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Problematyka zaburzeń reaktywnych i symulacji w praktyce sądowo-psychiatrycznej i penitencjarnej

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Batawia S., Uszkiewiczowa L.

Archiwum Kryminologii

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1964

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issue II

251-291

EN

Problems of reactive mental disorders and of the simulation of mental disorders have lately been very poorly represented in both psychiatrist and criminological literature. The present contribution discusses the sources of a considerable number of difficulties which emerge in practice when discussing the question of “Reactive disorder or malingering?”, as well as the errors of diagnosis in diagnosing malingering. The contribution is based on a analysis of material which comprizes three hundred and fifty cases of reactive mental disorders, and ninety-nine cases of malingering (simulation), with the accused; such material has been obtained from the Department of Forensic Psychiatry of the Psychoneurological Institute and from fifteen mental hospitals in Poland, to which prisoners were sent for observation. When making use of the term of “ malingering” , the contents of that notion ought to be narrowed down so as to comprize behaviour of such kind, which consists in an individual who is not mentally ill consciously producing definite psychopathological symptoms. We could not possibly consider to be malingering in the true sense of the word the producing by a mental patient (e.g. one suffering from schizophrenia) of symptoms which are not characteristic of the disorder in question. What is described by the term of sursimulation, even though it contains elements of malingering, essentially differs from true malingering. On the other hand, the view is not correct which reads that we may only then speak of malingering, when the simulating of symptoms of mental disorders makes its appearance with persons who do not exhibit any abnormal traits. Malingering most frequently makes its appearance with prisoners who exhibit symptoms of psychopathy, encephalopathy, mental deficiency, etc. The problem of metasimulation deserves special attention. The fact that at a given moment we have to do with a behaviour which indicates malingering is not by itself evidence that previously, during the period immediately preceding such malingering, reactive disorders did not appear with same prisoner. The symptoms of reactive disorders during the period which preceded the sending of the prisoner to a mental hospital may have become almost entirely extinguished, while their place was taken by an attitude of malingering, greatly reminiscent of the recent symptoms of reactive mental disorders. Besides, in cases of that kind there also arises, as a rule, the question of whether, side by side with elements of malingering, there do not appear feebly marked symptoms of reactive mental disorders, as remnants of the reactive disorders from which the patient had previously been suffering. Neither should another difficulty, which jurisdiction finds in its path, be forgotten. When having to do with an attitude of obvious malingering, one ought to take into consideration the possibility of malingering being gradually transformed into reactive disorders. The mechanism of malingering becomes fixed in the prisoner’s mind, it undergoes automation, and sets into motion a hysterical mechanism, which, in its turn, acts independently, in the way proper to it, owing to which psychogenic disturbances arise. Such a state as that cannot be described as malingering, in spite of the fact that it was simulation that not only constituted the starting-point of the disorders arisen, but had actually provoked, and to some extent moulded, them. An individual in that state no longer exercises any control over the symptoms of reactive disorders which have appeared, he ceases to exercise any mastery over them; the former malingering mechanism has been driven out of his consciousness and has become transformed into a new, and considerably more complicated hysterical mechanism. The cases discussed above may still run a course complicated in another way, namely after the transformation of malingering into reactive disorders certain symptoms of the latter in their turn are subject to undergo, even after the extinction of the disorders, a conscious consolidation through the new manifestation of the malingering mechanism. Therefore in such cases malingering may be observed, not only at the beginning, but also after the recession of the state of reactive disorders, in the form of metasimulation. The mechanism of the arising of reactive disorders is analogous to that of the arising of malingering; at the basis of both the above mechanisms there lie certain common fundamental tendencies. In all probability malingering runs along the very same tracks as hysterical reaction, and mobilizes, through the intermediary of autosuggestion, analogous mechanisms, causing, as it were, the automation of certain attitudes. Malingering individuals, even though at first they control that mechanism and consciously steer it, may lose their control over it. This leads to the cases of a transformation of malingering into reactive mental disorders, discussed above. The knowledge of making use of a mechanism approximating a hysterical one, of producing and fixing certain symptoms which would constitute a good imitation of disorders, is - as is well known - a most difficult thing. This is why long-lasting and consistently carried out malingering is an extremely rare phenomenon. An individual who simulates in such a way must be equipped with peculiar features, in order to be equal to tasks of that kind. Hence the well-know saying that “ one can simulate well only that which is close to the simulating persons’s individuality” (Lassegue), and that “ a good malingerer must be born such” (Braun). Among psychiatrists there prevails, generally speaking, an agreement as to the view that long-lasting and consistent malingering happens, as a rule, only with persons whose personality exhibits clearly pathological features. The data obtained from sixteen mental hospitals for the period of 1953 - 1960 bear witness to the fact that, out of 5,967 male prisoners sent there for psychiatric examination, mental reactive disorders have been found to exist with 711 cases (11.9 per cent.), and malingering of mental disorders in a mere 99 cases (1.6 per cent.). In the case of the 793 women, sent from prisons to mental hospitals for psychiatric examination, reactive disorders were found to exist in 73 cases (9.2 per cent.), and malingering in a mere 7 cases (0.9 per cent). When we analyse the 99 forensic-psychiatric reports which diagnosed malingering, it appears that we may distinguish two different groups of cases among them. The first of them comprizes 70 prisoners,, with whom the diagnosis of mere malingering does not arouse any essentia] diagnostical reservations. On the other hand, in the second group, which comprizes 29 cases, we have to do with 19 cases of undoubted metasimulation, as well as with 19 cases which are doubtful. Doubts arise in connection with the possibility of the co-existence of reactive disorders with simulation (5 cases), as well as with the presence of reactive disorders during the period immediately