Papers by Agnieszka Słopień
Psychiatria Polska
Cel pracyOcena częstości występowania czynników ryzyka związanych z przebiegiem ciąży i porodu or... more Cel pracyOcena częstości występowania czynników ryzyka związanych z przebiegiem ciąży i porodu oraz ze stanem dziecka po porodzie, w grupie dzieci i młodzieży z ADHD i grupie kontrolnej.Metoda205 niespokrewnionych dzieci i młodzieży z rozpoznaniem ADHD oraz 106 uczniów szkół podstawowych i ponadpodstawowych, w wieku 7-17 lat. Matki dzieci i młodzieży z rozpoznaniem ADHD oraz z grupy kontrolnej zostały poproszone o udzielenie wywiadu w celu uzyskania danych do uzupełnienia Kwestionariusza wywiadu ciążowo-okołoporodowego.WynikiIstotne statystycznie różnice (p<0,05) wykazano dla częstości występowania takich czynników ryzyka jak: występowanie u matki w I/II trymestrze ciąży chorób oraz innych problemów, narażenie matki przez cały czas trwania ciąży na stres oraz przyjmowanie przez nią leków, palenie przez matkę papierosów w czasie ciąży, wiek matki w chwili porodu <25 r.ż lub > 35 r.ż., zastosowanie substancji redukujących ból porodowy oraz występowanie problemów z dzieckiem w...
Psychiatria Polska
Wczesne zachorowanie na schizofrenię (przed 18 r.ż.) jest związane z wyższym niż w przypadku osób... more Wczesne zachorowanie na schizofrenię (przed 18 r.ż.) jest związane z wyższym niż w przypadku osób dorosłych ryzkiem opóźnionej lub niewłaściwej diagnozy, cięższym przebiegiem choroby, zwiększoną wrażliwością na działania niepożądane leków przeciwpsychotycznych. Celem pracy jest przedstawienie zaleceń na temat postępowania diagnostycznego i terapeutycznego u chorych na schizofrenię o wczesnym początku, przygotowanych na podstawie przeglądu literatury i konsensusu grupy ekspertów zajmujących się leczeniem schizofrenii. Formalne kryteria, których spełnienie wymagane jest do postawienia diagnozy schizofrenii, są takie same u dzieci i u dorosłych. Schizofrenia o wczesnym początku wymaga starannego różnicowania z zaburzeniami afektywnymi jedno i dwubiegunowymi, zaburzeniami ze spektrum autyzmu (ASD), zaburzeniami lękowymi. Ocena diagnostyczna w kierunku zaburzeń psychotycznych konieczne jest także w przypadku występowania zaburzeń zachowania, zachowań niszczycielskich i agresji oraz samou...
Clinical and Experimental Obstetrics & Gynecology, 2018
Hormonal contraception influences various areas of female health and behavior. The study group in... more Hormonal contraception influences various areas of female health and behavior. The study group included 41 women aged 18-25 (mean age 22.2 ± 3.4) years who used oral contraception with 3 mg of ethinyl estradiol and 2 mg of chlormadinone acetate for six months. The mean body mass index (BMI) of women from the study group was 23. 5 ± 2.3 kg/m 2. The exclusion criteria from the study group where contraindications for hormonal contraception (liver disease, porphyria, thrombosis, hormonally dependent cancer, and migraine). The control group included 31 women aged 18-25 (mean age 21.6 ± 2.4) years who did not use hormonal contraception. The mean BMI of controls was 22.4 ± 1.7 kg/m 2. Both the age and the BMI of controls were no statistically different from the study group. The sexual function of the studied women was assessed with the use of Female Sexual Function Index (FSFI). FSFI is a multidimensional self-reporting tool for the assessment of female sexual function. It consists of six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain (with 19 items). There were no statistically relevant differences between the study group and the controls in relations to the FSFI parameters. There is no impact of oral contraception with 3 mg of ethinyl estradiol and 2 mg of chlormadinone acetate on sexual function of users.
