Jak léčíme závislosti a na čem závisí úspěch?

MUDr. Petr Popov, MHA

Psychiatr. praxi. 2014;15(1):3  

Treatment of hospitalized patients with schizophrenia

prof.MUDr.Eva Češková, CSc., MUDr.Michaela Mayerová

Psychiatr. praxi. 2014;15(1):6-8  

The most frequent reasons for hospitalization in patients suffering from schizophrenia are relapses and pharmacoresistancy. The main cause of relapse is nonadherence which can be partially managed by depot antipsychotics. The gold standard of treatment in pharmacoresistant patients is clozapine. In spite of this clozapine is initiated late in clinical practice and before initiating clozapine, antipsychotic polypharmacy is very common. After the failure of clozapine monotherapy there are several possibilities including combination of clozapine with other antipsychotics and clozapine augmentation. There are very few controlled studies supporting...

Chronic insomnia

MUDr.Lucie Závěšická, Ph.D.

Psychiatr. praxi. 2014;15(1):9-14  

Sleep disorders comprise a very heterogeneous group of diseases. In psychiatric practice, we most commonly encounter primary and secondary insomnia, wherein insomnia is a symptom of another disease. Some tricyclic antidepressants, trazodone, mirtazapine, and melatonin can be used in treating chronic insomnia. Drugs generally are of additional importance in treating primary insomnia. The most effective approach is to affect the behavior that is linked to sleep by means of psychotherapy. Currently, cognitive behavioral therapy is considered to be the most sophisticated and effective method.

Mild cognitive impairment - Do we know more now?

MUDr.František Honzák

Psychiatr. praxi. 2014;15(1):15-18  

Mild cognitive impairment is heterogenous entity comprising both subjective and objektive impairment of at lest one of cognitive functions. Mild cognitive impairment is pathological condition, which is no more normal, but still not fulfilling kriteria for dementia. Review describes historical context of terminology, basic diagnostic kriteria for mild cognitive impairment, differential diagnostics and outskirt of therapeutic modalities of mild cognitive impairment.

Electroconvulsive therapy

MUDr.Richard Köhler

Psychiatr. praxi. 2014;15(1):19-22  

Electroconvulsive therapy is a complex treatment method, which, despite all the advances in pharmacotherapy, still remains the most effective and the fastest treatment for many psychiatric illnesses. This review sums up the changes, that this threatment have been through in the past decades, and current knowledge of its effectiveness, indications, contraindications and side effects.

Transient global amnesia and a sexual offence - an anusual casuistic

doc.MUDr.Jaroslav Zvěřina, CSc.

Psychiatr. praxi. 2014;15(1):23-24  

A casuistic of forensic expertise of 57 years old physician, banned for sexual abuse of children both gender is given. Previous forensic expertises were in the case basically different. Very atypical phenomenology of the offence and its isolated occurrence within the life of subject, combined with serious somatic diseases leads us to the diagnostic conclusion transient global amnesia. The offence was not sexually motivated.

The census of psychotropic drugs at the Dpt. of Psychiatry in Hradec Králové

MUDr.Zuzana Kopková, prof.MUDr.Ladislav Hosák, Ph.D.

Psychiatr. praxi. 2014;15(1):25-28  

We performed the census of psychotropic drugs in the patients hospitalized at the Dpf. of Psychiatry in Hradec Králové on the 1st of February, 2013. The aim of the census was to ascertain whether our treatment is in accordance with the guidelines, and no risk combinations of psychotropics are prescribed. Fifty-five patients (26 males and 2 9 women) at the average age of 52.5 years were hospitalized at our institution on the day of the census. The patients used 2.1 psychotropic drugs per person on average. Mood disorders and neurotic and anxiety disorders represented the most frequent diagnostic groups. Antidepressants, especially the dual ones...

Depressive pseudodementia (DPD)

MUDr.Vít Bičan

Psychiatr. praxi. 2014;15(1):39-40  

Depressive pseudodementia is a cognitive deficit, arising out of the depresivity (so-called false dementia). It is a serious complication of depressive disorder, whitch may lead to misdiagnosis and consequently, the wrong treatment, with consequence in prolongation of disease, or pharmacoresistance. Both signs of cognitive deficits and symptoms of typical in depression are obvious. Basic survey of depressive pseudodementia differential diagnostics is shown this paper.

The evaluation of the mental status in the criminal procedure and the providing psychiatric care

MUDr.Jiří Švarc, Ph.D.

Psychiatr. praxi. 2014;15(1):41-45  

The compendious article describes some procedural aspects of the evaluation of the mental status in the criminal procedure in Czech Republic. It defines the basic terms as insanity, mental disorder, forensic expertise, institute expertise, observation of mental state, prejudice, forensic treatment, protective detention etc. The article explains the difference of the evaluation of the juvenile offender, the evaluation of the credibility of the witness, the evaluation of the mental injury and some other practical aspects of the forensic evaluation. The article describes the legal possibilities of the access to medical records by the experts,...

Is every encounter of a therapist with a family family therapy?

MUDr.Vladislav Chvála, PhDr.Ludmila Trapková

Psychiatr. praxi. 2014;15(1):31-34  

Contribution to PPP treatment The authors conclude that family therapy is becoming commonplace part of eating disorder treatment. However, they come across the fact that family therapy is sometimes considered a mere meeting with the family, or a briefing on the food checking of an adolescent who resists treatment. Cooperation with the family can be variously intense, from a mere acquaintance and giving the information about the patient, through specific tasks to actual family therapy, which goes to the substance of the problem of eating disorders. The authors see it mostly in stagnant separation process. In their opinion, it is extremely...

Person Centered Psychotherapy and Pre-Therapy - The application in psychiatry

MUDr.Kateřina Faixová

Psychiatr. praxi. 2014;15(1):35-38  

This article summarizes the basic principles of Person Centered Psychotherapy introduced by Carl Rogers with an emphasis on the differences in relation with other psychotherapeutic schools, and prejudices that reflect this therapy. Furthermore, it focuses on the possibility concerning the psychotherapy with patients with severe mental illness resulting from method which is based on Roger’s philosophy – The Pre-Therapy. The last section provides two case studies to illustrate this approach in practice, with examples of therapeutic interviews. contact work.