It is my pleasure to introduce the newest issue of „Wiedza Medyczna” prepared by our team from the Department of Psychiatry CMKP in Bielanski Hospital, Warsaw. Being located in a large, multidisciplinary hospital, every day we meet both challenges and opportunities resulting from consulting patients hospitalized in different departments or emergency unit as well as cooperation with colleagues representing various specialities. Experiences of „liaison psychiatry”, the awareness of medical comorbidities and interdisciplinary approach are well reflected in the articles presented in this issue.
Obesity is one of the biggest healthcare challenges wordwide and a great concern in patients suffering from severe mental illness, especially schizophrenia. The introduction of second generation antipsychotics largely improved treatment outcomes, however, due to metabolic side effects, many of these drugs odd to the somatic burden of the disease. Therefore, treatment strategies targeted at reducing metabolic risk are very important in clinical practice and these have been comprehensively described in the first article. Psychotherapy represents one of the core interventions for mental disorders with cognitive behavioral therapy (CBT) being most commonly recommended according to recent quidelines and evidence from clinical studies. Minfulness-based therapies (MBT) represent a new, „third wave” therapy approach with growing evidence of its great usefulness e.g. in depression, anxiety or substance use disorders – these are reviewed in a second article. The next article brings forward the Compulsive Sexual Behavior Disorder – a new psychiatric diagnosis introduced to the ICD-11 that clinicians should become aware of. The phenomenon of out-of-control sexual behavior is being extensively investigated recently and the authors describe current evidence-based data as well as challenges for future studies. The last two articles in these issue are case reports. In the first one that should especially bring attention of psychiatrists and neurologists, we describe clinical investigation and management of a 64-year old female patient that was initially hospitalized due to depressive symptoms and a history of auditory hallucinations, further diagnosed as dementia with Lewy’s bodies. The second case report is dedicated to a young antipsychotic-naive female patient with acute psychosis that was most probably induced by the use of methylphenidate – a medication originally indicated for patients with Attention Deficit / Hyperactivity Disorder but more and more commonly used „off-label” in conditions such as narcolepsy, hypersomnia, depression or even to improve cognitive performance in healthy subjects. Due to safety reasons, these treatments should be carefully considered and monitored.
Have a great read!
Michal Lew-Starowicz MD, PhD, FECSM, Assoc.Prof.
Department of Psychiatry,
Centre of Postgraduate Medical Education,
Bielański Hospital, Warsaw, Poland