Clinical and Experimental Obstetrics & Gynecology, 2015
Objectives: The aims of the study were: evaluation of depressive symptoms in climacteric women, c... more Objectives: The aims of the study were: evaluation of depressive symptoms in climacteric women, comparison of depressive symptoms between peri-and post-menopausal women, and assessment of a possible relationship between the presence of depressive symptoms and the hormonal profile of the studied women. Materials and Methods: The study included 45 peri-menopausal and 95 post-menopausal women admitted to the Department of Gynecological Endocrinology, Poznań University of Medical Sciences, because of climacteric symptoms. The following parameters were evaluated in all studied women: intensity of climacteric symptoms (Kupperman Index), intensity of depressive symptoms (Hamilton depression scale), serum concentrations of hypothalamic-pituitarygonadal axis hormones (FSH, LH, 17β-estradiol), prolactin (PRL) and androgens [total testosterone, dehydroepiandrosterone sulfate (DHEAS)]. FSH, LH, 17β-estradiol, PRL, and total testosterone were evaluated by the immunoenzymatic methods and DHEAS was measured by the radioimmunological method. Results: Psychic and somatic manifestations of anxiety and fear, shallow sleep, and general somatic symptoms were the most frequent depressive symptoms in both studied groups. Both investigated groups differed in relation to the incidence and intensity of symptoms from the genital system (observed more often in post-menopausal women) and hypochondria (noted more frequently in peri-menopausal women). Numerous relationships between the incidence and intensity of certain symptoms and serum concentrations of the investigated hormones were found in both groups. The correlations were different in periand post-menopausal subjects.
Clinical and Experimental Obstetrics & Gynecology, 2016
The subject of the study is the evaluation of the correlation between the polymorphism of candida... more The subject of the study is the evaluation of the correlation between the polymorphism of candidate genes in the etiology of depression and the occurrence of the symptoms of the climacteric syndrome in women during menopause. The group subjected to the study comprised of 203 women aged between 42-65 years: 71 of them still menstruated (premenopausal group) and 132 at least one year after the last period (postmenopausal group), admitted to the Department of Gynecological Endocrinology at the University of Medical Sciences in Poznan with symptoms of the climacteric syndrome. All the examined women were evaluated according to the degree of severity of the climacteric syndrome symptoms using the Kupperman index and the concentration of FSH, LH hormones, 17β-estradiol, PRL, total testosterone, and DHEAS in peripheral blood serum. Among the candidate genes in the aetiology of depression the following were selected for the research: the serotonergic system receptor genes: 5HTR2A, 5HTR1B, 5HTR2C, TPH1, TPH2, and MAO-A; the genes of noradrenergic and dopaminergic systems (COMT, NET), the genes of the GABAergic (GABRB1) system, a gene of the estrogen receptor (ESR1), and the genes of the enzymes crucial in the methyl cycle (MTHRF, MTR, and MTHFD1). With regards to the correlation between the examined polymorphisms and the occurrence of the symptoms of the climacteric syndrome, the associations analysis indicated a connection between GABRB1.TaqI polymorphism and the occurrence of vertigo in premenopausal women (0.0198; after correction: 0.0497 CC to CA). The correlation was also found regarding the examined polymorphisms and the concentration of the examined hormones in blood serum: TPH1.MaeI polymorphism and the LH concentration in the postmenopausal group (0.004; after correction: 0.014 CC to CA), NET.Eco147I polymorphism, and the 17β-estradiol concentration in the postmenopausal group (0.0208; after correction: 0.048 GG to GA) and HTR2AMspI polymorphism and PRL concentration in all examined women (0.03; after correction: 0.038 TT to CT).
Clinical and Experimental Obstetrics & Gynecology, 2019
It is believed that major depression is currently the leading cause of disease related disability... more It is believed that major depression is currently the leading cause of disease related disability among women in the world. In this review the authors analyzed the features and associations between menopause, the hormones associated during this stage, and their influence on depression..
Medycyna Rodzinna, 2018
Biological rhythms, in particular sleep-wake cycle, have a significant effect on the functioning ... more Biological rhythms, in particular sleep-wake cycle, have a significant effect on the functioning of the body. Disturbances in this rhythm often result from an unhealthy lifestyle. Unfortunately, this phenomenon concerns both adults and adolescents. It can result in many psychosomatic problems and negatively affect child's development. In adults, it has negative effects on many aspects of life, including psychosexual life. Sleep disorders were once attributed only to elderly. Currently, this negative phenomenon has been occuring increasingly among young people. Fortunately, persons suffering from sleep disorders report these problems to family doctors and psychiatrists. Sleep disorders should be regarded as a medical condition. Nowadays, the approach to sleep disorders has changed significantly. Sleep disorders often require specialist, comprehensive treatment in sleep disorders clinincs.
