Low-dose interferon-α is standard therapy for hepatitis C. Psychotic disorders have been described as a scarce complication of the treatment that resolves with its termination.

we present a patient with negative personal and familial psychiatric history who developed serious chronic psychotic disorder with persistent cognitive impairment on the level of dementia after seven month interferon-α therapy. Profound parkinsonian side-effects of neuroleptic treatment accompanied the disturbances.

Potentially severe brain consequences of long-term low-dose interferon-α therapy for hepatitis C in a susceptible individual may emerge. The underlying cause of the susceptibility remain obscure, however dopaminergic, opioid, serotoninergic and glutaminergic pathways as well as HPA axis hypersensitivity might be supposed. This biological vulnerability might interact with the cytokine's action on brain. Relatively frequent and in some cases serious neuropsychiatric adverse effects of interferon-α therapy indicate the necessity of regular psychiatric consultations during the treatment.

Neuropsychological studies show the positive effect of treatment with atypical neuroleptics on cognitive functions in schizophrenia. The aim of this study was to assess the effect of olanzapine on prefrontal functions during 12-months of treatment in schizophrenia.

The study was performed in 48 schizophrenic patients, aged 20-48, who were treated with the generic olanzapine (Zolafren - Adamed, Poland). Psychometric evaluation was done using PANSS. Neuropsychological assessments included Wisconsin Card Sorting Test(WCST) and Trail Making Test and Stroop Color-Word Interference Test. The measurements were performed before, after 3,6 and 12 months of treatment. The daily dose of olanzapine was 5-25mg/day (mean 14.9 mg/day) after 3 month of treatment, and 5-20 mg (mean 13.6 mg/day), after 6 and 12 months of treatment.

The intensity of psychopathology on PANSS was at baseline 99 points, and after 3, 6 and 12 months of treatment 63, 54 and 51p, respectively, with significant systematic improvement during olanzapine treatment (p<0.001, ANOVA Friedman Test). After 3 month of treatment, there was a significant amelioration on TMT, Stroop, and WCST-conceptual responses. A after 3,6 and 12months of treatment significant improvements on TMT, Stroop and WCST were observed. The level of cognitive improvement was assessed with the decrease on negative symptoms. After 3 month – this correlated with improvement on TMT and WCST-perseverative errors, and after 6 and 12 months with TMT A and WCST perseverative errors.

The results obtained show a significant improvement of psychopathology and neuropsychological frontal lobe tests after long-term treatment with olanzapine.

The Polish multicenter Treatment Resistant Depression Project (TRES-DEP) has aimed to study a number of demographic, clinical and psychometric characteristics comparing patients with treatment-resistant (TR) and treatment non-resistant depression (TNR). Fifty patients with TR depression (group 1) and 50 patients with TNR depression (group 2) were included in this preliminary analysis.

Treatment-resistant depression was recognized on account of lack of significant improvement following at least two adequate courses of antidepressant treatment. The exclusion criteria were treatment with mood stabilizers, diagnosis of substance misuse, dementia or severe somatic disease. The presence of bipolarity features was assessed by Polish version of Mood Disorder Questionnaire (MDQ).

Significantly more patients with TR depression compared with TNR had family history of mental disorders, especially alcohol dependence (24% vs 8%, p=0,03), had more previous depressive episodes (8.5±5.0 vs 5.1±3.8; p=0.001), and reported shorter time from the last hospitalization (14.8±26.5 vs 41.9±71.1 months, p< 0.005). Patients from group 1 significantly more frequently fulfilled MDQ criteria for bipolarity than patients from group 2 (44% vs 12%, p< 0.001). Among TR patients, MDQ-positive compared with MDQ-negative more frequently reported treatment nonadherence (41% vs 18%, p=0.055), suicidal attempts (41% vs 18%, p=0.055) and inadequate remission (100% vs 21%; p< 0.05).

Our preliminary results point to clinical differences between patients with TR and TNR depression, including higher scores on bipolarity scale in TR. The features of bipolarity may be an important reason for non-response during antidepressant treatment of depression and worse clinical course and outcome.

Working memory and executive functions, connected with the activity of prefrontal cortex play an important role in complex mental processes. Wisconsin Card Sorting Test (WCST) is a main tool used for neuropsychological assessment of prefrontal cortex activity. Molecular genetics studies show the association between the performance on WCST and polymorphism of dopaminergic system genes in schizophrenia and healthy subjects, also with polymorphism of BDNF gene in bipolar disorders.

In this study an association between performance on WCST and polymorphisms of selected candidate genes was assessed.

