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Aggression in patiens with psychosis
Nichtová, Andrea ; Vevera, Jan (advisor) ; Papežová, Hana (referee) ; Končelíková, Dana (referee)
Most psychiatric patients do not behave aggressively, but they very often become victims of aggressive behaviour. However, in the practical part of this work, we focused on the phenomenon of aggressive behaviour in psychotic patients, and we address victimization of psychotic patients in the theoretical part because it is one of the most important predictors of aggressive behaviour not only in psychiatric patients but also in the general population. In the literature, we encounter three basic immediate causes of aggressive behaviour - psychotic, impulsive, and predatory (planned) - which we observed in hospital conditions. Specifically, we focused on impulsive behaviour in aggressive patients, given that it is assumed that psychotic patients have difficulties in this area. The aim of this study was to examine the immediate causes of aggressive behaviour and provide data from the Czech Republic on their prevalence. Another goal was to determine whether the factor structure in our work is consistent with the three hypothesized factors described by Nolan et al. Another goal was to explore impulsive behaviour in psychotic patients in light of the reported reduced impulse control and emotional dysregulation associated with the emergence of aggressive behaviour in psychotic patients. The study aimed to...
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Prognostic awareness in advanced cancer patients
Vlčková, Karolína ; Loučka, Martin (advisor) ; Světlák, Miroslav (referee) ; Vevera, Jan (referee)
Being aware of the severity of their medical condition is a key precondition for patients with advanced disease to be involved in advance care planning. This thesis aims to describe the phenomenon of prognostic awareness and identify factors that are related to prognostic awareness in patients with advanced cancer. The author of this dissertation thesis participated in a three-year project, which was supported by the Czech Science Foundation (IMPAC study, grant number 17-26722Y), which aims to map the preferences of patients with advanced disease and further describe factors related to prognostic awareness and assess its stability over time. The secondary goal was also to describe how patients with a serious diagnosis and their loved ones evaluate their participation in a research study. In the introductory chapter of this thesis, we describe the concept of prognostic awareness, methods of measuring it and the goals of this work. The dissertation thesis includes 4 publications that are focused on this topic and 1 publication that responds to the secondary goal of this dissertation thesis. The publications are followed by a discussion in which we deal with all our findings in the context of the latest evidence available on this topic. Our results prove that prognostic awareness is a complex...
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Functional movement disorders: pathophysiological mechanisms, diagnostic neurophysiological markers, and new therapeutic approaches
Slovák, Matěj ; Serranová, Tereza (advisor) ; Vevera, Jan (referee) ; Rusina, Robert (referee)
Functional movement disorders (FMD), previously referred as psychogenic, are characterized by inconsistency and incogruence with organic neurological disorders. The original psychological models of FMD were replaced by a neurobiological model of the disease. The identification of neurophysiological correlates of FMD and their comorbidities may add to the so far limited knowledge of the pathophysiology of these disorders. This Thesis focuses on three thematic areas of FMD: 1. assessment of prevalence of comorbid restless legs syndrome (RLS) and periodic limb movements (PLM) as an objective marker of RLS using actigraphy; 2. analysis of reflexive and volitional eye movements using videooculography (VOG); 3. evaluation of emotional arousal objectively by pupillometry and subjectively using affective ratings of emotional pictures. In total, 115 FMD patients and 76 age- and matched healthy controls participated in the studies. 1. FMD patients (N=96) presented with signficantly higher prevalence of RLS (43,8 % vs. 7,9 %, p<0,001) and clinically relevant PLM (20,8 % vs. 2,6 %, p=0,0002) compared to controls. The association of RLS/PLM with FMD raises the possibility of common pathophysiological mechanisms of these conditions and has clinical implications in management of FMD. 2. VOG analyses showed normal...
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Psychopathology, mental disorders and mitochondrial disorders
Sigitova, Ekaterina ; Raboch, Jiří (advisor) ; Doubek, Pavel (referee) ; Vevera, Jan (referee)
This study investigates the connection between different pathophysiological processes in mitochondria and psychopathological symptoms in patients with bipolar disorder. Changes in activity of selected components of the respiratory chain and overall respiratory rate of mitochondria were analyzed in patients with bipolar disorder when compared to healthy controls. Diagnostic scales and questionnaires, high-resolution respirometry, radiochemical and spectroscopic methods were used. 37 patients with a diagnosis of bipolar disorder (F31) and 21 healthy volunteers were involved in the study. Statistical analysis included the methods of parametric and nonparametric analysis, factor analysis, one-way analysis of variance and linear regression analysis. Obtained results revealed that cellular energetics plays a great role in the pathophysiology of bipolar disorder. There was a mild difference between different mitochondrial enzymes activity in patients within manic phases and depressive phases of the disease. Changes in mitochondrial respiration in patients with BD as compared to healthy controls were also shown. Mitochondrial respiration indexes for patients with BD in remission as compared to healthy controls were altered in accordance with the previous phase of the disease. Association between the...
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Analytical Rumination Hypothesis Testing: Depression as a Functional Adaptation.
Ševčíková, Marcela ; Preiss, Marek (advisor) ; Bob, Petr (referee) ; Vevera, Jan (referee)
Next to the traditional medical concept of depression, there is an expert opinion suggesting that depression is a functional adaptation to adversity. In the theoretical part of the thesis, we present the adaptive hypothesis of depression, the Analytical-Rumination Hypothesis (ARH). According to ARH, depression has evolved as an adaptive response to the complex problems. Depressive symptoms, such as anhedonia, social isolation, and psychomotor retardation, may help individuals to undisturbedly analyze their personal problems in a process called analytical rumination. The limited ability to focus on an external problem, e.g. on neuropsychological tests, is a by-product of analytical rumination. The aim of the dissertation thesis is to test the ARH. In the practical part, we present five studies using both quantitative and qualitative approaches, cross-sectional and longitudinal design, and samples with different statuses (clinical and non-clinical). The results of Study 1 confirm that depression is a response to a complex problem. Using a qualitative methodology, Study 2 examined the form of rumination and detected the presence of adaptive rumination in depressed individuals (causal analysis, analysis of the aspects of the problem and problem-solving analysis). The results of cross-sectional Study 3...
