|
| |
|
|
Functional-imaging and electrophysiological correlates of obsessive-compulsive disorder and their potential use in neurofeedback intervention
Kopřivová, Jana ; Horáček, Jiří (advisor) ; Papežová, Hana (referee) ; Stuchlík, Aleš (referee)
Background: Obsessive-compulsive disorder (OCD) is a common mental disorder that may seriously affect quality of life and even the ability to work. Despite advanced medical care there are still patients who do not respond or do not respond sufficiently to treatment. Recently proposed treatment strategies such as deep brain stimulation or repetitive transcranial magnetic stimulation have targeted several levels of fronto-striatal circuits which dysfunction underlies OCD pathophysiology. Likewise, neurofeedback (NFB) could target dysfunctional fronto-striatal networks by providing almost real- time feedback about their activity. As the success of these methods critically depends on good knowledge of dysfunctional loops in OCD, a more detailed investigation of neurobiological basis of this disorder is highly needed. Aims: The aim of the first part of this dissertation was to provide an overview of the current literature related to OCD and NFB. The second section of the thesis is based on five original studies of the author that were conceived to 1) explore anatomical correlate of OCD in our patients, 2) to verify its functional relevance and specificity in electroencephalographic (EEG) studies, and 3) to test the utility of the findings in NFB treatment of OCD. Methods: In our studies we included...
|
|
|
Neuronavigation of RMTS based on brain functional imaging in clinical aplication in auditory hallucinations
Klírová, Monika ; Horáček, Jiří (advisor) ; Papežová, Hana (referee) ; Rektorová, Irena (referee)
NEURONAVIGATION OF rTMS BASED ON BRAIN FUNCTIONAL IMAGING IN CLINICAL APPLICATION IN AUDITORY HALLUCINATIONS Monika Klírová Summary Transcranial magnetic stimulation (TMS) represents a noninvasive method used in diagnostics of neurological disorders and physiological research of sensoric, motor and cognitive function and intracortical relations. This method has found its leading position also in the treatment of neuropsychiatric disorders. TMS is based on the administration of short pulses of a strong magnetic field, which induces secondary electric currents in a limited volume of cerebral cortex. Therapeutic modification utilizes a repetitive TMS (rTMS) in which the magnetic coil generate a series of pulses of different frequencies. Low-frequency rTMS (LF-rTMS) of the left temporo-parietal cortex (LTPC) has been proposed as a useful therapeutic method for auditory hallucinations (AHs). Majority of rTMS studies use "standard" coil positioning, which is often not fully corresponding to cortical area(s) of maximal functional changes. Stereotactic neuronavigation enables the magnetic coil to be targeted according to the individual parameters obtained from neuroimaging. Individualized rTMS neuronavigated according to positron emission tomography (18 FDG PET) allows us to focus the coil explicitly on a given...
|
|
|
Bipolar Disorder and Diabetes Mellitus
Růžičková, Martina ; Höschl, Cyril (advisor) ; Haluzík, Martin (referee) ; Papežová, Hana (referee)
Despite lots of research, the genetic and pathophysiological basis of bipolar disorder (BD) remains unclear. One of the possible reasons is that BD spectrum comprises a heterogeneous group of different subtypes of the illness sharing certain pathophysiological or genetic mechanisms. Patients with co-morbid diabetes mellitus (DM) may represent such a subgroup of BD with a distinct pathophysiology and possibly different clinical characteristics of BD. This thesis is aimed at investigating the possible link between BD and DM. Bipolar patients have about 3 times higher risk of DM (type 2 in particular). The first part of my thesis outlines the possible links between DM and BD, including medication, alterations in the hypothalamo-pituitary axis and signal transduction, and genetics. In the second part, I examined the possible differences in clinical characteristics between patients with (N=26) and without (N=196) co-morbid DM. Next, I examined the variables showing differences between groups, using logistic regression. Patients were recruited via The Maritime Bipolar Registry. The prevalence of DM was 11.7%. Diabetic patients were significantly older than non-diabetic patients (P < 0.001), had higher rates of rapid cycling (P = 0.02), more chronic course of BD (P = 0.006), more disability (P < 0.001), lower...