The study included 200 healthy volunteers aged 18-60 years. Neuropsychological assessment was performed using WCST and following domains were evaluated: perseverative errors (inability to change the reaction), nonperseverative errors (attentional inability to avoid distraction), number of completed categories (ability to utilize new information), percent of conceptual responses (ability of conceptual thinking) and set to complete 1st category (ability to formulate a logical conception). Genotyping were done for polymorphism of dopaminergic: D1receptor (-48A/G) and catechol-O-methyltransferase (COMT108/158Val/Met), serotoninergic (5-HTTLPR), glutamatergic: FYNkinase (93A/G, IVS10+37T/C, Ex12+894T/G) and neurotrophic: brain-derived neurotrophic factor (BDNF:C-270T,Val66Met) genes.

A/G polymorphism of DRD1 gene was connected with better results on trials to complete 1st category. Better performance on nonperseverative errors was observed in females with Val/Val genotype of COMT. The C/T genotype of C-270T BDNF polymorphism was associated with higher percentage of conceptual responses.

The results obtained suggest a contribution of studied candidate genes to working memory and executive functions efficiency, connected with prefrontal cortex activity, in healthy subjects.

The human body changes with age. How do these changes influence brain functions? the objective of this study was to analyze differences in cognitive status between elderly and middle age people.

One hundred non-demented adults (29 M, 71 F) aged 46 - 88 years (mean 65.6; SD 11.0) living in rural regions of Poland entered the study. They were divided into two groups: people 40 - 65 years old (58,76; SD 5,74) and more than 65 years old (mean 73.8; SD 5.2). Dementia screening was performed using Mini Mental State Examination (MMSE). Cognitive functions were assessed by means of Stroop Test and Trail Making Test. Demographic, socioeconomic, clinical and lifestyle data were collected with the help of the semi-structure questionnaire. Data were collected by face to face interview.

The elderly group scored significantly worse on the cognitive tests, compared to the middle aged group. They had significantly worse results in MMSE, made significantly more mistakes in Stroop test part B, TMT part A and B. in the elderly the time needed to complete of both parts of Stroop test was significantly longer than in the younger group. Also there were significant correlation between the participants’ age and the time to complete the tests in each of these two groups.

Cognitive functions worsen with age which may be associated with the deterioration of the functioning of older people. the study is being continued in order to identify factors that may influence cognitive ageing.

Two common approaches to identify subgroups of patients with bipolar disorder are clustering methodology (mixture analysis) based on the age of onset, and a birth cohort analysis. This study investigates if a birth cohort effect will influence the results of clustering on the age of onset, using a large, international database.

The database includes 4037 patients with a diagnosis of bipolar I disorder, previously collected at 36 collection sites in 23 countries. Generalized estimating equations (GEE) were used to adjust the data for country median age, and in some models, birth cohort. Model-based clustering (mixture analysis) was then performed on the age of onset data using the residuals. Clinical variables in subgroups were compared.

There was a strong birth cohort effect. Without adjusting for the birth cohort, three subgroups were found by clustering. After adjusting for the birth cohort or when considering only those born after 1959, two subgroups were found. With results of either two or three subgroups, the youngest subgroup was more likely to have a family history of mood disorders and a first episode with depressed polarity. However, without adjusting for birth cohort (three subgroups), family history and polarity of the first episode could not be distinguished between the middle and oldest subgroups.

These results using international data confirm prior findings using single country data, that there are subgroups of bipolar I disorder based on the age of onset, and that there is a birth cohort effect. Including the birth cohort adjustment altered the number and characteristics of subgroups detected when clustering by age of onset. Further investigation is needed to determine if combining both approaches will identify subgroups that are more useful for research.

Electroconvulsive therapy (ECT) is the most effective treatment for drug-resistant depression. However, long-term effects of such therapy on cognitive functions have not been adequately studied.

The aim of the study was to estimate short-term and long-term effects of ECT on cognitive functions in patients with drug-resistant depression.

Thirty seven patients were included (10 male, 27 female), aged 34-75 years. Cognitive assessments were performed before, immediately after completion of 6-12 sessions of the ECT, and 3 months thereafter, using Benton Visual Retention Test, Digit Span of the Wechsler Adult Intelligence Scale (WAIS), the Rey Auditory Verbal Learning Test (RAVLT), Color Reading Interference (Stroop test), Verbal fluency test, Trail Making Test (TMT) and the Rey-Osterrieth Complex Figure Test (ROCF).

Immediately after ECT, a significant worsening was noted in memory (most elements of RAVLT) and in verbal fluency. However, 3 months after ECT, the indices of both RAVLT and verbal fluency significantly improved compared to baseline, and also, these of Benton and ROCF were significantly better than before ECT. The results of Digit Span (WAIS), Stroop and TMT were not affected by the treatment.

