Alzheimerova choroba jako evropská priorita

Psychiatr. pro Praxi, 2009; 10(6): 247  

Treatment of the primary insomnia from the psychiatrist point of view

doc. MUDr. Ján Praško CSc, MUDr. Lucie Závěšická, MUDr. Anežka Ticháčková

Psychiatr. pro Praxi, 2009; 10(6): 250-256  

Primary insomnia is characterized with difficulty initiating or maintaining sleep, or non-restorative sleep, lasting at least a month in duration. The treatment for short term insomnia with hypnotics is recommended. The use of hypnotics in treating chronic insomnia remains controversial. The non-benzodiazepine hypnotics zolpiden, zopiclone, and zaleplon are replacing benzodiazepines as first-line pharmacotherapy for short-term insomnia. Hypnotics should be considered only after a thorough diagnostic assessment of secondary causes of insomnia, after sleep hygiene has been improved and after behavioral treatments has been attempted. If these approaches are...

Pathogenesis of addiction

Mgr. Petra Elizabeth Váchová, MUDr. Luboš Janů Ph.D, MUDr. Sylva Racková

Psychiatr. pro Praxi, 2009; 10(6): 257-259  

Dependence is a complex chronic desease of CNS, the creation reasons of which are multifactorial. A lot of different views on origin and background of addiction as a desease exist. Addiction is a complex interdisciplinary problem, therefore more than one explanation of addictive behaviour origin can be found in a specialized literature. Despite the fact that preference is given to biological theories currently, also other theses play an important role in searching for predisposited factors of a desease called addiction. During the ambulatory treatment it is surely difficult to cover all factors responsible for starting long term abuse, addiction....

Sexual dysfunctions in patients with epilepsy

MUDr. Věra Zelená, doc. MUDr. Robert Kuba Ph.D

Psychiatr. pro Praxi, 2009; 10(6): 260-263  

Epilepsy as a chronic brain dysfunction is often accompanied by psychiatric comorbidities that can worsen quality of life even more than epileptic seizures themselves. Frequent sexual dysfunction and its correlation with depression and anxiety rate is also referred in epileptic patients. Psychiatric disorders as well as sexual dysfunction are often underdiagnosed and undertre

Pathological hoarding

MUDr. Miroslava Khollová

Psychiatr. pro Praxi, 2009; 10(6): 264-267  

Hoarding and saving behavior has been observed in several neuropsychiatric disorders, including schizophrenia, dementia, eating disorders, and mental retardation, as well as in nonclinical populations, but it is most commonly found in patients who have OCD. This article is focusing on present research about this problem, including the definition and manifestations of the problem. There is described model for understanding hoarding behavior. This model addresses information-processing deficits (e.g., attention, organization, memory, decision making), beliefs and emotional attachments to possessions, and distress and avoidance. This article reviews...

Rape trauma - clinical and forensic implications

PhDr. et Ph.Dr. Radek Ptáček, Ph.D, doc. PhDr. Ludmila Čírtková, CSc, MUDr. Ilja Žukov CSc

Psychiatr. pro Praxi, 2009; 10(6): 268-271  

The article deals with clinical signs and forensic relations of rape trauma. It gives basic overview of diagnostics and occurrence of the phenomenon and further deals with questions of credibility assessment of victims of rape and their possible traumatization. The article is intended to forensic and clinical psychiatrists who may work with victims of rape. The article is accompanied by a case study.

The antidepressants treatment in patients with high cardiovascular risk: benefit or risk?

MUDr. Radkin Honzák CSc, MUDr. Milan Vrána, DrSc

Psychiatr. pro Praxi, 2009; 10(6): 272-274  

Antidepressive treatment with sertraline, citalopram and paroxetine in patients with high cardiovascular risks is effective and safe (group safety provided by results of clinical studies). The efficacy and safety of antidepressive drug in patients with severe depression may be enhanced by means of primary and secondary prevention, ie. by beta-blockers or statins. Our recommendation is: to monitor individual safety in patients with high cardiovascular risk before the start of antidepressant therapy and during its application by way of monitoring heart rate variability (HRV) or at least by monitoring rest heart frequency. The treatment of serious...

The Czech version of the Adolescent Dissociative Experiences Scale

MUDr. Jan Soukup, prof. MUDr. Hana Papežová, CSc, mudR. Aleš Kuběna, MUDr. Viera Mikolajová

Psychiatr. pro Praxi, 2009; 10(6): 276-279  

The Adolescent Dissociative Experiences Scale (A-DES) is a measure for screening of the pathological dissociation in adolescents. The Czech version has very good psychometric characteristics, but the scale itself is not sufficient for stating or ruling-out the clinical diagnosis of a dissociative disorder. The article summarizes findings of the validation study in Czech Republic and gives practical advices for the use of the scale in clinical practice and in research. The authors recommend to screen for dissociation adolescents suffering from more complex behavioral disturbances, with impulse dyscontrol, ADHD or history of traumatic experiences.

Cost effectiveness of antidepressant treatment

MUDr. Jana Skoupá

Psychiatr. pro Praxi, 2009; 10(6): 280-281  

Depressive disorders represent a significant burden for individuals, families and society. This is firstly due to high disease incidence and prevalence, secondly due to notably costs for healthcare and social systems. The article gives an overview of international health-economic literature with focus on cost-effectiveness. Results show that modern antidepressants (SSRI or non-SSSRI) are more cost-effective compared to previously used tricyclic antidepressants (TCA). Improved cost-effectiveness corresponds with better safety and tolerability resulting in higher treatment adherence. A combination of pharmacotherapy and cognitive behavioral therapies...

Coopera 2009

MUDr. Hana Mihulová, doc. MUDr. Radovan Přikryl Ph.D

Psychiatr. pro Praxi, 2009; 10(6): 282-283  

Educational project Coopera brings a new look at communication problems in the treatment of patients with schizophrenic disorders. At the same time, one possibility is prepared to deal with problematic points in communication with the patient and his surroundings on the basis of communication algorithms presented and above all confidence-building, therapeutic relationship, motivation and support joint decision-making about optimal treatment.

Ambulantní psychiatři volili nejlepší kazuistiku

Bc. Martin Jíša

Psychiatr. pro Praxi, 2009; 10(6): 284-285  

Autodidaktický test 6/09

Psychiatr. pro Praxi, 2009; 10(6): 286