Psychiatry for Practice, 2024, issue 3

Editorial

Syndrom vyhoření: změna paradigmatu

Mgr. et Mgr. Marek Vácha, Ph.D.

Psychiatr. praxi. 2024;25(3):111

Review articles

Pharmacotherapy of restlessness in dementia

doc. MUDr. Roman Jirák, CSc.

Psychiatr. praxi. 2024;25(3):115-119 | DOI: 10.36290/psy.2024.019

Neuropsychiatrical symptoms of dementia are a serious group of disorders in dementia. Among them, the most noticeable and most disturbing are the symptoms of restlessness - agitation, gross restlessness, aggressiveness. These symptoms often lead to the patient being hospitalized or placed in a specialized social service facility. Mainly non-pharmacological approaches are used to alleviate restlessness, but they are often not enough. Therefore, it is necessary to use pharmacotherapy. The article discusses the possibilities of this type of treatment, its advantages and disadvantages.

Emotionaly unstable adolescents - diagnostics and therapy

doc. PhDr. Jana Kocourková, MUDr. Jiří Koutek, Ph.D., MUDr. Tereza Strnadová, MUDr. Kryštof Kantor

Psychiatr. praxi. 2024;25(3):120-124 | DOI: 10.36290/psy.2024.020

Emotionaly unstable adolescents represent a large group of patients currently dealt with pedopsychiatric facilities, both outpatient and inpatient. The vast majority are adolescent girl who come mainly for anxiety - depressive symptoms, self harm and suicidal behavior. Emotional instability in adolescence represents a spektrum of severity, starting with emotional lability common in adolescence, up to disturbances in personality development, which in the most serious case can reset in emotionally unstable - bordeline personality disorder. Therapy requires an integrated approach, with an emphasis on psychotherapy and family therapy, as well as indicated...

Safewards - how to work with conflicts on psychiatric wards

Mgr. Tomáš Petr, Ph.D., Mgr. Jaroslav Pekara, Ph.D.

Psychiatr. praxi. 2024;25(3):126-130 | DOI: 10.36290/psy.2024.021

Psychiatric wards are places where many factors come together that can result in various forms of conflict or unwanted or challenging behaviour. Each conflict has a negative impact on the overall atmosphere of the ward, affecting the experience of staff and their work performance, as well as the patients who naturally perceive the tense atmosphere. The causes of conflicts in psychiatric wards and their triggers have long been the focus of prof. Len Bowers' team in the UK. Researchers have been trying to understand and describe the underlying sources of conflicts on psychiatric wards, their triggers and possible staff responses. Based on extensive research,...

Coaching for mental illness

PhDr. Sylvie Navarová

Psychiatr. praxi. 2024;25(3):131-139 | DOI: 10.36290/psy.2024.022

The article provides basic information about the coaching method. Coaching developed as a method in the 1980s at a time when new person-centered and solution-focused psychotherapeutic approaches were emerging. Coaching was first applied in sports and later in companies as part of management skills. In the 1990s, coaching also began to develop in the Czech Republic. It is currently used as an approach to clients in social services, in schools, but also by freelance coaches. The field of life coaching is developing, i.e. the processing of personal issues of clients through this method. Coaching is a conversation in which the coach asks questions that...

Case report

Racemic ketamine in the treatment of a polymorbid female patient with a resistant depressive disorder with severe suicidal ideation and with pain disorder - a case study

MUDr. Miloslav Kopeček, Ph.D., MUDr. Veronika Andrashko, Ph.D., MUDr. Pavel Knytl, Ph.D., prof. MUDr. Jiří Horáček, Ph.D., FCMA

Psychiatr. praxi. 2024;25(3):148-152 | DOI: 10.36290/psy.2024.024

A 47-year-old female patient was hospitalized for her 5th depressive episode within periodic depressive disorder, the current phase severe with suicidal ideation. Despite repeated treatment with antidepressants, she considered euthanasia abroad. She had reached a total score of 28 on the 8-item version of the Sheehan Suicidality Scale (S-STS 10.0). In addition to depressive disorders, the patient suffered from numerous somatic comorbidities. We started acute treatment with ketamine twice a week, first intranasally and later subcutaneously. After four applications of ketamine, the patient was discharged to outpatient maintenance treatment. Considering...

Yellow card, hypnotherapy for a specific phobia, aviophobia

Mgr. et Mgr. Šárka Bezvodová

Psychiatr. praxi. 2024;25(3):154-156 | DOI: 10.36290/psy.2024.025

The case report demonstrates the use of hypnosis in psychotherapy (PST) as the principal method in treating a specific (isolated) phobia, aviophobia. The article describes in detail the part of PST that is focused on a phobia and prepares a patient for air travel. Specifically, there were five sessions in which hypnosis was used three times. In between the sessions, the client also practised autogenic training and worked with autosuggestions. After she had flown successfully, PST was resumed and then a pause was agreed on, which, in fact, turned out to be termination of the therapy. The case report shows a high efficacy of hypnotic-suggestive methods...

E-version

Reasons and impacts of hypnotic overuse in seniors

Mgr. Petra Höferová, PhDr. Eva Aigelová, Ph.D.

Psychiatr. praxi. 2024;25(3):E1-E5 | DOI: 10.36290/psy.2024.026

The aim of the research was to determine the reasons for the overuse of hypnotics, how sleep changes due to their overuse, the negative effects observed by the users themselves, and whether withdrawal symptoms occur after discontinuing the medication. The research sample consisted of 11 seniors and 4 close persons of the seniors and caregivers. The research employed a qualitative design. The research method was a semi-structured interview, and interpretative phenomenological analysis was used for subsequent data processing. Results: The most common reasons for the overuse of hypnotics include sleep problems and a lack of awareness of the risks associated...

Psychopharmacological profile

Risks of psychopharmacy polypharmacy in patients in long-term institutional care

PharmDr. Kristina Pechandová, Ph.D., PharmDr. Ivana Tašková, PGDip.

Psychiatr. praxi. 2024;25(3):140-147 | DOI: 10.36290/psy.2024.023

The article focuses on the issues of psychopharmacotherapy in patients in long-term institutional care, where emphasis should be placed particularly on rational and safe pharmacotherapy. The authors discuss the specific challenges associated with meeting the needs of this population, managing problematic behaviours, and simultaneously minimizing the risk of over-prescription. They emphasize that inappropriate combinations of psychotropic drugs can lead to serious health complications. They critically evaluate current practices and aim to highlight the need for monitoring the risks of psychiatric polypharmacy. Drug-related problems and specific risks...