Ceska a Slovenska Psychiatrie最新文献

In this work the author is trying to show some problems related to informed consent in psychiatry. It deals especially with problems of medical research, sterilisation, involuntary therapy, treatment of drug addition etc. In each of these areas there can come to a clash of interests between the society and the patient. The informed consent turns our attention to the patient.

The authors present a comprehensive account of stimulants from chemical structure to clinical use. They analyze in detail the function and pharmacokinetic properties of stimulants but also their clinical and undesirable side-effects. The section on the interaction of stimulants and other drugs and other types of treatment is very important. The second part of the paper deals with indications and contraindications of stimulants, incl. the possible risk of the development of dependence. There are many indications for stimulants in clinical (in particular paedopsychiatric) practice.

We studied the influence of homosexual (egosynton) orientation towards the variables of subjective well-being by means of the 5 scales of the Berne Questionnaire of Subjective Well-Being on the sample of 104 men. The results prove that there is no difference between homosexually and heterosexually oriented men in the overall life satisfaction, the number of contemporary problems, the number of somatic complaints, in the rate of depressive mood and in the scale of self-esteem. This fact may be connected with the capability of coping with their homosexual orientation.

The most typical features of hyperactivity in children (ADHD) are deficient attention, impulsiveness and hyperactivity on which the present paper is focused. With this problem symptoms are associated such as sensomotor problems, intellectual questions, impaired sleep, emotional disorders and behavioural disorders. The part devoted to etiology analyzes the impact of the environment and of genetic factors on ADHD whereby the latter factor is dominant. As regards treatment, the authors discuss not only pharmacological treatment, but also counselling for parents and teachers of thus affected children.

Excessive day-time sleepiness (EDS) is in more than 80% of the subjects caused by the sleep apnoe syndrome (SAS), narcolepsy and idiopathic hypersomnia. SAS is treated by continuous positive airway pressure or by uvulopalatopharyngoplasty. Narcolepsy is manifested by imperative sleepiness which may be preceded by a period of non-imperative EDS. In the treatment of narcolepsy "preventive" day-time naps and administration of stimulants are used. EDS cannot be completely eliminated in some narcoleptics. EDS in idiopathic hypersomnia can be usually influenced only by stimulants. The author gives an account of the medication used in 57 patients with narcolepsy (mean age 51.7 years, range 16-75) and experience with this therapy. Ephedrine was used by 45.6% patients (usually combined with phenmetrazine) amphetamines in 26.3%, phenmetrazine in 82.5% and mazindol in 19.3%. Significant phenmetrazine dependence was developed by one patient from a group of more than 200 narcoleptics. Other causes of EDS are illnesses and circumstances which interfere with nocturnal sleep. There it is important to influence at the first place the quality of the nocturnal sleep. Diseases of circadian rhythmicity elicit EDS teo and can be treated using special therapeutical approaches. EDS may be the manifestation of psychiatric diseases.

The submitted original paper deals with hyperactivity of children (ADHD) and their treatment by means of the stimulant Aponeuron. The authors made a long-term, double blind, placebo controlled trial which comprised more than 20 hyperactive children. The applied methods are described in detail and the results of individual investigations are summarized. Moreover it is a subject to which in the local professional literature, contrary to that in other countries, little attention was paid, although it is a frequent disorder. Administration of Aponeuron (and stimulations in general) proved useful in the treatment of this disorder. The subtle and crude motorics improved, symptoms of hyperactivity disappeared and the general school performance of the child improved.

The authors draws attention to the problem of neuropsychological rehabilitation. He emphasizes the problem of exploiting the patient's experience during rehabilitation into practical life. He provides data on rehabilitation in vivo and in vitro. He reflects on the development of computer rehabilitation of cognitive functions from neuropsychological tests and presents some examples based on Scandinavian experience. The author also draws attention to his own experience with the neuropsychological computer programme TRAIN THE BRAIN and gives an account of the work with this programme. He recommends the use of computer programmes in psychological and neuropsychological practice. He emphasizes their possibilities in patients with traumatic brain damage and the possibility to follow up systematically changes during recovery which are difficult to record in written tests. Changes in recovery which were recorded by the computer programme frequently did not correspond with changes of the mental state of the patient. Rehabilitation computer programmes also enable to activate of psychiatric patients with performance disorders. The author emphasizes possibilities of neuropsychological rehabilitation and recommends its further development in the Czech Republic.

The aim of the study was to present the problem area of psychological health from the point of view of the rational-emotive theory and therapy, which in our cultural context is still one of the less known and not broadly accepted theoretical and applicable cognitive-behavioral approaches to disorders of psychological health. This theory emphasizes primarily the cognitive cause of emotional problems but also the personal responsibility of an individual for maintaining health-damaging thought habits, schemas and empirically unverifiable irrational beliefs, if one is uncritically and rigidly holding on to them. Substituting them more rational personal life philosophies and attitudes, based on objective and correctly perceived reality mediates adequate, functional behaviors and leads to healthy emotional consequences. This is a reason why the basic criteria of rational thinking and behaving (discussed in the study) can be thought in terms of a support psychological health and also in terms of prevention of psychological disturbances.

Evaluation, assessment and statement whether sexual abuse is involved is based largely on the statement of the victim--the child or adolescent. The author describes the differences of games of abused and not abused children. From available sequences recommended and generally accepted during investigations where there is suspicion of sexual abuse she describes in detail the technique of using anatomical dolls.

Stimulants (methamphetamine) produced illegally in domestic laboratories play today - key role on the drug scene in the Czech Republic. In the past, however, a similar place was held by some preparations used (though to a limited extent) lege artis. At present we can observe an increased interest in stimulants in both spheres-on the mentioned drug scene as well as in medicine. The article deals in particular with the second sphere, i.e. the problem of the addictive character of stimulants prescribed by physicians.