Maciej Wojciech Pilecki

Sex differences in prevalence of overweight and obesity, and in extent of overweight index, in children and adolescents (3–18 years) from Kraków, Poland in 1983, 2000 and 2010

OBJECTIVE The increasing prevalence of overweight and obesity among children is now an important health problem. This fact, however, does not reflect the scale of the problem. The aim of the present study was to find how much the BMI threshold was exceeded in a population from Kraków. DESIGN The study was based on three cross-sectional surveys conducted in 1983, 2000 and 2010. The prevalence of overweight and obesity was estimated based on the International Obesity Task Force cut-off points. In addition to these, an extent of overweight (EOW) index was calculated. SETTING Poland. SUBJECTS Children aged 3-18 years (n 14 534) from Kraków. RESULTS Between the populations examined in 1983 and 2010, the EOW index in boys rose by almost 10 %, and the prevalence of overweight and obesity by 39 %. In girls, however, the EOW index decreased by 45 %, while the prevalence of overweight and obesity remained at similar levels. Analyses in separate age groups showed that the EOW index increased only among early adolescents (150 % for boys, 94 % for girls) and late adolescents (390 % and 64 %, respectively). CONCLUSIONS The observed increased prevalence of overweight and obesity mainly concerned boys and was accompanied by an increase in the amount by which the BMI threshold values were exceeded.

Depression and anxiety in the practice of cardiology.

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[Convergence insufficiency with unilateral exophoria at near in schizophrenia and bipolar disorder - a preliminary study].

OBJECTIVES The study describes an abnormal convergence symptom, i.e. unilateral exophoria at near, in patients with schizophrenia (SZ) and bipolar disorder (BD). The aim of this paper is to present the symptom and discuss its possible explanations. METHODS 29 patients with SZ, 15 patients with BD and 20 healthy controls (HC) took part in the study. The neurological assessment was done with International Co-operative Ataxia Rating Scale (ICARS) and Neurological Evaluation Scale (NES). RESULTS The abnormal vergence pattern was observed in 12 patients with SZ, 1 patient with BD and 0 HC. Symptom appeared statistically more often in SZ patients than in BD patients and HC. SZ patients with vergence symptom performed significantly worst in oculomotor and dysarthia subscores of ICARS. CONCLUSIONS The symptom can be linked to disruptions in cortico-ponto-cerebellar network and midbrain. It was the only neurological symptom that differed SZ and BD groups, thus it might be used in differential diagnosis. Further research is needed to obtain a full clinical description of the symptom.

Relationship between cerebellar impairments and lexicon retrieval in schizophrenia - preliminary study

Summary Aim of the study. Investigation of relationship between cerebellar motor dysfunctions and language im- pairments connected with cerebellum during phonological and semantic fluency tasks and verb genera- tion task in schizophrenic patients and healthy control group. Subject or material and methods . 14 schizophrenic patients on olanzapine, clozapine or quetiapine treat- ment and 13 healthy volunteers were examined. Motor signs were assessed by using the International Co-operative Ataxia Rating Scale (ICARS). Phonological and semantic fluency tasks were performed. All of the words were recorded and counted. Results . Patients with schizophrenia revealed significantly higher ICARS mean score (12.21) than control group (3.92), and lower number of proper generated words in semantic fluency and verb generation tasks. Strong negative correlation (rs(13) = -0.71, p<0.01) was found between ICARS total score and number of proper answers in verb generation task. Discussion. Higher number of total ICARS score in schizophrenia patients in comparison to control group may suggest cerebellar impairments. There is disproportion between semantic and phonological fluency. Significant correlation between verb generation and cerebellar signs supports a hypothesis of cerebellum dysfunction during this task in schizophrenia patients. Conclusions . Schizophrenic patients reveal impairments which may be connected with the cerebellum. schizophrenia / verb generation / cerebellum / cognitive dysmetria

Thirty years’ follow-up of depressive adolescents: a preliminary report

Materials and Methods: The method employed for this baseline study was screening school-age children. A sample of children from different schools and different backgrounds were screened with the Krakow Depression Inventory (KID) in 1985. A follow-up study was performed 15 years later and a second follow-up study 30 years later. The follow-up questionnaires were devised by authors of the original study and sent out to the baseline sample by post. A preliminary analysis of the responses to the second follow-up study is presented.

