Psychiatry for Practice, 2011, issue 3

Editorial

Psychiatrie pro praxi je úspěšná na cestě ke svým čtenářům

redakce

Psychiatr. praxi. 2011;12(3):91

Review articles

Sexuality in individuals with organic mental disorders

MUDr.Petra Sejbalová

Psychiatr. praxi. 2011;12(3):96-97

The article presents an overview of sexual disorders most commonly encountered in individuals with organic mental disorders. In addition to common functional disorders such as low sexual desire, failure of genital response, or orgasmic dysfunction, the article deals with less common, but certainly more challenging disorders such as secondary hypersexuality and altered sexual preference the manifestations of which pose a burden to the patient’s surroundings. The latter issue is illustrated by a report of a case of altered sexual preference due to an organic mental disorder.

Antidepressants augmentation with antipsychotics

MUDr.Bc.Libor Ustohal, Ph.D., prof.MUDr.Eva Češková, CSc., doc.MUDr.Radovan Přikryl, Ph.D.

Psychiatr. praxi. 2011;12(3):98-99

Treatment of resistant depression is particularly complicated. Just these patients need often hospitalization, what means burden on them and on the public health system. Second generation antipsychotics perform nowadays more important role in the treatment of treatment resistant depression and among them especially quetiapine, which was recently approved as the first antipsychotic in this indication in our country. Aripiprazole is another antipsychotic agent convenient for depressive patients. A case study showing the use of quetiapine XR and aripiprazole in the antidepressants augmentation is presented in this article.

Treatment of depression in old age

prof.MUDr.Eva Češková, CSc.

Psychiatr. praxi. 2011;12(3):100-104

Depressive disorder is the most common mental disorder (after memory impairment) in old people. In the development of late-life depression hereditary factors may play minor part, biological factors and psychosocial stress being more important. Late-life depression has partially a different clinical picture including a higher risk of suicidal behaviour. In efficacy of antidepressants no significant differences were found between younger and older people with depression. Therefore safety and tolerability of individual antidepressants represent the most important criterion for treatment choice in common clinical practice. Nowadays, an individualized...

Treatment of depression in patiens with eating disorders

MUDr.Pavel Theiner, Ph.D.

Psychiatr. praxi. 2011;12(3):105-107

Eating disorders comprise anorexia nervosa, bulimia nervosa and some other not otherwise specified items. The therapeutic approach differs. They are themselves difficult to treat with the treatment based mainly on psychotherapeutic interventions; the pharmacotherapy plays a minor role. There is no effective drug for treatment of the core symptoms of anorexia; fluoxetin with certain evidence of efficacy plays a role in bulimia. Eating disorders are highly comorbid in the practice and depressive syndrome is most represented among these comorbidities. The treatment of depression in eating disorders differs from the treatment of depressive disorder....

Case report

Application of continuous glucose monitoring system in psychotic phase

MUDr.Eva Elšíková, MUDr.Iveta Poljaková

Psychiatr. praxi. 2011;12(3):108-111

Psychotic state as a emotional stressor for organism may be considered to cause fluctuations of glycemia. In a case study, the authors describe the use of monitor and subcutaneous sensor Guardian REAL-Time CGMS produced by Medtronic in a psychotic subject with diabetes mellitus. They evaluate the feasibility of this method in this clinical condition and mention eventual pitfalls in result interpretation. They discuss the up to date evidence concerning the influence of mood and emotions on glycemia. They suggest possible improvements of the method.

Evaluation of maximal ACHEI dosage use in AD patients in the Czech Republic and basic information

doc.MUDr.Jakub Hort, Ph.D., doc.MUDr.Iva Holmerová, Ph.D.

Psychiatr. praxi. 2011;12(3):112-115

about the caregivers role in the system of care about this patients The primary goal of the non-interventional study “CARE” was to investigate the percentage of patients in the Czech Republic who are treated with maximal dose of ACHEI, the secondary goal was to map basic information about caregiver’s role in the system of care about AD patients. 395 patients were enrolled to the study. 77.9 % of patients were treated with maximal doses of ACHEI during the maintenance therapy. The most common type of care was family care, which was the only type of care in 69.5 % of patients.

Psychopharmacology

The novel antidepressant agomelatine shows also anxiolytic effects

prof.MUDr.Alexandra Šulcová, CSc.

Psychiatr. praxi. 2011;12(3):124-125

A novel drug in the class of antidepressants agomelatine is unique in its pharmacological mechanisms of action. Initially it was investigated to treat circadian sleep disturbances due to its agonistic influence on the melatonergic (MT1 and MT2) receptors. Preclinical as well as clinical studies however demonstrated antidepressive effects of agomelatine what is believed to be associated with its combined pharmacological action that is a blockage at serotonin 5-HT2C receptors. Stimulation of these receptors is known to induce panic in man and anxiogenic-like effects in animals, while their blockage elicited anxiolytic action. Furthermore the...

At a glance

Non-pharmacological interventions in therapy of dementia

MUDr.Kateřina Sheardová

Psychiatr. praxi. 2011;12(3):126-128

A successful therapy of dementia influences positively cognitive functions as well as the quality of life and the behavioral and psychological symptoms (BPSD). BPSD will eventually develop in all dementia patients. They represent a heavy burden for caregivers and therefore they might reduce the patient´s time spent in the home background. Non-pharmacological interventions are an effective tool in reducing the caregiver burden that informal carers might try or access to manage the behavioral complications of dementia.

Psychotherapy

Hypnosis in dissociative disorders treatment

MUDr.Bc.Aleš Grambal, MUDr.Zuzana Grambalová, prof.MUDr.Ján Pavlov Praško, CSc.

Psychiatr. praxi. 2011;12(3):116-119

Dissociative disorders have heterogenic and mostly dramatic manifestation. Dissociative states are frequently present in patiens suffering from other psychiatric disorders. Usually we can find a context between dissociative disorder and traumatic experience in the patients history. The psychogenic etiology is evident. Dissociation is the psychological defence against unbearable stress. The promptitude for reaction to stress with disociation begans in the disharmonious childhood. Disorder persisting several years becomes chronic and resisting to treatment. The first choice of the therapies are psychoterapeutic interventions, hypnosis is in the...

Signs of schizophrenia in the draw-a-person test

PhDr.Radko Obereignerů, Ph.D., MUDr.Katarína Obereignerů, PhDr.Renata Gajdačková, Mgr.Magdaléna Šmídová, Mgr.Tomáš Divéky, Mgr.David Čáp, prof.MUDr.Ján Pavlov Praško, CSc.

Psychiatr. praxi. 2011;12(3):120-123

The draw a person test is one of the most frequently using psychological tests. Its diagnostic benefit is orientational, therefore it makes it possible to examine a possibility of consequential psychopatological phenomenons. The draw a person test reflects the presence of florid psychotic symptoms and presence of negative symptoms, especially cognitive deficits in schizophrenia. We differentiate empirically specific phenomenons in particular types of schizophrenia in the drawing.