2011; 13, 2

ARCHIVES OF PSYCHIATRY AND PSYCHOTHERAPY
VOLUME 13 ISSUE 2 June 2011

CONTENT

5 Initial glycine serum level is not a predictor of the recovery resulting from glycine augmentation of antipsychotic treatment
Dominik Strzelecki, Olga Kałużyńska, Olga Józefowicz, Tomasz Pawełczyk, Jolanta Rabe-Jabłońska
Summary
Glycine is a non-competitive NMDA co-agonist of an ionotropic NMDA receptor in the glutamate system. Beneficial effects of this amino acid on primary negative symptoms of schizophrenia were revealed in the literature. The main research hypothesis assumes the existence of a relationship between negative symptoms of schizophrenia and serum glycine concentration.
Aim. The aim of the study is finding a relationship between the initial glycine serum concentrations together with changes in concentration of this compound and severity of schizophrenia symptoms (in PANSS) and selected cognitive functions as a result of application of glycine at a dose of 0.8g/kg/day orally added to the existing antipsychotic treatment.
Method. A group of 28 individuals with schizophrenia with predominantly negative symptoms completed a 6-week open-label prospective study. The patients received oral glycine (60g/day) in parallel with the existing antipsychotic treatment At the beginning and end of the study serum glycine levels were measured and the severity of the symptoms of schizophrenia using PANSS and cognitive functioning (using Wisconsin Card Sorting Test, Trail Making Test and Stroop Test) were assessed.
Results. From the data, obtained on two check-ups before and after the 6 weeks of glycine application, no significant correlations between serum glycine concentrations and either the PANSS score (subscales assessing positive and negative symptoms, general psychopathology and a total score) or the cognitive battery results were found excluding a correlation between the increase in the glycine concentration and the reduction in the number of errors in the second part of the Trail Making Test (TMT).
Conclusion. Measurements of serum amino acid concentrations do not allow direct assessment of severity of disease symptoms or resulting improvement. Unfortunately, the initial serum glycine concentration may not be used as a predictor of the improvement resulting from augmentation of antipsychotic treatment with glycine. The results obtained in the whole PANSS scale and in its subscales suggest beneficial effects of glycine in the applied dose on the psychopathology of schizophrenia.
key words: schizophrenia / negative symptoms / glycine /NMDA / glutamic acid / glycine / serum concentration

13 Factor structure of symptoms in the Kraków Depression Inventory KID IO “C1”
Renata Modrzejewska, Jacek Bomba, Andrzej Beauvale
Summary
Aim. The aim of this article is partial empirical verification of the depression image theoretical concept underlying the KID IO “C1” construction, and also, a check of the questionnaire’s factor relevancy.
Material. KID results of a study of an untreated population sample of 17-year-olds were analysed statistically. Out of 1823 questionnaires, 1349 were included in the analysis (560 filled in by boys and 789 girls by girls). Of these, 499 respondents received a screening diagnosis of depression. 474 sheets were rejected at random to standardise the distribution of the overall scale results. In search of the presence of a general factor and to verify the legitimacy of the division of depressive symptoms according to the clinical criterion, factor analyses were conducted using the principal components method with oblimin, quartimax and varimax rotations separately and jointly for both sexes.
Results. The following new factors were identified: I – pessimism, II – mood instability, III – difficulty in learning, IV – self-destruction, V – fear of the future, VI – eating problems.
Conclusions. The analyses conducted only partially confirm the validity of a clinical-picture based questionnaire. A non-compliance of a number of factors with the assumed questionnaire scales emerges. A non-uniform symptomatic depression image in late adolescence phase is confirmed. Two factors stand out decidedly: self-destructive behaviours and eating problems.
key words: adolescent depression / Kraków Depression Inventory (KID) / factor analyses

21 A psychological diagnosis of the structure of the body self in a group of selected young Polish females without eating or other mental disorders
Bernadetta Izydorczyk
Summary
Aim. The main aim of this research was to describe psychological characteristics contributing to a variety of ways of experiencing and perceiving one’s own body in a group of selected young Polish females revealing no eating disorders (anorexia or bulimia nervosa, psychogenic binge eating, obesity or overweight) or other mental disturbances.
Method. The Eating Disorder Inventory (EDI) devised by Garner, Thompson’s Body Dissatisfaction Inventory, and projective techniques - Thompson’s Silhouette Test and a thematic drawing: “body image”. 100 females aged 20–26 participated in the research.
Results. Statistical analysis of the data obtained as a result of this research allowed to distinguish three significantly different clusters (types) in the group of 100 examined females and to make a psychological diagnosis of the body self characteristics in a population of selected females. Three types of psychological profile were distinguished among the examined subjects demonstrating significantly different strength levels of the body self components.
Conclusions. A psychological diagnosis of the types of body perception and body-related experiences can support prophylactic activities aimed at preventing eating disorders, and facilitate the process of detecting the risk factors behind eating disorders in the population of adolescent girls and young Polish women.
key words: body self / body image / psychological diagnosis / females without mental disturbances

