Funkcjonowanie tarczycy ma doniosłe znaczenie dla kształtowania się, dojrzewania i aktywności ośrodkowego układu nerwowego. Związek klinicznych zaburzeń czynności tarczycy z zaburzeniami psychicznymi, w tym z upośledzeniem funkcji poznawczych, wydaje się być dobrze udokumentowany. Nieprawidłowe stężenia hormonów tarczowych mogą prowadzić do pogorszenia procesów kognitywnych poprzez zmiany w neurotransmisji, nasilanie stresu oksydacyjnego, czy też wpływ na przemiany β-amyloidu i metabolizm glukozy w ośrodkowym układzie nerwowym. Wątpliwości dotyczą przede wszystkim subklinicznych form dysfunkcji tarczycy. Według niektórych danych, mają one wykazywać związek ze stanem funkcji poznawczych oraz być jednym z czynników przyśpieszających mechanizmy prowadzące do zwyrodnienia tkanki mózgowej i w konsekwencji do otępienia. Wyniki badań nad korelacją aktywności tarczycy z funkcjami poznawczymi oraz nad ewentualnym korzystnym wpływem suplementacji hormonalnej na procesy kognitywne przynoszą jednak sprzeczne wyniki, co przynajmniej częściowo może wynikać z dużych problemów metodologicznych. Nie należy także wykluczać korelacji odwrotnej, gdzie toczący się proces neurozwyrodnieniowy wpływałby na czynność tarczycy, np. poprzez zmienioną produkcję i wydzielanie tyreoliberyny. Pomimo kilkudziesięciu lat intensywnych badań, wyjaśnienie tego związku jest nadal dalekie od rozstrzygających ustaleń.

Approximately 70% of people will experience a traumatic event in their lifetime, but post-traumatic stress disorder (PTSD) will only develop in 3.9% and complex post-traumatic stress disorder (CPTSD) in 1–8% of the population worldwide, although in some countries (e.g., Poland and Northern Ireland) it will develop in a much higher percentage. Stress-related disorders have a complex pathogenesis involving neurophysiological, genetic, epigenetic, neuroendocrine and environmental factors. This article reviews the current state of knowledge on the molecular aspects of selected PTSD symptoms: hypervigilance, re-experiencing, emotion dysregulation and dissociation, i.e., the symptoms with strong neurobiological components. Among analysed susceptibility factors are specific gene polymorphisms (e.g., FKBP5, COMT, CHRNA5, CRHR1, 5-HTTLPR, ADCY8 and DRD2) and their interactions with the environment, changes in the HPA axis, adrenergic hyperactivity and disturbances in the activity of selected anatomical structures (including the amygdala, prefrontal cortex, corpus callosum, anterior cingulate gyrus and hippocampus). It is worth noting that therapeutic methods with proven effectiveness in PTSD (TF-CBT and EMDR) have a substantial neurobiological rationale. Molecular aspects seem crucial when searching for effective screening/diagnostic methods and new potential therapeutic options.

Background: In this study, we analyze the association of social isolation in the first phase of the pandemic with perceived stress among residents of Poland and Italy with a look at how these populations adjust to and comply with implemented regulations, guidelines, and restrictions.Materials and Methods: Internet survey with Perceived Stress Scale (PSS-10) and questions regarding mobility patterns, attitude, and propensity to adjust toward the implemented measures and current health condition was made among Polish and Italian residents (Cronbach’s alpha 0.86 and 0.79, respectively). The sample size was 7,108 (6,169 completed questionnaires in Poland and 939 in Italy).Results: The Polish group had a higher stress level than the Italian group (mean PSS-10 total score 22,14 vs 17,01, respectively;p< 0.01). There was a greater prevalence of chronic diseases among Polish respondents. Italian subjects expressed more concern about their health, as well as about their future employment. Italian subjects did not comply with suggested restrictions as much as Polish subjects and were less eager to restrain from their usual activities (social, physical, and religious), which were more often perceived as “most needed matters” in Italian than in Polish residents.Conclusion: Higher activity level was found to be correlated with lower perceived stress, but the causality is unclear. Difference in adherence to restrictions between Polish and Italian residents suggests that introducing similar lockdown policies worldwide may not be as beneficial as expected. However, due to the applied method of convenience sampling and uneven study groups, one should be careful with generalizing these results.

