Abstract Introduction: Health consciousness is a theoretical construct that, depending on the concept, constitutes a psychological structure expressed primarily in the cognitive and behavioural sphere. It determines how individuals respond to health issues and the extent to which they are ready to take action to improve them. The level of health consciousness in the patient and his/her family has an impact on the achieved therapeutic effects. Due to the lack of an analogous tool for testing health consciousness in the Polish literature on this subject, the research objective was to create a Polish adaptation of the Ch.S.Hu Health Consciousness Scale and determine its psychometric properties. Material and methods: The study covered 599 people. Out of their group, a sample (N=291) was randomly drawn in order to conduct an exploratory factor analysis and determine the level of the reliability of the tool. The model was verified by a confirmatory factor analysis (N=599). HCS validity measures were based on the analysis of intergroup differences and correlations between selected variables. Results: The Polish version received a five-factor structure, containing 24 items. Both the entire scale and almost all subscales have a very high reliability coefficient (α=0.80). Medical professionals/persons with medical education achieve significantly higher results in HCS than other respondents. Conclusions: Conclusions. The Polish version of HCS has very good psychometric properties. This means that the tool is reliable and accurate. It can be used in both scientific research and individual diagnosis.

Abstract Introduction: The aim of this study was to characterize types of gamers in terms of selected personality traits. Material and methods: The study involved 576 individuals aged 16 to 19 years. The participants were surveyed using Gough and Heilbrun’s ACL, the Coping with Stress Questionnaire, and the Psychological Inventory of the Aggression Syndrome. Results: The four types of online gamers identified in the first part of the study reported in this paper differed significantly in the following personality characteristics: self-image, coping styles and aggression types. Conclusions: 1. Individuals severely addicted to Internet gaming, significantly more often than those addicted moderately, mildly or not addicted at all, used escapist and emotional coping strategies and responded with auto-aggression, and physical and displaced aggression. Compared to the respondents not addicted to online gaming, they had a more negative self-esteem and were characterized by greater impulsivity, hostility, and were less responsible and autonomous. 2. Adolescents moderately addicted to gaming, compared to their non-addicted peers, were characterized by greater hostility, impulsivity, proneness to conflict, tendency to humiliate others, and verbal, physical and indirect aggression. 3. Young people with mild online gaming addiction, significantly more often than non-addicted adolescents, used psychoactive drugs, showed self-aggressive behavior and responded with displaced aggression in situations of stress.

Abstract Introduction: SARS-CoV-2 infection might be presented in many various specific and non-specific manifest and symptoms from different systems. Also, the psychotic symptoms are documented but the explanation for their pathophysiology remains debatable and a complex matter. The main objective of this paper is to present cases of patients without a history of psychiatric disorders who developed the first episode of psychosis during the SARS-CoV-2 infection. Material and methods: Two cases of not-related patients with no previous psychiatric history developed psychotic episodes during COVID-19 infection. In both cases chronologically first they experienced symptoms of infection, secondly, delusions and psychomotor agitation that required psychiatric hospitalization. Full remission was observed after antipsychotic treatment in both cases. Results: Even though the pathophysiology of the post-COVID-19 psychiatric symptoms remains unclear, some reports that indicate associations between the infection and the onset of such symptoms. The infection itself, by the induction of cytokine storm followed by the excessive release of pro-inflammatory cytokines, is considered to stimulate the potential onset of the psychosis, however, other factors such as medications used during treatment (with a particular emphasis on glucocorticosteroids) or psychological factors should be considered as well. Conclusions: Patients infected with SARS-CoV-2 might develop serious psychotic episodes even without a prior psychiatric history. Besides, psychiatric symptoms might be the first the even the only manifestations associated with the active SARSCoV-2 infection which seems to be very challenging especially in cases of rapid psychotic episodes without any clear respiratory symptoms.

Abstract Introduction: Since implementation, electroconvulsive therapy has remained very effective treatment in psychiatry. The aim of this study is to present the differences in its use in medical practice around the world. The range of diseases in which ECT is most commonly used and the frequency of its use in different countries were compared with special attention to the differences between highly and poorly developed countries. Material and method: Review of literature by searching PubMed and Google Scholar databases using the keywords: indications of ECT, frequency of ECT use for papers published from 1991 to 2021. Results: Among the diseases for which electroconvulsive therapy is used worldwide, major depression dominates, while in Asia and Africa this therapy is used in schizophrenia. In Latin America it is used primarily for schizophrenia and bipolar disorder. In Poland, it is used for depression, bipolar disorder, and fewer for schizophrenia. The highest rate of people treated with therapy per 100,000 population is found in countries such as the USA (51), Canada (23.2-25.6), Australia (37.85), Sweden (41), Finland (23), Slovakia (29.2), Estonia (27.8) and Belgium (47). Conclusions: There is a relationship between the range of diseases most frequently treated with ECT, the frequency of use and the level of country development. In the high developed countries, ECT is used mainly in major depression, in less developed countries more frequent treatment of schizophrenia may be determined by the high cost of medications and limited availability of hospital beds. The highest rates of use of this therapy are found in more developed countries.