Pharmacotherapy in Psychiatry and Neurology, 2020
A clinical picture of bipolar affective disorders in children and adolescents is variable and dep... more A clinical picture of bipolar affective disorders in children and adolescents is variable and dependent on the specificity of developmental age. From diagnostic and therapeutic point, especially difficult are cases with the pre-pubertal onset. In the article, a case report of 18-year observation of male patient with the onset of bipolar affective disorder at 11 years of age is presented. This very early pre-pubertal onset of the illness was manifested with rapid cycling, depressive episode with psychotic symptoms and the classic symptoms of mania. The use of lithium carbonate appeared effective and safe. Lithium was used for two years in combination with valproates, and in following years as monotherapy. In recent two years, due to depressive episodes of moderate intensity, the patients also received fluoxetine on periodic basis. No adverse effects of the treatment were observed.
Eating disorders and substance use disorders frequently co-occur. Twin studies reveal shared gene... more Eating disorders and substance use disorders frequently co-occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa (BN) and problem alcohol use (genetic correlation [rg], twin-based=0.23-0.53). We estimated the genetic correlation between eating disorder and substance use and disorder phenotypes using data from genome-wide association studies (GWAS). Four eating disorder phenotypes (anorexia nervosa [AN], AN with binge-eating, AN without binge-eating, and a BN factor score), and eight substance-use-related phenotypes (drinks per week, alcohol use disorder [AUD], smoking initiation, current smoking, cigarettes per day, nicotine dependence, cannabis initiation, and cannabis use disorder) from eight studies were included. Significant genetic correlations were adjusted for variants associated with major depressive disorder (MDD). Total sample sizes per phenotype rang...
Journal of Endocrinological Investigation, 2019
Background Climacteric symptoms are a variety of disturbing complaints occurring during menopausa... more Background Climacteric symptoms are a variety of disturbing complaints occurring during menopausal transition, many of which may be influenced by hormonal abnormalities other than related to sex steroids. Aim of the study In this study, we investigated the association between the intensity of climacteric symptoms measured with the Kupperman index and a thyroid status. Material and methods We evaluated by measuring serum thyrotropin (TSH), and free thyroxine (fT4) 202 euthyroid women admitted to the Department of Gynecological Endocrinology, Poznan University of Medical Sciences because of climacteric symptoms. Patients were both in perimenopause (n = 74) and postmenopause (n = 128), with no history of thyroid disorders. Results Results presented as the mean value and standard deviation were as follows: age 54.2 ± 4.9 years, BMI 26.8 ± 4.6 kg/ m 2 , Kupperman index 26 ± 13.1 points, TSH 2.4 ± 2.6 mU/l, fT4 1.2 ± 0.37 ng/dl. We observed a negative correlation between fT4 and the time since the last menses (R = − 0.38; p = 0.02) as well as between serum TSH concentration and sweating (R = − 0.18; p = 0.03), general weakness (R = − 0.17; p = 0.03), and palpitation (R = − 0.18; p = 0.02) and a positive correlation between fT4 and nervousness (R = 0.34; p = 0.007) and palpitations (R = 0.25; p = 0.04). In the perimenopausal subgroup, there was a positive correlation between fT4 and general weakness (R = 0.42; p = 0.03), palpitations (R = 0.50; p = 0.009), and paresthesia (R = 0.46; p = 0.01). In the postmenopausal subgroup, there was a negative correlation between TSH and sweating (R = − 0.21; p = 0.03). Conclusions Menopausal symptoms are related to thyroid status in euthyroid menopausal women.
Oxford Bibliographies Online Datasets, 2018
Females with autism are often undiagnosed, misdiagnosed, or receive a diagnosis of autism at a la... more Females with autism are often undiagnosed, misdiagnosed, or receive a diagnosis of autism at a later age than males. This can result in adverse outcomes in their well-being, mental health, education, employment, and independence. Furthermore, the autism spectrum in females is associated with adverse outcomes after puberty, including anxiety, depression, high incidence of suicide, eating disorders, and high rates of other medical problems. The term “autism spectrum disorder” (ASD) and “autism spectrum condition” (ASC) and autism are used interchangeably, including in the citations of this article, and in the article itself. The term “autism spectrum condition” (ASC), coined by Simon Baron-Cohen, is used in the literature to respect both females and males on the autism spectrum who feel that the term “disorder” is stigmatizing, whereas ASC presents both the strengths and difficulties of individuals on the autism spectrum. Autism has traditionally been considered a male-dominated diagnosis, and its current features linked with descriptions in the major diagnostic classification systems are based primarily on males. While researchers continue to question the epidemiology, prevalence, and presentation of autism, there is an emerging awareness and growing clinical recognition that autism in females has a unique symptomatology and may, in fact, be more common in this population than previously acknowledged. Cultural and social aspects may also impact on the autistic characteristics presented by autistic females. Autism may also manifest itself differently, and more subtly, especially in individuals who are not recognized early in life or who do not have profound intellectual or communication difficulties. The current diagnostic assessments have mainly been developed for an autistic male population, and thus may lack the required sensitivity to identify autistic females. It is argued that these assessments may have an inhibitory potential in confirming the diagnosis of autism in females, as they do not reflect the unique presentation of autism in females, demonstrated by greater compensatory capacity and an ability to develop sophisticated methods of “camouflaging” and masquerading in order to blend in with neurotypical peers. Sex and gender stereotypes and differences in patterns of autistic behavior may contribute to females being overlooked in a diagnostic setting. Timely diagnosis and support, however, can reduce the difficulties that females with autism experience. Timely diagnosis can reduce abuse, exploitation, and certain co-occurring conditions, allowing us to better inform females’ needs in education, leisure, social relationships, and employment, so as to promote their well-being and independence.