preceding malingering (3 cases), or finally, because of data which speak in favour rather of reactive disorders than of malingering (11 cases). Thus it is only in seventy cases that the diagnosis of malingering does not arouse any serious doubts; neither should it be forgotten that, at the same time (i.e. during the same seven-and-a-half-year period) as many as 711 cases of reactive mental disorders were observed with prisoners in sixteen mental hospitals. Thus cases of malingering of long duration are an extremely rare phenomenon in forensic psychiatrist practice. For the purpose of establishing how do the data look which concern long-term malingering of mental disorders in prisons, data concerning the number of cases of malingering within the period of one year have been obtained from the psychiatrists employed in two large Warsaw prisons, which are, in principle, destined only for prisoners under investigation. It was found that the number of malingering prisoners amounted, in one prison to nine, and in the other to five. Taking into consideration the number of all the prisoners detained in those prisons in the course of twelve months, the “ co-efficient of malingering” , calculated as per one thousand prisoners, amounts to 1.86 and 0.96 respectively. After a correction has been introduced, because of the possibility of certain prisoners failing to report for examination, that co-efficient should not exceed 2 pro mille.[1] Among the 350 cases of reactive disorders, selected by lot out of the total number of reports with a diagnosis of “ reactive disorder” for the purpose of obtaining a representative sample, metasimulation during the period of clinical observation has been stated to take place in as many as 24.8 per cent, of the cases. When examining the two groups of cases: those of “ pure” malingering and those of metasimulation, we can establish the essential differences which exist between them. Those prisoners with whom no reactive disorders have been found to exist during observation, simulate other symptoms of psychotic disorders than those prisoners, with whom malingering has made its appearance only after the extinction of reactive disorders in hospital. In the group of the seventy “ pure” cases of malingering the most numerously represented is the simulation of memory defects and of mental deficiency, or else of dementia; apart from the above, prisoners also simulate symptoms of conversion hysteria, of hallucination or delusion, as well as, exceptionally, symptoms of stupor. On the other hand, in the group of fifty cases of metasimulation, more than one-half of the total number consisted of prisoners who simulated symptoms of pseudodementia along with elements of puerilism (which were altogether absent from the group of “ pure” simulation). Of cases of con- fabulation with symptoms of pseudodelusions there were eight, while there were none of them in the “ pure simulation” group. Of individuals who simulated memory disorders there were three times less. Deserving of particular attention are the twenty-six cases of “ pure” malingering, in which the whole manner of simulating, the contents of the pseudo-symptoms produced, and the prisoner’s entire behaviour are of such a kind, that it seems improbable that the simulating individual could suppose that he would succeed in deluding his environment. The attitude of such prisoners is one of playful contradiction, usually coupled with irony and mockery with regard to the medical personnel; their behaviour is characterized by elements of acting and indeed of clowning; the absurdity of their utterances is glaring. Periodically, however, states of a certain inhibition make their appearance, and from time to time sudden changes of mood are visible, considerable tension, violent attempts at aggressive behaviour, and tendencies to self-mutilation. It was Mönkenmöller who, once upon a time, drew attention to that peculiar form of malingering, in which it is impossible to detect any intelligible purpose. In such cases malingering assumes the character of acting which gives the malingerer some satisfaction (“spielerische Simulation' 4, as Utitz called it); The picture of malingering gives one to think by its specific features, and is distinguished, from the other types of malingering, by its altogether exceptional primitivism and inconsistency. 92 per cent, of the prisoners who simulated in that way were recidivists with a considerable number of previous convictions to their names. In the anamnesis of nearly one-half of them alcoholism and brain trauma, as well as other chronical brain diseases, made their appearance. More than one-half of their total number have performed self-mutilation in prison. In the cases of “pure”, true malingering there appear, in the hospital material investigated, numerous prisoners with symptoms of encephalopathy (37.1 per cent.) and psychopaths (about 40 per cent.), as a rule described as impulsive, irritable, aggressive. Not a single malingering prisoner has been qualified as an individual with a normal personality. The prisoners who simulated mental disorders are recruited - 81 per cent, of them - from among recidivists, as a rule from among juvenile or young offenders: sixty-six per cent, of the investigated were under twenty-five years of age. They belonged to the category of offenders who commit common offences, mostly offences against property, with thefts predominating. Among the reactive mental disorders to be met with in forensic psychiatrist practice and in the prisons, two kinds of disorders may be distinguished. First of all, the group of disorders of the type of hysterical disorders, the majority of which has a more primitive character; they are: pseudodementia, Ganser’s syndrom, puerilism, states of incomplete stupor and of stupor, fancies with contents similar to those of delusions, and symptoms of conversion hysteria. It is precisely that category of disorders that oftentimes causes particular difficulties in practice, when it is a matter of distinguishing them from malingering. The second group of reactive disorders, with more psychotic symptoms, comprizes: reactive depressions, stupor, and syndroms with delusions and hallucinations and paranoid states. In this category of disorders disturbances of consciousness are much more clearly discernible than they are in the first. Bunyeyev, however, correctly emphasizes the fact that clinical experience points to the fact that in the several syndroms distinguished above there are frequently contained elements, of other reactive syndroms, and, moreover, in a considerable number of cases it can be observed, how, in the course of the disorders, one set of syndroms gives way to other symptom syndroms. Consequently, the clinical picture is usually considerably more complicated than would result from a description that would only take into consideration the most fundamental elements. Among the three hundred and fifty cases of reactive disorders with prisoners under investigation the several syndroms make their appearance In the following dimensions: Pseudodementia 90 cases 25.7 per cent. Puerilism 16 “ 4.6 per cent. Ganser’s syndrom 17 “ 4.9 per cent. Depressions 79 “ 22.6 per cent. Syndrom of stupor (41) 59 “ and states of incomplete stupor (18) 47 “ 16.9 per cent. Syndroms with hallucinations and delusions 13.4 per cent. Paranoid states 12 “ 3.4 per