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Cerebellar functions in Attention DeficitHyperactivityDisorder
Goetz, Michal ; Hort, Vladimír (advisor) ; Příhodová, Iva (referee) ; Papežová, Hana (referee)
Univerzita Karlova v Praze 1. lékařská fakulta Studijní obor: Lékařská psychologie a psychopatologie MUDr. Michal Goetz Cerebelární funkce u poruchy pozornosti s hyperaktivitou Cerebellar functions in Attention Deficit Hyperactivity Disorder Abstract Školitel: Doc. MUDr. Vladimír Hort, CSc. Praha 2014 1 Prohlášení Prohlašuji, že jsem závěrečnou práci zpracoval samostatně a že jsem řádně uvedl a citoval všechny použité prameny a literaturu. Současně prohlašuji, že práce nebyla využita k získání jiného nebo stejného titulu. Souhlasím s trvalým uložením elektronické verze mé práce v databázi systému meziuniverzitního projektu Theses.cz za účelem soustavné kontroly podobnosti kvalifikačních prací. V Praze 14. 2. 2014 MUDr. Michal Goetz 2 Identifikační záznam GOETZ, Michal. Cerebelární funkce u poruchy pozornosti s hyperaktivitou [Cerebellar functions in Atention Deficit Hyperactivity Disorder]. Praha, 2014. 190 stran, Disertační práce (Ph.D.). Univerzita Karlova v Praze, 1. lékařská fakulta Práce byla ...
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Multifamily Therapy in the Treatment of Eating Disorders
Tomanová, Jana ; Papežová, Hana (advisor) ; Miovský, Michal (referee) ; Eisler, Ivan (referee)
This paper gives the summary of the six-year operations of multi-family therapy programme in eating disorders at The Eating Disorders Centre at The Psychiatric Clinic, Prague. The research done has been the first experience with multi-family treatment of psychiatric patients in the Czech Republic. This therapy concept is often used abroad as a form of work with patients suffering from the diagnosis of eating disorders. It is a "first choice" method due to NICE Guideline(2004). The inspiration for the Prague team was the London Maudsley model. The main aims of the research were: 1/ to introduce this therapeutic approach into a complex treatment of patients suffering from eating disorders, optimize the functioning structure and programme and stabilize the therapeutic team and 2/ to evaluate the effectiveness of multi-family treatment and suggest the suitable metodology. Since 2004 twenty families which form the observed group have been involved in the project. The combination of qualitative and quantitative methodology was chosen during the primary stage of the research. The methods used were: questionnaires of Beck Depression Inventory (BDI),Schwartz scale of therapy assessment (SOS-10), the life quality questionnaire (SQUALA) and Rosenberg self-concept questionnaire (RSE). We evaluated ten...
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Neuroanatomical aspects of nonGmotor effects of deep brain stimulation
Růžička, Filip ; Růžička, Evžen (advisor) ; Papežová, Hana (referee) ; Druga, Rastislav (referee)
Summery The underlying mechanisms of weight gain and other affective and cognitive changes after initiation of deep brain stimulation in Parkinson's disease are still unclear. Considering the functional organization within the subthalamic nucleus (STN); limbic, associative and sensorimotor regions residing in the medial, central and later STN respectively, we hypothesized that weight gain may be related to medial localization of stimulation, while motor improvement may be related to lateral localization of stimulation within the STN (study 1). We further hypothesized that stimulation close to the limbic and associative part of the STN may be associated with negative impact on limbic system leading to enhanced anxiety and changes in the hypothalamic- pituitary- adrenal axis (HPA)(study 2). Therefore, the primary aims our study were to assess changes in body weight (study 1) and the hypothalamic- pituitary- adrenal axis (HPA) (study 2) in relation to the position of the active stimulating contact within the nucleus. ...
