ObjectivesOral lichen planus (OLP) is a chronic, multifocal, sometimes painful, inflammatory disease of the oral mucosa. OLP can predispose development of psycho-emotional disorders. Until now, the relationship between the severity of lichen planus and the psychological profile of patients (psychological well-being, perceived stress and pain coping strategies) has never been studied.Material and MethodsStudy was conducted on 42 OLP patients. Number of sites involved, severity and activity score of OLP were evaluated. Psychological tests were used to evaluate patients’ psycho-emotional condition. The mean duration time of symptomatic OLP was 43 months.ResultsWe detected that the longer the duration of subjective symptoms, the poorer the quality of life and the higher the level of perceived stress (PSS). Also, the higher the PSS results, the greater the anxiety and depression on Hospital Anxiety and Depression Scale (HADS). Likewise, higher level of depression in HADS was strongly correlated with worse quality of life. (p≤0.05).ConclusionsIn this study, we detected a relationship between duration of the disease, level of perceived stress and quality of life. The longer the disease lasts, the higher it tends to catastrophize. This may influence development or increase of the anxiety and depression and may decrease patients’ quality of life.

IntroductionStigma is a multistage process that makes person marked by the stigma to be perceived as diminished or even as “not fully human”. The internalized stigmatization is seen as one of the levels of stigma to be present in persons with mental illness. A new perspective to mediation models between internalized stigma and illness-related factors is needed.AimTo assess the relationship between insight in mental illness and internalized stigma, as well to verify the knowledge of illness-related factors on the phenomenon of internalized stigma among patients with severe mental illnesses.MethodsA cross-sectional study design conducted among participants of both sexes between 18 years old and 65 years old with diagnosis of psychotic disorders (F20–29) and mood disorders (F30–39), who after reading the information about the study, give their written consent to participate. Among used methods were: a questionnaire of Internalized Stigma of Mental Illness (ISMI) by Ritsher [Boyed] et al. translated into Polish version and self-prepared interviews. Insight into mental illness was assessed using the Positive and Negative Syndrome Scale.ResultsThe preliminary results showed patients with the insight into the mental illness have significantly higher scores on the ISMI scale. Moreover, inpatient participants and those with the diagnosis of depression were characterized by higher level of stereotype endorsement compared with outpatients and psychotic patients.ConclusionsThe obtained results may contribute in the clinical and therapeutic fields, assuming that insight and the type of treatment are strongly linked with the process of recovery and the internalized stigma.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Klozapina pozostaje jednym z najskuteczniejszych leków stosowanych w psychiatrii. Jest lekiem pierwszego rzutu w schizofrenii lekoopornej oraz w przypadku późnych dyskinez u pacjentów uprzednio leczonych innymi lekami przeciwpsychotycznymi i uciążliwych zachowań agresywnych. Dodatkowo wyraźnie redukuje ryzyko zachowań samobójczych i poprawia jakość życia. Wśród działań niepożądanych klozapiny wymienia się m.in. agranulocytozę i granulocytopenię, drgawki, zapalenie mięśnia sercowego, zespół metaboliczny, ślinotok, sedację. Pomimo licznych działań niepożądanych śmiertelność wśród osób leczonych klozapiną jest niższa niż wśród ogółu pacjentów chorujących na schizofrenię. Klozapina obniża próg drgawkowy oraz indukuje drgawki. Ryzyko ich wystąpienia zależy od dawki leku i wynosi około 4,4%. Najczęściej opisywane są drgawki toniczno-kloniczne, następnie mioklonie i napady atoniczne. Trudności w mówieniu, mioklonie, upadki w przebiegu napadów atonicznych mogą być zwiastunami drgawek toniczno--klonicznych. Monitorowanie poziomu klozapiny w surowicy i elektroencefalografia, chociaż pomocne w prowadzeniu terapii, nie wykazały skuteczności w ocenie ryzyka wystąpienia drgawek. W przypadku politerapii warto zwrócić uwagę na możliwość interakcji klozapiny z licznymi lekami. Po pierwszym napadzie drgawek rekomenduje się zmniejszenie dawki klozapiny, a w razie wystąpienia kolejnych napadów -wprowadzenie leku przeciwdrgawkowego. Lekami pierwszego rzutu w leczeniu drgawek indukowanych klozapiną są kwas walproinowy i lamotrygina. Warto zauważyć, że lamotrygina nie wchodzi w interakcje z metabolizmem klozapiny oraz potencjalizuje jej działanie przeciwpsychotyczne. Z myślą o profilaktyce napadów drgawkowych zaleca się stopniowe zwiększanie i stopniową redukcję dawek klozapiny. Słowa kluczowe: klozapina, drgawki, działania niepożądaneClozapine remains one of the leading antipsychotic medications to date. It is a first-line drug in treatment-resistant schizophrenia, tardive dyskinesia in patients previously receiving other antipsychotics as well as in patients with aggressive behaviour. Furthermore, clozapine therapy significantly reduces suicidal behaviour and improves the quality of life. Clozapine-related adverse effects include, among other things, agranulocytosis and granulocytopenia, seizures, myocarditis, metabolic syndrome, sialorrhea, sedation. Despite the numerous adverse effects, the mortality among clozapine-treated patients is lower compared to the overall schizophrenic population. Clozapine lowers the seizure threshold and induces seizures. The risk of seizures is dose-dependent and is approximately 4.4%. Tonic-clonic seizures are most commonly reported, followed by myoclonus and atonic seizures. Difficulty in speaking, myoclonus and falls during atonic seizures may be signs of approaching tonic-clonic seizures. Although the monitoring of clozapine serum levels and electroencephalography were shown to be an effective aid in the therapy, they failed to show efficacy in assessing the risk of seizures. In the case of combina...