Tadeusz Nasierowski

BDNF as a biomarker in the course and treatment of schizophrenia.

Many scientists agree that the genes involved in the aetiology and pathogenesis of psychiatric diseases could serve as biomarkers - biological indicators of the health status. Genetic markers may inform about general predispositions of a person to develop certain diseases, while other biochemical factors, such as concentrations of substances in body fluids, reflect the actual condition of the organism. Researchers involved in studies on schizophrenia are interested in the gene and protein of the brain-derived neurotrophic factor (BDNF) due to the role of this neurotrophin in the process of neurogenesis, synaptogenesis and its influence on the functioning of dopaminergic neurons. Among patients diagnosed with schizophrenia, the BDNF gene polymorphisms and methylation in the promoter sequences were studied. The neurotrophin was also assayed in the blood of patients, also taking into account the effect of pharmacotherapy on the BDNF concentration, and post-mortem in the brains of the patients. The results of current studies are contradictory. The only systematically confirmed observation is the lowered concentration of BDNF in the serum of patients with schizophrenia compared to healthy controls. It seems that so far our knowledge about the BDNF gene expression and the functions of the protein is not sufficient to include BDNF analysis in the clinical assessment of patients with schizophrenia.

In the Abyss of Death: The Extermination of the Mentally Ill in Poland During World War II

We do not know exactly how many mentally ill people were killed by Nazis in Poland during World War II. Twenty thousand is an estimate. Facts concerning the murder of the mentally ill reported in this article do not include all such acts as very many more took place. I describe only the principal crimes that occurred in large psychiatric hospitals and took a toll of 13,000 victims.

Magnesium in schizophrenia

Many psychopathological symptoms, including schizophrenia, can be associated with magnesium metabolism disturbances. In the literature, contradictory data exist regarding magnesium levels in patients with this disorder. However, this situation might be caused by determination of extracellular concentration of magnesium; although, this is mainly an intracellular ion. There are no data concerning determination of the ionized fraction of magnesium in patients with schizophrenia, while the ionized fraction represents 67% of the total pool of magnesium in healthy people. Also, the mechanism of magnesium action-the effect of magnesium ions on NMDA and GABA receptors-has not yet been fully investigated. There are preliminary studies aimed at increasing the effectiveness of schizophrenia pharmacotherapy via magnesium supplementation. Multidirectional activity of magnesium can significantly increase its therapeutic effect in psychiatry. This observation is confirmed by recent studies conducted by various research teams. However, further studies on the role of magnesium supplementation in patients with schizophrenia are needed.

Ionized magnesium in plasma and erythrocytes for the assessment of low magnesium status in alcohol dependent patients

BACKGROUND Studies on the homeostasis of magnesium in alcohol-dependent patients have often been characterized by low hypomagnesemia detection rates. This may be due to the fact that the content of magnesium in blood serum constitutes only 1% of the average magnesium level within the human body. However, the concentration of ionized magnesium is more physiologically important and makes up 67% of the total magnesium within a human organism. There are no data concerning the determination of the ionized fraction of magnesium in patients addicted to alcohol and its influence on mental health status. METHODS This study included 100 alcohol-dependent patients and 50 healthy subjects. The free magnesium fraction was determined using the potentiometric method by means of using ion-selective electrodes. The total magnesium level was determined by using a biochemical Indiko Plus analyzer. In this study, different psychometric scales were applied. RESULTS Our results confirm the usefulness of ionized magnesium concentrations in erythrocytes and plasma as a diagnostic parameter of low magnesium status in alcohol-dependent patients. CONCLUSIONS The lower the concentration of ionized magnesium, the worse the quality of life an alcohol-dependent person might experience. In the case of total magnesium, no such correlation was determined.

