Background: Insomnia, as one of the most common sleep disorders, is a significant health problem, especially among patients suffering from drug-resistant depression. Problems related to the quality of sleep in that population can significantly affect the effectiveness of treatment and quality of life, which is why it is necessary to search for effective therapeutic interventions in this area. Objective: The aim of this study was to compare the effectiveness of esketamine and other standard antidepressants in improving sleep quality in patients with drug-resistant depression. The main research question is whether and to what extent esketamine improves sleep parameters compared with other antidepressants. Methods: This study involves the analysis of data collected from 50 patients divided into two groups: those using esketamine in combination with other antidepressants and those using other antidepressants. The analysis of the results focuses on the assessment of differences in AIS scores between the groups assessed using the Athens Insomnia Scale (AIS). Results: Insomnia occurs much less frequently among people using esketamine than among people not using this drug. With the increase in the time of using esketamine and with the increase in the dose, the level of insomnia decreases. Conclusions: Esketamine brings about a rapid improvement in sleep quality, which is a significant advance in the treatment of drug-resistant depression. The obtained results not only confirm the effectiveness of esketamine but also show its advantage over traditional treatment methods in improving sleep quality.

Cel pracy: Badanie miało na celu określenie częstości występowania pica wśród polskich nastolatków w wieku 15-19 lat, zidentyfikowanie najczęściej spożywanych niejadalnych substancji oraz niezależnych czynników zwiększających ryzyko picy. Metoda: W badaniu udział wzięło 1696 uczniów szkół średnich z całej Polski. Zastosowano wielokrotny losowy dobór próby. W badaniu wykorzystano trzyczęściowy kwestionariusz własnego autorstwa, który zawierał pytania metrykalne, pytania diagnostyczne dla zaburzenia pica oraz ocenę wybranych aspektów stanu psychicznego. Oceniano zależności pomiędzy wybranymi zmiennymi (np. miejscem zamieszkania, poziomem aktywności fizycznej, posiadaniem rodzeństwa czy poziomem wykształcenia rodziców), charakterystyką innych zaburzeń odżywiania oraz spożywaniem alkoholu. Przed przeprowadzeniem badania ankietę zwalidowano. Wyniki: 3,2% badanych jadło skrobię w postaci surowej mąki, papieru lub chusteczek higienicznych, 5,7% zjadało wydzielinę z nosa, a 0,2% cząstki szkła. 1,5% respondentów wymagało wizyty u specjalisty z powodu zjedzenia substancji nieodżywczej. 10% respondentów określiło nasilenie stresu rodzinnego powyżej 90. percentyla, podobnie 9,4% respondentów określiło wysokie nasilenie stresu szkolnego. 37,1% badanych dokonywało samookaleczeń. Wnioski: Kryteria diagnostyczne pica spełniało 5,7% badanych. Najczęstszymi substancjami nieodżywczymi spożywanymi przez respondentów były: wydzielina z nosa, surowa skrobia i włosy. Niezależne czynniki zwiększające ryzyko wystąpienia pica obejmowały mieszkanie w mieście, obecność zachowań autoagresywnych, obecność myśli samobójczych i wysoki poziom stresu w szkole.

Purpose: The aim of this study was to determine the risk of suicidal behavior in patients who were involuntarily hospitalized in forensic psychiatry departments, taking into account demographic variables such as age, level of education and length of stay of patients in the department. Material and methods: The study involved 112 patients of forensic psychiatry wards with a basic level of security, who completed an original questionnaire covering demographic data and the SBQ-R questionnaire on suicidal behavior. Results: The vast majority of patients studied were assigned to the low-risk category (96%), meaning they did not exhibit significant symptoms suggesting suicidal risk. Statistical analysis revealed no significant relationship between patient age and suicidal risk. Similarly, length of hospitalization had no significant effect on SBQ-R scores. Conclusions: Most patients scored low on the Suicide Risk Assessment Scale (SBQ-R), indicating a low level of suicidal ideation and tendencies.

Objective: Subjective mood assessment is a crucial element in the diagnostic and therapeutic process in psychiatry. Assessment of subjective mood is particularly important among forensic psychiatric patients. This population is characterized by specific environmental factors—isolation, limited autonomy, and stress related to legal proceedings. This situation can significantly impact patients’ well-being and mood. The aim of this study is to discuss the specificity of subjective mood assessment in the forensic psychiatric patient population and the importance of this tool in everyday clinical practice. Material and methods: The study was conducted in forensic psychiatry departments under basic security conditions using a survey method among 112 patients. The research tool included a research questionnaire with a demographic and clinical survey and the Beck Depression Inventory. Results: The overall level of depressive symptoms among patients was relatively low. The highest symptom severity was associated with feelings of guilt, loss of interest, and pessimism. The analysis revealed a significant correlation between the length of hospitalization and the level of depression – the longer the stay, the higher the mean scores on the Beck Depression Inventory (p = 0.00001). The highest values were observed among patients hospitalized for 5 to 9 years. Conclusions: The analysis shows that patients in forensic psychiatry wards have a low level of depressive symptoms, but their severity increases with the length of stay.