cent. Conversion hysteria 20 “ 5.7 per cent. Fancies with contents similar to delusions 10 “ 2,8 per cent. Pseudodementia, Ganser’s syndrom and puerilism between them account for 35.2 per cent, of the material investigated. Pseudodementia and puerilism frequently constitute the source of serious difficulties when it is a matter of distinguishing them from malingering, if hospital observation is of too short duration. Seventy per cent, of the above cases spent over three months on observation in hospitals, including nearly twenty per cent, who spent more than six months there. After a syndrom of pseudodementia, it may be sometimes observed the malingering of the extinct symptoms of that syndrom (metasimulation). Among the cases of metasimulation in the material under investigation in fifty-five per cent, malingering was precisely connected with pseudodementia. Reactive depressions are the second set, as far as numbers are concerned, in the material under investigation (22.64 per cent.). Reactive depressions are of various character. The obvious colouring of the majority of such states with hysterical traits frequently lends a peculiar stamp to the clinical picture, and may incorrectly suscitate a suspicion of malingering. Mental disorders with a stupor syndrom, as is well known, rarely arise as isolated type of reaction. Considerably more frequently stupor takes place after pseudodementia, Ganser’s syndrom and puerilism, not infrequently after a period of a seeming withdrawal of all reactive symptoms. What is more, after stupor there frequently appear once more symptoms of other reactive disorders, first and foremost those of pseudodementia (Bunyeyev, Pastushenko). In cases of incompletely developed stupor there frequently appear suspicions of malingering, even though such casses ought to be numbered undoubted mental disorders. When discussing cases with a hallucination and delusion syndrome one ought to remember that even in such cases the suspicion of malingering occasionally makes its appearance. This is influenced by the fact that the contents of the hallucination are closely connected with the prisonner’s own situation, that his behaviour is characterized by lively emotional reactions, and that he not infrequently manifests interest in his further lot, his family, etc. In fact the suspicion of malingering as a rule proves to be unfounded. Morever, it should not be forgotten that, in cases with a hallucination and delusion syndrome there not infrequently emerge serious diagnostic difficulties in connection with the posibility of the existence of schizophrenia. Among the reactive disorders observed with prisoners in the hospitals there were twelve cases of acute paranoid state. In this, relatively very infrequent, syndrom, which develops against a background of intensified fear and anxiety, and rapidly disappears under conditions of hospitalization, the existence of hallucinations, mainly visual ones, has also been found. The symptoms which approach delusions include the so-called confabulation, with contents resembling those of delusions (“wahnhafte Einbildungen” ), which had been described by Birnbaum more than fifty years ago. The inventing of occasionally the most improbable and queerest facts takes place against a background of usually glaringly expressed hysterical traits; occasionally elements of pseudodementia and puerilism become visible. All this together may suscitate serious suspicions of malingering; prolonged observation, however, makes it posible to find the existence of clearly reactive disorders. Of such cases there were ten in the material under investigation. Predominant among them were cases of persecutory pseudodelusions (eight cases), with the most absurd and fantastical subject-matter. In the remaining two cases it was grotesque grandiose pseudodelusions that made their appearance. Both the attitudes and the behaviour of all such individuals were, as a rule, in complete contradiction with the contents of their utterances. Those prisoners who exhibited symptoms of reactive mental disorders differ in an essential way from those prisoners who simulate pathological symptoms. First of all, there are considerably less recidivists among them: the percentage of the latter did not exceed 33 per cent, while with the simulators it reached 81 per cent. Among the prisoners with reactive disorders there are less individuals who would exhibit organic changes of the brain (23 per cent., as compared with 37,1 per cent, with the malingerers), while, on the other hand, the percentage of persons of the schizoid type is considerably larger (36 per cent., as against about 10 per cent, with the malingerers), as well as that of psychopaths with obvious hysterical traits (31.4 per cent., as against about 20 per cent, with the malingerers). A mere 4.5 per cent, of the total number of prisoners with reactive mental disorders under investigation were found to be persons whose premorbid personality did not suggest any suspicions concerning pathology; all the remaining ones figure, in the diagnoses, either as psychopaths, or else as persons with symptoms of encephalopathy. In spite of the lack of any exhaustive anamneses in a great many cases it was found possible to state that at least 17 per cent, of the prisoners sent to mental hospitals because of reactive mental disorders had already previously suffered from such disorders. The cases of reactive states of a protracted character, numerous in the material under investigation (32 per cent, among the cases dealt with in the Institute of Psychoneurology) make one realize the importance of a proper conception of the problem of reactive mental disorders with prisoners. In those cases states which could at first produce an impression of simulation were relatively numerously represented. Mistrust in such cases might well be increased by the fact that nearly one-half of them consisted of prisoners accused of the perpetration of homicide. A hospital observation which went on for many months on end, not only did confirm the diagnosis of a reactive mental disorder, but has also, over and above that, demonstrated that those mental disorders had, in a considerable number of cases, become so deep, that a large number of the patients had to be assigned for release from prison. Merely about 22 per cent, of the total of those suffering from protracted disorders recovered their health and could, later on, be prosecuted before a law-court. A working hypothesis in both prisons and forensic-psychiatric practice should therefore be the premisse that a pure malingering of mental disorders going on for a longer period of time is an altogether exceptional phenomenon, and that, as a rule, we have to do, in such cases, with reactive disorders. A different approach not only does run counter to the present-day state of psychiatrist knowledge, but is also highly harmful for both forensic and prison practice, as well as being inhumanitarian. [1] In order to avoid any misunderstandings it ought to be emphasized that we are here referring to cases of long duration, of a malingering of mental disorders going on for at least several weeks on end. Clumsy attempts at simulating pathological symptoms for a period of a few days, naturally, altogether elude a psychiatrist who is not permanently employed in the prison in question, and, in all probability happen much more frequently