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The detection of cognitive dysfunction in multiple sclerosis
Blahová-Dušánková, Jana ; Kubala Havrdová, Eva (advisor) ; Papežová, Hana (referee) ; Rektorová, Irena (referee)
Evaluation of cognitive impairment is often omitted in multiple sclerosis (MS), as the available instruments usually require considerable time and resources, and are not readily available in all countries. The aims of this study were to examine validity of the Czech translation of the MACFIMS (Minimal Assessment of Cognitive Function in MS), to validate the BICAMS (Brief International Cognitive Assessment for MS) and to compare outcomes of the MACFIMS and the BICAMS. We evaluated 367 MS patients and 134 healthy controls with the MACFIMS battery, which also comprises the 3 tests of the BICAMS (Symbol Digit Modalities Test, Brief Visuospatial Memory Test- Revised, California Verbal Learning Test, second edition). The most accurate BICAMS criterion of cognitive deficit was that of at least 1 of the overall 3 tests outside the normal range (sensitivity = 94%, specificity = 86%, p=10-28). Outcomes of the Czech translation of the MACFIMS were comparable to its original. The MACFIMS and the BICAMS identified cognitive deficit in 55% and 58% of the MS patients, respectively. Both the BICAMS and MACFIMS predicted patient vocational status. The BICAMS is highly sensitive and specific to cognitive impairment in MS as defined by the MACFIMS. This impairment is significantly associated with vocational status. Our work...
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Cognitive Impairment in Parkinson's Disease
Bezdíček, Ondřej ; Růžička, Evžen (advisor) ; Papežová, Hana (referee) ; Hort, Jakub (referee)
Cognitive impairment is considered as essential feature of non-motor symptoms in Parkinson's disease (PD). It is a result of underlying pathological processes in the brain of PD patients and it leads to decreased quality of life. In this thesis an analysis of the structure and profile of cognitive impairment is presented with special emphasis on executive functions and memory. We take diagnostic entities developed for the description of PD cognitive spectrum such as mild cognitive impairment (PD-MCI) and dementia (PD-D) as examples of heterogeneity and different severity of cognitive impairment in PD. However, neuropsychological methods in Czech version that would measure these diagnotic units were not adequatly validated. In the experimental part we test a hypothesis, if gait disorder with falls in PD is interconnected with cognitive impairment, and if PD-fallers have more severe cognitive deficit than PD-non-fallers. On the basis of nine validity or normative data studies we show psychometric properties and clinical utility of several basic neuropsychological methods in the Czech population for memory (Rey Auditory Verbal Learning Test, California Verbal Learning Test, Second Edition, Memory For Intentions Screening Test and Enhanced Cued Recall Test), sustained attention and executive functions...
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Psychosocial Effect Of Bariatric Surgery and the Patient's Satisfaction with the Surgery
Kravarová, Eva ; Papežová, Hana (advisor) ; Dragomirecká, Eva (referee) ; Stárková, Libuše (referee)
The doctoral dissertation is focused on the evaluation of the effect of bariatric surgery and on identifying the parameters that are related to the patients' satisfaction with the surgery. Telephone survey was used to collect data. 122 bariatric candidates were inquired, 86 of them were operated. The average time after the surgery was 20,2 months. The average weight loss was 26.6 kgs. There was a significant improvement in the monitored domains - physical appearance, general health, self-esteem, marital satisfaction, occupational functioning and social functioning. The negative effects of the surgery (post-surgery vomiting, difficulties in dietary adherence, other complications) were also experienced by significant number of patients. In total, 87% respondents were satisfied with the surgery and 13% were dissatisfied. The chi-square test was used to identify factors influencing subjective satisfaction with the surgery and the results were recorded at 95% and 99% significance levels. The satisfaction is associated with the improvement of general health and self-esteem (p<0.01), physical appearance, marital satisfaction, occupational functioning and social functioning (p<0.05). Less satisfied were patients who had troubles with postoperative dietary adherence and those with an insufficient weight...
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Objective and subjective characteristics of sleep in chronic insomnia
Janků, Karolina ; Kopřivová, Jana (advisor) ; Papežová, Hana (referee) ; Šonka, Karel (referee)
Background: Insomnia is one of the most prevalent sleep disorders, negatively impacting the quality of life and increasing the risk of other health problems. Many patients with insomnia underestimate their sleep quantity compared to objective sleep measures. This objective and subjective sleep discrepancy (sleep misperception) occurs in different insomnia subtypes as well as in insomnia with a comorbid psychiatric disorder. Although previous research suggests that the sleep discrepancy reflects specific objective sleep alterations, the results of studies are inconsistent. Moreover, its relation to psychiatric comorbidities is not clear, as well as its role in the insomnia treatment. Aims: The theoretical part of the present thesis aimed to provide an overview of the recent research on sleep discrepancy in insomnia. The experimental part consists of four studies with the following goals: (1) to explore sleep electroencephalographic (EEG) correlates of sleep discrepancy in insomnia patients (Study 1); (2) to assess the association between sleep discrepancy and psychopathology (Study 2); (3) to examine changes of sleep discrepancy during and after the cognitive behavioural therapy for insomnia (CBT-I; Study 3); (4) to assess whether the additional chronotherapeutic tool can enhance the effect of CBT-I...
