Rozhádané sestry a medicína

MUDr. Radkin Honzák, CSc.

Psychiatr. praxi. 2024;25(2):59  

Toxic psychosis and its clinical significance

Mgr. Ing. Irena Semančíková, MUDr. Miloslav Kopeček, Ph.D., prof. Mgr. Ondřej Bezdíček, Ph.D.

Psychiatr. praxi. 2024;25(2):62-70 | DOI: 10.36290/psy.2024.011  

The review article focuses on the diagnostics, clinical symptoms and therapy of "toxic psychoses", i.e., substance-induced psychotic disorders, the prevalence of which increased significantly in recent decades due to a considerable increase in the production and consumption of psychoactive substances. This is a type of mental and behavioral disorders caused by the use of psychoactive substances, resulting in secondary psychosis. Differential diagnostics focuses mainly on distinguishing the symptoms of toxic psychosis from schizophrenia, where especially positive symptomatology can overlap. Due to the heterogeneity of the group of toxic psychoses, the...

The present and the future of pharmacogenetic testing with focus on the pharmacotherapy of depression

prof. MUDr. Eva Češková, CSc., MUDr. Petr Šilhán, Ph.D.

Psychiatr. praxi. 2024;25(2):71-75 | DOI: 10.36290/psy.2024.012  

The paper deals with possibilities of pharmacogenetic testing in psychiatry. The greatest progress has been made in depressive disorder. Several expert groups and professional associations specialize on developing guidelines for pharmacogenetics testing. Consensus and high level of evidence have been achieved in genotyping of P450 CYP2D6 and CYP2C19 enzymes. It was found that their activity is associated with efficacy and tolerability of many drugs. Nowadays, the multigenes, mostly commercially produced tests, are becoming important. They can help with choice and adequate dosing of drug in individual patient. Undoubtedly, the pharmacogenetics will...

Alcohol withdrawal and its treatment

doc. MUDr. Lucie Kališová, Ph.D., MUDr. Hana Voltrová

Psychiatr. praxi. 2024;25(2):76-82 | DOI: 10.36290/psy.2024.013  

The use of alcohol in the Czech Republic is socially accepted, and worldwide we reach the top ranks in the annual intake of pure alcohol per adult. The consequence is a high incidence of alcohol dependence in our population. Alcohol has complex impact on a brain and neurotransmitter balance is rebuilt due to persistent intake of alcohol. After the cessation of alcohol abuse, there is a predominance of excitatory activity in the brain and a withdrawal state develops, which can be life-threatening. Due to the high prevalence of alcohol abuse in our country, every psychiatrist is likely to encounter the issue of withdrawal from alcohol, and it is important...

Emerging recommended practices for the diagnosis and treatment of Alzheimer's disease and other cognitive disorders: an interdisciplinary consensus

prof. MUDr. Robert Rusina, Ph.D., MUDr. Vanda Franková, prof. MUDr. Aleš Bartoš, Ph.D., doc. MUDr. Svatopluk Býma, CSc., MUDr. Ing. Klára Knápková, MUDr. Astrid Matějková, MUDr. Zuzana Šnajdrová, MUDr. Hana Vaňková, Ph.D.

Psychiatr. praxi. 2024;25(2):83-86 | DOI: 10.36290/psy.2024.018  

Care for patients with Alzheimer's disease (AD) and other cognitive disorders has been fragmented in the Czech Republic and unevenly and inadequately accessible in different regions. Neurologists, psychiatrists, geriatricians and general practitioners are involved in treatment. The aim of the implementation of the National Action Plan for AD and Similar Diseases 2020-2030 (NAPAN), approved by the Government of the Czech Republic, is to establish a single recommended approach for the diagnosis and treatment of patients with AD and similar diseases, so that the patient always receives good comprehensive care, regardless of the consulted specialist and...

Anxiety in the patients (not only) in dental care

MDDr. Ondřej Kohout, prof. MUDr. Ladislav Hosák, Ph.D.

Psychiatr. praxi. 2024;25(2):88-92 | DOI: 10.36290/psy.2024.014  

Patients´ fear of examination and treatment is an integral part of the most physicians´ routine not only a dentist´s one. Up to 75% of the population are afraid of being treated by a dentist. About 10% of people suffer from an overwhelming fear (odontophobia) with all the social, health and economical consequences of a neglected dental care. This review article offers an overview of the treatment options of dental phobia. The first prerequisite for a successful treatment is the application of local anesthesia. Milder forms of odontophobia can be managed with non-pharmacological methods, such as a gentle attitude, diversion of attention, and appropriate...

ADHD in the spectrum of neurodevelopmental disorders: a case report of a combined deficit with comorbidities

MUDr. Hedvika Ernsten

Psychiatr. praxi. 2024;25(2):93-98 | DOI: 10.36290/psy.2024.015  

ADHD, as well as Asperger syndrome belong to the spectrum of neurodevelopmental disorders. Like each of them, it is defined among others by impaired growth and maturation of neurons leading to structural and functional abnormalities of the central nervous system. Attempts to a more systematic definition of their biomarkers are related to the effort to find a connection with the functional characteristics of this group of disorders. The progress of brain imaging methods offered by magnetic resonance has evolved from mere volumetry to determination of the structural abnormalities, herein focused at the white matter. As in all neurodevelopmental disorders...

Malignant catatonia in a patient with undifferentiated schizophrenia

MUDr. Martin Vereš, prof. MUDr. Bc. Libor Ustohal, Ph.D.

Psychiatr. praxi. 2024;25(2):99-102 | DOI: 10.36290/psy.2024.016  

Malignant catatonia is a rare and life-threatening disease. The current ICD or DSM diagnostic systems do not define diagnostic criteria for malignant catatonia, however it is generally defined as a form of catatonia with symptoms of autonomic instability. Without treatment, malignant catatonia carries a high mortality rate, so early diagnosis and treatment is absolutely essential for the patient's prognosis. The preferred therapeutic approach involves the use of benzodiazepines and electroconvulsive therapy, on the other hand, antipsychotic should not be used in treatment of malignant catatonia. Due to the potential for serious somatic complications,...

Dissociation and clinical-psychological differential diagnosis: a case report

Mgr. Roman Koky

Psychiatr. praxi. 2024;25(2):103-105 | DOI: 10.36290/psy.2024.017  

The case describes the case of a middle-aged man who was hospitalized in a psychiatric hospital for non-specific dissociative symptoms. To clarify the patient's problems, the doctor indicated a clinical-psychological examination, in which the neuropsychological and procedural background of the problems were ruled out. On the contrary, the cause of dissociative states appeared to be decompensation in the terrain of a borderline structured personality.