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Practice of application the assumed functions of communal home of mutual aid in support of persons with mental disorders presented on the case of work program of the Communal Home of the Mutual Aid 2 in Stalowa Wola

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Witkowska-Paleń A.

Praca Socjalna

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2019

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vol. 34(3)

117-136

EN

Communal homes of mutual aid are day support centers for persons with mental disorders. They provide varied services for the persons with mental disorders and with intellectual disabilities. The aim of this article is to show the role and scope of operation of such facilities in a formation of social support network for persons with mental disorders, using the case of the Communal Home of Mutual Aid no 2 in Stalowa Wola. The analysis conducted based on the Home’s internal documentation, demonstrated that the facility provides for its beneficiaries different forms of support and activation, including practical trainings which involve: trainings of functioning in everyday life (e.g. personal hygiene training, cleaning training, cooking training, management of financial resources), trainings of interpersonal skills and resolving conflicts, trainings of the ability to spend free time as well as various forms of therapies (e.g. occupational therapy, art therapy) and relaxation trainings (e.g. classes held in the garden). The centre also provides actions aimed at preparation of the beneficiaries to participate in other programmes of communal support, including also the professional activity. The main objective of such activities is forming and strengthening of life and social skills of persons with mental disorders, encouraging their resourcefulness and autonomy, and to help them to overcome isolation barriers and ensure conditions of social integration of people with disabilities in their local environment.

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Mental disorders and somatic disease – an interdisciplinary issue

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Szcześniak D., Rymaszewska J.

Family Medicine & Primary Care Review

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2012

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issue 3

507-513

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Contemporary challenges in the work of court probation officer for adults. Critical recognition from the perspective of the Polish experience

66%

Kwieciński A.

Nowa kodyfikacja prawa karnego

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2014

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vol. 34

81 - 90

EN

The paper focuses on the issue of probation officer participation in the supervision exercised over offenders exhibiting mental health dysfunctions. The analysis included in the paper applies to both currently applicable law and the proposed legislative solutions. The author’s critical remarks also include proposals de lege lata and de lege ferenda.

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Prevalence of selected mental disorders among graduation class adolescents: data from a screening study

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Nowicka-Sauer K., Karcz B., Dymowska A., Siebert J.

Family Medicine & Primary Care Review

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2018

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issue 3

241-244

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The prevalence of depression symptoms and other mental disorders among patients aged 65 years and older – screening in the rural community

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Kujawska-Danecka H., Nowicka-Sauer K., Hajduk A., Wierzba K., Krzemiński W., Zdrojewski Z.

Family Medicine & Primary Care Review

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2016

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issue 3

274-277

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Ocena i perspektywy rozwoju systemu terapeutycznego wykonywania kary pozbawienia wolności

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Kwieciński A.

Nowa kodyfikacja prawa karnego

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2019

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vol. 54

67-83

EN

This publication focuses on the problems of imprisonment relating to those sentenced with mental disorders, addicted to drugs or other means of intoxication, as well as the physically handicapped. The proposals in this work are based not only on the study of specialized literature and an analysis of legislative measures, but also on pilot studies in therapeutic wards all over Poland. In the conclusions the proposals de lege lata and de lege ferenda have been included, with reference to this important feature of prison services.

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Narodowy Program Ochrony Zdrowia Psychicznego – przyczyny niezreazaliowania celów i zadań

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Gostyńska M. M.

Kontrola Państwowa

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2017

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vol. 62

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issue 4 (375)

108-124

EN

The organisation of psychiatric care in our country, apart from the low level of its financing, is the main barrier that hampers the access to services to patients with psychiatric disorders. In the past, the model of isolation predominated in treatment. Contemporary science proposes an environmental model of psychiatry which is an optimal solution for the patients and their families. The reconstruction of the system was to be provided through effective realisation of the Psychiatric Health Protection System in the years 2011-2015. In her article, the author discusses the details of the Programme, and she presents the reasons for missing its objectives and tasks that were spotted during the NIK audit.

