Psychiatr Pol
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The article discusses the preliminary results of a follow-up study carried out in 2009-2010 on former patients with a diagnosis of anorexia nervosa and bulimia nervosa, first seen in 2001-2004 at the Department of Child and Adolescent Psychiatry, the Jagiellonian University Medical College in Krakow. At that time they had been taking part in a research project, whose aim was to define the relationships among the psychopathological picture of eating disorders, self-image and family relations and also the influence of socio-cultural factors. The aim of the current study is to attempt to define factors influencing the course and prognosis of eating disorders in the studied group. ⋯ The occurrence of symptoms of binging and purging turned out to be a negative prognostic factor in the whole group of patients suffering from eating disorders. A smaller starting declared intensity of aspiring to slimness and level of dissatisfaction with own body by patients measured with the EDI, and satisfaction in the area of communication and emotional commitment on the part of the mother (of the patient) in her relationship with her husband (the father of the patient) measured with the KOR were positive prognostic factors. The significant overrepresentation of patients with a diagnosis of restrictive anorexia in the group of persons with clinical improvement may have an influence on the obtained results.
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To assess cultural attitudes and beliefs among (female) patients being treated for various kinds of eating disorders in comparison with (female) patients diagnosed with depression and healthy girls. ⋯ The obtained results may indicate the greater significance of cultural mechanisms in bulimia than anorexia nervosa. They may also be an expression of the limited possibility of introspection of girls with a diagnosis of restrictive anorexia. A negative perception of femininity in the family and culture accompanies not only eating disorders, but also depressive disorders.
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Clinical practice and data from literature indicate that up to 30% of the patients suffering from depression meet criteria for treatment-resistant depression. In the past decade, interest in the use of NMDA receptor modulators in the treatment of treatment-resistant depression is increasing. The use of ketamine--an noncompetitive antagonist of the NMDA receptors, allows some patients suffering from treatment resistant depression to achieve rapid and significant improvement. ⋯ Neurobiological basis of the glutaminergic pathways and the postulated role of glutamate in mood modulation have been described, as well as possible adverse events associated with ketamine infusion. Concerns relate to the optimal dosage, frequency of administration, long-term safety and efficacy of the therapy. Interesting results of the published articles encourage further studies on therapeutic use of NMDA receptor modulators in the treatment of treatment-resistant depression.