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Possibilities of prevention reflecting geriatric principles: Functional status and depressivity in old age
Vaňková, Hana ; Čelko, Alexander (advisor) ; Dohnal, Karel (referee) ; Jirák, Roman (referee)
Possibilities of prevention reflecting geriatric principles: Functional status and depressivity in old age Hana Vaňková, MD Abstract Background: Given the population ageing in Europe and in the Czech Republic, strategies aiming to prevent functional decline in older age are of great importance. Depression in old age increases functional decline and is also associated with increased morbidity, mortality and deterioration of quality of life (Anstey et al., 2007; Karakaya et al., 2009). Therefore, there is a need for a comprehensive intervention addressing both functional status and depressive symptoms. Methods: Using comprehensive geriatric assessment, the relationship between functional status and depressive symptoms was examined in 308 residents of long-term care facilities (RCFs) in the Czech Republic. Depressive symptoms were measured using the 15-item Geriatric Depression Scale. An additional randomized control trial (RCT) evaluated the effect of a dance-based therapy on depressive symptoms in 162 institutionalized older adults with average age over 80 years. Results: A multiple regression analyses adjusted for sociodemographic factors and for taking antidepressants found that cognitive function and functional limitation by pain were most strongly associated with depressive symptoms. The ability to...
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Anti-platelet effects of citalopram
Richter, Tomáš ; Alušík, Štefan (advisor) ; Jirák, Roman (referee) ; Matějovská Kubešová, Hana (referee)
Introduction Citalopram is a preferred medication used for the treatment of depression and belongs to a group known as selective serotonin reuptake inhibitors (SSRI). When used on a long-term basis, it leads to a significant decrease of serotonin in thrombocytes. Citalopram-treated patients often display haemorrhagia that is explained by its anti-platelet effect, which is also - more or less - the case for other medications from the SSRI group. Aim of the Thesis The aim of the thesis was to find out: a) Whether citalopram treatment (2 weeks) has influence on the plasma concentration of thromboxane B2; b) Whether there is a relation between the expected decrease of thromboxane B2 levels and the plasma concentration of citalopram. Methods and Patient Population We carried out clinical and laboratory tests on a study population consisting of elderly and polymorbid patients who underwent a 14-day citalopram treatment with daily doses of 20mg. Among other tests, we observed the plasma concentration of thromboxane and citalopram. Out of 160 patients examined, 78 patients were assessed. Results Our study has proved that even a short-term citalopram treatment results to a significant increase in the plasma concentration of thromboxane B2 and the suppression rate of thromboxane B2 correlates with the higher...
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Alzheimer's Disease and Family Caregiver Burden. Impact of Alzheimer's Disease on Family Caregiver Psychosocial Health.
Zvěřová, Martina ; Jirák, Roman (advisor) ; Holmerová, Iva (referee) ; Zvolský, Petr (referee)
Alzheimer's Disease is a progressive, irreversible neurodegenerative illness and the most common of the dementing disorders. Only few diseases disrupt patients and their relatives so completely or for so long a period of time as Alzheimer 's. Caring is held to be very demanding and emotionally involving. Caregiver burden has been defined as a multidimensional response to emotional, social, physical, psychological, and financial stressors associated with the caregiving experience. The objective of the 1st study was to assess the degree of burden and its possible change in family caregivers of the long-term sick family member with progressive Alzheimer's disease during eight-month monitoring. In addition to the common psychiatric examination the Mini- Mental State Examination (MMSE) was administered in patients to indicate the severity of the dementia and the Zarit Burden Interview was administered in caregivers to assessed degree of burden. The total of 60 people have been examined - 30 patients with AD and 30 their caregivers (24 females, 6 males) were recruited from the Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague. At the beginning of the study there were 18 patients with mild stage of AD (60%), 11 patients suffered...
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Diabetes mellitus type 1 and depression. Psychopathology by somatic deseases
Komorousová, Jana ; Beran, Jiří (advisor) ; Lacigová, Silvie (referee) ; Jirák, Roman (referee)
Diabetes mellitus is a severe chronic life-long disease. The condition itself introduces a need for patient's lifestyle adjustment to the disease and a number of everyday therapeutic and diagnostic restrictions. Therefore, mental disorders are more common in diabetic patients than in the rest of the population. Biochemical and hormonal connections between mental disorders and diabetes mellitus represent another reason for their higher incidence in diabetic patients. Comorbid mental diseases can further negatively influence the course of diabetes. They are especially depression, anxiety disorders, eating disorders and cognitive disorders including dementia. Type 2 diabetes is also more common in patients with primary mental disease, as is e.g. schizophrenia and bipolar affective disorder. Regarding therapy, psychoactive drugs are used in diabetic patients. It is important to respect the specifics of the underlining disease during drug selection. The main factor for the selection of the medication is, apart of mental problems, the influence on body weight and blood glucose. Mental disorders can be also treated by psychotherapy and psychoeducation. Studies performed in diabetic patients with mental problems suggest the need for intervention in this area. The practical part of the work introduces a...