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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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The role of endometriosis in the development of dyspareunia and algopareunia.
Fiala, Luděk ; Zvěřina, Jaroslav (advisor) ; Vevera, Jan (referee) ; Adamík, Zdeněk (referee)
Endometriosis is defined as the presence of endometrial cells outside the uterine cavity. The underlying symptom is pain, endometriosis is often associated with primary or secondary sterility, and it is assumed to be involved in the development of female dyspareunia and algopareunia. There are many theories regarding the cause of the disease, however, none of them affects the complex state of the disease which occurs in the population according to statistics in 10-15 % of women. In women with a diagnosis of sterility and infertility, the incidence of endometriosis is described in more than 40 %. Also, more than 50 % of women describe the most diverse forms of dyspareunia and algopareunia that affect not only women's own lives but also their relationships. The illness thus becomes important not only from a purely medical point of view but also from a psychosocial point of view. It should be noted that there is currently no known specific laboratory marker to diagnose endometriosis. Likewise, there is no unambiguous solution within the therapy, whether it is conservative, surgical, or combined. An important fact is that endometriosis is diagnosed with a considerable delay, according to statistics; it takes up to 11 years from the discovery of the first, often indefinite symptoms, to the unequivocal...
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Analytical Rumination Hypothesis Testing: Depression as a Functional Adaptation.
Ševčíková, Marcela ; Preiss, Marek (advisor) ; Bob, Petr (referee) ; Vevera, Jan (referee)
Next to the traditional medical concept of depression, there is an expert opinion suggesting that depression is a functional adaptation to adversity. In the theoretical part of the thesis, we present the adaptive hypothesis of depression, the Analytical-Rumination Hypothesis (ARH). According to ARH, depression has evolved as an adaptive response to the complex problems. Depressive symptoms, such as anhedonia, social isolation, and psychomotor retardation, may help individuals to undisturbedly analyze their personal problems in a process called analytical rumination. The limited ability to focus on an external problem, e.g. on neuropsychological tests, is a by-product of analytical rumination. The aim of the dissertation thesis is to test the ARH. In the practical part, we present five studies using both quantitative and qualitative approaches, cross-sectional and longitudinal design, and samples with different statuses (clinical and non-clinical). The results of Study 1 confirm that depression is a response to a complex problem. Using a qualitative methodology, Study 2 examined the form of rumination and detected the presence of adaptive rumination in depressed individuals (causal analysis, analysis of the aspects of the problem and problem-solving analysis). The results of cross-sectional Study 3...
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Sleep correlates of early risk of bipolar disorder in children and adolescents.
Šebela, Antonín ; Goetz, Michal (advisor) ; Příhodová, Iva (referee) ; Vevera, Jan (referee)
Background: Reports of subjective sleep impairments have been replicated in adults with bipolar disorder (BD) and young BD patients. Furthermore, circadian rhythm alterations are a core feature of BD. Despite the impairment in circadian rhythms and altered sleep included in various heuristic developmental models of BD, thus far, biomarkers in population at risk for BD have not been sufficiently objectively validated. Thus, we conducted: a) Explorative study of sleep and rest-activity circadian rhythm among offspring of BD parents. b) Study of sleep and rest-activity circadian rhythm among offspring of BD parents without the presence of psychopathology (except depression and anxiety disorders) based on our exploratory findings. Methods: a) 14 days of actigraphic assessment and subjective scales (Pediatric Sleep Questionnaire, PSQ; the Morningness/Eveningness Questionnaire, MEQ; and The General Behavior Inventory Sleep Subscale, GBISS) to assess circadian preference, and to identify sleep impairment symptoms. Psychopathology was assessed using psychiatric interview. b) ≥ 14 days of actigraphic assessment with advanced methods to assess the chronotype, social jet lag and sleep macrostructure, psychiatric interview and subjective psychometric scales to assess the full psychopathology profile. Results:...
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Czech version of the Personality inventory for DSM-5 (PID-5): Theoretical background, psychometric properties and implications for clinical practice.
Riegel, Karel Dobroslav ; Preiss, Marek (advisor) ; Vevera, Jan (referee) ; Praško Pavlov, Ján (referee)
2 ABSTRACT In the Alternative DSM-5 Model for Personality Disorders (AMPD), the diagnosis of specific personality disorders is obtained through an evaluation of the level of impairment in personality functioning and an assessment of dimensional personality traits associated in 25 "lower order" facets and 5 "higher order" domains. The Personality Inventory for DSM-5 (PID-5) was developed for examination of personality traits within this system. This Ph.D. thesis covers five relevant publications regarding AMPD, particularly PID-5. First, the authors introduce the theoretical background of the PID-5. Attention is paid on its ease of use, data interpretation and use of these data for treatment planning in different clinical settings. Two empirical studies test PID-5 psychometric properties (internal consistency, validity, discrimination capacity and unidimensional structure) in the sample of community volunteers (n=351) and a clinical sample of psychiatric patients (n=143). PID-5 was administered individually and in a group setting using pen-paper method and online data collection. 33 respondents completed the inventory twice to check test-retest reliability. Authors presumed, evidence will be found to support internal consistency and convergent validity of the PID-5 personality trait domains, as well as their...
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