The article presents the structure and content of a twelve-day inpatient program focused on the diagnostics and psychoeducation of attention deficit disorders in adults. The program takes place at a specialized unit integrating clinical assessments with daily psychoeducational sessions. These sessions aim to enhance patients' understanding of ADHD and other attention disorders, develop coping strategies, and support self-regulation. The program is interdisciplinary, involving collaboration among a psychiatrist, clinical psychologist, neurologist, physiotherapist, somnologist, nutrition and addiction specialist, and music therapist. The article outlines the design of the educational modules, the specifics of therapeutic group work, and the benefits of an intensive short-term setup in enhancing motivation, self-awareness, and future treatment planning. Practical experiences and recommendations for further development of similar services are also discussed.

ADHD in adult women often remains unrecognized for years and is frequently misdiagnosed as an anxiety and/or depressive disorder, or their difficulties are instead attributed to a primary disorder of emotion regulation or to nonspecific stress-related overload associated with family and caregiving responsibilities. Compared with men, women's clinical presentations are typically less externally conspicuous (with lower levels of disruptive motor hyperactivity) and more internalized, with prominent inattention, executive function impairments, chronic disorganization, and emotional dysregulation. Symptom expression may further fluctuate across the lifespan in relation to reproductive hormonal changes, including the menstrual cycle, pregnancy and the postpartum period, and perimenopause. This article summarizes the characteristic manifestations of ADHD in adult women, common sources of diagnostic error, and the clinical implications of hormonally related symptom variability.

The introductory part of this review article on ADHD presents the prevalence, historical development, etiology, symptoms and diagnosis, including the importance of psychological assessment. It also discusses the pharmacotherapeutic options available in the Czech Republic, including their efficacy, side effects, interactions with other medications, potential health risks, and specific aspects of use in pregnancy and lactation. It also describes the differences between ADHD in childhood and adulthood.

The second part of the review article on ADHD focuses on the common comorbid disorders that co-occur with ADHD, their differential diagnosis and current pharmacotherapeutic approaches targeting ADHD and individual comorbidities. Furthermore, it addresses the issue of self-injurious and suicidal behaviours in patients with ADHD, along with pharmacological interventions for these conditions.

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 overlapping areas exist in findings of white matter structure and in genomic findings, as well as an existing parallel in overlap of clinical manifestations. All neurodevelopmental disorders in general share a cognitive impairment the profile of which being characteristic for a particular diagnostic unit to some extent. However, its form in each individual patient is at the same time unique, being mostly composed of several types of deficits. The differentiation of individual aspects of cognition can be found in a detailed neurocognitive examination. The case report describing a 33-year-old patient thus offers a view of a neurodevelopmental continuum, not being strictly separated in diagnostic units. In each patient, instead of being fixed to diagnostic units it is advisable to focus on individual symptoms where we expect the possible benefit of pharmacotherapy. In case of a multiple deficit with comorbidities, we cannot avoid polypharmacotherapy, though as considerate as possible.

ADHD symptoms in adulthood may not be the patient's only problem; it may be overshadowed by other clinically significant serious psychiatric syndromes. Differential diagnosis of episodes of affective disorder accompanied by a later detected psychotic illness and differentiation of the primarily based core ADHD symptoms is quite possible provided that a detailed data of patient's clinical history are obtained. In the pharmacotherapy of such a patient it is useful to set individual therapeutic priorities which are not always the same for each and everyone. Treatment can be similarly complicated as polymorbidity, where monotherapy is seldom sufficient. It is also necessary to take the occurrence of adverse events into account including the less frequent ones, such as high sensitivity to the undesired effects of medication occuring even at usual therapeutical doses.

The case study describes a young adult woman coming to a psychiatric clinic primarily for problems with attention deficit. The patient is diagnosed with ADHD and started on non-stimulant medication atomoxetine, causing improvement in attention, impulsivity and hyperactivity leading to improvement in academic functioning and better time management.

