Publications (49) View all
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Article: Manganese-Induced Parkinsonism Among Ephedrone Users and Drug Policy in Poland.
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ABSTRACT: A recent government's prohibition policy in Poland was partially successful with a reduction of the synthetic drugs market and a decrease in drug-related poisoning mortality rates. However, a new threatening trend is observed. There are a growing number of individuals in Poland and other European countries using legal pharmaceuticals containing ephedrine or pseudoephedrine to produce stimulants. This case report describes a history of a male patient with polysubstance dependence who administered self-designed ephedrone derived from Sudafed using potassium permanganate. He revealed significant clinical symptoms of manganese-induced parkinsonism. No effective treatment could be recommended. Awareness of this severe neurological and social consequences should lead to prevention efforts including educational programs and initiatives reducing availability of the legal medications containing ephedrine or pseudoephedrine. More research is needed to enhance our knowledge about manganism and potential treatment regimens.Journal of Addiction Medicine 04/2013; · 1.95 Impact Factor -
Article: Age-dependent symptomatology of depression in hospitalized patients and its implications for DSM-5.
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ABSTRACT: BACKGROUND: We investigated effects of current age and age at onset on symptomatology of depression with reference to proposed revisions in DSM-5. METHODS: The study entailed medical records of 326 inpatients diagnosed with major depressive disorder, including 520 depressive episodes, with 113 first episodes lifetime. Subjects were divided into three groups: young-adults, middle-aged adults and older adults. RESULTS: In young-adults, active suicidal ideation, lifetime suicidal attempts, irritability, anhedonia and persistent depressive symptoms between the episodes were more frequent than in the other groups. Among older adults, depression was associated with insomnia, hypochondriasis, somatization, decreased appetite, weight loss, memory impairment and decreased activity. The older age was not associated with higher number of previous episodes of depression, bigger severity or duration of a single episode or a different degree of remission. Early-onset depression was associated with more suicidal attempts. LIMITATIONS: The study was retrospective and the sample may be treated only as representative for hospitalized depressed patients. CONCLUSIONS: Age and age at onset are important factors influencing the course and symptomatology of a depressive episode. Depressive episodes with anxiety and with suicide risk severity are important specifiers that vary with the age at onset and/or age of the patient and should be considered for inclusion in the DSM-5 revision.Journal of affective disorders 01/2013; · 3.76 Impact Factor -
Article: The CC genotype in the T102C HTR2A polymorphism predicts relapse in individuals after alcohol treatment.
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ABSTRACT: The serotonin system is hypothesized to contribute to predisposition and course of alcohol dependence. However, the potential association between the T102C polymorphism (rs6313) in the type 2A serotonin receptor (HTR2A) gene and treatment outcomes in alcohol dependence has not been investigated. The aim of the study was to assess the contribution of this genetic polymorphism as a predictor of relapse in relation to other previously identified predictors. A sample of 254 alcohol dependent subjects, were recruited in alcohol treatment centers in Warsaw, Poland and prospectively assessed at baseline and follow-up after 12 months. At baseline, information about demographics, psychopathological symptoms and alcohol problems was obtained. The stop-signal task was performed and blood samples for genetic analysis of HTR2A T102C (rs6313) were collected. Relapse was defined as any drinking during the follow-up period. The statistical analysis showed that the CC genotype was significantly associated with increased relapse. Other significant factors were baseline depressive symptoms, number of drinking days during the 3 months prior to the baseline assessment, severity of alcohol-related problems, and a lifetime history of impulsive suicide attempts. Logistic regression analysis with and without the genetic factor revealed that adding the genetic factor increased the R square value by about 4%, with the CC genotype in the T102C polymorphism being the strongest predictor of relapse (OR = 2.32). The significant influence on relapse of the CC genotype, which is associated with fewer 5-HT2A receptors in the central nervous system, suggests the possibility that this genetic polymorphism could influence response to serotonergic medications.Journal of psychiatric research 01/2013; · 3.72 Impact Factor -
Article: Psychosocial predictors of impulsivity in alcohol-dependent patients.
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ABSTRACT: Impulsivity is an important risk factor of severe course of alcohol dependence. However, the significance of environmental determinants of impulsivity has been underestimated. The aim of this study was to identify psychosocial factors increasing the level of impulsivity in alcoholics. Levels of impulsivity were measured in 304 alcohol-dependent patients. The stop-signal task was used to assess behavioral impulsivity, and the Barratt Impulsiveness Scale, to measure global and cognitive impulsivity. Correlations between impulsivity and psychosocial variables were examined. A significant association between level of impulsivity and severity of psychopathological symptoms was observed. Patients who reported childhood sexual or physical abuse, lower social support, and more severe course of alcohol dependence were more impulsive, especially in the cognitive domain. When entered into a linear regression analysis model, severity of alcohol dependence, psychopathology, and childhood physical abuse remained significant. These results suggest that psychosocial variables are important factors associated with high levels of impulsivity in alcohol-dependent patients.The Journal of nervous and mental disease 01/2013; 201(1):43-7. · 1.77 Impact Factor -
Article: Possible Association between Suicide Committed under Influence of Ethanol and a Variant in the AUTS2 Gene.
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ABSTRACT: rs6943555 in AUTS2 has been shown to modulate ethanol consumption. We hypothesized that rs6943555 might be associated with completed suicide. We genotyped rs6943555 in 625 completed suicides and 3861 controls using real-time TaqMan Allelic Discrimination Assay. All individuals were Polish Caucasians. We detected an association between suicide and rs6943555 A allele (OR = 1.17, P = 0.018 for allelic comparison, OR = 1.24, P = 0.013 for dominant, and OR = 1.18, P = 0.020 for co-dominant model of inheritance). The association remained significant after adjusting for age and gender (co-dominant: P = 0.002 and dominant model: P = 0.001). After stratifying suicides according to blood ethanol concentration (BAC≤ 20 mg/dl and BAC > 20 mg/dl) the association remained significant only for cases who committed suicide under influence of alcohol (co-dominant: OR = 1.37, P = 0.004 and dominant model: OR = 1.45, P = 0.006). To validate this finding we genotyped another cohort of 132 cases. We reproduced the association between rs6943555 A allele and suicide under influence of ethanol (allelic comparison: OR = 1.55, P = 0.023; co-dominant : OR = 1.54, P = 0.031; dominant model: OR = 1.84, P = 0.015). Analyzing pooled suicides with BAC >20 mg/dl (N = 300) we found the association of rs6943555 A allele not only vs. controls (allelic OR = 1.41, P = 0.00029) but also vs. cases with BAC ≤ 20 mg/dl (N = 449, allelic OR = 1.33, P = 0.019). In our study rs6943555 A allele is associated with suicide committed after drinking ethanol shortly before death. The rs6943555 A allele may be linked to adverse emotional reaction to ethanol, which could explain the association with lower consumption in general population as well as the predisposition to suicide under influence of ethanol.PLoS ONE 01/2013; 8(2):e57199. · 4.09 Impact Factor
