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Experiencing a situation of extreme danger can lead to serious stress disorders (such as PTSD) that can affect both the victims and the professional helpers. Military operations in Ukraine in the first half of 2022 started an ongoing migration crisis, resulting in the displacement of approximately 3.5 million people to Poland. It is indicated that post-traumatic stress disorders may affect up to one third of adult refugees. Exposure to traumatic stress related to assault, limitation of basic resources, fear, insecurity, death, and a sense of injustice affected the entire population of the country. As a result, refugees, healthcare professionals, uniformed services, volunteers, and NGO workers constitute a group at risk of developing stress-related disorders, including post-traumatic stress disorder (PTSD). The presented recommendations were developed by an interdisciplinary team of experts in the field of psychiatry, clinical psychology, psychotherapy, and family medicine to present systematic guidelines for diagnostic procedures in medical and psychological practice.

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Post-traumatic stress disorder (PTSD) is a mental distress that occurs after participation in traumatic event such as the experience of natural disaster, car accident, terrorist attack or armed conflict, being a victim of sexual assault, tortured, physically abused, traumatized or being in any other life-threatening situation. The trauma victim does not always have to be in the position of the o directly threatened with physical harm. The disorder may be developed also as a result of an acute reaction to stress caused by participation in situation in which another person suffer so unimaginable that the further normal life of witness becomes impossible. Patients are often convinced that they lose previous ability to exist irretrievably. Globally PTSD is an increasingly recognized disorder. It can be predicted that in Europe, due to the ongoing war in Ukraine and the migration crisis, the frequency of severe disorders related to traumatic stress will systematically increase. In recent years, there has been a significant progress in knowledge and the development of methods for counteracting PTSD. The empirically confirmed forms of treatment include psychotherapeutic and pharmacotherapeutic interactions. The presented recommendations were developed by a team of experts in the field of psychiatry, clinical psychology, psychotherapy and primary care in order to proposed guidelines for therapeutic procedures in medical and psychological practice. The position statement of the working group have been developed in line with evidence-based practice as a part of three-stage procedure including: literature review, the issue discussion and development of the unified expert position.

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Psychotherapy is a well-established method of treating many mental disorders. It has been proven that psychotherapy leads to structural and functional changes in the brain; however, knowledge about the molecular and cellular mechanisms of these changes is limited. Neuroplasticity and one of its mediators, brain-derived neurotrophic factor (BDNF), are potential research targets in this field. To define the role of BDNF concentration in serum, or in plasma, and BDNF promoter gene methylation in saliva or leucocytes, in psychotherapy, an extensive literature search was conducted in the PubMed and Web of Science databases. The literature review was conducted based on papers published up until May 2021 that included pre and post psychotherapy measurements of either BDNF concentration levels or promoter gene methylation status. Ten studies were indicated as eligible for analysis: eight studies that investigated peripheral BDNF concentration levels, one study that investigated methylation status, and one study that included an evaluation of both subject matters. Patients underwent cognitive behavioral therapy or interpersonal psychotherapy. Patients were diagnosed with borderline personality disorder, major depressive disorder, anorexia nervosa, bulimia nervosa, or post-traumatic stress disorder. There were only three of the nine studies that showed statistically significant increases in BDNF concentration levels after psychotherapy. The two studies that involved BDNF gene methylation status showed a decrease in methylation after dialectical behavioral therapy of borderline patients.

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Diagnosis of suicide risk is a clinical challenge requiring an interdisciplinary therapeutic approach. Except for psychological explanation of the suicidal mechanism, there is evidence that it is associated with brain chemistry disturbances as oxidative stress. The objective of this study was to explore the role of oxidative stress components in suicidality comparing subjects at different stages of suicide. The study included psychiatric inpatients aged 18-64 (n = 48) with different psychiatric diagnoses. Blood specimens were collected from subjects and tested for oxidative stress biomarkers: superoxide dismutase (SOD), dityrozine (DT), oxidative stress index (OSI), glutathione peroxidase (GPx), total antioxidant capacity (TAC trolox), ferric reducing ability of plasma (FRAP), total oxidant status (TOS), catalase (CAT), advanced glycoxidation end products (AGE), NADPH oxidase (NOX), and advanced oxidation protein products (AOPP). The Columbia Severity Suicide Scale (C-SSRS) was used for suicidality assessment. Subjects with a history of suicide ideations over the last three months had significantly higher levels of NOX, AOPP, and OSI. There was no significant relationship to any oxidative stress component levels either with a history of suicide behaviors or with suicide attempts over the last three months. The levels of NOX and AOPP were both positively correlated to the intensity of suicidal thoughts. Moreover, there was a positive correlation between a number of suicide attempts during a lifetime with AGE and DT and negative with CAT. Similarly, the subjects with a history of suicide attempts had significantly higher AGE and DT levels and lower CAT values. The study confirmed that oxidative stress plays an important role in the pathophysiology of suicide and specific oxidative stress measures vary in suicidal and non-suicidal psychiatric inpatients.

