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MUDr. Radkin Honzák, CSc.

Psychiatr. praxi. 2022;23(1):3  

Causes of mental disorders - general aspects

prof. MUDr. Ladislav Hosák, Ph.D., Mgr. Jiřina Hosáková, Ph.D.

Psychiatr. praxi. 2022;23(1):8-12 | DOI: 10.36290/psy.2022.001  

Causes of mental disorders are complex. Both genetic (single nucleotide polymorphisms, copy number variations, epistasis) and environmental (biological, psychological, social, spiritual) factors participate in their etiology. Epigenetics frequently plays an important role in gene-environment interactions. This review sums up the basic knowledge on general principles in etiology of mental disorders. New DNA sequencing techniques including innovative statistical procedures, validation and quantification of environmental factors, creation of international multicentric research consortia or seeking of protective factors in etiology of mental disorders...

Mild behavioral impairment as a prodromal stage of neurodegenerative diseases

Mgr. Veronika Matušková, doc. MUDr. Martin Vyhnálek, Ph.D.

Psychiatr. praxi. 2022;23(1):13-16 | DOI: 10.36290/psy.2022.002  

Neuropsychiatric symptoms in older adults are part of the clinical manifestation of neurodegenerative diseases and may even be their first symptoms. We describe the concept of mild behavioral impairment (MBI), which refers to new-onset, persistent neuropsychiatric symptoms emerging after the age of 50 years that are assumed to have a neurodegenerative etiology. We introduce the newly adapted Czech version of the Mild behavioral impairment - checklist developed to measure neuropsychiatric symptoms in older adults and for the MBI detection.

CBIT - a new treatment method for tics and Tourette syndrome

MUDr. Štěpánka Kicková, Ph.D., MUDr. Ondřej Fiala, Ph.D.

Psychiatr. praxi. 2022;23(1):17-19 | DOI: 10.36290/psy.2022.003  

Tics are the most common movement disorder in childhood affecting up to 28% of children. The exact cause of tic is unknown, curative therapy does not exist. So far, a symptomatic pharmacotherapy has been the main treatment option. This paradigm has undergone a fundamental change in recent years, and the non-pharmacological method CBIT (Comprehensive Behavioral Intervention for Tics) has become the first-choice treatment. CBIT is at least as effective as drug therapy without the risk of adverse side-effects, moreover it can be effectively delivered online. Although CBIT is not very widespread in the Czech Republic, it should be gradually introduced...

Urinary retention as a rare complication of psychotropic drug use

doc. MUDr. Dana Končelíková, Ph.D., PharmDr. Gabriela Vaculová

Psychiatr. praxi. 2022;23(1):e3-e7  

Urinary retention can develop as a result of a number of somatic as well as mental disorders. Identifying the cause is crucial in the proper treatment of patients. This review article aims to present the basic groups of psychotropic drugs, their indications and the possible connection with the development of urinary retention. Substances from the group of antipsychotics and antidepressants, substances affecting the anticholinergic and serotonergic systems, are considered to be risky. In principle, however, psychotropic drugs can be described as safe in terms of the risk of developing urinary retention. Caution should be exercised especially in at-risk...

Psychogenic erectite dysfunction

MUDr. Taťána Šrámková, CSc.

Psychiatr. praxi. 2022;23(1):e8-e16  

Psychogenic erectile dysfunction occurs in 20 % of all cases of erectile dysfunction. It should be highligted that organic erectile dysfunction is very often complicated by psychological factors that lead to the fixation of the disorder. These include fear, depression, anticipatory tension (anxiety about expecting an erectile failure), personality characteristics and conflicts in a relationship - a partner's sexual incompatibility. The primary psychogenic erectile dysfunction is the inability to achieve and maintain the erection of sufficient rigidity for the implementation of satisfactory sexual intercourse, if we have ruled out an organic cause by...

Treatment of anxiety disorders

Ivana Tašková

Psychiatr. praxi. 2022;23(1):e17-e27  

Anxiety disorders are a very frequent group of mental disorders. Up to 15 % of the population experience some type of anxiety disorder during their lifetime. The most common types of anxiety disorders include social phobia, panic disorder, generalized anxiety disorder, mixed anxiety depressive disorder, agoraphobia, specific phobias, and post­‑traumatic stress disorder. Anxiety therapy should be comprehensive. Along with pharmacotherapy, psychotherapy plays essential role here. Anxiolytics are used for the treatment of anxiety disorders. The spectrum of anxiolytic drugs includes antidepressants, benzodiazepines, non­‑benzodiazepine anxiolytics,...

How COVID-19 pandemic influences mental health of children and adolescents

MUDr. Jan Uhlíř

Psychiatr. praxi. 2022;23(1):e28-e32  

Covid-19 pandemic has affected the lives of most children and adolescents around the world. School closure was one of the anti-epidemic measures and schools in the Czech Republic was closed for the longest time of all EU countries. Most outschool acitivities was forbiden too. Travel between districts was restricted for some time. The parents of the children often stayed to work at home. This was reasons for social isolation of children and adolesncents. A number of clinical studies have already been published, which have confirmed the deterioration of the mental health in children and adolescents. The aim of the article is not only to point out the...