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The comparsion of the effect of psychothrapy and repetitive transcranial magnetic stimulation in treatment of binge eating disorder.
Jaššová, Katarína ; Papežová, Hana (advisor) ; Kocourková, Jana (referee) ; Novák, Tomáš (referee)
Introduction: Among eating disorders, the binge eating is the most common disorder with prevalence to 7,8%. It is frequently connected with overweight, or obesity. Current treatment of binge eating is based on psychotherapy, pharmacotherapy and regime approach. Recently, repetitive transcranial magnetic stimulation appears as hopeful therapeutic method, for example used with success as an alternative therapy to treatment of resistant major depresion. Because of its non-invasiveness, good tolerability and minimal side effects, new options of its use are studied. It seems to be a promising therapeutic method for treatment of eating disorders. Dorsolateral prefrontal cortex is considered as main experimental target of stimulation for treatment of binge eating disorder. Methods: Study was conceived randomized double-blind placebo controlled. The active group was stimulated by high-frequency rTMS, with stimulation parameters: frequency 10Hz, 1500 pulses, 107s inter-train, 100 % minimal motor threshold and 10 sessions of stimulation. The control grooup was stimulated by sham rTMS coil. Both groups completed FCQ-S and FCQ- T questionnaire before stimulation, after 10. session and one month after 10. session. Results: We noticed statistically significant decrease of craving in FCQ-S questionnaire after 10. session...
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Occurrence and symptoms of adulf ADHD in patients with eating disorders.
Štěpánková, Tereza ; Papežová, Hana (advisor) ; Stárková, Libuše (referee) ; Kocourková, Jana (referee)
Introduction: Recently published reviews and meta-analytic studies have shown increased interest in research of the ADHD and ED comorbidity. We conducted a case-control study (133 ED female patients/93 healthy control), screening for ED among ADHD patients (N=64) and a pilot study of a support group program for adults with ADHD and psychiatric comorbidities. Methods: Adult and childhood ADHD symptoms were assessed by self-report and other- report versions of a Barkley Adult ADHD questionnaire (BAARS-IV). Patients with ED and ADHD comorbidity underwent a structured interview (DIVA 2) and Integrated Visual and Auditory Performance Tests (IVA Plus) to confirm the ADHD diagnosis. Participants of the pilot program were assessed prior to and after the therapy by the Schwartz Outcome Scale (SOS) and Quality of life (SQUALA) questionnaires. Results: Using self-report questionnaire of current symptoms 61 (46 %) of ED patients were detected as likely having ADHD compared to 22 (24 %) from a healthy control group, 37 (28 % ) of ED patients were identified with the high probability of ADHD diagnose compared to 12 (13 %) from a healthy control group with significant differences. Screening for disordered eating behaviors indicated previously documented higher prevalence of overweight among men with ADHD...
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Interdisciplinary and multidisciplinary approaches to care for people with eating disorders - foreign inspiration
Brandtlová, Lucie ; Vrzáček, Petr (advisor) ; Papežová, Hana (referee)
The diploma thesis is focused on the one hand on the ways of the coordination of the multidisciplinary teams and the interdisciplinary cooperation of the professionals helping people with eating disorders (EDs) and on the other hand on the challenges that these professionals are facing and what are their solutions. The findings of the empirical part are based on a qualitative research using mostly semi-structured interviews with 17 professionals. Most of the professionals from the nonprofit type of organizations and from the treatment facilities had one permanent coordinator and they used regular team meetings as a part of the coordination. On the other hand the professionals with their private practice cooperating with each other were choosing the coordinator case by case or had none at all and they shared the information mostly irregularly by phone or email. The most frequent challenges of this cooperation were its time, financial, energy and coordination consuming character, insufficient knowledge or experience of some other professionals regarding EDs or their unwillingness to cooperate, myths about EDs or a disharmony among the cooperating professionals. The recommendations for practice are: a careful selection of the colleagues according to their competence, similar views and willingness to...
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