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OBJECTIVES: This paper presents the construction of the CSSS - a short screening scale intended for diagnosis of cognitive deficits among people with schizophrenia. METHODS: 160 persons (124 with schizophrenia and 36 healthy controls) were tested using the initial version of the CSSS scale consisting of 11 subscales. Correlation analysis between the subscales' results was carried out, as well as confirmatory factor analysis, internal consistency analysis of the scale, IRT (item response theory) analysis of the items' difficulty, and analysis of the scale's accuracy as a classifier. RESULTS: One factor (overall cognitive efficiency) explains 37% of the variance of the subscales' results. The scale has satisfactory internal consistency (Cronbach's alfa = 0.83). Subjects with schizophrenia achieved significantly lower scores than healthy subjects. The area under the ROC curve (AUC) for discriminating between subjects with schizophrenia and healthy subjects was 0.83. Cut-off point of 16 raw points is 86% sensitive and has 70% specificity. CONCLUSIONS: The form of the tool that has been achieved as a result of presented analyses suggests that this scale has a potential to fulfil the assumed goals, which will be tested during continuing validation studies.

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OBJECTIVES: The present study is focused on further validation procedure of the CSSS - short screening scale designed for fast detection of persons with cognitive impairment and coexisting psychosocial disorders that demand deeper neuropsychological diagnosis and rehabilitation. METHODS: 67 subjects with schizophrenia and 36 healthy controls were examined with the CSSS, BACS, PANSS, and the Global Assessment of Functioning (GAF). Relationships between the CSSS score, age and education were tested with simple linear regression in groups of 124 subjects with schizophrenia and 36 healthy controls. RESULTS: Numerous statistically significant (p< 0.05) relationships between the CSSS and the BACS subtests, and the CSSS and the PANSS subscales were observed. The corrected CSSS score differs GAF ? 70 group from GAF >70 group. CONCLUSIONS: The CSSS is a short method with satisfactory validity, that is adequate to the assumed goals and might be promising with respect to further development.

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OBJECTIVES: The purpose of the study was to examine the relation between cognitive functioning in people with borderline personality disorder and their overall functioning level, as well as psychopathology intensification specific for this type of disorders. METHODS: 64 patients aged 18-55 (M = 30.09) with borderline personality disorder (emotionally unstable personality - borderline type in the ICD-10) were examined. The study used: demographic-descriptive questionnaire, SCID II, Borderline Symptom Checlist-23, and Global Assessment of Functioning (GAF). For cognitive assessment, The Rey Auditory Verbal Learning Test, The Rey-Osterrieth Complex Figure test, TMTA, TMTB, verbal fluency test, Stroop test and Frontal Assessment Battery (FAB) were used. RESULTS: The average GAF score in the sample was M =43.65. Significant differences between the comorbidity group and non-comorbidity group were observed with respect to the GAF scores (Mann-Whitney U = 300.500, p = 0.008) as well as a number of significant (p < 0.05) correlations between the level of cognitive functions and functioning in patients with no co-morbidity. CONCLUSIONS: Clinically significant disturbances in general and social functioning persisted in the group of subjects with borderline personality disorder. The obtained data seem to suggest that the cognitive functions affect the overall functioning only in patients with psychiatric co-morbidity. In people without psychiatric co-morbidity there is a relationship of cognitive functions only with certain aspects of psychopathology specific to BPD.

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Borderline personality disorder is highly associated with suicidal behaviors. The authors of the current case study present the introduction model of original Crisis Intervention Procedure for Borderline Patients (CIP-BP) which is a method focused on restoring emotional balance, reducing the severity of symptoms and the risk of suicidal behavior, as well as developing optimum solutions for further action. Its aim is to enable the patient to regain control of their emotional memory, increase autonomy and restore important interpersonal relations by using the original resources of this person. The procedure aims at providing nursing personnel with a practical tool to effectively avert the crisis and prevent further decompensation of BPD patients. Further pre-post study is required to determine the effectiveness of the procedure.