|
|
|
Dissociation: Phenomenology, Pathophysiology and Relation to Obsessive-Compulsive Disorder
Raszka, Michal ; Praško Pavlov, Ján (advisor) ; Papežová, Hana (referee) ; Libiger, Jan (referee)
The aim of this study was to investigate dissociative symptoms in OCD from many angles. This is the context in terms of psychopathology, prediction of therapeutic effects of cognitive-behavioral therapy (CBT), neuropsychology (with emphasis on inhibitory processes), the structure of personality, and neurobiology. The work offers a model of neurobiological correlates of blending dissociation and OCD, which has been experimentally validated parts.
|
|
|
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...
|
|
|
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...
|
|
|
Eating Disorders: Epidemiology and Risk Factors
Pavlová, Barbara ; Papežová, Hana (advisor) ; Kocourková, Jana (referee) ; Šípek, Jiří (referee)
This thesis explores the epidemiology and risk factors of eating disorders. It focuses on the impact of the political and cultural changes that occured in the Czech Republic in the early 1990s. The term eating disorders includes mental illnesses characterized by disturbances in eating behaviour: anorexia nervosa, bulimia nervosa and various eating disorders not otherwise specifieed. It appears that the incidence of anorexia nervosa was increasing until 1970s and remains stable since. The incidence of bulimia nervosa was rising until the end of 1990s. However, the data come from the western countries only. The epiemiological data from the Central and Eastern Europe region remain sparse. Eating disorders have multifactorial aetiology; which includes the recently emerging factors related to migration and acculatuation. Therefore, we hypothesised that the prevalence and incidence of eating disorders in the Czech Repulic rose in the 1990s and that factors associated with migration experiences may play a role in the development and maintenance of eating disorders. This thesis contains three different papers exploring different aspects of this hypothesis. The first paper shows that the number of hospital admissions for eating disorders in females aged 10-39 quadrupled between 1981 and 2001, and remained high till...
|
|
|
Dissociation in adolescence. Validation of the Czech version of the A-DES in the clinical and non-clinical group of adolescents
Soukup, Jan ; Papežová, Hana (advisor) ; Hrdlička, Michal (referee) ; Praško, Ján (referee)
The purpose of this study was to find psychometric properties of the Czech language version of the Adolescent Dissociative Experiences Scale (Armstrong et al., 1997). 653 non-clinical participants and 162 adolescent psychiatric inpatients completed Czech versions of the A-DES and SDQ-20 questionnaires (Somatoform dissociative questionnaire; Nijenhuis et al., 1996), and provided further information (data regarding demographic variables, diagnoses, further psychopathology). The Czech A-DES has very good internal consistency, test-retest reliability and a good validity, though its predictive power is limited. The ADES scores significantly correlate with the measure of somatoform dissociation, self injurious behavior, reported traumatic experiences, a presence of clinician-observed dissociative symptoms, and polysymptomatic diagnostic picture (three comorbid diagnoses, differential diagnosis). A-DES scores were significantly higher in ADHD group, but not in a group with a diagnosis of a dissociative disorder. The study supports the intercultural validity of the concept of the dissociation and its clinical correlates; however, further research of the intercultural differences is needed. The authors stress the need to screen all adolescent psychiatric patients for dissociation, especially those who show more...
|
|
|
The Relation between Neuropsychological Characteristics and Clinical Status of Anorexia Nervosa Patients
Žuchová, Světlana ; Papežová, Hana (advisor) ; Preiss, Marek (referee) ; Heretik, Anton (referee)
1) to examine the repeatability of the quantitative scoring system for the Rey Complex Figure Test (RCFT) developed by Taylor, as well as of the scoring system developed by Booth to measure central coherence; 2) to examine the effects of hospital treatment on visuo-spatial memory, central coherence, and clinical status in a sample of anorexia nervosa (AN) inpatients; 3) to examine the relationship between neuropsychological characteristics, as assessed by the RCFT, and the clinical status of AN patients, as assessed by BMI and self-reporting measures (CR-EAT and EDE-Q); 4) to explore any possible correlation between the observed neuropsychological characteristics and the outcome of hospital treatment. We examined a sample of 31 AN inpatients, 29 women and 2 men. All patients completed the RCFT upon admission, and 21 patients were re-tested at the discharge, the test consisting of both a copy and recall trial. They also completed self-reporting measures (CR-EAT and EDE-Q) and their BMI was measured at both baseline and discharge. (...) This is suggested both by the correlations between this EDE-Q scale and the accuracy of the recall (p<0.05) and the central coherence of the recall (p=0.063) at the baseline, as well as by the correlations between the accuracy of the recall (p<0.05) and the central coherence...
|
guest ::
RSS feed.