Quo Vadis Psychiatria Nostra

MUDr. Pavel Horák CSc., MBA

Psychiatr. pro Praxi, 2008; 9(5): 199  

Individualized treatment in the light of current guidelines

prof. MUDr. Eva Češková CSc

Psychiatr. pro Praxi, 2008; 9(5): 205-208  

The paper deals with possibilities of individualized treatment within individual steps of actual Czech guidelines for treatment of depressive disorder. Giving the first choice includes all available antidepressants (AD), it is necessary to tailor the choice to the clinical picture and individual tolerability. At the level of the second step the strategies of AD change, dose escalation and augmentation are discussed in more details. The further strategies include combinations of antidepressants and other less common treatment options.

Pharmacologically induced depression

MUDr. Richard Krombholz

Psychiatr. pro Praxi, 2008; 9(5): 209-212  

Pharmacologically induced depression is often underestimated in clinical practice. It is caused usually by treatment of somatic disease. There are a number of known effective substances with properties to induce secondary depressive symptoms as a part of their adverse reactions. The author in this article points out major drug groups that have the potential to trigger drug induced depression. The article does not have the ambition to be completely comprehensive ant it is not possible also because of the topic character. The goal of the article is to draw psychiatrists attention to this problem who serve as consultants for nonpsychiatry departments...

THE SLEEP AND MEMORY IN RELATION TO MEDICATIONS

MUDr. Claudia Borzová

Psychiatr. pro Praxi, 2008; 9(5): 213-216  

In the offices of specialists and primary care physicians we encounter together or separately occuring symptoms-impaired sleep and impaired memory. It is known or anticipated from practice that sleep and memory are associated. The article describes the relation of sleep and memory on a theoretical level in relation to its causes and medications. During treatment of sleep or memory disorder sleep should remain of sufficient quality that cognitive functions are preserved. The choice of medication for a sleep disorder should reflect the risk of cognitive function impairment or the influence on psychic condition.

Treatment of schizophrenia is a moving target

prof. MUDr. Jan Libiger CSc

Psychiatr. pro Praxi, 2008; 9(5): 218-222  

In the course of the last 60 years, pharmacological treatment of schizophrenia focused on varying targets. Chlorpromazine, originally an antihistaminic compound, found its main use in psychiatry because of its sedative properties. Non - specific sedation reduced the agitation of psychotic patients. It took forty years before the sedation related term „neuroleptics“ for drugs that treat psychosis, has been replaced by the more appropriate term „antipsychotics“. The confidence with which we are using antipsychotics may be well served by a sobering review of changes in the indications of these drugs and changes of the knowledge...

The endogenous time keeping system

prof. RNDr Helena Illnerová DrSc, PharmDr. Alena Sumová CSc

Psychiatr. pro Praxi, 2008; 9(5): 224-227  

The circadian system provides an endogenous daily programme for the entire organism and may fulfil even the role of a calendar. It is an integrating system: it encompasses a central clock and clocks in peripheral organs which are coordinated and synchronized by the central clock. At the same time the circadian system depends on its environment and is periodically entrained by surrounding stimuli, mostly by photic ones. The discipline which studies the role of time in biology, the so called chronobiology, covers mostly the circadian rhythmicity and affects many branches of theoretical medicine like physiology, biochemistry, molecular biology, neurobiology....

How to establish and treat a cause of patient desorientation in hospital departments for somatic diseases?

doc. MUDr. Roman Jirák CSc

Psychiatr. pro Praxi, 2008; 9(5): 228-229  

Episodes of desorientation are very serious complications during hospital therapy of somatic diseases. Desorientation may reach different grades (sometimes only by place and time, sometimes also by person). The severity of desorientation may vary even in short time intervals. The most frequent cause of orientation disorders are deliria. These states are frequently caused or triggered by somatic diseases for which the patient is treated or by unrecognised somatic disease. Amnestic syndromes are based on a block of consolidation of episodic memory. In dementia, the cause of desorientation is also amnestic syndrome, but associated deliria may contribute...

Psychotherapy of sexuology out-patients

MUDr. Petra Sejbalová, Mgr. Jana Míchalová

Psychiatr. pro Praxi, 2008; 9(5): 231-233  

The article deals with psychotherapy of sexuology out-patients. The first part deals with sexual dysfunctions. We try to name the most frequent psychological aspects of individual dysfunctions and outline possibilities for their psychotherapeutic treatment. The second part of the article deals with sexual identification dysfunctions (transsexualism), paraphilias (deviations) and sexual abuse and violation traumas.

Aripiprazol podávaný dlouhodobě u schizofrenní pacientky kvalitně sociálně stabilizované

MUDr. Helena Kučerová HonDG

Psychiatr. pro Praxi, 2008; 9(5): 234-235  

HYPNÓZA JAKO SOUČÁST PSYCHOTERAPEUTICKÉHO PROCESU

Mgr. Blanka Doležalová

Psychiatr. pro Praxi, 2008; 9(5): 236-239  

Omezující prostředky v psychiatrii

MUDr. Jiří Švarc Ph.D

Psychiatr. pro Praxi, 2008; 9(5): 243-245  

Psychiatři a praktičtí lékaři pracují na společném projektu

MUDr. Jan Stuchlík, Mgr. Barbora Wenigová

Psychiatr. pro Praxi, 2008; 9(5): 246  

ETHICS DIFFICULTIES IN PSYCHOTHERAPY

MUDr. Michal Kryl

Psychiatr. pro Praxi, 2008; 9(5): 240-242  

Despite the growing number of ethical issues and dilemmas ensuing from the rapid development of medicine, medical practice often seems to prefer technical aspects of care to those of ethics. Yet, the physician‘s ethical attitude is normally highly appreciated by the patient. What is and what is not ethical in psychotherapy? This is one of the questions that our paper raises from the perspective of four key ethical principles – beneficience, non-maleficience, autonomy and justice.