The results suggest that the negative effects of ECT on cognitive functions are transient. After three months, the indices of memory, verbal fluency as well as Benton and ROCF were significantly better than those before the treatment. Therefore, in addition to antidepressant effect in drug-resistant depression, electroconvulsive therapy, in a long-term perspective, may also exert a favorable influence on some cognitive functions.

Orthorexia nervosa (ON) is an excessive fixation on the consumption of healthy food and an obsession with its biological purity. The aim of this study was to assess the prevalence of ON in a population of Polish urban adolescents and some possible contributory factors.

Validation and adaptation of the ORTO-15 Questionnaire was made in the group of 399 participants (15–21 years old). The validation procedure incorporated three basic methods to be applied in the reliability analysis. The reliability analysis of the ORTO-15 Questionnaire based on repeatability of the responses presents a very good (kappa: 0.81–1.00 for 5 items) and a good repeatability (kappa: 0.61–0.80 for 10 items). The reliability analysis based on the value of the Cronbach's α reached a satisfactory level (0.7–0.9). The ORTO-15 questionnaire was considered a reliable tool to identify the risk of ON in population studies in the group of urban youth aged 15–21. Assessment was made among 1899 high school students, 992 girls, and 907 boys, aged 15–21 years.

The mean value of the ORTO-15 was 39.2 ± 3.6 points, with no sex difference. The main factors connected with orthorexia, according to the “Orthorexia 35” definition were excess weight, sporting activities, out-of-school activities, smoking status, working parents and a high family income.

This study, of a large number of adolescents, showed a prevalence of ON similar to that recorded in adult populations. This is a first assessment of orthorexia among adolescent population.

The authors have not supplied their declaration of competing interest.

The aims of the study were: (1) to evaluate longitudinally symptomatic remission in first-episode (FE) schizophrenia, (2) to describe symptoms, social functioning and quality of life (Qol) in relation to remission status, and (3) to determine the long-term outcome of schizophrenia and its early predictors.

Sixty-four patients were assessed 1 month after a first hospitalization (T1), 12 months (T2), 4–6 years (T3), and 7–11 years (T4) after T1. The patients were allocated to three remission groups according to their remission status over the whole observation period, e.g. stable remission (SR), unstable remission (UR) and non-remission (NR). The PANSS, Social Functioning Scale and WHOQoL were used to evaluate the patients’ psychosocial functioning levels, symptomatic and functional remissions and satisfying QoL. A good outcome was defined as meeting, simultaneously, the criteria of symptomatic and functional remissions and satisfying QoL at T4, while failure to meet all of these criteria was defined as a poor outcome.

Among them, 17.2% patients were in stable remission, 57.8% in unstable remission and 25.0% were unremitted at all time points. The SR group had lower levels of psychopathological symptoms and reported better social functioning and QoL than the NR group. During the follow-up, the symptoms increased, social functioning slightly improved and QoL did not change. At T4, 53% of the sample had a poor outcome, which was independently predicted by the longer duration of untreated psychosis and a lack of satisfying QoL at T1.

Our results demonstrate that: (1) the long-term course in schizophrenia is heterogeneous and that three illness trajectories exist, (2) social functioning and QoL are only partially connected with symptomatic remission (3), the risk of a poor outcome may potentially be reduced by appropriate interventions at an early stage of the illness.

To use the Hypomania Checklist (HCL-32) and the Mood Disorder Questionnaire (MDQ), for detecting bipolarity in depressed patients.

One thousand and fifty-one patients fulfilling ICD-10 criteria for unipolar major depressive episode, single or recurrent, were studied. Patients were assessed using a structured demographic and clinical data interview, and by the Polish versions of the HCL-32 and MDQ questionnaires.

Hypomanic symptoms exceeding cut-off criteria for bipolarity by HCL-32 were found in 37.5% of patients and, by MDQ, in 20% of patients. Patients with HCL-32 (+) or MDQ (+) differed significantly from patients with HCl-32 (−) and MDQ (−) respectively, by being less frequently married, having more family history of depression, bipolar disorder, alcoholism and suicide, earlier onset of illness, and more depressive episodes and psychiatric hospitalizations. The percentage of patients resistant to treatment with antidepressant drugs was significantly higher in HCL-32 (+) vs HCL-32 (−) and in MDQ (+) vs MDQ (−): 43.9% vs 30.0%, and 26.4% vs 12.4%, respectively.

The results confirm a substantial percentage of bipolarity in major depressive disorder. Such patients have a number of clinical characteristics pointing on a more severe form of the illness and their depression is more resistant to treatment with antidepressants.