity of depressive symptoms in the studied sample of parents. This cross-sectional study involved 39 parents of autistic children and 45 parents of non-autistic children. They completed a set of tests: a survey on sociodemographic and clinical data and psychometric questionnaires, i.e., Beck Depression Inventory II (BDI), De Jong Gierveld Loneliness Scale (DJGLS), and Perceived Stress Questionnaire (KPS). A rise in external and intrapsychic stress, independently, was linked to a rise in the severity of depressive symptoms. The severity of depression, loneliness and stress was higher among parents of autistic children compared with parents of non-autistic children. Intrapsychic stress exhibited an indirect effect through loneliness on the worsening of depressive symptoms.

The Association between Temperament, Chronotype, Depressive Symptoms, and Disease Activity among Patients with Inflammatory Bowel Disease-A Cross-Sectional Pilot Study.

The psychological aspect may play an important role in ulcerative colitis (UC) and Crohn's disease (CD). The aims of this study were to explore the differences between patients with UC and CD regarding chronotype, temperament and depression, and to assess the psychological factors mentioned as predictors of disease activity. In total, n = 37 patients with UC and n = 47 patients with CD were included in the study. They underwent a clinical assessment, including the Mayo score or Crohn Disease Activity Index (CDAI), and completed questionnaires: a sociodemographic survey, Formal Characteristics of Behavior-Temperament Inventory (FCB-TI), Chronotype Questionnaire (CQ), and the Beck Depression Index II (BDI). The Sensory Sensitivity score was higher among patients with CD than UC (p = 0.04). The emotional reactivity and endurance scores were higher among women than men with CD (p = 0.028 and p = 0.012 respectively). CQ Morningness-Eveningness (ME) correlated with Endurance (p = 0.041), Emotional Reactivity (p = 0.016), and Activity (p = 0.004). ME correlated with Rhythmicity among CD patients (p = 0.002). The Mayo score was predicted by Perseverance. The CDAI score was predicted by the BDI score. The pattern of the relationship between chronotype and temperament may differentiate patients with UC and CD. Personal disposition may play a role in the clinical assessment of patients with IBD.

Lonely in the City-Sociodemographic Status and Somatic Morbidities as Predictors of Loneliness and Depression among Seniors-Preliminary Results.

Up to a third of the population of older adults has been estimated to suffer from feelings of loneliness, which is considered a risk factor of depression. The aim of this paper is to compare the perceived level of loneliness and depression in seniors living in the country and in the cities and assess somatic morbidity and sociodemographic status as predictors of loneliness and depressiveness. n = 92 older adults in primary care units filled out a set of questionnaires: authors' survey on sociodemographic data and morbidities, Beck Depression Inventory II (BDI, to measure depressiveness) and De Jong Gierveld Loneliness Scale (DJGLS, to assess loneliness). There was a strong, positive and statistically significant correlation between the BDI and DJGLS scores (R = 0.855, p < 0.001). City residents had on average higher BDI and DJGLS scores. Linear regression models were constructed to predict BDI and DJGLS scores. The set of statistically significant predictors were similar for BDI and DJGLS. Sociodemographic status and somatic morbidities accounted for around 90% of variance of depressiveness and loneliness scores in the studied group. Living alone was found to be the strongest relative predictor of both loneliness and depressiveness in the studied sample of the older adults. Our current results suggest that there might be a need to improve social support in the late adulthood as an intervention to diminish the sense of loneliness and depressiveness.

The apotheosis of intellectual disability in fictional literature.

Purpose: Intellectual disability is an extremely complex phenomenon and can therefore be considered on the basis of either intellectual malfunction patterns and adaptability disorders, or in the optics of the socio-cultural construct. The ephemeral truth about the essence of the phenomenon of intellectual disability is formulated in a fluid and dynamic way at the border of culture and biology which justify the fact of analyzing it on the field of medical humanities. The broad perspective of the view of the phenomenon outlined in the first part of the paper provides the basis for understanding the image of a character with intellectual disabilities in fictional literature. The primary objective of the research was to get to know and understand the apotheosis of intellectual disability in selected works of fine literature. Views: Basis assumptions of the hermeneutic method were applied in this research. Hermeneutics is a specific methodology on literary grounds, as it does not provide the user with ready-made techniques or tools for text analysis, emphasizing the lack of universal means of deciphering the meanings of literature. The meaning of the text becomes a reference developed by interpretation, which is a question of the hypotheses generated by the recipient. The area of analysis consists primarily of the categories of wisdom and good outlined in the silhouettes of the presented literary heroes. Conclusions: As a result, characteristic ways of understanding wisdom and good in relation to characters with intellectual disabilities were identified, and thus the image of apotheosis was outlined.

Music therapy and psychotherapy as non-pharmacological methods supporting therapy in medicine - similarities and differences.