31 Body self-perception in subjects beginning a three-month multifaceted group weight loss programme
Wojciech Gruszka, Magdalena Olszanecka-Glinianowicz, Piotr Kocełak, Tomasz Wikarek, Piotr Dąbrowski, Zbigniew Mucha, Barbara Zachorska-Markiewicz
Summary
Aim. Disturbances of body self-perception may lead to eating disorders such as anorexia nervosa and obesity. This self-perception is one of the most important factors influencing the decision to begin weight reduction therapy. The aim of this study was to assess self-perception of subjects that became involved with a multifaceted group weight loss programme.
Material and methods. The study group involved 80 obese subjects starting a three month multifaceted group weight loss programme (age 41.8±11.9 years, BMI 35.7±5.3 kg/m²). At the commencement of the first meeting, body self-perception was assessed using the Figure Rating Scale adapted by Stunkard’s (FRS), followed by anthropometric measurements and BMI calculation. The figures corresponding to the calculated BMI were compared with the figures selected by the participants using the FRS scale.
Results. In 78.7% (n=63) of subjects, body self-perception was parallel to BMI. Whereas in the remaining 21.3% (n=17) of subjects, body self-perception differed from the BMI. Seven subjects visualised their own figure as more obese and 10 subjects perceived their own figure as less obese. The increased disturbance of body self-perception correlated positively with age, body mass, and BMI (r=0.32, p=0.005; r=0.30, p=0.01 and r=0.34, p=0.01, respectively).
Conclusion. Body self-perception in the majority of obese subjects beginning a multifaceted group weight loss programme is accurate. Increased disturbance in self-perception of obesity corresponds with increases of age, body mass, and BMI.
key words: self-perception / obesity / Figure Rating Scale

37 Association between attitudes towards body image, negative emotions about one’s own body and self-state representations in a clinical sample of eating disordered women
Anna Brytek-Matera, Lony Schiltz
Summary
Aim. The purpose of the study was to assess the body image disturbance in patients with eating disorders.
Methods. The clinical samples include 25 women with anorexia nervosa, 25 with bulimia nervosa and 30 normal weight women. All participants were assessed with the Body Attitude Test, the Body Dissatisfaction Scale and the Contour Drawing Rating Scale and their clinical and sociodemographic features were recorded.
Results. In patients with anorexia ideal self, that is one’s representation of the attributes that someone would like the person to possess (the patient’s perspective), is less pathological compared to the patients with bulimia. However, the ought self, that is, one’s representation of the attributes that someone believes the person should possess (the perceived perspective of family and friends), is more pathological in group with anorexia nervosa.
Conclusions. The correlations between the examined variables of body image, as well as the results of a structural analysis using PRINCALS, were interpreted at the light of the state-of-the-art in body image disturbance. Results are discussed on the background of social comparison literature.
key words: body image disturbance / self-discrepancy / anorexia nervosa / bulimia nervosa

45 The authorial model of the therapy used in night terrors and sleep disorders in children
Małgorzata Talarczyk
Summary
Aim. The article describes the authorial model of the therapeutic work with children and their families used in night terrors and sleep disorders in children.
Methods. The reported symptoms concerned children 7 to 12 years old and were based on difficulties in falling asleep without the physical proximity of a parent or waking up at night and the reported anxiety as well as the need of the presence of a parent. The presented model of psychotherapy was worked out by the author on the basis of many years of clinical practice as well as searching for a possibly quick form of helping both children and their parents. The psychotherapy was conducted with 15 families in the form of a family therapy in the systemic approach and an individual therapy with a child conducted in the cognitive-behavioral approach.
Results. In all 15 families, in which the described model of psychotherapy was conducted, the symptoms of night terrors and sleep disorders in children subsided.
Conclusions. The authorial model of the therapy with the use of a “night link” may be an example of an integrative therapy within the framework of which the remission of symptoms was only possible due to connecting individual and family interactions.
key words: night terror / sleep disorders / psychotherapy