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequent mental disorders in children and adolescents. ADHD is a complex disorder withhigh polygenetic hereditary burden and multifactorial etiology. Research suggests that in addition to the known factors that contribute to the pathogenesisof ADHD (genetic, neurobiochemic, structural, environmental) also oxidative stress plays an important role. In patients with ADHD raised, unchanged, ordecreased oxidative stress markers were identified compared to healthy subjects. Compounds with antioxidant properties include also natural polyphenolicsubstances, which may exhibit in vivo also biomodulating activities on the level of signaling pathways and to influence the fate of a cell, including nerve cells.Through these activities. polyphenols can affect attention and hyperactivity in patients with ADHD and contribute to mitigating the symptoms of ADHD.

Attention-deficit/hyperactivity disorder (ADHD) in adults is clinicaly established by review of symptoms and impairment. ADHD in adults is associated with significant psychiatric comorbidity and higher than average rates of diviorce, unemployment, motor vehicle accidents and i tis a risk factor for substance abuses. ADHD is associated with different characteristic of substance abuse: substance abuse transitions more rapidly to dependence, and lasts longer in adults with ADHD than those without ADHD. Self-medication may be a factor in the high rate of substance abuse in adults with ADHD. Pharmacologic treatment includes noradrenergic agents and stimulants plays a fundamental role in the management of ADHD. It reduces the risk of substance abuse in patients with ADHD. Treatment include a combination od addiction treatment, psychotherapy and pharmacotherapy. Monitoring of patients during treatment is necessary to ensure compliance with the treatment plan.

Summary. Behavioral interventions should be considered as first-line treatment of insomnia, although further evidence from randomized controlled trials (RCTs) is needed to prove efficacy in ADHD. Among pharmacological treatments RCTs support the use of melatonin to reduce sleep-onset delay in ADHD. There is more limited evidence for efficacy other medications.

Attention deficit and/or hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that persist into adulthood in the majority of cases. Diagnosis of ADHD should be considered even if not diagnosed earlier during childhood; persistence of symptoms and fuctional impairment are essential. Stimulants and atomoxetine are the drugs with the strongest evidence of efficacy in therapy of adult ADHD. Atomoxetine is the only drug approved for treatment of adult ADHD in the Czech Republic. This paper summarizes data on diagnosis and psychopharmacotherapy of adult ADHD.

ADHD is a relatively new diagnostic unit which however describes a well-known symptomatology. ADHD is a genetically determined neurodevelopmental disorder and its core symptoms (inattention, hyperactivity and impulsivity) change slightly during the life-course. The disorder begins in childhood and usually continues through adolescence into adulthood. Each developmental period possesses its own diagnostic and therapeutic particularities.

Main aim of this article is to inform pediatrists about our actual view on the clinical picture, epidemiology, pathophysiology and diagnosticprocedures of ADHD and about the therapeutic approaches to this disorder. According to DSM 5, revised diagnostic and statistical manual of mental disorders, we accept ADHD as a neurodevelopmental disorder with common onset in childhood and lifelong duration in at least at halfof the patients. ADHD can be result in various consequent problems in adult life e.g. emotional, relational or social. Hyperactivity is often thefirst symptom in early childhood, severe inattention with some consequences in academic performance is usually observed at basic schoollevel. Comorbidity complicates diagnostic process. Proper therapy can help to harmonize the development of personality, to build self-esteemand to improve socialization in adulthood.

Transition to parenthood is accompanied by psychosocial changes in both new mother and father. There is a higher risk of exacerbation or new onset of mental disorders in this period. Early attachment and healthy parent-child bond are determinants of infant´s undisturbed neurobehavioral development. Breastfeeding plays an important role in this process. The presence of untreated mental disorder affects early parent-child relationship in a negative way. Therefore, early and effective treatment intervention is essential. Psychotropic drugs with safe profile during lactation should be chosen, so the mother should be able to breastfeed her infant. Data on safety profile of psychotropic drugs are based on small observational studies or meta-analyses. This information is not available for most of the psychotropic drugs, thus, their safety profiles are just estimated. Sertraline, paroxetine and nortriptyline are listed in the current guidelines as relatively safe antidepressants in lactation. Published data suggests that benzodiazepines and Z-hypnotics pass into maternal milk minimally and oxazepam, alprazolam, and zolpidem have the safest profile in lactation. Methylphenidate, used for treatment of ADHD, also appears to be compatible with breastfeeding.