Non-pharmacological methods such as music therapy and psychotherapy are increasingly used in psychiatry and somatic medicine as adjuvant therapies. This trend is due to the crisis of scientific knowledge, the development of postmodern philosophy and the existential confusion of the man. Also, shifting the treatment from hospitals to the social environment of the patient creates an area and provides an opportunity for non-pharmacological methods of therapy. Unlike pharmacological therapy, the effectiveness of psychotherapy and music therapy in particular has not been extensively investigated. This is due both to the lack of financial resources to be assigned for such studies and to the impossibility to evaluate the effectiveness of these therapies using the double-blind method. The lack of strong evidence of the effectiveness of nonpharmacological therapies often results in the omission of these methods in the treatment and the risk of application of ineffective or harmful methods. Only cognitive behavioral therapy has been supported by a fairly reliable assessment of effectiveness, due to the care of the community of professionals associated with this trend for scientific evaluations. In music therapy, like in psychotherapy, we have the phenomenon of setting, transference, countertransference and resistance. In both methods, therapeutic contact is included and determines the framework duration of the therapy. The language of music therapy is much less unambiguous and yielding much more possibilities of interpretation than the language of psychotherapy. Both these areas of therapy, however, are intersecting, and it is impossible to delineate a border between them. Further research into the effectiveness of these evolving methods is all the more necessary as the growing crisis of trust in science, the lack of new effective medications and the dominance of postmodern concepts in public discourse increasingly draw attention to the environmental context of the disorders, their social nature and the possibility of therapy in the social environment of the patient away from the excessive number of medical procedures.

The paradigms of contemporary psychiatry.

Psychiatry is a medical discipline that uses to the equal extent biological sciences as well as humanities and social sciences. Among specialists, the division into the so-called humanistic and biological psychiatrists is still maintained. The paper is an attempt of a paradigmatic approach to contemporary clinical and theoretical psychiatry.The humanistic paradigm of psychiatry presumes that every psychological and behavioral disorder is a social construct. It depends on culture whether the specific phenomenon is classified as a norm or a pathology. In the biological world, we have only certain phenomena, and their pathologization and depathologization are a product of culture.The neurocognitive paradigm of psychiatry assumes that the functioning of the brain is responsible for the development of mental disorders. Such disorders may be neurodevelopmental, functional or neurodegenerative in nature. In addition, psychopathology, although it derives from tradition, benefits nowadays from the apparatus of conceptual cognitive psychology and cognitive science. Our attempt to systematize the paradigmatic fundamentals of psychiatry is the first attempt at systematization of the foundations of modern psychiatry with an indication of its distinctiveness from other medical sciences.

Type D personality and the degree of control of bronchial asthma.

INTRODUCTION: Poor asthma control is probably associated with both biological and psychological factors. Type D pattern of behavior is characterized by negative emotionality and inhibition in social relationships. It was previously found to be associated with cardiovascular diseases. AIM: To evaluate the correlation between the degree of asthma control and the severity of the components of type D behavior pattern. MATERIAL AND METHODS: The research was conducted on a group of 117 subjects with bronchial asthma. The control group consisted of 32 healthy subjects. The degree of bronchial asthma control was determined using the Asthma Control Test. The D pattern of behavior was measured using the DS-14 questionnaire. RESULTS: The risk of type D behavior pattern, defined as scoring at least 10 points in both scales (Negative Emotionality and Social Inhibition), was higher in subjects with uncontrolled asthma than in healthy individuals (OR = 5.19; 95% CI: 1.74-15.44), those with partial control of asthma (OR = 6.04; 95% CI: 1.87-19.52) and subjects with good control of asthma (OR = 8.46; 95% CI: 3.09-23.16). The severity of depressiveness correlated positively with the number of infections in the past year. Negative emotionality correlated positively with the number of infections and social inhibition. CONCLUSIONS: Type D pattern of behavior may be associated with diagnosis and severity of asthma. Due to its link to poor control of asthma symptoms, a high level of negative emotionality among patients with asthma might be of particular interest to the clinicians.

[Inadequacy of the paradigms of special education to subjects with severe and profound grade intellectual disability - the need for pragmatic realism in psychiatry and special pedagogy]. / Nieadekwatnosc paradygmatów pedagogiki specjalnej wobec osób z niepelnosprawnoscia intelektualna w stopniu znacznym i glebokim ­ potrzeba pragmatycznego realizmu w psychiatrii i pedagogice specjalnej.

People with severe and profound grade disabilities are the subject of interest in psychiatry, clinical psychology and special pedagogy. Unfortunately, the paradigmatic approach to special education based on postmodern philosophy is in contrast to the biomedical approach that is based on the positivist and Cartesian models. The paper is an attempt to systematize the similarities and differences between the humanistic approach and the modern biomedical model, which, despite the apparent differences, do not differ so much from each other. Work with a person disabled intellectually in the severe or profound degree is governed by the principles of methodical realism, taking into account to an equal extent the principal deficits, the concomitant diseases, limitations and the social context. The deeper the impairment and disability is, the smaller is the role of the humanistic paradigm in work with the client in the medical management and educational process. Changing the paradigms of special pedagogy has drawn attention to the social context of disability, separating, however, special pedagogy from modern medicine and psychology, cognitive-oriented and psychometry-based. The postmodern paradigm has become an ideology, which makes it difficult to work with deeply disabled people. Only the multidirectional approach including a variety of paradigms makes it possible to provide integrational aid to people with severe and profound grade intellectual disabilities. Working with such a disabled person should take into account equally the biomedical and humanistic aspects.

[The case of an adult man with savant syndrome in the course of autism spectrum disorder]. / Przypadek doroslego mezczyzny z zespolem sawanta w przebiegu spektrum autyzmu.

The paper reports on a case of 57-year man with autism spectrum disorder and epilepsy with an unusual feature of calendar calculation. Namely, this is the case of savant syndrome, which appears rarely in the course of various neuropsychiatric disorders. Commorbidity of epilepsy and autism particularly predispose to the aforementioned syndrome. In the presented case, apart from the calendar calculation, the man has high language abilities. As previous studies suggest, the extraordinary abilities among persons with savant syndrome works similarly to the language module in healthy persons. Savant syndrome may appear in any patient with neuropsychiatric disorders, particularly in those suffering from autism spectrum disorder with comorbid epilepsy.