53 Comorbidity of aspirin-induced asthma and panic disorder versus gender and presence of profound psychological traumas
Anna Potoczek
Summary
Background. The author examined psychiatrically a group of 100 ambulatory patients with aspirin induced asthma (AIA). The special interest of the study was the careful analysis of the presence of panic disorder (PD) and time, context and content of different psychological traumas that the patients had throughout their lives.
Methods. 100 consecutive adults with confirmed, physician-diagnosed aspirin-induced asthma underwent psychiatric interview and assessment using M.I.N.I 5.0, Panic And Agoraphobia Scale (PAS) and Life Inventory. Psychiatric assessment was performed by experienced liaison psychiatrist according to ICD-10 and DSM-IV diagnosis. Aspirin-induced asthma presence was assessed by pulmonologist according to NHLBI/NAEPP 2007.
There were 66 women (66%) and 34 men (34%). The average age was 52.7 (SD=12.3) for women and 48.8 (SD=13.0) for men.
Results. In the group of 100 patients with asthma, women were majority (66%) with higher level of anxiety symptoms than men. It may be due to specific trauma of suffering and/or death of emotionally close person, which occurred in adulthood. This kind of trauma may have impact on the development of panic disorder. Women are more exposed to this sort of trauma due to their social role.
Conclusions. It is possible, that psychological traumas affect the development, course and severity of anxiety symptoms in asthmatic patients.
key words: asthma / panic disorder / depression / gender / trauma

59 Gender and presence of profound psychological traumas versus the presence and intensity of panic disorders in difficult and severe asthma and aspirin-induced asthma of different severity
Anna Potoczek
Summary
Background. The author examined psychiatrically a group of 106 patients with difficult asthma and 100 patients with aspirin-induced asthma of different severity. The special interest of the study was the careful analysis of the time, context and content of different psychological traumas that the asthmatic patients from both groups had throughout their lives.
Methods. 106 consecutive adults with confirmed, physician-diagnosed difficult asthma and 100 patients with aspirin-induced asthma underwent psychiatric interview and assessment using M.I.N.I 5.0 and Panic And Agoraphobia Scale (PAS). Psychiatric assessment was performed by experienced liaison psychiatrist according to ICD-10 and DSM-IV diagnosis. Difficult and aspirin-induced asthma presence was assessed by pulmonologist according to NHLBI/NAEPP 2007.
In difficult asthma group there were 78 women (74%) and 28 men (26%). The average age was 51.3 (SD=14.5) for women and 47.5 (SD=12.7) for men. In aspirin-induced asthma group there were 66 women (66%) and 34 men (34%). The average age was 52.7 (SD=12.3) for women and 48.8 (SD=13.0) for men.
Results. In both groups of asthmatic patients women were majority (74% with difficult asthma and 66% with aspirin-induced asthma) with higher level of panic disorder symptoms than men. It may be due to specific trauma of suffering and/or death of emotionally close person, which occurred in adulthood. This type of trauma may have an impact on the aetiology of panic disorder. Women are more exposed to this sort of trauma than men due to their social role.
Conclusions. It is possible, that psychological traumas affect the development, course and severity of panic disorder in asthmatic patients. They may play a special role in development of difficult asthma.
key words: asthma / panic disorder / gender / trauma

67 The participation of patients with schizophrenia in psychoeducation – the analyses from the patient’s perspective
Małgorzata Chądzyńska, Katarzyna Charzyńska
Summary
Aim. The aim of this study was to find out what the patients opinion about psychoeducation in schizophrenia.
Method. We examined 169 patients suffering from schizophrenia. They answered once a questionnaire about demographic data, their opinion about participation in sessions, the motivation to psychoeducation and the themes of sessions.
Results. 84% of the patients declared that they like psychoeducation.The main reason for participation in psychoeducation was the willingness to get more information about the illness and prevent the relapses. Approximately 50% of the respondents considered level of their knowledge on the illness to be not satisfactory.
Conclusions. The patients want to get more information about the illness and obtain more knowledge how to cope with symptoms in order to improve the quality of their life. It is important for the therapists to create an emotional atmosphere which helps to understand each other. During the psychoeducation sessions the therapist should use more different means to get the patients involved in participation.
key words: schizophrenia / psychoeducation