Atomoxetine is a selective norepinephrine-reuptake inhibitor indicated for the management of ADHD (F90.0) in children over six years of age, adolescents and adults. There is positive evidence for effectiveness of atomoxetine on core ADHD symptomatology and various comorbid conditions and quality of life. Commonly reported side effects, especially in the beginning of treatment, include headache, stomachache and decreased appetite. Atomoxetine can affect heart rate and blood pressure; cardiovascular status should be regularly monitored. The persistence of the therapeutic effect of atomoxetine through 24 hours enables once-daily dosing and thus can maintain efficacy in treating the symptoms of ADHD beyond the initial hours of the day spent in school, such as during afternoon study time, leisure activities or preparing for bed.

Atomoxetine may be considered for patiens with ADHD who are unresponsive to stimulant treatment, have co-morbid conditions (tic, anxiety, enuresis, slep disturbances, eating problems) or where there is potential for drug abuse. Atomoxetine should be initiated by a schedule of dose increases and cross-tapering with methylphenidate. The switching method selected is at the discretion of the clinician and should be made on a patient-by-patient basis.

The article focuses on the most important topics within the issue of healthy usage of technology in children: 1. blue light and its impact on childhood
sleep, 2. the use of screens to accelerate cognitive development, and 3. the early screen exposure and later development of ADD/ADHD. With regard
to the critical milestones of cognitive development, we discuss the most risky group, i.e. children aged 0 to 6 years. The text summarizes the main
findings from current foreign and domestic research, and is accompanied by the basic guidelines of technology use in toddlers and preschool children.

CONCERTA® is a once-daily, long-acting formulation of methylphenidate and indicated for the treatment of ADHD in children from six years and adolescents. The osmotic release oral system (OROS) methylphenidate formulation is designed to deliver methylphenidate in a controlled manner for approximately 12 hours, thereby allowing extended coverage of symptoms ADHD during the day. Compared to methylphenidate IR the new OROS formulation of methylphenidate brings numerous benefits: simple dosage improves adherence to treatment, reduces risks of stigmatization and misuse and the stability of serum levels of the medication contributes to a more pronounced effect on neurocognitive and behavioral symptoms of ADHD and improves tolerability and compliance.

Review characterized international psychopharmacological praxis in therapy of ADHD. Paper compared present and future at ADHD psychopharmacology in Czech republic. Author takes down all drugs what are uses full in various types of ADHD and co morbid conduct disorders.

Preterm birth is a significant risk factor for number of psychiatric disorders and neurodevelopmental impairments. However, mental health issues of preterm children are substantially underestimated in comparison with that somatic. This article has several objectives: to summarize the most important findings of preterm mental health studies, to inform briefly about the recent research on preterm children born with very low birthweight and to draft concept of psychological and psychiatric care for children with serious perinatal stress.

This article provides a comprehensive summary of mood stabilizers used in routine clinical psychiatric practice in the Czech Republic. These medications are used to reduce the risk of depressive or manic episodes in patients with bipolar or schizoaffective disorder. The article pays particular attention to lithium, covering its pharmacological profile, proven efficacy, and adverse effects associated with its administration. Additionally, sodium valproate, carbamazepine, and lamotrigine are described in detail from pharmacological and psychiatric perspectives. The article concludes with a summary of recommendations for clinical practice.

Telemedicine is a modern method of providing healthcare that uses information and communication technologies to enable remote contact between doctors and patients. Its aim is to improve the availability of specialist care, facilitate long-term patient monitoring, and make more efficient use of healthcare system capacity. In the Czech Republic, child psychiatry was one of the first fields to begin systematically using telemedicine. Since January 2024, remote contact in child psychiatry using video cameras has been officially available, becoming an important addition to outpatient care. This article summarizes two years of clinical experience with the provision of telemedicine services, presents the results of a questionnaire survey among parents and children, and analyzes the challenges associated with the development of digital tools and technologies in child psychiatry.