From diagnosis of depression, generalized­‑anxiety disorder, schizoaffective disorder to diagnose of microtubule­‑associated protein tau mutation (MAPT) S305N presenile dementia, weaknesses of phenomenological classification

MUDr. Eliška Nosková, prof. MUDr. Aleš Bartoš, Ph.D., MUDr. Miloslav Kopeček, Ph.D.

Psychiatr. praxi. 2022;23(1):20-29 | DOI: 10.36290/psy.2022.004  

We report a case of a 43-years old woman patient with presenile dementia with the finding of a microtubule-associated protein tau mutation (MAPT) exon 10 on chromosome 17, specifically mutation S305N. Depressive and anxiety symptoms were recognized early from 36 years of her age. In contrast to that, subjective complaints about memory and memory deficit were overlooked, which was the cause of the late diagnose of presenile dementia. After confirming memory deficit we started the differential diagnostic process for etiology, because of her age and mixed clinical symptomatology. Diagnosis of Alzheimer's disease with early onset before 65th year of age...

Possibilities of pharmacotherapy of postpartum depression while maintaining lactation

MUDr. Antonín Šebela, Ph.D.

Psychiatr. praxi. 2022;23(1):31-34 | DOI: 10.36290/psy.2022.005  

The period of pregnancy and postpartum is a time of challenge for all parents, and mental health disorders greatly complicate the situation. Depression is one of the most common mental disorders that can affect a woman after childbirth. Decisions about pharmacotherapy of mental disorders in pregnancy and lactation are a source of uncertainty in clinical practice. However, knowledge about the safety of antidepressants during breastfeeding is evolving dynamically, and according to current knowledge, we have a choice of several antidepressants that are considered compatible with breastfeeding. The communication is accompanied by a case study.

Lurasidone in monotherapy in a patient with a diagnosis paranoid schizophrenia - monitoring the effect on psychoptatology and somatic health

MUDr. Vlastimil Nesnídal

Psychiatr. praxi. 2022;23(1):35-37 | DOI: 10.36290/psy.2022.006  

Modern treatment of psychotic diseases offers a wide range of options for the selection of psychotropic drugs with great effectiveness on the positive symptoms of schizophrenia. In the modern concept of treatment, however, it is important not only the initial treatment of positive symptoms, but also the therapy of negative symptoms, and especially the patient's cooperation with treatment. The treatment adherence can be severely disrupted by the side effects of psychotropic drugs, which are very successful in the treatment of positive symptoms, but in long-term therapy they cause side effects that often lead to medication discontinuation or adversely...

Trevicta - power in simplicity

MUDr. Lucia Huťanová

Psychiatr. praxi. 2022;23(1):38-40  

One of the many claims that schizofrenia enforces on patients is the need for regular use of complex medication. Regularity is a key, but unfortunately often impracticable remission condition. The following case shows how choosing the right LAI medciation can improve the quality of life.

Legal aspects of caring for patients with limited personality - a general introduction to the problem

JUDr. Šárka Špeciánová

Psychiatr. praxi. 2022;23(1):50-54 | DOI: 10.36290/psy.2022.010  

This article provides physicians with a basic overview of the provisions related to the limitation of capacity to legally act. First part of this article focuses on the Civil Code and provides overview of the terms and functioning of the so called supportive measures in case of adult's decreased ability to legally act. In case these moderate and less restrictive measures do not suffice, it is possible to proceed to the restriction of legal capacity. The court may decide to limit person's legal capacity and may only do so if it is in the interest of the person concerned and with full recognition of such person's rights and uniqueness. The next part...

Balint group - looking for hidden meanings in relationship of doctor and patient

MUDr. Štěpánka Machová

Psychiatr. praxi. 2022;23(1):44-47 | DOI: 10.36290/psy.2022.009  

Dealing with an extensive workload of doctors can be manifested in different ways and often causes significant stress for the professionals. If the doctor is not able to cope with the extensive workload, he/she can experience burnout syndrome. This can be caused by physical and emotional exertion. The relationship between the doctor and the patient is one of the significant factors that influences the process and the outcome of any medical treatment. Michael Balint, who is considered the pioneer of the field of psychosomatics, had studied the relationship between the doctor and his/her patient. Michael Balint introduced the Balint groups for doctors...

Gender dysphoria as a phenomenon of our time?

MUDr. Vladislav Chvála, PhDr. Ludmila Trapková

Psychiatr. praxi. 2022;23(1):e33-e41 | DOI: 10.36290/psy.2022.015  

At our daily outpatient clinics in Prague and Liberec, we are increasingly recruiting families with adolescents who suffer from gender dysphoria for family therapy. The situation began to remind us of the 1990s, when we saw an increase in families with eating disorders. As then, our attention is drawn to the speed with which the phenomenon, known only in specialized workplaces, is spreading throughout the Western world. The similarity is important for a family therapist. Both phenomena begin to manifest in the same developmental phase of the family, at the beginning of puberty and during it. In family therapy terminology, these are symptoms of the...

Gestalt therapy of somatoform disorders

Mgr. et Mgr. Alena Pučelíková

Psychiatr. praxi. 2022;23(1):41-43 | DOI: 10.36290/psy.2022.008  

Patients with somatoform problems often receive psychotherapeutic care. The article discusses the Gestalt psychotherapy as an appropriate psychotherapeutic approach to work with these patients. The case report contains two examples of experiments focused on working with the body.