IntroductionThe authors present a comprehensive-efficacy of pharmacotherapy and rehabilitation in the social house for people with mental health disorders carried out systematically for many years in the 40 year old patient.ObjectivesPatient 40 years old, male, secondary education, imposed a total inability to work. The first episode of the disease was in his 25 years, a syndrome of depression in a moderate degree, the next episode of schizophrenia-catatonic. In the therapy was used first generation antipsychotics, despite regular medication had not obtained complete remission and frequent exacerbations were the cause of several subsequent hospitalizations. During the last hospitalization in 1997, recognizing the diagnosis was verified with paranoid schizophrenia. After discharge, the patient in accordance with the recommendation began rehabilitation in the social house for people with mental health disorders, which still continue. Because of side effects after the previously used antipsychotic drugs second-generation - ziprasidone was incorporated in 2005. The use of this drug caused a significant decrease in body weight, increased social activity (a return to artistic activities - painting), improving the quality of life. Due to persistent chronic anxiety has been further adjustment of treatment in 2008 included amisulpride and valproate.ConclusionsThe treatment used a comprehensive, full remission of symptoms generation, and a significant reduction in negative symptoms. Currently, the patient actively participates in all activities organized in the environmental treatment of self-help home, living independently in daily activities, carry out the artistic passion of winning prizes at exhibitions and presentations of work.

The development of treatment programs should focus also on the patientś subjective perspective. According to our findings agonistic opioid maintenance treatment yields not only to treatment response but also to improvements in patients quality of life.

Aims:Tobacco dependence is common in patients with mental disorders. At the same time the self-esteem of these patients is very low. Failures, which inmates may suffer during smoke cessation, may lower their self-esteem more and more. The aim of the study was to indicate the influence of CBT on self-esteem and smoking cessation among inmates.Methods:The study comprised 44 mentally ill heavy smokers (38 with schizophrenia and 6 with depression). CBT was adopted for the experimental group (n=19). The CBT-group participated in twelve weekly two-hour therapeutic sessions concentrated on enhancing a self-esteem, and twelve weekly educational sessions. The control group (n=25) participated in educational training only. The study was of a linear character. The following methods were used: Self-Esteem Scale, Fagerstrom Test for Nicotine Dependence, characteristic of tobacco use questionnaire and monitoring the amount of cigarettes.Results:An improvement in self-esteem was observed in the period following the therapy among CBT-group in comparison with the control group. After therapy inmates from CBT-group smoked less cigarettes than control group and faster decided on a smoking cessation. After interventions self-esteem was negatively correlated with amount of cigarettes. Twelve patients from CBT-group stopped smoking completely in comparison with eight from control group.Conclusions:CBT improves the self-esteem in mentally ill patients and it may by used as a very helpful method for smoking cessation among this group of smokers.