Abstract Introduction: Brain-derived neurotrophic factor (BDNF) is a polypeptide of 247 amino acid residues and is widely distributed throughout the central nervous system of the CNS. It plays an important role in the survival, differentiation, growth, and development of neurons in the central nervous system. The human BDNF gene is located on chromosome 11 in the p13-14 region and covers approximately 70 kb. The gene has a complex structure as it consists of 11 exons (I-IX, plus Vh and VIIIh) and nine functional promoters. BDNF expression in the brain is relatively low but it is found in most major regions of the brain. Material and methods: The gene encoding the brain-derived neurotrophic factor BDNF has many polymorphisms, but one of them mainly attracts the attention of researchers. This is a common, non-conservative polymorphism - rs6265 - a single nucleotide SNP polymorphism that results in an amino acid change – valine (Val) to methionine (Met) - at codon 66. Results: Polymorphism rs6265 is associated with many neuropsychiatric disorders, including depression or a higher risk of addiction, but it also determines other features, such as e.g. sports performance. Few studies are investigating the relationship between rs6265 polymorphism and predisposition to play sports. Conclusions: The results on the effect of rs6265 BDNF polymorphic variants on the risk of depression and addition are inconsistent, indicating a significant association in some studies and none in others. Therefore, more studies are needed to determine how rs6265 affects gene expression and function.

Abstract Introduction: Suicidal behavior and substance abuse constitute a serious public health problem. Aim: The study was to analyze the relationships between suicidal behaviors (ideation, plans, attempts) and substance abuse in adolescents. The authors also took into account the respondents’ motivation to attempt suicide and use psychoactive substances, as well as some demographic variables. Participants: The study involved 3493 secondary school students aged 16-17 years. The group included 69.41% girls and 30.59% boys. Methods: The participants were surveyed with a self-report questionnaire designed by one of the authors. Results: Statistically significant relationships were found between the respondents’ suicidal behaviors and the risky use of alcohol, cannabis, amphetamine, and designer drugs. Conclusions: 1. The use of psychoactive substances increases the risk of suicidal ideation and plans, as well as suicidal attempts in adolescents and young adults. 2. Significantly more respondents who report suicidal ideation, plans and attempts, in comparison to those who do not report such thoughts and behaviours, abuse alcohol and consumer cannabis, amphetamine and designer drugs to cope with problems and olster self-confidence. 3. In the group of respondents who report suicidal behaviour, psychoactive substances are consumed by significantly more men than women and by significantly more city inhabitants than people living in the country. 4. Young people, who report suicidal thoughts, plans, and attempts, are initiated into alcohol consumption at an earlier age than their non-suicidal peers.

Abstract Introduction: Susac syndrome (SuS) is a rare immune-mediated disease caused by occlusions of microvessels in the brain, retina and inner ear. It is characterized by the clinical triad of encephalopathy, visual disturbances and hearing loss. The diagnosis of SuS is based mainly on the clinical symptoms and the supporting tests in which characteristic changes occur in the MRI. Case report: Here, we present a case of a patient with possible SuS with psychiatric symptoms. A 31-year-old woman was admitted to the Department of Psychiatry due to deteriorating mental health for several weeks manifested as a negative mood and suicidal thoughts. During hospitalization, a neurological consultation was conducted, in which the patient was identified as conscious, psychomotor sluggish, with impaired verbal contact and persistent hearing and vision impairment. Cross-sectional assessment of cognitive functions revealed that the patient had a generalized syndrome of neuropsychological deficits, which confirms the diagnosis of dementia. Discussion: This case summary provides an example of a woman diagnosed with SuS manifested as a cognitive impairment with associated vision and hearing deterioration. It is worth emphasizing the fact that such presentation of the triad of at disease onset is rare. The characteristics of the organic changes in the brain described in the MRI probably explain the symptoms described in that case. The prognosis of SuS depends on early diagnosis and treatment. Conclusions: A diagnosis of SuS should always be considered in the presence of nonspecific neuropsychiatric symptoms and progressive multifocal neurological symptoms, hearing loss, and visual impairment. An important fact is that the typical triad of SuS symptoms in most cases does not occur simultaneously, which makes the diagnostic process very difficult and may lead to misdiagnosis.