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MENTAL HEALTH IN THE PANDEMIC TIMES

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FRĄCKOWIAK-SOCHAŃSKA M.

Society Register

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2020

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vol. 4

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issue 3

67-78

EN

The primary aim of this paper is an attempt at the analysis of the prospective direct and indirect, short- and long-term consequences of COVID-19 pandemic for the individuals’ mental health. The secondary aim is to deconstruct the binarity of categories of “mental health” and “mental disorder” in the context of the global critical situation. The pandemic and its consequences such as isolation requirements as well as uncertainty in diverse aspects of life burden the individuals with the stress that results in the increase of anxiety and depressiveness, which challenges the public mental health care systems. Since the anxiety and depressive states are the reactions to a hazardous outside situation, the categories of “mental health” and “mental disorder” needs reconsideration. The theoretical framework of present analyses is determined by the theory of social (cultural) trauma. The method used for the present study is a meta-analysis of theoretical literature, the results of empirical research on COVID-19 pandemic published so far (mostly in medical journals), studies on psychosocial aspects of the previous pandemics (SARS and Ebola), and press publications selected on the basis of their content on mental health issues in the context of the coronavirus pandemic.

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Problemy w funkcjonowaniu systemów wsparcia medycznego i społecznego dla osób z zaburzeniami psychicznymi – wnioski z analizy na przykładzie województwa wielkopolskiego

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Trawkowska D., Frąckowiak-Sochańska M.

Annales Universitatis Mariae Curie-Skłodowska, sectio J – Paedagogia-Psychologia

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2017

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vol. 30

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issue 4

EN

This article deals with problems in functioning of medical support system and social support and integration system addressed to persons with mental disorders in Poland on the example of Greater Poland Voivodeship. This voivodeship is representative as far as the mental health problems’ prevalence and the type of the most common mental disorders diagnosed among people are concerned. The local data reflect very similar tendencies as cross country and international analyses. Moreover, the analysis of the local system of support for people with mental disorders carried out by the authors of this article revealed that the inadequacies of the system reflect the tendencies observed in the cross country Polish scale. In this context, the recommendations formulated by the authors can be applied (with some necessary corrections) in different local environments.

PL

Przedmiotem artykułu jest analiza problemów w funkcjonowaniu systemów wsparcia medycznego i społecznego dla osób z zaburzeniami psychicznymi na przykładzie województwa wielkopolskiego. Dane o zasięgu międzynarodowym, ogólnopolskim i lokalnym wskazują, że województwo wielkopolskie jest reprezentatywne pod względem natężenia oraz typu najczęściej diagnozowanych problemów zdrowia psychicznego ludności. Ponadto analiza systemu wsparcia dla osób doświadczających zaburzeń psychicznych, przeprowadzona przez autorki niniejszego artykułu, wskazuje na reprezentatywność województwa wielkopolskiego w skali kraju pod względem problemów wynikających z niedostatków systemowych rozwiązań mających na celu przeciwdziałanie zaburzeniom psychicznym. Punktem wyjścia w niniejszym opracowaniu jest zarysowanie globalnego kontekstu problematyki zaburzeń psychicznych. Następnie problematyka ta została omówiona w świetle analiz ogólnopolskich i regionalnych. W tym kontekście zostały opisane zagrożenia związane z funkcjonowaniem systemu ochrony zdrowia oraz systemu pomocy i integracji społecznej, a także sformułowano rekomendacje mające na celu przeciwdziałanie barierom rozwoju systemu wsparcia dla osób z zaburzeniami psychicznymi w różnych uwarunkowaniach lokalnych.

11

Psychologiczna analiza postaw pracowników domów pomocy społecznej wobec mieszkańców z zaburzeniami psychicznymi

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Sękowski A., Witkowska B.

Roczniki Psychologiczne

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2004

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vol. 7

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issue 1

57-75

EN

Research results presented in the article focus on the correlation between attitudes towards people with mental disorders and chosen personality traits. Research involved 150 people – employees of social care homes. Job characteristics and the nature of contact with social care homes dwellers constituted the criterion for placing the analysed person into one of the subgroups. Three subgroups of equal size have been recognised: employees at social – therapeutic department(I), medical staff (nurses) (II), economic department employees (III). The following methods have been used: The Scale for Defining Attitudes Towards People with Mental Disorders, Raven’s Progressive Matrices, Study of Values by G. W. Allport, P. E. Vernon, G. Lindzey, Stait-Trait Anxiety Inventory by C. D. Spielberger, J. Strelau, M. Tysarczyk, K. Wrześniewski, The Questionnaire: ”What are you like?” by P. Sears. Within the analyzed group people from subgroup I manifested the most positive attitudes, people from subgroup II were slightly less favourably inclined, and people from subgroup III showed the least positive approach. The application of multiple regression equation showed that among the analysed variables trait anxiety has significant meaning for the type of attitudes both in group I and II. In subgroup III a significant influence on manifested attitudes is exerted by the following variables: economic values, intellectual level, artistic values and trait anxiety.

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Problem jakości życia u pacjentów z łuszczycą.

50%

Walniczek P.