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Relationship of olfactory functions and psychopathology in patients with autism spectrum disorders
Dudová, Iva ; Hrdlička, Michal (advisor) ; Drtílková, Ivana (referee) ; Jirák, Roman (referee)
The aim of our study was to examine olfactory functions (odor detection thresholds, odor identification and odor preference) and to explore their relationship with psychopathology in children with autism spectrum disorders (ASD). Thirty-five patients with Asperger's syndrome and high functioning autism (mean age 10,8 ± 3,6 years; 31 boys) were compared with 35 healthy control subjects (mean age 10,4 ± 2,4 years; 28 boys). There were no significant differences between groups with regard to mean age (p = 0,598) and gender proportion (p = 0,324). Olfactory testing (threshold and identification) used the Sniffin' Sticks test. Odor pleasantness was assessed on a 5-point scale using the Identification part of the Sniffin' Sticks test. The severity of autistic psychopathology was measured by the Childhood Autism Rating Scale (CARS). Participants with ASD, in comparison with healthy controls, were significantly impaired relative to odor detection thresholds (6,3 ± 3,1 vs. 7,9 ± 2,0; p = 0,025). Autistic participants were significantly better in correctly identifying the odor of an orange (94 vs. 63%; p < 0,05) and significantly worse at correctly identifying the odor of cloves (40 vs. 74%; p < 0,05). With regard to identification of fourteen other substances, there were no significant differences. There...
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The picture of mental illness in the print media in three central European countries
Nawková, Lucie ; Jirák, Roman (advisor) ; Bražinová, Alexandra (referee) ; Vevera, Jan (referee)
Media are considered to be the public's primary source of information regarding mental illness. Evidence suggests that media representations of people with psychiatric disorders are frequently negative and contribute to their stigmatization. On the other hand, media can play an important role in reducing this stigmatisation by providing adequate information about this topic and engaging in antistigma campaigns. Up to now there was no standardised measurement of the stigma of mental illness in print media using clearly operationalized definitions. The objectives of this project were twofold; to develop a standardised and objective instrument to measure stigma of mental illness in print media; and to conduct an analysis of the current coverage on mental health/illness issues in Czech, Croatian, and Slovak print media. The development of the Picture of Mental Illness in Newspapers (PICMIN) instrument was based on the principles of content analysis, a research technique for making replicable and valid inferences from text to the kontext in their use. The instrument consists of eleven descriptive and five analytical categories. The most interesting findings based on the analysis of media representations of mental illness were; a similarly high level of stigmatizing articles across countries, clearly...
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Early diagnostic of mnestic disorders in neurodegenerative diseases
Laczó, Jan ; Bojar, Martin (advisor) ; Jirák, Roman (referee) ; Mareš, Jan (referee) ; Rektorová, Irena (referee)
The ageing of the world's population means that the number of people with dementia, especially Alzheimer's disease (AD), will dramatically increase. That's why there is now a great effort to detect the presence of AD in its earliest predementia stages, in the stage of mild cognitive impairment (MCI), and particularly to identify individuals with amnestic syndrome of the hippocampal type (Ha-MCI - preclinical AD). The aim of our studies was to reveal whether spatial navigation testing could serve as an early biomarker of AD - whether spatial navigation is impaired early in patients with MCI, especially in Ha-MCI patients. We used the human analogue of the Morris water maze, the Hidden Goal Task (HGT), which is designed t! o separate two different modes of navigation, egocentric (body- centred, hippocampus independent) and allocentric (world-centred, hippocampus dependent), using a real space navigation setting called the Blue Velvet Arena (BVA), fully enclosed cylindrical arena, as well as a computer version of the BVA. Our results suggest that spatial navigation is impaired already in patients with amnestic MCI, who are more likely to progress to AD, especially in those with amnestic syndrome of the hippocampal type. The Ha-MCI patients presented severe spatial navigation impairment similar to that seen in...
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The influence of sertraline treatment on the metabolic and antropometric parameters in people with depression
Podlipný, Jiří ; Beran, Jiří (advisor) ; Filipovský, Jan (referee) ; Jirák, Roman (referee)
Introduction: Pharmacotherapy with antidepressants can cause a metabolic risk, can be neutral in terms of metabolism or can perform a metabolic benefit for the treated patients. Objective: The aim of the presented study is to assess the effects of long-term use of sertraline on the particular laboratory and anthropometric parameters in somaticaly healthy or compensated outpatients treated for unipolar depression. Methods: The study was performed in cooperation of Centre of Preventive Cardiology (CPC) of 2nd Department of Internal Medicine and Department of Psychiatry of Charles University in Prague, Faculty of Medicine in Plzeň (Pilsen) and University Hospital Plzeň, Czech Republic. A screening of risk factors in relation to the development of cardiovascular (CV) diseases and metabolic syndrom was carried out in 350 people from the cohort Pilsen Longitudinal Study III (PILS III) at CPC. The participants filled in a Czech version of the Zung Self-Rating Depression Scale (SDS) simultaneously with the screening. Those of them scoring up the threshold set for the suspicion of depression in SDS were invited to the department of psychiatry outpatient's office in order to undertake a psychiatric examination. There were 31 persons in total fulfilling the following criteria: (1) aduld patients diagnosed with...
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