Abstract Introduction: In recent years, social networking sites (SNS), such as Facebook, Twitter or Instagram have gained immense popularity and have become an essential part of many people’s everyday lives. In Poland, 19 million people, i.e. about a half of the whole population, are active SNS users. Aim: The aim of the present study was to analyze the relationship of family and personality factors with daily SNS usage time in adolescents aged 14 to 19 years. Participants: The study included 291 junior-high and high school students aged 14–19 years. In this sample, 246 individuals had an SNS profile. Methods: The following instruments were used: an Inquiry Form designed by the present authors, Gough and Heilbrun’s Adjective Check List, the Coping with Stress Questionnaire by Janke, Erdmann and Boucsein and the Buss and Durkee Hostility-Guilt Inventory. Results: Based on correlation coefficients, significant associations were found between increased daily SNS usage and negative relationships with parents, maladaptive coping, and increased aggression. Conclusions: 1. Participants who spent more time using SNS were more likely to feel lonely in their families and have a sense of not being accepted and understood by their parents. 2. Young people who spent more time using SNS were more likely to respond to a stressful situation with a sense of helplessness and resignation and to cope by downplaying their problems and seeking substitute gratification or support. 3. Young people who spent more time using SNS were more likely to respond with indirect aggression, negativism, suspicion, hostility and verbal aggression.

Abstract Introduction: There are numerous points of controversy over the psychological interpretation of the so-called S responses – namely, the interpretation of white space in the Rorschach test. The aim of my paper was to verify the position held by Charles P. Fonda, who claims that the meaning of S responses depends on the results of the test as a whole. Materials and methods: I have presented the responses of two young men and coded them according to the Comprehensive System developed by John E. Exner. I chose this way of processing data as the most precise, relatively well formalized, and detailed one. The two examinees gave an almost identical number of responses in the whole test and a similar number of S responses, similarly distributed across the cards of the test. Results: I assessed and compared the results of the two examinees in terms of the effectiveness of their cognitive processes, self-control ability, mental resources, social adjustment, and self-esteem. Finally, I looked closely at the contents of a few responses, as in my opinion they symbolically expressed the examinees’ basic problems. Discussion: I tried to avoid describing the examinees’ psyche in nosological terms and to focus on presenting the way in which they experienced the world, as well as on how this experience affected their behavior. Conclusions: I found that in Examinee 1 criticism towards other people may stem from an excessively idealistic attitude to the world and from the ensuing disappointments. Good cognitive functioning, resistance to stress, positive self-esteem, and the socialized emotional sphere make this man’s S responses a sign of creative engagement in the problems encountered rather than a sign of maladjustment. In the case of Examinee 2, S responses can be understood as defiance and a generalized attitude of negativism, which play the role of defense against the excessively complicated, not fully comprehensible, and inhospitable world; these responses may, in their turn, contribute to the intensification of problems and to an increase in maladjustment.

Abstract Background: X-linked adrenoleukodystrophy (X-ALD) is an inherited metabolic disease which causes demyelination of the white matter of the brain. The symptoms include mental impairment, progressive paresis, impaired motor coordination, and epileptic seizures. Diagnosis is established mainly by genetic testing. Currently, the recommended treatment is haematopoietic stem cell transplantation (HSCT). Goal: The aim of the study was to present the case of a patient suffering from X-ALD, who developed symptoms of bipolar disorder in the initial phase of the disease prior to the onset of characteristic neurological symptoms. Case presentation: In 2015, a 33-year-old patient was admitted to a psychiatric department due to aggressive behaviour he showed towards his wife and other family members. He had been treated for a depressive episode in 2005, and for a manic episode without psychotic symptoms earlier in 2015. During the successive psychiatric hospitalizations, in addition to psychopathological symptoms, the patient had been observed to have neurological symptoms, which included progressive paraparesis and ataxia. In 2018, based on imaging and genetic tests, the patient was diagnosed with X-ALD. The patient’s condition gradually deteriorated; with time, he was unable to move on his own. During a hospital stay in 2019, he was transferred to an internal medicine department due to a progressive urinary tract infection, which, however, could not be controlled, and the patient died. Conclusions: 1. X-ALD is a rare metabolic illness. In the early stages of the disease, various psychopathological symptoms, including affective disorders, are observed. 2. Early initiation of adequate treatment increases the chances of extending the patient’s life. 3. In the present case, the patient did not die due to the underlying disease, but due to causes typical of bed-bound patients, i.e. complications of progressing infection.