Współczesne Pielęgniarstwo i Ochrona Zdrowia

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2018

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issue 3

70-72

PL

Łuszczyca jest schorzeniem najczęściej uwarunkowanym genetycznie. Jest chorobą przewlekłą o podłożu wielowymiarowym. Cierpi na nią około 1–3% populacji. U ponad połowy pacjentów rozwijają się stany lękowe i depresyjne. Z powodu łuszczycy 1 na 20 chorych podejmuje próbę samobójczą. Nawrotowy charakter tej choroby jest mocno związany ze stresem psychicznym badanych. Łuszczyca wymaga od pacjentów ciągłego zmagania się z jej nawrotami. Choroba wpływa na poczucie własnej wartości i postrzegania własnego ciała. Chorzy bardzo często rezygnują z aktywności fizycznych (m.in. seksualnej), unikają kontaktów z ludźmi, jak również miejsc publicznych. Stres jest niewątpliwie czynnikiem wyzwalającym bądź nasilającym zmiany chorobowe. Narastające dermatozy w łuszczycy są przyczyną dużych lęków i obaw związanych ze zdrowiem. Bardzo wyraźne i negatywne emocje zostawiają mocny ślad w psychice, skutkuje to skrępowaniem dotyczącym cielesności, a co za tym idzie – obniżeniem samooceny. Zaznaczona jest wyraźnie silna i złożona zależność miedzy stresem a łuszczycą. Choroba, która w widoczny, czasami drastyczny sposób zmienia wygląd skóry, wpływa na jakość życia uwarunkowaną stanem zdrowia. Schorzenie, które zmienia ciało człowieka w sposób zauważalny, wpływa na sposób kształtowania własnej wartości, samooceny, a tym samym przekłada się na jakość życia pacjenta.

EN

Psoriasis is the most often genetically conditioned disease. It is a chronic disease with a multidimensional background. About 1–3% of the population suffers from it. Over half of patients develop anxiety and depression. Due to psoriasis, 1 in 20 patients make a suicide attempt. The recurrent character of this disease is strongly related to the mental stress of the subjects. Psoriasis requires patients to constantly struggle with its relapses. The disease affects self-esteem and the perception of your own body. Patients often give up physical activity (including sexual activity), avoid contact with people, as well as public places. Stress is undoubtedly a factor triggering or intensifying disease changes. Growing dermatoses in psoriasis are the cause of major fears and health concerns. Very clear and negative emotions leave a strong mark in the psyche, which results in embarrassment affecting corporality, and thus a reduction in self-esteem. A strong and complex relationship between stress and psoriasis is clearly marked. Disease, which in the visible sometimes drastic way changes the appearance of the skin affects the quality of life conditioned by the state of health. A condition that changes the human body in a noticeable way affects the way of shaping self-esteem, self-esteem, and thus translates into the quality of life of the patient.

13

Zapobieganie i leczenie depresji - wykonywanie zadań przez samorządy

50%

Kramarczyk-Rosiak K., Śliwiński J.

Kontrola Państwowa

|

2019

|

vol. 64

|

issue 4 (387)

51-65

EN

The NIK audit focused on the effectiveness of local self-government units’ activities taken with regard to depression prevention and treatment. The audit was conducted in 13 local self-government units, and covered the years 2015–2017 (three first quarters). In-depth examination comprised designing and planning of the measures related to depression prevention and treatment, the actual implementation of these measures, and the use of public funds allocated for this purpose. The assumption behind was that the activities of the local self-governments should complement the mental health services portfolio guaranteed by the National Health Fund (Polish: Narodowy Fundusz Zdrowia, NFZ).

14

Prawne aspekty znaczenia badań lekarskich przy wydawaniu prawa jazdy osobom cierpiącym na choroby objawiające się utratą świadomości

50%

Najman M.

Studia Administracji i Bezpieczeństwa

|

2023

|

vol. 15(15)

219-232

EN

Nowadays motorizing plays essential role in functioning of a significant part of society. It increases living comfort and money-making abilities. The legislator bearing in mind the importance of owning a vehicle allows to be a driver also for people with mental disorders. The aim of the article is to draw attention to the discrepancy between the importance of medical examinations, with particular reference to driver candidates with diseases which symptom is loss of consciousness, and the public perception of importance of these examination. The article presents the procedure of obtaining a driving license, with particular emphasis on the role of medical examination in this procedure. The whole is crowned with de lege ferenda postulates, indicating possible measures that could contribute to improving the existing legal standing

PL

Posiadanie własnego środka transportu jeszcze dekadę temu stanowiło symbol zamożności i prestiżu. Współcześnie zmotoryzowanie jest niezbędne dla funkcjonowania dla znacznej części społeczeństwa. Zwiększa to komfort życia oraz możliwości zarobkowe. Ustawodawca mając na względzie istotność posiadania własnego pojazdu zezwala na jego prowadzenie również osobom z zaburzeniami psychicznymi. Celem artykułu jest zwrócenie uwagi na rażącą rozbieżność pomiędzy znaczeniem badań lekarskich, ze szczególnym uwzględnieniem kandydatów na kierowców u których występują choroby objawiające się utratą świadomości, a społecznym postrzeganiem ich znaczenia. W artykule przedstawiona została procedura wydania prawa jazdy, ze szczególnym uwzględnieniem roli lekarzy w tym postępowaniu. Całość wieńczą postulaty de lege ferenda, wskazujące możliwe środki, jakie mogłyby przyczynić się poprawie istniejącego stanu prawnego.

15

Izolacja od społeczeństwa po odbyciu w pełni kary pozbawienia wolności

44%

Dawidziuk E.

