The aim of the present study was to compare the concentrations of KYNA, 3-OH-KYN and the cytokines TNF-α and IL-6 in patients with depression vs. healthy controls as well as in patients with depression treated pharmacologically vs. those treated using ECT. We also evaluated the relationship between the concentrations of KYNA, 3-OH-KYN and the cytokines TNF-α and IL-6 and clinical improvement measured on the MADRS scale in patients treated pharmacologically and those treated with ECT.Subjects and methods: The study group comprised 29 patients aged 28 to 60 years with a diagnosis of a major depressive episode. Eleven of the patients received pharmacological treatment and 18 were treated with ECT.Patients were assayed for serum levels of KYNA and the cytokines IL-6 and TNF-α. Clinical improvement was measured on the MADRS depression rating scale and the clinical global impression (CGI) scale.Results: Significant differences were found in KYNA levels between depressive patients and healthy controls. Pharmacological treatment significantly contributed to the increase in KYNA levels and ECT – to the increase in TNF-α levels in depressive patients.Conclusions: Depressive patients have significantly lower concentrations of KYNA than healthy individualsDepressive patients who have undergone pharmacological treatment have significantly higher KYNA concentrations than before treatment.Depressive patients who have undergone ECT treatment have significantly lower TNF-α concentrations than before treatment.High pre-treatment levels of IL-6 are associated with a lower MADRS improvement index in pharmacologically treated patients with depression.
New achievements within structural and functional imaging of central nervous system offer a basis for better understanding of the mechanisms underlying many mental disorders. In everyday clinical practice, we encounter many difficulties in the therapy of eating disorders. They are caused by a complex psychopathological picture, varied grounds of the problems experienced by patients, often poor motivation for active participation in the treatment process, difficulties in communication between patients and therapeutic staff, and various biological conditions of eating disorders. In this paper, the latest reports on new concepts and methods of diagnosis and treatment of anorexia nervosa have been analyzed. The selection of the analyzed publications was based on the criteria taking into account the time of publication, the size of research cohorts, as well as the experience of research teams in the field of nutritional disorders, confirmed by the number of works and their citations. The work aims to spread current information on anorexia nervosa neurobiology that would allow for determining the brain regions involved in the regulation of food intake, and consequently that may be a potential place where neurobiochemical processes responsible for eating disorders occur. In addition, using modern methods of structural imaging, the authors want to show some of the morphometric variations, particularly within white matter, occurring in patients suffering from anorexia nervosa, as well as those evaluated with magnetoencephalography of processes associated with the neuronal processing of information related to food intake. For example as regards anorexia nervosa, it was possible to localize the areas associated with eating disorders and broaden our knowledge about the changes in these areas that cause and accompany the illness. The described in this paper research studies using diffusion MRI fiber tractography showed the presence of changes in the white matter pathways of the brain, especially in the corpus callosum, which indicate a reduced content of myelin. These changes probably reflect malnutrition, and directly represent the effect of lipid deficiency. This leads to a weakening of the structure, and even cell death. In addition, there are more and more reports that show the normal volume of brain cells in patients with long-term remission of anorexia. It was also shown that in patients in remission stage there are functional changes within the amygdala in response to a task not related symptomatologically with anorexia nervosa. The appearing in the scientific literature data stating that in patients with anorexia nervosa there is a reduced density of GFAP + cells of the hippocampus and increased expression of vimentin and nestin, is also worth noting.
Schizophrenic psychoses are a heterogeneous group of diseases that affect about 1% of the world’s population. The first symptoms of the disease usually manifest between ages 20 and 30. The diagnostic criteria for schizophrenia and its subtypes are characterized in detail in ICD-10. Diagnosis is based primarily on the presence of productive symptoms such as delusions or hallucinations occurring for at least one month which cannot be explained in another way. Schizophrenia is a disease which largely affects social functioning of patients, such as occupational performance, family life, interpersonal relationships or housing situation. Apart from the sociological aspect, social lives of schizophrenia sufferers are significantly impoverished due to cognitive impairment associated with improper functioning of NMDA receptors. The study describes a case of a patient suffering from paranoid schizophrenia which sheds light on the social functioning of this group of patients.
Alcohol dependence and its treatment is not an exactly resolved problem. Based on the EZOP [Epidemiology of Mental Disorders and Accessibility of Mental Health Care] survey, which included a regular analysis of the incidence of mental disorders in the population of adult Polish citizens, we were able to estimate that the problem of alcohol abuse in any period of life affects even 10.9% of the population aged 18-64 years, and those addicted represent 2.2% of the country’s population. The typical symptoms of alcohol dependence according to ICD-10, include alcohol craving, impaired ability to control alcohol consumption, withdrawal symptoms which appear when a heavy drinker stops drinking, alternating alcohol tolerance, growing neglect of other areas of life, and persistent alcohol intake despite clear evidence of its destructive effect on life. At the moment, the primary method of alcoholism treatment is psychotherapy. It aims to change the patient’s habits, behaviours, relationships, or the way of thinking. It seems that psychotherapy is irreplaceable in the treatment of alcoholism, but for many years now attempts have been made to increase the effectiveness of alcoholism treatment with pharmacological agents. In this article we will try to provide a description of medications which help patients sustain abstinence in alcoholism therapy with particular emphasis on baclofen.
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