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Journal Article 2014; 35(8): 711-717 PubMed PMID: 25702300 Citation  Keywords:  Adult, Antidepressive Agents:therapeutic use, Anxiety Disorders:drug therapy, Combined Modality Therapy, Depressive Disorder:drug therapy, Female, Humans, Male, Middle Aged, Psychotherapy:methods, Self Concept, Social Stigma, Treatment Outcome,.   

OBJECTIVE: Many psychiatric patients suffer from self-stigma. One consequence of these internalized prejudices is decreased treatment efficacy. Much has been written about the effects of self-stigma in patients with severe mental disorders. However, individuals with minor psychiatric disorders also suffer from self-stigma. It is therefore necessary to explore the effect of self-stigma on treatment efficacy of neurotic patients.

METHOD: Aim of out study was to investigate relationship between self-stigma, severity of symptoms, and presence of comorbidit disorder and treatment outcome in neurotic patients. Patients were treated by combined psycho and pharmacotherapy. Level of self-stigma was measured by Internalized Stigma Of Mental Illness scale. Severity of anxiety and depressive symptoms was assed by Beck Anxiety Inventory, Beck Depressive Inventory and Clinical Global Impression Scale.

RESULTS: Level of self-stigma was significantly correlated with the levels of anxiety, depression and global evalutions of a mental state on the beginnig of the therapy. Up to our results patients with higher level of self-stigmatization had lower improvement after combined treatmet in respect to perceived anxiety symptoms.

CONCLUSION: Self-stigma seems to be an important factor influencing efficacy of combined treatment. More researches focused on self-stigmatization should be done to find an optimal therapeutic strategy for patients with higher level of self-stigmatization....

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Journal Article 2014; 35(8): 676-683 PubMed PMID: 25702295 Citation  Keywords:  Adolescent, Adult, Age of Onset, Dwarfism, Pituitary:psychology, Female, Human Growth Hormone:administration & dosage, Humans, Male, Quality of Life:psychology, Severity of Illness Index, Young Adult,.   

BACKGROUND: Transition is a term used to describe the period of adolescence after which the final adult height during growth hormone (GH) treatment is achieved. According to re-evaluation results in insulin tolerance test (ITT) patients with severe and partial growth hormone deficiency (GHD) may be distinguished.

OBJECTIVES: The aim of the study was to assess QoL in patients with different degrees of GHD in transition phase.

METHODS: QoL was evaluated in 76 subjects aged 16-25 years with severe (SGHD, n=26), partial GHD (PGHD, n=22) and normal GH secretion (NGH, n=28) using SF-36 v.2™ Health Survey and the Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA) questionnaires.

RESULTS: Physical Component Score (PCS), Physical Functioning (PF) and General Health (GH) results were significantly lower in patients with SGHD than in NGH group. SF-36 v.2™ Health Survey scores in PGHD were similar as in NGH patients. There were no statistically significant differences in QoL-AGHDA scores between the examined groups. We found positive correlations between peak GH in ITT and PF (r=0.29; p=0.02) or Role Emotional (r=0.37; p=0.002) scores.

CONCLUSIONS: We demonstrated that the QoL in adolescents and young adults with severe GHD in transition period is disturbed mainly in terms of physical health and emotions. These changes were detected only by generic SF-36, but not by disease-specific QoL-AGHDA questionnaire. Therefore AGHDA-QoL assessment may not be applicable in GHD patients in transition period. QoL in the patients with partial GHD is unchanged in comparison to growth hormone sufficient subjects....

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Journal Article 2014; 35(Suppl 2): 175-179 PubMed PMID: 25638383 Citation  Keywords:  Animals, Antioxidants:pharmacology, Antipsychotic Agents:pharmacology, Cells, Cultured, Clozapine:pharmacology, Inflammation:drug therapy, Interleukin-6:metabolism, Macrophages:drug effects, Mice,.   

OBJECTIVES: Clozapine is an atypical antipsychotic drug known for its impact on production of pro-inflammatory cytokines. The aim of our work was to examine the impact of clozapine on the production of interleukin 6 (IL-6) by the LPS (lipopolysaccharide) stimulated macrophage cells and to confirm or exclude that it regulates the inflammation due to its interaction with alpha 7 nicotinic receptor (nAChR). Secondly, we focused on a verification of the antioxidant effect of clozapine.

METHODS: The levels of IL-6 in cell culture media were determined by ELISA method. Antioxidant properties of clozapine were estimated based on the reduction of 2,2-diphenyl-1-picrylhydrazyl radical.

RESULTS: The IL-6 level produced by cells treated clozapine decreased significantly from IL-6 level created by clozapine-untreated cells. However, the production of IL-6 in the cells treated with clozapine and simultaneously with selective alpha 7 nAChR antagonist methyllycaconitine did not alter significantly from the IL-6 production in the cells treated just with clozapine. The free radical scavenging activity of clozapine in concentration 1.00 mM was found equivalent to 0.13 mM of standard antioxidant N-acetyl-L-cystein.

CONCLUSION: Our study confirmed, that clozapine reduces production of IL-6 in LPS-activated macrophage cells nevertheless we denied that it would be mediated through alpha 7 nAChR. Moreover antioxidant potential of clozapine was observed.