Deinstitutionalization in Italian psychiatry - the course and consequences Part II. The consequences of deinstitutionalization

The Italian mental health care is based on Law 180 (it. Legge 180), also called Legge Basaglia, from the name of the author of the reform, Franco Basaglia. It was adopted on May 13th 1978. The new legislation resulted from the actions of a strong anti-psychiatric movement and it brought about a major change in the organization of psychiatric care. The reform and its consequences were widely studied by the researchers, especially in the United Kingdom and the United States of America. The authors point out many successes of the reform, especially in its beginning. They seek the sources of its failure in a faulty and incomplete implementation. Legge Basaglia completely changed the structure of mental health care in Italy, finally bringing psychiatry back to medicine and the general hospitals, as well as promoting community-based psychiatry. Deinstitutionalization in Italy was not related to an increase in compulsory psychiatric hospitalizations, suicide attempts by the mentally ill, nor did it raise the number of crimes committed by them. It also did not cause common trans-institutionalization, with the transfer of patients to the private sector, as predicted by its opponents.

Deinstitutionalization in Italian psychiatry - the course and consequences Part I. The course of deinstitutionalization - the activity of Basaglia's group

Psychiatric reform in Italy consisted of the implementation of legislative changes derived from anti-institutional experiments conducted by Franco Basaglia and his group in the 60s and 70s of the 20th century. The activity of Basaglias group was an integral part of the European reform movement of that time, which profited from the economic, cultural and political prosperity for changes in psychiatry. Italian antipsychiatry has led to the most radical experiment in deinstitutionalization in history. It involved the whole public sector of psychiatry and across a quarter-century resulted in a grand social debate on the situation of the mentally ill and the need for systemic change of their treatment and care. Inspired mainly by phenomenological analysis, Basaglia opted for close emphatic contact with the mentally ill. While the British, French and American anti-psychiatrists contested the psychiatric care system as such, the Italian radicals made an approach to disassemble it from the inside and successfully gained social support for the process of deinstitutionalization. Basaglia promoted his ideas across Europe, including the World Health Organization (WHO) forum.

Effect of Disturbances of Zinc and Copper on the Physical and Mental Health Status of Patients with Alcohol Dependence

The concentrations of copper and zinc in the tissues of alcohol-addicted people can significantly correlate with the variables describing their mental state. Studies on the homeostasis of zinc in alcohol-dependent patients have often been characterized by low hypozincemia detection. This may be caused by a low content of zinc in blood serum (1%) compared to the average zinc level in the body. Unfortunately, most authors have identified extracellular zinc in their studies. In the available literature, data on the level of copper in patients suffering from alcohol dependence are inconsistent. Our study included 100 alcohol-addicted patients (the study group) and 50 healthy subjects (the control group). Mental state was measured using appropriate psychometric scales. We used inductively coupled plasma mass spectrometry (ICP-MS) to determine copper and zinc content. Our results confirm the purposefulness of the use of zinc concentration in erythrocytes as a diagnostic parameter for low zinc status in alcohol-dependent patients. Alcohol-dependent patients with reduced concentrations of zinc in erythrocytes/copper in blood plasma differed significantly from alcohol-dependent patients with normal concentrations in terms of clinical parameters. With regard to zinc in blood plasma and copper in erythrocytes, this situation has not been found. The clinical symptoms of hypozincemia and copper deficiency in patients addicted to alcohol usually relate to disorders in central nervous system functioning, and they result in a decreased quality of physical and mental life.

Freemasonry and psychiatry in Poland

The history of Freemasonry in Poland is linked with the national independence movement. Masonic organizations supported its ideas, even though they were not always compliant with Masonic ethics. Polish Freemasonry was reborn in 1920, with an important role played by three psychiatrists: Rafał Radziwiłłowicz, Witold Łuniewski and Jan Mazurkiewicz, who were Grand Masters of the Grand National Lodge of Poland. Some of the ethical problems discussed at the lodge sessions were later reflected in their academic and social work. Mazurkiewicz’s work was most crucial to the development of Polish psychiatry. His presentation of the clinical picture of schizophrenia, formulated in the 1930s, was identical with the concept proposed by Andreasen and Crow in the 1980s.