Ketamine administered at subanesthetic doses represents a rapidly acting and safe intervention with the most robust evidence for efficacy in major depressive disorder, particularly in treatment-resistant depression. In a subset of patients, a rapid reduction in suicidal ideation has also been observed. The effect of a single administration is typically time-limited and usually necessitates repeated or maintenance dosing within a defined clinical regimen. In clinical practice, off-label use of racemic ketamine is encountered alongside intranasal S-ketamine (Spravato®) used within officially approved indications, whereas R-ketamine remains experimental. The most common routes of administration are intravenous and intranasal, with alternative routes including intramuscular, subcutaneous, and oral administration, and investigated extended-release formulations. Outside depressive disorders, available data are heterogeneous and often limited; the greatest attention has been directed toward the potential use in post-traumatic stress disorder and obsessive-compulsive disorder. However, results are mixed, and standardized protocols for routine clinical implementation are lacking. In the field of addictology, ketamine is being investigated as an adjunct to psychotherapy in certain substance use disorders, with potential effects on craving and relapse, although the current evidence remains limited and indications require caution. With appropriate patient selection and adequate monitoring, ketamine demonstrates a favorable safety profile, characterized by transient dissociative/psychotomimetic and sympathomimetic effects. With repeated administration, monitoring of blood pressure, urinary tract symptoms, and liver function tests is recommended, along with systematic assessment of abuse potential and drug-drug interactions.

Introduction: Major depressive disorder is one of the most common mental disorders, but many patients do not have access to appropriate psychotherapy due to limited service availability, stigma, or financial barriers. Internet-based cognitive behavioral therapy (CBT)-based therapeutic programs represent an innovative and affordable alternative to standard psychotherapy. This study aims to evaluate the feasibility, adherence, and effectiveness of the Mindwell online CBT program for people with mild to moderate depressive symptoms. Method: A total of 188 patients who were referred by health insurance companies based on referrals from outpatient psychiatrists or general practitioners entered the program between January 1 and May 30, 2024, of whom 126 were included in the study. The PHQ-9, GAD-7, and BAI scales were used to measure depressive and anxiety symptoms at the beginning. PHQ-9 and GAD-7 were completed before the start of therapy and during each module. Adherence was defined as completing at least 6 modules out of a total of 11. Results: A total of 64 patients (51% of the sample) completed 6 modules. These patients experienced a statistically significant reduction in both depression and anxiety symptoms (PHQ-9, paired t-test: t = 5.883 df = 63; p < 0.0001; GAD-7: t = 5.273 df = 63; p < 0.001). The effect size (for PHQ-9; Cohen's dz = 0.98 for GAD-7 Cohen's dz = 0.62) suggests high program effectiveness. Adherence analysis showed that higher adherence was negatively correlated with the severity of depressive symptoms at baseline, but was not associated with treatment effectiveness. Conclusion: The results show that the online CBT program is a feasible and effective tool for patients with mild to moderate depression. The program represents a significant step towards improving access to psychotherapy and overcoming barriers associated with traditional treatment.

The article examines a hidden, and serious phenomenon that has devastating psychological, social, and financial impacts. It is a relatively new type of crime that deliberately targets the fundamental human need for love and connection. The article debunks common misconceptions about the profile of victims. It explains the techniques of psychological manipulation, such as love bombing, mirroring, and the creation of a trauma bond. Through two case studies, it demonstrates how psychological manipulation and trauma manifest in the clinical presentation of victims. It addresses the challenges of differential diagnosis and argues that the seemingly delusional belief in the existence of a relationship is not a primary psychopathology but a defensive reaction to trauma. Given the nature of this phenomenon, a trauma-informed approach to treatment is emphasized.

The authors would like to refer to the significance of EEG biofeedback (neurofeedback) therapy in treating ADHD as the most frequent and best validated indication. Although the medical treatment of ADHD disorders was historically the only effective intervention in reducing the main symptoms, there are about 25 % of no responders. Therefore the need has arisen to offer these children other biological appro aches in the treatment of this serious disorder, since the disorder is not manageable only by pedagogical – psychological interventions.