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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.
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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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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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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...
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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...
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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...
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Suicidal behavior in childhood and adolescence
Koutek, Jiří ; Hrdlička, Michal (advisor) ; Papežová, Hana (referee) ; Stárková, Libuše (referee)
Objectives: The aim of this study was to identify risk factors and possible predictors of severity of suicidal behavior of children and adolescents. Methods: Seventy-seven patients (15 boys and 62 girls) aged 15.5 1.6 years on average, hospitalized due to a suicidal attempt in the department of pediatric psychiatry, were examined. Structured interviews with patients and their parents were used to clinically assess circumstances of suicidal behavior, relevant risk factors and severity of suicidal behavior. Results: The results indicated that patients with any previous traumatic experience tended to have somatically less severe suicidal attempts (p = 0.050). Intensity of suicidal intent was associated with a history of depression (p = 0.014) and anxiety disorders (p = 0.004), and the current stress from a mental disorder (p = 0.014). Somatic severity of suicidal behavior was significantly associated with intensity of suicidal intent (p = 0.014). A history of any trauma (previous traumatic experience predicted less severe suicidal behavior, p=0.053) and the current stress from sexual problems (p=0.067) were identified as predictors of somatic severity of suicidality. These two predictors showed only a trend level of significance. The only significant predictor of intensity of suicidal intent was the current...
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název v anglickém jazyce není uveden
Vevera, Jan ; Papežová, Hana (advisor) ; Mohr, Pavel (referee) ; Yamamotová, Anna (referee)
Závěr Naše výsledky tedy ukazují, že ve stabilním zdravotním systému zneužívání návykových látek není hlavní příčinou násilného chování u schizofreniků. Prevence zneužívání návykových látek tedy není dostatečnou strategií к redukci násilného chování u těchto pacientů. К jeho redukci by spíše mohly přispět terapeutické intervence cílené na zvládnutí impulsivních stavů a poruch osobnosti, které se v současnosti jeví jako hlavní příčiny násilného chování schizofreniků (Nolan et al., 1999; Nolan et al., 2003). Zavedení psychoterapeutických technik, cílených na tyto charakteristiky, jako je například kognitivně behaviorální terapie zaměřená na zvládání zlosti, už ukazují slibné výsledky u pacientů s PTSD, psychotickými poruchami a poruchami psychického vývoje (Chemtob et al., 1997; Novaco, 2003). Terapie atypickými antipsychotiky, která podle současných poznatků zlepšuje kognitivní fungování u pacientů se schizofrenií (Bilder et al., 2002) , by mohla vést к redukci útoků, vznikajících na základě špatného pochopení situace. Vzhledem к nízkému počtu pacientů, zneužívajících návykové látky, se domníváme, že násilné chování zaznamenané v naší studii reprezentuje násilí, které primárně souvisí s podstatou psychopatologických příznaků, především s poruchami kontroly impulsů, poruchami osobnosti a psychotickými...
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Španělská historická sídla na Seznamu UNESCO a jejich vliv na cestovní ruch
Papežová, Hana ; Netková Jarmila (advisor)
Diplomová práce pojednává o 11 španělských historických městech, která byla zapsána na Seznam světového dědictví. Součástí práce je krátká charakteristika UNESCO včetně procesu zápisu památek na Seznam světového dědictví. U jednotlivých měst jsou popsány důvody k jejich zápisu, hlavní atraktivity a cestovní ruch. Součástí práce je srovnání počtu turistů v historických městech a posouzení jejich zapojení do celkového cestovního ruchu Španělska. Práce také hodnotí nabídku poznávacích zájezdu českých cestovních kanceláří do popsaných měst.
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