Depression and anxiety are the most common psychiatric disorders in end-stage renal disease (ESRD) patients treated with hemodialysis (HD) and may correlate with lower quality of life and increased mortality. Depression treatment in HD patients is still a challenge both for nephrologists and psychiatrists. The possible treatment of depressive disorders can be pharmacological and non-pharmacological. In our article, we focus on the use of sertraline, the medication which seems to be relatively safe and efficient in the abovementioned population, taking under consideration several limitations regarding the use of other selective serotonin reuptake inhibitors (SSRIs). In our paper, we discuss different aspects of sertraline use, taking into consideration possible benefits and side effects of drug administration like impact on QTc (corrected QT interval) prolongation, intradialytic hypotension (IDH), chronic kidney disease-associated pruritus (CKD-aP), bleeding, sexual functions, inflammation, or fracture risk. Before administering the medication, one should consider benefits and possible side effects, which are particularly significant in the treatment of ESRD patients; this could help to optimize clinical outcomes. Sertraline seems to be safe in the HD population when provided in proper doses. However, we still need more studies in this field since the ones performed so far were usually based on small samples and lacked placebo control.

Medication-induced psychotic disorder (MIPD) is a diagnostic term for a syndrome with symptoms such as hallucinations and delusions directly related to drug intake. The purpose of this review is to report and comment on the current knowledge about pathomechanisms, risk factors, symptoms, and treatment of MIPD caused by selected widely used medications. PubMed, Scopus, and Google Scholar databases were searched for articles on MIPD published prior to January 2021 using search terms 'psychosis' OR 'psychotic disorder' AND 'side effects' combined with certain medications group. The initial search was then narrowed to medications with more pathomechanisms than only direct dopamine-inducing activity that are widely used by clinicians of various medical specialties. Steroids, antiepileptic drugs, antimalarial drugs, and antiretroviral drugs can induce psychosis with persecutory delusions and auditory hallucinations as the most frequently reported symptoms. Mood changes and anxiety may precede psychosis after steroids and antimalarials. Psychiatric history and female sex are risk factors for most of the MIPD. Treatment involves cessation of the suspected drug. Administration of atypical antipsychotic drugs may be helpful, although there is insufficient data to support this approach. The latter should be done with careful consideration of pharmacokinetic and pharmacodynamic interactions. MIPD is a rare condition. The appearance of psychotic symptoms during systemic treatment may be associated with administered medications, psychiatric comorbidity, or be a part of the clinical picture of a certain disorder. Furthermore, sometimes it may be challenging to distinguish MIPD from delirium. Therefore, we consider that the key to proper management of MIPD is a thorough differential diagnosis.

Background:During the first wave of the COVID-19 pandemic (April to May 2020), 6,169 Polish and 939 Italian residents were surveyed with an online questionnaire investigating socio-demographic information and personality traits (first section) as well as attitudes, position, and efficacy perceptions on the impact of lockdown (second section) and various health protection measures enforced (third section).Methods:The “health protection attitude score” (HPAS), an endpoint obtained by pooling up the answers to questions of the third section of the survey tool, was investigated by multiple linear regression models, reporting regression coefficients (RC) with 95% confidence intervals (95% CI).Results:Concerns for business and health due to COVID-19 were associated with a positive attitude toward risk reduction rules. By contrast, male sex, concerns about the reliability of information available online on COVID-19 and its prevention, along with the feeling of not being enough informed on the transmissibility/prevention of SARS-CoV-2 were associated with a negative attitude toward risk mitigation measures.Discussion:A recent literature review identified two social patterns with different features in relation to their attitude toward health protection rules against the spread of COVID-19. Factors positively associated with adherence to public health guidelines were perceived threat of COVID-19, trust in government, female sex, and increasing age. Factors associated with decreased compliance were instead underestimation of the COVID-19 risk, limited knowledge of the pandemic, belief in conspiracy theories, and political conservativism. Very few studies have tested interventions to change attitudes or behaviors.Conclusion:To improve attitude and compliance toward risk reduction norms, a key intervention is fostering education and knowledge on COVID-19 health risk and prevention among the general population. However, information on COVID-19 epidemiology might be user-generated and contaminated by social media, which contributed to creating an infodemic around the disease. To prevent the negative impact of social media and to increase adherence to health protection, stronger content control by providers of social platforms is recommended.