Psychiatric wards in general hospitals - the opinions of psychiatrists employed there.

Objectives: The world literature is reporting economic destabilisation of psychiatric wards in general hospitals related to the new rules of financing (managed care). The aim of this paper is to analyse the literature on psychiatric wards in general hospitals, and to know the opinions of psychiatrists employed in these wards in Poland regarding organisational model and the stability of these wards.

Methods: The 18-items Likert-type questionnaire was send to 83 psychiatric wards in Poland and published on the website psychiatria.

Acute psychosis in the course of treatment of acute adrenal crisis with hydrocortisone in the patient with secondary adrenal insufficiency - a case study.

Objectives: Presentation of the risk of psychosis induced by the treatment of adrenal crisis with high doses of hydrocortisone.

Methods: A case analysis in the context of the literature.

Results: There are reported psychoses in the patients with adrenal hypofunction and hyperfunction.

Depression in Parkinson's disease: the effectiveness and risk of pharmacotherapy. Clinical review.

Parkinson's disease (PD) is a neurological disease with a heterogeneous pattern of neurological symptoms and concomitant psychiatric syndromes. These syndromes are triggered by alterations to neurotransmission that are likely common for both neurological and psychiatric symptoms. Syndromes such as depression, anxiety, or cognitive impairment can precede motor symptoms of PD and delay its diagnosis.

[The level of cortisol, DHEA, DHEA-s in plasma serum and the connection with the lipids and response to treatment in women with depression].

Unlabelled: In depression an increase, decrease, or a relative deficiency of dehydroepiandrosterone (DHEA) and the beneficial effects of its administration were observed. The correlation of low serum DHEA level and increased cardiac risk was confirmed in healthy subjects only in men (not in women). Taking into consideration the increased risk of heart disease in depression, it is interesting to investigate the level of DHEA, DHEA-S, and cortisol, as so its correlation with lipid profile, and reaction to treatment in women with depression.

[Dissociative fugue in a maternity ward patient--a case report].

Aim: To pay attention to the role of stress connected with delivery, obstetric history, as to the pathologies in the infant as predictors of dissociative disturbances in the patient of the maternity ward.

Method: The case analysis.

Case Description: The thirty-year-old woman with secondary education, married and employed had left the maternity ward with her baby unnoticed on the fourth day after giving birth.

[MORS--the stationary model centre of sociopsychiatric rehabilitation for youths--the program and evaluation].

Introduction: The psychosocial consequences of psychosis in the youth are educational negligence's, poor peer relations and difficulties in achieving life independency. MORS--the Stationary Model Centre of Sociopsychiatric Rehabilitation was created for overcoming these problems.

Aim: To present the programme of rehabilitation and its effects in MORS.

Bupropion in the treatment of depression in Parkinson's disease.

A 78-year-old female with a nine-year history of depression was hospitalized due to worsening depression and symptoms associated with Parkinson's disease (PD). Her motor abilities improved on levodopa and the depression improved after a trial of bupropion, following unsuccessful treatment with other antidepressants. We found four reports on successful treatment of depression in PD with bupropion.

[Dehydroepiandrosteron (DHEA) in the mechanisms of stress and depression].

There is growing interest in the role of Dehydroepiandrosteron (DHEA) in depression. To evaluate the validity of its administration in depression, the role of DHEA in the mechanism of depression and cardiovascular risk, as so the results of clinical trials must be considered. According to accessible literature, both concepts of depression--monoaminergic and glucocorticoid--are related.

[Evaluation of the ICAR program--Internet communication and active rehabilitation for people with mental disorders].

Unlabelled: Prevalence of Internet use indicates, that introducing internet to people with mental disorders might have a positive impact on their social integration. There are concerns about negative effects of dealing with virtual reality on the mental health of Internet users.

Aim: Evaluation of the ICAR program--"Internet communication and active rehabilitation for people with mental disorders" concerning its utility in psychiatric rehabilitation.

[Personality and behavioural disturbances, with delusional-hallucinatory and delirium episodes in the course of hyponatremia due to paraneoplastic inappropriate vasopressin secretion (SIADH)].

Aim: To broaden the knowledge about somatic mechanisms of psychic disturbances.

Method: Presentation of a 54 year old male with psychic disturbances and hyponatremia.

Results: After six months with head ache, nausea, exhaustion, irritability, lacking drive, and appetite--acute psychic disturbances abruptly arose.

[Social support of chronically mentally ill patients].

Aim: Assessment of the social support system of mentally ill persons covered by a local rehabilitation programme situated in Targówek, Warsaw.

Method: The sample consists of 92 participants with serious mental illness. Bizoń's Social Support Inventory and Social Support Map were used.

Implementation of social services for the chronically mentally ill in a Polish mental health district: consequences for service use and costs.

Background: In accordance with the mental health reform in Poland, from 1970 to 1980 the following mental health facilities were established within the general health system in the Warsaw District of Targowek: general hospital psychiatric ward, day hospital, outpatient clinic (OC), and community mobile team (CMT) with some procedures of assertive community treatment (ACT). In 1998 (according to the Mental Health Act of 1994), within the social welfare system, new community facilities were established in this district with psychosocial rehabilitation programs for the chronically mentally ill. These new social welfare facilities were a vocational rehabilitation center (VCR), community center of mutual help (CCOMH), and specialized social help services at client homes (SSHS).

[Specifics of working with chronic mentally ill patients in Specialised Social Help Services--experiences in training and supervision meetings].

Information was presented on the development and efficiency of The Specialised Psychiatric Social Help Services for the mentally ill in Poland. It took into consideration the specifics of this work and formal requirements for special training of the staff. The experiences of the 3.

[The influence of community support services on the costs of treatment of chronically mentally ill patients].

Aim: To determine changes in costs of treatment for chronically mentally ill patients after their admittance to new social help units; Vocational Rehabilitation Center, Community Center of Mutual Help and Specialised Social Help Services at Client's Home.

Method: In the group of 73 chronically mentally ill persons, for two years before and after their admission to social help units, the global amount of care (months x persons) and all the costs (PLN) in both social help and mental health systems were compared.

Results: For two years after the admission to the mentioned services all the costs in mental health system were significantly decreasing (71.

[The importance of community services for rehabilitation and social support to decrease psychiatric hospitalization].

Goal: The evaluation of community services for social support concerning minimalization of psychiatric hospitalizations.

Method: Mean duration, global time and the number of stays in hospital ward, day treatment ward and "home hospitalisation"; in two year periods before and after their admission to an Occupational Therapy Workshop (O.T.