Dobré partnerské vztahy a zdravotní stav

MUDr. Radkin Honzák, CSc.

Psychiatr. praxi. 2020;21(2):59  

Residual symptoms of depression and their importance in common clinical practice

prof. MUDr. Eva Češková, CSc.

Psychiatr. praxi. 2020;21(2):62-64 | DOI: 10.36290/psy.2020.011  

Residual symptoms in depressive disorder and their importance in common clinical praxis Residual symptoms are common, and they may occur even in patients fulfilling criteria for remission. Residual symptoms are associated with aworse outcome; therefor they should be identified, distinguished from side effects and treated as soon as possible. The treatment depends on the prevailing residual symptom. Although in average the available antidepressants do not differ in efficacy there are differences in the rate of influencing individual residual symptoms. The treatment strategy includes changing to another antidepressant, adjunctive medication and combination...

Current trends in treatment of generalised anxiety disorder

MUDr. Eliška Nosková, MUDr. Antonín Šebela, Ph.D., MUDr. Pavla Stopková, Ph.D.

Psychiatr. praxi. 2020;21(2):66-72 | DOI: 10.36290/psy.2020.012  

Generalized anxiety disorder is described as an excessive and disproportionate anxiety and worry about minor matters in daily living, which are accompanied with wide spectrum of somatic symptoms. This review is focused primary on current guidelines and news in pharmacological treatment. Further it is focused on psychotherapy options and possibilities of clinical application of rTMS, or ketamin. After decades of relative stagnation the field of clinical testing is opening also for group of anxiety disorders. In our review we also overview current ongoing clinical trials, which show the possibilities of treatment generalised anxiety disorder in the future.

Schizo-obsessive symptoms

MUDr. Kryštof Kantor, prof. MUDr. Klára Látalová, Ph.D.

Psychiatr. praxi. 2020;21(2):74-77 | DOI: 10.36290/psy.2020.013  

Obsessive compulsive disorder is among the comorbid disorders in schizophrenia. Although these two disorders form independent diagnostic categories, their characteristics show similarity to one another and their symptoms may also overlap. Obsessive compulsive disorder is expected to occur in up to 12 % of patients with schizophrenia. This knowledge leads to suggestions of the category of schizo-obsessive disorders and the definition of schizo-obsessive disorder as aseparate unit showing differences from both schizophrenia and obsessive compulsive disorder. The clinical significance of schizo-obsessive symptoms can be described from 3 perspectives:...

Treatment possibilities of pharmaco-resistant schizofrenie in common clinical practice

prof. MUDr. Eva Češková, CSc., MUDr. Martin Hýža, Ph.D.

Psychiatr. praxi. 2020;21(2):78-82 | DOI: 10.36290/psy.2020.014  

The paper is focused on available therapeutic approaches to schizophrenia in common clinical practice. The literature and clinical experience stress the exclusion of pseudoresistance, caused mainly by nonadherence. The gold standard is clozapine. Further possibilities include augmentation and combination of antipsychotics; however, for these strategies there is not enough evidence and results are inconsistent. Augmentation is aimed mostly on persistent and dominant symptoms (depressive and negative symptoms, cognitive deficit). The most frequently used combination is combination of clozapine with an antipsychotic with complementary pharmacological profile.

Mental health and immunity

MUDr. Miroslava Navrátilová, Ph.D.

Psychiatr. praxi. 2020;21(2):83-88 | DOI: 10.36290/psy.2020.015  

The relationship between the mental state and the human immune system is known from clinical practice - short-term stress is a functional, physiological response that stimulates the immune system. Likewise, short-term inflammation is a natural reaction to injury or infection. Conversely, chronic stress worsens the response of the nervous, endocrine and immune systems and can lead to immunodeficiency. The review summarizes the clinical experience of an internist with a focus on clinical nutrition and intensive metabolic care in psychiatric patients and selected significant findings in the field of mental health and immunity.

Partners' relationship and depression

PhDr. Petra Kasalová, prof. MUDr. Ján Praško, CSc., MUDr. Marie Ocisková, MUDr. Jakub Vaněk, MUDr. Michaela Holubová, MUDr. Aleš Grambal, Ph.D., MUDr. František Hodný, MUDr. Lucie Bundárová, MUDr. Vlastimil Nesnídal, MUDr. Daniela Zmeškalová, MUDr. Antonín Kolek

Psychiatr. praxi. 2020;21(2):90-95 | DOI: 10.36290/psy.2020.016  

Recognition of mood disorders and their treatment has improved considerably in recent years. In terms of public health and the development of depressive disorder, it is important to explore the risk factors involved in its development. One of the risk factors is marital discrepancy, however deeper understanding of specific factors in the process of relationship issues, development and maintenance of depressive disorder is still little known. Research into interpersonal factors affecting the onset and course of depression is therefore an important topic in research efforts.

Transformations of addiction treatment - therapy without power (powerlessness)

MUDr. Jiří Dvořáček

Psychiatr. praxi. 2020;21(2):100-104 | DOI: 10.36290/psy.2020.018  

In-patient programs for addicted people in the Czech Republic evolved from the original apolinar model. Each treatment facility has adapted this model differently, but the programs have some common features - a high degree of program structuring, a high level of control of patients, a hierarchical therapeutic community with a strong staff role, sanction systems, fixed program offer, high level of limitations in contact with the original environment. Many of these elements do not correspond to the possibilities and needs of actual patients, current civilization values and do not allow to create such a therapeutic environment and a relationship in which...

Extreme aggressive behavior in children and adolescents

MUDr. Jiří Koutek, Ph.D., doc. PhDr. Jana Kocourková

Psychiatr. praxi. 2020;21(2):105-107 | DOI: 10.36290/psy.2020.019  

Extreme aggressive behavior in children and adolescents can lead to injury or death to the other person. The crime of murder committed by children and adolescents is relatively rare, on the border of criminology, psychology, psychiatry and pedagogy. In our group of 26 child and adolescent perpetrators of murderous behavior in the completed or attempted stage, there was only 1 psychotic disorder, 3 sexual disorders, in 22 cases adisharmonious development of personality was found.

Confidentiality obligation of health care professionals and its breaking under the current legislation - Part 1

JUDr. Šárka Špeciánová

Psychiatr. praxi. 2020;21(2):108-111 | DOI: 10.36290/psy.2020.020  

This article deals with the confidentiality obligations of health care professionals, it describes material scope of such obligations. Situations are described which are exempt from such mandatory confidentiality under the applicable legislation. This article also examines the cooperation of health professionals with courts in civil proceedings and in criminal proceedings and cooperation with the Police of the Czech Republic.

Case study of a child patient with psychotic symptoms in a transcultural context

MUDr. Stefania Dvořáčková Fasouli, Mgr. Kateřina Ingrová

Psychiatr. praxi. 2020;21(2):96-99 | DOI: 10.36290/psy.2020.017  

The case study describes an eleven-year-old Asian patient who was admitted to the Children'sHospital to investigate amonth-long difficulty in swallowing food and fluids, hypersalivation and spitting, which led to weight loss. The patient was examined for the exclusion of organic causes and at the same time the suspicion of the psychogenic origin of the complaints was expressed. There for, apsychological, and subsequently, apsychiatric consultation was requested. On the basis of these consultations, an acute psychotic disorder due to decompensation of aneurodevelopmental disorder from the autistic spectrum was suspected. The patient was transferred...