Archiwum Kryminologii

|

2019

|

issue XLI/1

219-260

EN

The article describes the functioning of the National Centre for the Prevention of Antisocial Behaviour in Gostynin on the basis of interviews that the author conducted with patients there during three visits to the Centre as an employee of the Office of the Commissioner for Human Rights. It is a detention centre described as a medical facility where therapy is provided for people with mental disorders such as mental retardation, personality disorder, or sexual preferences disorder. The author describes examples of patients’ legal situations and the observance of their constitutional rights. It was organised in 2014 on the basis of legislation from 22 November 2013. That act states that the civil court shall decide whether a person who has served their entire criminal sentence a danger to society because of his/her disorders. The Constitutional Tribunal has stated in its judgements that the act, apart from one article, is consistent with the Polish Constitution. In practice, we can observe many legislative gaps or a need to change a binding law. The number of patients at Gostynin is increasing rapidly whilst the existing problems have not been solved by the legislature, who do not wish to consider the problems pointed out many times by the Commissioner for Human Rights.

PL

Artykuł opisuje funkcjonowanie Krajowego Ośrodka Zapobiegania Zachowaniom Dyssocjalnym w Gostynie na podstawie rozmów, jakie autorka przeprowadziła z pacjentami Ośrodka w czasie trzech jego wizytacji jako pracownik Biura Rzecznika Praw Obywatelskich. Ośrodek ten jest miejscem pozbawienia wolności oznaczonym jako podmiot medyczny, w którym prowadzona jest terapia dla osób z zaburzeniami psychicznymi w postaci upośledzenia umysłowego, zaburzenia osobowości lub zaburzenia preferencji seksualnych. Ośrodek został stworzony w 2014 r. na podstawie ustawy z 22 listopada 2013 r. Autorka opisuje przykłady dotyczące sytuacji prawnej kilku pacjentów Ośrodka i problemów z respektowaniem ich praw konstytucyjnych. Ustawa przewiduje, że sąd cywilny podejmuje decyzję, czy uznać osobę, która w pełni odbyła karę pozbawienia wolności, za stwarzającą zagrożenie dla społeczeństwa ze względu na zaburzenia i w dalszym ciągu pozbawiać ją wolności poprzez umieszczenie w KOZZD albo zastosować nadzór prewencyjny. Trybunał Konstytucyjny uznał przepisy ustawy, z wyjątkiem jednego, za zgodne z Konstytucją RP. W praktyce ustawa zawiera szereg luk prawnych bądź wymaga nowelizacji w zakresie obowiązujących uregulowań. Liczba pacjentów wzrasta bardzo szybko, a problemy pozostają nierozwiązane przez ustawodawcę, który nie chce się pochylić nad zgłaszanymi wielokrotnie przez Rzecznika Praw Obywatelskich zagadnieniami.

16

Dlaczego jest mi źle? Odczucia egzystencjalne Jean-Paula Sartre’a w kontekście fenomenologicznej psychopatologii Thomasa Fuchsa

42%

Chojnacka M. A.

Kultura Współczesna. Teoria. Interpretacje. Praktyka

|

2019

|

vol. 107

|

issue 4

15-29

EN

This article picks certain motifs from Jean-Paul Sartre’s philosophy on the structure of human subjectivity and juxtaposes them with reflections based on phenomenological psychopathology by Thomas Fuchs. The three ‘dimensions’ of human subjectivity, as distinguished by Sartre and Fuchs, are compared: the feeling of self, the feeling of the other and the feeling of time. Consequently, the existential feelings described by Sartre are connected with mental disorders distinguished by Fuchs in an attempt to recognise a place for Sartre’s theory of existentialism in the most recent discussion on phenomenological psychopathology.

17

The use of Snoezelen in prevention and therapy of mental and behavioural disorders

42%

Dziewiątkowska-Kozłowska K.

Przegląd Pedagogiczny

|

2021

|

issue 1

298-309

EN

The subject of the author’s discussion is to present the Snoezelen as a method supporting comprehensive human development, which can be used in the therapy and prevention of mental health. The starting point for considerations is the currently observed upward trend in the scope of the occurrence of difficulties in mental functioning, especially in Poland, affecting an ever wider group of people. The use of therapeutic support dedicated to individual patients was presented. The search for new solutions in the field of optimization of psychological and therapeutic help was considered, due to the growing need to mobilize interdisciplinary therapeutic activities. The Snoezelen method was indicated as a promising form of therapeutic support with high international effectiveness in various recipients. The author points out the need to include the Snoezelen among the fundamental methods of therapy, at the same time, reflecting the need to expand research in this area.

18

Od izolacji do leczenia. Ewolucja stosunku do psychicznie chorych w dziewiętnastowiecznych Prusach na przykładzie funkcjonowania Prowincjonalnego Zakładu dla Chorych Psychicznie w Darłowie (1841–1900)

42%

Chróściak E.