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AIM: The assessment of suicidal risk is one of the most difficult diagnostic challenges. The aim of present article is to report the process of development and preliminary validation of the Verbal Suicide Scale. MATERIAL AND METHOD: A total of 121 psychiatric inpatients aged 19-67 anonymously completed Verbal Suicide Scale (VSS). The study took place in the Clinic of Psychiatry, Medical University of Warsaw in Mazovia Specialist Health Center in Pruszków, Poland. RESULTS: Factor analysis validated the three factor structure. Cronbach's alpha reliability for each factor was satisfactory: 0.876 for scale 1, 0.700 for scale 2 and 0.710 for scale 3. CONCLUSIONS: VSS is a short instrument for evaluating the attitude toward suicide and can be a useful tool in mental health nursing practice. Further research and analyses are required to refine the theoretical and external reliability of the method.

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BACKGROUND: The potential dynamics of cognitive impairment in schizophrenia is discussed in the literature of the field. Recent publications suggest modest changes in level of cognitive impairment after first psychotic episode. Present article attempts to explore cognitive differences between patients and controls across age groups and differences between age groups in clinical group. METHODS: One hundred and twenty-eight hospitalized patients with schizophrenia (64 women and 64 men) and 68 individuals from the control group (32 women and 32 men) aged 18-55 years were examined. The patients were divided into age groups (18-25, 26-35, 36-45, 46-55). Both groups were examined using Wisconsin Card Sorting Test, Rey Auditory Verbal Learning Test, Rey Osterrieth Complex Figure Test, Trail Making Test (A and B), Stroop Test, verbal fluency test and Wechsler digit span. RESULTS: Patients with schizophrenia obtained significantly lower scores versus the control group in regard to all the measured cognitive functions (Mann-Whitney U; p < 0.05. Most deficits were present in all age groups, however, statistically important impairment in executive functions (WCST) were present only in "older" groups. CONCLUSIONS: Patients with schizophrenia obtained less favourable results than the control group in all age groups. Deficits regarding executive functions do not seem to be at a significant level among the youngest group, whereas they are more noticeable in the group of 46-55-year-olds. Executive functions are significantly lowered in the group aged 36-45 in comparison to the "younger" groups. The level of cognitive functions shows a mild exacerbation in connection with age, whereas cognitive rigidity proved to be related to the number of years spent without hospital treatment.

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Suicidal behaviors in psychiatric patients are one of the main challenges in current clinical practice. The aim of this study was to investigate the gender differences in suicide risk for psychiatric patients in Poland and the influence of life satisfaction in different stages of life on suicidal tendencies. A descriptive-exploratory approach to inquiry was used for this study. Sixty patients aged 16-67 (45% males and 55% females) answered the demographic-descriptive questionnaire, the Suicide Behaviors Questionnaire-Revised (SBQ-R) and the Cantril Self-Anchoring Striving Scale (CSASS). The results suggest that women turned out to show higher risk of suicidal behavior than men (p<0.001). Moreover, women displayed strong negative correlation between suicide risk and the anticipated life satisfaction in the future (rho=-0.542), while men displayed negative correlation between suicide risk and the pre-illness level of functioning (rho=-0.638). The findings suggest that different therapeutic approaches for each gender should be applied in suicide prevention process.

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AIM: The Montreal Cognitive Assessment is a screening test for diagnosis of Mild Cognitive Impairment- MCI. Only one version of the method was available in Poland so far. In order to assess progression of cognitive impairment, or to diagnose effectiveness of therapy, two equivalent version of method are needed. English additional version 7.2. was translated and culturally adapted to sustain reliability of the assessment. Then equivalency of both Polish versions was investigated. This paper examines whether both Polish versions of MoCA are equivalent, and describes the process of its cultural adaptation. METHODS: 66 psychiatric patients (37 men, 29 women) with different levels of cognitive impairment were examined using both Polish versions of MoCA. Both versions were administered randomly to patients with no time interval in between. RESULTS: No significant differences (p=0,601) for total MoCA scores were found between first version of Polish MoCA, and alternate version. Equivalency measured by correlation coefficient Spearman's rho correlation coefficient (rho=0,926) proved to be high. CONCLUSIONS: Both Polish versions of MoCA are equivalent, and can be useful in repeated measurement of progress in cognitive impairment or in testing of the effectiveness of treatment.

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