Anorexia nervosa (AN) is a serious eating disorder characterized by restriction of energy intake ... more Anorexia nervosa (AN) is a serious eating disorder characterized by restriction of energy intake relative to requirements, resulting in abnormally low body weight. It has a lifetime prevalence of approximately 1%, disproportionately affects females1,2, and has no well replicated evidence of effective pharmacological or psychological treatments despite high morbidity and mortality2. Twin studies support a genetic basis for the observed aggregation of AN in families3, with heritability estimates of 48%-74%4. Although initial genome-wide association studies (GWASs) were underpowered5,6, evidence suggested that signals for AN would be detected with increased power5. We present a GWAS of 3,495 AN cases and 10,982 controls with one genome-wide significant locus (index variant rs4622308, p=4.3x10−9) in a region (chr12:56,372,585-56,482,185) which includes six genes. The SNP-chip heritabilityof AN from these data is 0.20 (SE=0.02), suggesting that a substantial fraction of the twin-based he...
Journal of Attention Disorders, 2016
Objective: The aim of the study was to assess the relationship of overweight, the polymorphisms o... more Objective: The aim of the study was to assess the relationship of overweight, the polymorphisms of selected candidate genes, and deficits in the executive functions among children with ADHD. Method: We examined 109 boys with ADHD aged between 7 and 17 years. The study indicated variants of 14 polymorphisms in eight candidate genes. We applied seven neuropsychological tests to evaluate the executive functions. Overweight was diagnosed on the basis of the guidelines of the International Obesity Task Force. Results: Analyses revealed significant association between DRD4 rs1800955, SNAP25 rs363039 and rs363043, 5HTR2A rs17288723, and overweight in boys with ADHD. There were no significant differences in the level of neuropsychological test results between patients with overweight and without overweight. Conclusion: Overweight in boys with ADHD is associated with polymorphisms in three candidate genes: DRD4, SNAP25, and 5HTR2A, but not through conditioning deficits in cognitive functions.
Neuropsychiatria i Neuropsychologia, 2017
Pediatria i Medycyna Rodzinna, 2016
Bulimia psychiczna stanowi poważny i złożony problem zdrowotny, z którym spotyka się w swej prakt... more Bulimia psychiczna stanowi poważny i złożony problem zdrowotny, z którym spotyka się w swej praktyce wielu specjalistów, w tym lekarzy rodzinnych i lekarzy stomatologów. Celem pracy jest przedstawienie problemu (rozpowszechnienia bulimii, objawów, sytuacji szczególnych, leczenia) ze zwróceniem szczególnej uwagi na aspekt zmian w obrębie jamy ustnej. W niniejszym artykule opisano postulowane przyczyny i czynniki spustowe choroby, kryteria diagnostyczne, początek i możliwy przebieg, patologie zębów i śluzówek jamy ustnej w wyniku choroby, a także inne schorzenia współwystępujące z bulimią (w tym cukrzycę). Praca ma charakter poglądowy. Metodą badawczą była analiza dostępnego piśmiennictwa na temat bulimii psychicznej uzupełniona o doświadczenia własne. Na podstawie źródeł wnioskuje się, że właściwa diagnostyka i leczenie bulimii psychicznej są możliwe tylko przy współpracy wielu specjalistów: psychiatry lub psychiatry dzieci i młodzieży, stomatologa i lekarza rodzinnego oraz w razie potrzeby innych lekarzy. Niezbędny, integralny aspekt leczenia stanowi psychoterapia. Wczesne podjęcie terapii jest kluczowe dla uzyskania dobrych wyników. Z powodu niskiego poczucia choroby część pacjentów nigdy nie trafiłaby do psychiatry, gdyby nie interwencja lekarza rodzinnego lub lekarza stomatologa.