Zapiski Historyczne

|

2020

|

vol. 85

|

issue 2

95-112

EN

The situation of the mentally ill changed significantly at the end of the eighteenth and in the nineteenth century, the era that saw a gradual dissemination of humanitarian ideas. In Prussia, the humanitarian reforms began in the early nineteenth century and resulted in the establishment of several institutions for the mentally ill, which were to appear in all provinces of the Hohenzollern monarchy. One of these facilities was the institution in Darłowo (Rügenwalde), which was established in 1842. The aim of the paper is to answer the question whether the humanitarian proposals were implemented in practice. To date, Polish researchers have studied these issues only in the context of the Province of Silesia and Province of Posen. The application of the comparative method and the analysis of the documents, including rules and guidelines for the facility in Darłowo, have demonstrated that the implementation of the reforms in the Province of Pomerania was significantly delayed. The facility in Darłowo was not meant as an institution for treating patients with mental illness until the 1860s. The organisation of the staff, little or no variety in categorising patients, and slim chances of leaving the facility indicate that its main aim was to isolate patients from the society. The humanitarian ideas can be deemed to have been implemented only as of 1863, i.e. after the institution had been reorganised. It was then that the main task of the facility became to effectively and non-violently treat the mentally ill and enable their return to society.

19

Problematyka zdrowia psychicznego ujęta w filmowym przekazie medialnym na przykładzie „Przerwanej lekcji muzyki” Jamesa Mangolda

42%

Dudek M.

Annales Universitatis Paedagogicae Cracoviensis. Studia de Cultura

|

2020

|

vol. 12

|

issue 4

56-69

EN

Film is a medium which reaches viewers strongly. Besides its entertainment function, it has influence on shaping attitudes. However, it is a work of art and has its own principles. It is important to maintain moderation in presenting content, so that it is close to reality and does not harm anyone. The paper concentrates on the audio-visual work by James Mangold, Girl, Interrupted. It is known to wide audience, therefore it is worth considering the content which it conveys. The paper presents the results of the author’s analysis based on available literature.

PL

Film jest medium mocno trafiającym do odbiorców. Poza funkcją rozrywkową ma wpływ na kształtowanie postaw. Jest on jednak wytworem artystycznym i rządzi się swoimi prawami. Ważny jest umiar w przedstawianiu pewnych treści, tak by nie odbiegały one od rzeczywistości i nie były krzywdzące dla określonych osób. Artykuł pochyla się nad utworem audiowizualnym w reżyserii Jamesa Mangolda Przerwana lekcja muzyki. Znany jest on szerokiemu gronu widzów, dlatego warto zastanowić się nad przekazywanymi przez niego treściami. Artykuł prezentuje wyniki analizy przeprowadzonej przez autorkę na podstawie dostępnej literatury.

20

Uwagi de lege lata i de lege ferenda na tle projektu ustawy o zmianie ustawy o ochronie zdrowia psychicznego (nr z wykazu prac legislacyjnych UD 444)

42%

Wojcieszak-John A.

Opolskie Studia Administracyjno-Prawne

|

2023

|

vol. 21

|

issue 2

223-239

PL

Artykuł w syntetyczny sposób prezentuje wątpliwości natury prawnej pojawiające się na tle projektu ustawy o zmianie ustawy o ochronie zdrowia psychicznego. Rozważania podjęte przez autorkę koncentrują się wokół propozycji zmian w zakresie terminologii psychiatrycznej, przesłanek stosowania środków przymusu bezpośredniego oraz procedury stosowania środków przymusu bezpośredniego. Autorka analizuje założenia projektu nowelizacji ustawy o ochronie zdrowia psychicznego z punktu widzenia sytuacji pacjentów z zaburzeniami psychicznymi. Z uwagi na charakter proponowanych rozwiązań, a także krytykę obowiązującego prawa autorka podejmuje polemikę ze stanowiskiem prezentowanym przez twórców projektu, a także proponuje postulaty de lege ferenda. Całość rozważań zwieńczona jest podsumowaniem, w którym autorka zwraca uwagę na brak językowej precyzji ze strony projektodawców, która może przyczynić się do ograniczania praw i wolności pacjentów z zaburzeniami psychicznymi.

EN

This article synthesizes the legal doubts that arise against the background of the draft law on amendments to the Law on Mental Health Protection. The considerations undertaken by the author focus on the proposed changes in psychiatric terminology, the premises for the use of direct coercive measures and the procedure for the use of direct coercive measures. The author analyzes the assumptions of the draft amendments to the Law on Mental Health Protection from the point of view of the situation of patients with mental disorders. Due to the nature of the proposed solutions, as well as criticism of the current law, the author enters into a polemic with the position presented by the authors of the project and proposes de lege ferenda postulates. The entire discussion is crowned with a conclusion, in which attention is drawn to the lack of linguistic precision on the part of the drafters. This may contribute to a restriction of the rights and freedoms of patients with mental disorders.

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Izolacja od społeczeństwa po odbyciu w pełni kary pozbawienia wolności

Dlaczego jest mi źle? Odczucia egzystencjalne Jean-Paula Sartre’a w kontekście fenomenologicznej psychopatologii Thomasa Fuchsa

The use of Snoezelen in prevention and therapy of mental and behavioural disorders

Od izolacji do leczenia. Ewolucja stosunku do psychicznie chorych w dziewiętnastowiecznych Prusach na przykładzie funkcjonowania Prowincjonalnego Zakładu dla Chorych Psychicznie w Darłowie (1841–1900)

Problematyka zdrowia psychicznego ujęta w filmowym przekazie medialnym na przykładzie „Przerwanej lekcji muzyki” Jamesa Mangolda

Uwagi de lege lata i de lege ferenda na tle projektu ustawy o zmianie ustawy o ochronie zdrowia psychicznego (nr z wykazu prac legislacyjnych UD 444)