Cel pracyZ uwagi na współwystępowanie objawów zaburzeń lękowych i zaburzeń obsesyjno-kompulsyjnych (OCD) oraz hipotezy mówiące o wspólnych czynnikach etiopatogenetycznych, poddano badaniu występowanie i nasilenie objawów lękowych, nasilenie grup objawów nerwicowych oraz przeprowadzono analizy czynnikowe w dwóch grupach pacjentów: z rozpoznaniem zaburzeń obsesyjno-kompulsyjnych (OCD) i zaburzeń lękowych uogólnionych (GAD).MetodaBadanie przeprowadzono retrospektywnie w dwóch grupach pacjentów: 76 - z rozpoznaniem OCD i 186 - z rozpoznaniem GAD. Źródłem informacji o występowaniu i nasileniu objawów był Kwestionariusz Objawowy „O” (KO). W badaniu uwzględniono wpływ płci oraz istnienia lub nie dysfunkcji poznawczych (testy Bender i Benton), na badane zależności.WynikiNie stwierdzono istotnych różnic w nasileniu większości objawów lękowych w grupie pacjentów z rozpoznaniem OCD i GAD. Pacjenci z GAD cechowali się istotnie wyższym średnim nasileniem zaburzeń fobicznych, konwersyjnych, zaburzeń autonomicznych z zakresu serca i układu sercowo-naczyniowego oraz hipochondrycznych, w porównaniu do pacjentów z OCD. Analizy czynnikowe wykazały istnienie zarówno w grupie OCD jak i w GAD istnienie trzech podobnych czynników: „niepokój/depresyjność”, „obsesje” i „kompulsje”. Ponadto w OCD wyodrębniono między innymi czynnik „depresyjności”, natomiast w GAD czynnik odpowiadający lękowi separacyjnemu.WnioskiBadanie wskazuje na istotne znaczenie lęku w obrazie OCD, który może osiągać nasilenie podobne jak w GAD. Występowanie i nasilenie objawów lękowych oraz somatyzacyjnych, może być powiązane z występowaniem dysfunkcji poznawczych, co wymaga dalszych badań.

Objective: Because of the heterogeneity of obsessive-compulsive disorders (OCDs) and their co-occurrence with anxiety disorders, we investigated the prevalence, severity, and correlations between obsessive and compulsive symptoms reported by patients diagnosed with OCD or generalized anxiety disorder (GAD). Methods: A retrospective study was conducted in 2 groups of patients: 76 patients diagnosed with OCD [F42 according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10)], and 186 patients diagnosed with GAD (F41.1 according to ICD-10), who had presented for therapy at the day ward. The Symptom Questionnaire “O,” based on the Symptom Checklist 90-Revised (SCL-90-R) questionnaire, was used to assess obsessive, compulsive, and anxiety symptoms. The analysis took into account the impact of sex and the presence or absence of cognitive dysfunction (as assessed using the Bender Benton Visual Retention and Bender-Gestalt tests) on the associations being investigated. Results: We observed that obsessive and compulsive symptoms were more prevalent and more strongly expressed in the group with OCD than in the group with GAD. However, almost all patients with GAD (94%) confirmed the presence of some obsessive-compulsive symptoms. The study revealed differences in correlations with obsessions and compulsions between the OCD and GAD groups. In the group with OCD, no significant correlation between the severity of obsessions and compulsions was identified, whereas in the group with GAD, a significant positive correlation was found between the severity of those symptoms. In both the GAD and OCD groups, a greater intensity of obsessive-compulsive symptoms was accompanied by an increase in the severity of anxiety symptoms (with this effect noted to a greater extent with obsessions than compulsions). Conclusions: The study revealed that patients with GAD often have coexisting obsessive-compulsive symptoms, which may not be identified during routine psychiatric examination. Obsessive-compulsive symptoms observed in patients with GAD may show a different structure than obsessive-compulsive symptoms in patients with OCD. The results of this study suggest that compulsions are more specific for the diagnosis of OCD than obsessions. Compulsions, such as counting related to the need for order and symmetry, may be associated with some cognitive dysfunctions and male sex, a finding that requires further research.

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IntroductionHyperprolactinemia is a common endocrinological disorder. Some data suggest that psychological factors (e.g. personality traits) may play a role in hyperprolactinemia genesis.ObjectivesIncreased prolactin level (PRL) is described as clinical observations in some patients, usually with a diagnosis of borderline personality disorder. In the international literature there is lack of broader description and information of clinical implications of this phenomenon.AimThe aim of the study is to evaluate the prevalence of hyperprolactinemia in patients with diagnoses F40-F69 according to ICD-10 and an evaluation of the changes in PRL after psychotherapy.MethodsThe study population comprised 64 patients, mainly females (73%), with primary diagnosis of neurotic or personality disorder. Prolactin level was measured during the first and last week of the psychotherapy. Between the measurements patients underwent intensive short-term (12 weeks) group psychotherapy in a day hospital for neurotic and behavioural disorders.ResultsHyperprolactinemia was found in 41% of males and 42.4% of females in the study group. After psychotherapy significant reduction in prolactin level was observed in 80% of woman with hyperprolactinemia.ConclusionsHyperprolactinemia is observed in almost 40% of patients with neurotic and personality disorders. Psychodynamic psychotherapy can be a significant factor improving PRL level in patients with neurotic and personality disorders, specifically women.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe hypothalamus—pituitary—adrenal axis (HPA axis) dysregulation plays an important role in the pathophysiology of anxiety disorders. Salivary cortisol level is a useful indicator of HPA axis dysfunction.ObjectivesMost data suggests elevated cortisol awakening response (CAR) in anxiety disorders, but there are studies indicating opposite pattern (flat CAR).AimGoal of this study was to determine whether patients with anxiety and personality disorders show a specific daily cortisol patterns and weather this pattern changes after 12 weeks of intensive predominantly psychodynamic combined group and individual psychotherapy.MethodThe studied population comprised 77 patients, mainly females (72.7%), with primary diagnosis of anxiety disorder 40.9% or personality disorder 59.1%. The Symptom Checklist “0” was used to assess the pre- and post-treatment levels of patients’ symptoms. Pre- and post-treatment cortisol levels were measured in three saliva samples collected during one day (at awakening, 30 min after awakening, at 22.00).ResultsThe obtained results were partly similar to previous research. We found four different daily CAR patterns: decreased (drop 30 min after awakening), flat (rise 0–49% 30 min after awakening), normal (rise 50–75% 30 min after awakening) and elevated (rise over 75% 30 min after awakening), two of them (flat and elevated) were considered as typical for anxiety disorders. Groups of CAR pattern differed significantly in the level of sleep symptoms, dysthymia symptoms and avoidance/dependency symptoms. The changes in the CAR pattern after psychotherapy were not significant.ConclusionsAnxiety disorders and personality disorders are characterized by more than two specific daily salivary cortisol patterns.Disclosure of interestThe authors have not supplied their declaration of competing interest.