Background: Cognitive impairment is associated with long-term disability that results in the deterioration of both the social and professional status of individuals with schizophrenia. The impact of antipsychotic therapy on cognitive function is insufficient. Cognitive training is therefore proposed as a tool for cognitive rehabilitation in schizophrenia. In this study we investigated the effect of self-administered cognitive training using a smartphone-based application on the cognitive function of paranoid schizophrenia patients focusing on response time, correct answer rate, incorrect answer rate, and fatigability to check, if these functions can be functional markers of successful cognitive-smartphone rehabilitation. Methods: 1-year multicenter, open-label randomized study was conducted on 290 patients in a state of symptomatic remission. 191 patients were equipped with the full version of the application and conducted cognitive training twice a week. Reference group (n = 99) was provided with a version of the application having only limited functionality, testing the cognitive performance of patients every 6 months. Results: Statistically significant improvement was observed in both the rate of correct answers (by 4.8%, p = 0.0001), and cognitive fatigability (by 2.9%, p = 0.0001) in the study group, along with a slight improvement in the rate of incorrect answers (by 0.9%, p = 0.15). In contrast, the reference group, who performed cognitive training every 6 months, demonstrated no significant changes in any cognitive activities. Conclusions: Cognitive trainings facilitated by a smartphone-based application, performed regularly for a longer period of time are feasible and may have the potential to improve the cognitive functioning of individuals with schizophrenia. Correct answers and cognitive fatigability have potential to be functional markers of successful smartphone-based psychiatric rehabilitations in schizophrenia patients.

Sexual dysfunctions in people with schizophrenia are more severe than in the general population and are an important element in the treatment of schizophrenia. The mechanism of sexual dysfunction in patients treated for schizophrenia may be related to the side effects of antipsychotic drugs (hyperprolactinemia, suppression of the reward system), but it may also be related to the pathogenesis of schizophrenia itself. The aim of the study was to present the possibility of using amantadine in the treatment of sexual dysfunction in schizophrenia without the concomitant hyperprolactinemia. In an open and naturalistic case series study, five men treated for schizophrenia in a stable mental state were described. All patients reported a prolonged lack of sexual desire and sexual activity prior to treatment with amantadine. After exclusion of hyperprolactinemia, patients received amantadine 100 mg in the evening. Sexual dysfunction was assessed using subscales of the 14-point Short Form of the Changes in Sexual Functioning Questionnaire (CSFQ-14). On subsequent visits after 1, 2 and 3 months of administration of amantadine, an improvement in sexual functioning was observed in all patients. Although this is only the preliminary report, amantadine may become a new indication for the treatment of sexual dysfunction in schizophrenia patients.

Regularne uprawianie ćwiczeń fizycznych ma wiele zalet zdrowotnych i słusznie jest postrzegane jako pozytywne, akceptowane społecznie zachowanie. Jednak z tego samego powodu istnieje duże ryzyko, że pacjenci i klinicyści mogą przeoczyć niebezpieczeństwo uzależnienia od ćwiczeń, które powoduje szkody w sferze somatycznej, emocjonalnej i interpersonalnej. Obecny stan wiedzy nie pozwolił na włączenie uzależnienia od ćwiczeń jako sprecyzowanej kategorii w obowiązujących klasyfikacjach ICD-10, ICD-11 i DSM-5. Jednak zaburzenie to spełnia ogólne kryteria uzależnień i na tej podstawie jest włączone do kanonu uzależnień behawioralnych. Celem artykułu jest przedstawienie wiedzy, która pomoże w rozpoznaniu i zrozumieniu mechanizmów fizjologicznych i psychologicznych związanych z uzależnieniem od ćwiczeń fizycznych oraz przybliży dostępne metody psychoterapii. Praca ma charakter przeglądowy i przedstawia, terminologię, kryteria rozpoznawania, dane epidemiologiczne, mechanizmy rozwijania się uzależnienia, najbardziej popularne narzędzia pomocne w diagnozie przesiewowej lub autodiagnozie oraz czynniki ryzyka pojawienia się uzależnienia od ćwiczeń. Autorzy uwzględnili także specyficzne umiejscowienie uzależnienia od ćwiczeń w kontekście innych zaburzeń psychicznych, kontrowersje, niespójności wyników badań i braki w danych naukowych związane z omawianym zjawiskiem. W podsumowaniu zaproponowano dalsze ścieżki rozwoju badań.