Psychiatry for Practice, 2009, issue 3

Editorial

Co trápí uživatele psychiatrické péče?

Psychiatr. pro Praxi, 2009; 10(3): 107

Review articles

Risk of death and insidious complications of eating disorders

doc. MUDr. Libuše Stárková CSc

Psychiatr. pro Praxi, 2009; 10(3): 112-116

Why do the eating disordered patients die? What are the causes of their sudden deaths? The article is based on works published abroad and presents several case reports which shows us the covered face of these serious disorders.

Concepts of evaluation of the long-term treatment of schizophrenia

doc. MUDr. Ján Pečeňák, CSc, MUDr. Mgr. Helena Aziri

Psychiatr. pro Praxi, 2009; 10(3): 117-121

Long-term treatment with antipsychotics is a standard recommendation in the treatment of schizophrenia. The effectiveness of treatment depends on many factors like prevailing symptomatology and type of schizophrenia, patient’s adherence to treatment and natural course of schizophrenia. These factors interfere with an evaluation of treatment effect mainly if the principles of Evidence Based Medicine are applied. The main goal of the article is to mention some aspects of long-term antipsychotic treatment that could help in understanding of results in published clinical studies and transforming these data to clinical practice.

Atypical antipsychotics in the augmentation of antidepressants in the treatment of depressive disorder

MUDr. Martin Bareš

Psychiatr. pro Praxi, 2009; 10(3): 122-124

Depressive disorder is a relatively common disease in the population. Lifetime prevalence of major depression is 5–12 % in men and 9–26 % in women. Only 20–30 % patients treated with first antidepressant achieves remission. The use of atypical antipsychotics in the augmentation of antidepressant treatment is modern and often used method in the treatment of resistant depression. The authors comment the results of double-blind studies in this topic and discuss problem areas of this type of treatment.

Hypnotics

MUDr. Zuzana Lattová

Psychiatr. pro Praxi, 2009; 10(3): 125-129

Hypnotics are among the most commonly prescribed drugs. However, it must be remembered that the basic approach to a patient with insomnia involves nonpharmacological interventions such as assessment and clarification of sleep hygiene principles. Moreover, most insomnias, including all acute and secondary insomnias, are caused by other, external (non-sleep) factors. By altering these, sleep can be improved even without administering hypnotics. Of drugs affecting insomnia, third-generation hypnotics are administered in a short term as first-choice drugs. BZDs are considered second-choice drugs while other substances with antihistaminergic activity...

Complex antidepressant effect and pain

MUDr. Marek Páv

Psychiatr. pro Praxi, 2009; 10(3): 130-134

Pain and depression are pathological states influenced by serotonergic and noradrenergic system functioning. In the treatment of both states are used drugs, affecting both neurotransmitter systems. In the chronic pain pathogenesis besides neuronal system changes takes place also glial cell activation, which can endure acute pain stimulus and participate in the pain chronification. Antidepressant treatment is affecting depressive syndrome and pain affective and cognitive component due neuroplastic processes modulation. Inflammatory mediators can activate stress axis and influence neurotransmitter metabolism during chronic pain states, antidepressants...

Psychiatric consult and depressive disorder

MUDr. Zdeněk Faldyna

Psychiatr. pro Praxi, 2009; 10(3): 135-138

Depression is a common problem in consultation-liaison psychitry. Recent years have brought more systematic knowledge on the links between depression and somatic disease, particularly between depression and cardiovascular diseases. The paper summarizes the basic issues that need to be addressed when diagnosing and determining treatment for depression during a psychiatric consult. Consult services and depression in gynaecological and paediatric patients are also dealt with. A consultation-liaison psychiatrist cannot be content with the „depressed mood > depression > antidepressant“ algorithm; his considerations and recommendations must...

Case report

The homicide and his victim in the forensic treatment

MUDr. Jiří Švarc Ph.D, Mgr. Radek Vokál

Psychiatr. pro Praxi, 2009; 10(3): 139-141

The case reports of the non deviant sex offender and robber who repeated his delinquency in sexuology forensic treatment in psychiatric hospital. Finally he commit a slaughter and was sentenced to the life imprisonment. The casuistry demonstrates the importance of the forensic expertise and the necessity of detention institution (in Czech Republic exists from this year) for such cases when even forensic treatment is not protective enough.

Casuistic of a patient with supranuclear progressive paralysis which was admited into a mental hospital

MUDr. Šárka Grussmannová

Psychiatr. pro Praxi, 2009; 10(3): 142-143

The casuistic describes a case of a 52-year-old patient with a neurological disease – the supranuclear progressive paralysis. The patient had been repeatedly investigated by neurologists and psychiatrists for a long time, at the end he was transfered to mental hospital being diagnosed with affective disorder. A suspicion of a neurological cause of the disease was officially pronounced there, the patient was therefore transfered to the regional neurological departure where the neurological disease was confirmed.

Aripiprazol in a treatment of bipolar affective disorder

MUDr. David Filipovský

Psychiatr. pro Praxi, 2009; 10(3): 144

A case report is presented of a 33-year-old female with long-term diagnosis of unipolar depression. After acute manic episode was the diagnosis reclassified to the bipolar affective disorder. We had to modify treatment strategy, antidepressant drugs was discontinued. She used olanzapine to the treatment of acute manic episode, but she had a switch to the depression and olanzapine had negative side effects. Then we found optimal treatment for her finally-combination of lamotrigine with aripiprazol.

Psychopharmacology

Reccommended procedure for switching from Ritaline to Strattera treatment in children with ADHD

prof. MUDr. Ivana Drtílková CSc

Psychiatr. pro Praxi, 2009; 10(3): 145-147

Atomoxetine may be considered for patiens with ADHD who are unresponsive to stimulant treatment, have co-morbid conditions (tic, anxiety, enuresis, slep disturbances, eating problems) or where there is potential for drug abuse. Atomoxetine should be initiated by a schedule of dose increases and cross-tapering with methylphenidate. The switching method selected is at the discretion of the clinician and should be made on a patient-by-patient basis.