Overweight and obesity risk factors in children aged 3–7 years: a prospective study in the city of Kraków

Abstract Background: Early identified factors determining overweight and obesity in childhood may be important for preventive purposes. Aim: To evaluate the influence of the commonly accepted and hypothetical risk factors for overweight/obesity and their mutual relations, using the method of classification trees. Subjects and methods: The data were collected during anthropometric surveys carried out in 2010 in Kraków, Poland. The study involved 1042 pre-school children aged 3–7 years. BMI was calculated for all subjects classified as underweight, normal body weight and overweight, according to the IOTF cut-offs. In order to determine the correlation between genetic, environmental and lifestyle factors and the child’s BMI, this study used information from a questionnaire filled in by the mothers. Results: Relatively high birth weights, relatively long times of breastfeeding and father’s obesity were conducive to the appearance of overweight and obesity in boys. Other overweight risk factors included alcohol consumption by the mother, her low education level and a relatively low mother’s age at birth. Among girls, factors leading to overweight included high birth weight, high father’s BMI and family situation reported as below very good by their mothers. It was found that a moderate duration of breastfeeding is conducive to a normal weight of children at pre-school age, although in boys this regularity is better documented. Conclusions: The biological, social and lifestyle factors related to the child’s mother significantly determined the child’s BMI.

The association between self-image and defence mechanisms in a group of adolescent patients receiving psychiatric treatment.

OBJECTIVES The aim of the study was to explore the relationship between various areas of self-image and defence mechanisms in adolescents. The study included a division into groups according to whether or not they were receiving psychiatric treatment. METHODS Data were obtained from two groups: a clinical group (30 persons), consisting of adolescent patients of the Adolescent Inpatient Ward of the Child and Adolescent Psychiatry Clinic and a control group (40 persons), adolescents attending upper secondary school. The Defence Style Questionnaire DSQ-40 and the Offer Self Image Questionnaire were used in the study. RESULTS Results showed no differences, in the maturity levels of the defence mechanisms, between the two groups. Subjects from the clinical group had a significantly lower self-image of themselves than subjects from the control group.. In both groups, the use of mature defence mechanisms was accompanied by a positive self-image, while the use of less mature defence mechanisms was associated with a lower self-image. Comparison of the groups revealed different relationships between the aspects of self-image and used defence mechanisms, in particular the mechanism of projection. Number of significant correlations was greater in the clinical group. CONCLUSIONS In the context of lower self-image, the study revealed the importance of such defence mechanisms as projection, acting out, somatization or schizoid fantasies. The obtained results seem to confirm a hypothesis that the assessment of the maturity of defence mechanisms in the period of adolescence is less clear and clinically useful.

Outcome of Polish teenage patients with eating disorders

Summary аim of the study . The aim of the study was to assess outcome of patients with eating disorders in a Polish socio-cultural context. Material and methods . Re-assessed after 6.72 years (SD 0.99 years, min 4.58 years, max 8.81 years), 47 of 112 patients consulted initially in the outpatient clinic of the Child and Adolescent Psychiatry Unit be- tween 2002/2004 in Krakow, Poland with one of the eating disorders. results . Complete remission (absence of symptoms for three months) took place in 55% of patients from the restrictive anorexia nervosa group and in 27.3% of patients from the bulimia nervosa group. A full range of symptoms was observed in 10% of patients from the restrictive anorexia nervosa group and in 36.4% of patients from the bulimia nervosa group. In both groups, the longer the follow-up study, the worse outcome observed. Discussion. Small size of group in the follow-up study caused a significant limitation. Conclusion . The remission rates indices for restrictive anorexia nervosa are similar to those presented in other follow-up studies. In the case of bulimia nervosa, they are lower than average. An analysis of di- agnosis variability between the initial and the follow up assessment indicates low crossover rate from an- orexia nervosa to the bulimia nervosa group. anorexia / bulimia / follow-up study