Psychiatria Polska, 2015
CelOcena częstości występowania zaburzeń ciągłości snu u kobiet w okresie przekwitania, ocena zal... more CelOcena częstości występowania zaburzeń ciągłości snu u kobiet w okresie przekwitania, ocena zależności pomiędzy występowaniem zaburzeń ciągłości snu a stopniem nasilenia zespołu klimakterycznego i występowaniem poszczególnych objawów zespołu klimakterycznego, jak również ocena zależności pomiędzy występowaniem problemów ze snem a stężeniem gonadotropin, prolaktyny i hormonów płciowych w surowicy.MetodaZbadanych zostało 140 kobiet (średni wiek 54,4 ± 4,7 lat), które kolejno zgłosiły się do Kliniki Endokrynologii Ginekologicznej z powodu objawów zespołu klimakterycznego. Do oceny typu i nasilenia zaburzeń ciągłości snu użyto pytań o jakość snu ze Skali Depresji Hamiltona. Nasilenie objawów zespołu klimakterycznego oceniano przy użyciu indeksu Kuppermana. U wszystkich badanych oznaczono stężenia hormonów: follikulotropiny (FSH), lutropiny (LH), 17β-estradiolu, prolaktyny (PRL), testosteronu całkowitego, siarczanu dehydroepiandrosteronu (DHEAS) oraz globuliny wiążącej hormony płciowe ...
Psychiatria polska
The aim of the study was the evaluation of chromosomal aberrations, especially locus q11-q13 of c... more The aim of the study was the evaluation of chromosomal aberrations, especially locus q11-q13 of chromosome 15 and polymorphisms in the g-aminobutyric acid receptor subunit B3 gene (GABRB3) and genetic aetiology of autistic disorder. We studied 20 probands (aged 4-27 years old) and their parents and siblings (73 persons). Following cytogenetic methods were used: conventional GTG-banding analysis, study of fra(X), fluorescence in situ hybridisation, with two specific probes: SNRPN and UBE3A/D15S10. Dinucletide (CA)n repeat polymorphism at the GABRB3 gene was analysed using PCR-STR method. Chromosomal analysis revealed paracentomere inversion--46, XX, inv(9)(p11q13) in 1 patient, but this is frequently found in population chromosomal variation. FISH didn't reveal abnormalities in 15q11-q13 region. ETDT analysis didn't reveal connection between autistic disorder and studied marker. Lack of anomalies in 15q11-q13 region may be related to small number of probands, heterogenity of ...
Psychiatria polska
Anorexia nervosa (AN) is a disease of complex ethiopatogenesis. Population genetics studies sugge... more Anorexia nervosa (AN) is a disease of complex ethiopatogenesis. Population genetics studies suggest a significant role of genetic factors in the morbidity risk. Family and twin studies allow for the estimation of the heritability--the influence of genetic factors on the specific phenotype--of the anorexia nervosa in 50-80%. Due to the low prevalence of the disease, the adoption studies have not been performed. The rapid development of the molecular biology methods gives possibility for the searching of the specific genes increasing the risk of anorexia nervosa. Linkage studies are based on scanning the whole genome for loci associated with susceptibility to a certain disease. In the preliminary studies, no linkage was found between anorexia nervosa and the markers on the chromosomes 1-5, 13 and X. In the association studies, relationship between vulnerability to AN and polymorphism in 5-HT2a receptor and uncoupling proteins gene were reported. These results need further confirmation.
The Scientific World Journal, 2012
Objective. The aim of the study was an evaluation of possible relationships between polymorphisms... more Objective. The aim of the study was an evaluation of possible relationships between polymorphisms of serotoninergic system genes and the risk of depression in postmenopausal women.Methods. We studied 332 women admitted to our department because of climacteric symptoms. The study group included 113 women with a diagnosis of depressive disorder according to the Hamilton rating scale for depression; the controls consisted of 219 women without depression. Serum 17β-estradiol concentrations were evaluated using radioimmunoassay, while polymorphisms in serotoninergic system genes: serotonin receptors 2A (HTR2A), 1B (HTR1B), and 2C (HTR2C); tryptophan hydroxylase 1 (TPH1) and 2 (TPH2), and monoamine oxidase A (MAO-A) were evaluated using polymerase chain reaction-restriction.Results. We found that the 1460T allele ofMAO-Ac.1460C>T (SNP 1137070) appeared with a significantly higher frequency in depressed female patients than in the control group (P=0.011) and the combined c.1460CT + TT g...
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Papers by Agnieszka Słopień