Aim: The aim of the study was to assess the level of life satisfaction of forensic psychiatry patients and to identify selected demographic and clinical factors related to life satisfaction, with particular emphasis on illness acceptance. Material and methods: The study included 121 patients hospitalized in four forensic psychiatry departments. Life satisfaction was assessed using the Satisfaction with Life Scale (SWLS), and illness acceptance using the Acceptance of Illness Scale (AIS). The relationship between SWLS scores and age and AIS scores was analyzed, as well as differences in SWLS scores based on gender, duration of hospitalization, psychiatric diagnosis, and pharmacotherapy regimen. Spearman’s rank correlation, Student’s t-test, one-way ANOVA, and the Mann-Whitney U test were used depending on the type of variables. A nominal significance level of α = 0.05 was adopted. No p-value correction was applied due to multiple testing. Results: The mean SWLS score was 19.82 ± 7.50 points. The study group showed varied levels of life satisfaction. After converting the results to the sten scale, 39.7% of participants achieved results corresponding to a low level of life satisfaction, 26.4% - an average level, and 33.9% - a high level. The mean AIS score was 28.06 ± 7.70 points; low level of illness acceptance was found in 10.7% of participants, average in 47.1%, and high in 42.1%. There were no statistically significant differences in SWLS scores depending on gender (p = 0.412), psychiatric diagnosis (p = 0.951), pharmacotherapy regimen (p = 0.930), or duration of hospitalization (p = 0.211). There was no statistically significant correlation between the SWLS score and age (rho Spearman’s ratio = -0.166; p = 0.068). However, a weak positive correlation was observed between the AIS score and the SWLS score (rho Spearman’s α = 0.215; p = 0.018), statistically significant at the nominal level of α = 0.05. Conclusions: of life satisfaction were found among the patients included in the study. The largest group consisted of participants classified as low (39.7%), but the differences in numbers between categories did not indicate a clear dominance of one category over the other. In the study group, the most common levels of illness acceptance were medium (47.1%) or high (42.1%). There was no statistically significant correlation between SWLS scores and age, nor were there any statistically significant differences in SWLS scores based on gender, psychiatric diagnosis, pharmacotherapy regimen, or length of hospitalization. However, a weak positive correlation was observed between illness acceptance and life satisfaction, significant at the nominal level of α = 0.05. The cross-sectional nature of the study does not allow for conclusions about a causal relationship between these variables. The results suggest the validity of considering illness acceptance in further studies on life satisfaction in forensic psychiatric patients.

Treatment-resistant depression (TRD) remains one of the most clinically challenging forms of depressive disorders. In many patients, reduction in symptom severity does not translate into full functional recovery; therefore, assessment of treatment effectiveness should also include health-related quality of life (HRQoL). Objective: The aim of the study was to compare changes in HRQoL in patients with TRD receiving a treatment strategy including intranasal esketamine as add-on therapy to ongoing treatment based on selective serotonin reuptake inhibitors (SSRIs) and in patients treated with SSRI-based therapy without esketamine. Materials and Methods: A prospective, observational, comparative cohort study was conducted in real-world clinical practice. Sixty adult patients were included: 30 received intranasal esketamine as add-on therapy to ongoing SSRI-based treatment and 30 received SSRI-based treatment without esketamine. The study protocol did not impose a separate SSRI dose-optimization algorithm; drug selection and dose modifications remained at the discretion of the treating physician in accordance with routine clinical practice. Quality of life was assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and the 36-Item Short Form Health Survey (SF-36). Depressive symptom severity was assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating Scale (HDRS). Assessments were performed at baseline, weeks 4, 8, and 12, and after 12 months. Results: Both groups showed improvement in quality of life and reduction in depressive symptom severity, with larger absolute changes in the group receiving esketamine. Differences involved WHOQOL-BREF domains and selected standard SF-36 subscales. Conclusions: In this observational cohort, the treatment strategy including intranasal esketamine was associated with greater improvement in several HRQoL measures than SSRI-based treatment without esketamine. Because treatment exposure was not assigned by the investigators and residual confounding cannot be excluded, the findings should not be interpreted as evidence of an isolated causal effect of esketamine.