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Journal Article 2014; 35(Suppl 2): 169-174 PubMed PMID: 25638382 Citation  Keywords:  Depressive Disorder:complications, Female, Humans, Hypothalamo-Hypophyseal System:growth & development, Neurotransmitter Uptake Inhibitors:adverse effects, Pituitary-Adrenal System:growth & development, Postpartum Period:psychology, Pregnancy, Pregnancy C.   

: Depression during pregnancy and in the post partum period is a significant health issue in modern society. The estimated prevalence of depression in pregnancy ranges from 13-20%. The major dilemma for gynecologists is to treat or not to treat depression during gestation and lactation. Consequences of untreated depression can be so serious that the benefit of antidepressant therapy may overweigh the possible risk for injury of fetal/neonatal development. Currently, selective serotonin re-uptake inhibitors (SSRIs) and serotonin and noradrenaline re-uptake inhibitors (SNRIs) are commonly used for treatment of maternal depression. The review article brings up-to-date knowledge on effects of maternal adversity (depression) and/or antidepressants on the development of the hypothalamus-pituitary-adrenal axis of the offspring in relation to postnatal behavior and reactivity to stressful stimuli. Treated as well as untreated maternal depression presents a risk for the developing fetus and neonate. The authors stress the need to evaluate the relative safety of SNRIs/SNRIs by means of relevant experimental models to assess if these drugs can be assigned to treat pregnant and lactating depressive women.

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Journal Article 2014; 35(7): 645-652 PubMed PMID: 25617890 Citation  Keywords:  Adult, Anti-Anxiety Agents:therapeutic use, Antidepressive Agents:therapeutic use, Antipsychotic Agents:therapeutic use, Cross-Sectional Studies, Female, Humans, Male, Medication Adherence:psychology, Middle Aged, Outpatients:psychology, Psychotic Disorde.   

OBJECTIVE: Adherence to treatment of mental disorders is one of the key factors influencing its success and, secondarily, the patients' quality of life and social adaptation. The cross-sectional study of 90 outpatients diagnosed with psychotic disorders aimed at determining if there was a relationship between discontinuation of psychoactive drugs in the past, current adherence to treatment and self-stigma.

METHODS: The assessment was made with the objective and subjective Clinical Global Impression - Severity scale, Drug Attitude Inventory, Internalized Stigma of Mental Illness (ISMI) scale and demographic data. The questionnaires were filled out by 79 patients, of whom 5 handed in incomplete questionnaires. Complete sets of data were obtained from 74 patients.

RESULTS: The data analysis showed that the levels of self-stigma as assessed by the total ISMI scores was not statistically significantly correlated with most of the demographic factors (age, age of illness onset, gender, education, marital status, employment, duration of the illness, number of hospitalizations and antipsychotic dosage). However, there was a significant negative correlation with current adherence to treatment....

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Journal Article 2014; 35(7): 624-632 PubMed PMID: 25617887 Citation  Keywords:  Adolescent, Adult, Aged, Aged, 80 and over, Czech Republic, Female, Humans, Male, Mental Disorders:diagnosis, Middle Aged, Mood Disorders:diagnosis, Neurotic Disorders:diagnosis, Psychometrics:methods, Psychotic Disorders:diagnosis, Reproducibility of Res.   

OBJECTIVE: Self-stigma in psychiatric patients is an issue deserving both research and therapeutic attention. The objective of the present study was to evaluate the psychometric properties of a Czech version of the Internalized Stigma of Mental Illness (ISMI) scale assessing the levels of self-stigma in individuals with mental disorders.

METHODS: It consists of 29 items classified into 5 subscales, namely alienation, stereotype endorsement, perceived discrimination, social withdrawal and stigma resistance. The study group comprised 369 patients with a mean age of 41.5±13.3 years, of whom 210 (56.6%) were females.

RESULTS: The most frequent diagnosis was neurotic disorders (46.1%), followed by affective disorders (18.4%), substance use disorders (13.3%), psychotic disorders (10.8%), personality disorders (9.5%) and organic disorders (1.6%). Reliability of the scale was evaluated by internal consistency analysis (α=0.91), the split-half method (Spearman-Brown coefficient: 0.93) and test-retest at 3 weeks from the first measurement (N=17; r=0.90, p<0.05).

CONCLUSION: Exploratory factor analysis of the scale was performed, its validity was verified and norms were established that were based on T-scores and sten scores for the entire scale and individual subscales. The Czech translation of the ISMI has adequate psychometric properties....

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Journal Article 2014; 35(7): 613-618 PubMed PMID: 25617885 Citation  Keywords:  Adult, Aged, Aged, 80 and over, Biopsy:adverse effects, Brain Neoplasms:mortality, Female, Humans, Lymphoma:mortality, Magnetic Resonance Imaging:methods, Male, Middle Aged, Morbidity, Retrospective Studies, Risk Factors, Stereotaxic Techniques:adverse ef.   

OBJECTIVES: Stereotactic biopsy is a suitable method for sampling intrinsic brain lesions. Although this method is considered to be a safe procedure, some risk of complications still exists. The aim of the study was to retrospectively assess the morbidity and mortality of MRI-guided stereotactic biopsy of lesions which were histologically proven to be brain lymphoma.

METHODS: We retrospectively studied all accessible medical records for patients who had undergone MRI-guided stereotactic biopsy of brain lesions with histologically proven brain lymphoma from January 2007 to December 2012. Our cohort included 45 patients, 27 males and 18 females, aged 23-84 (63±14) years.

RESULTS: Forty-nine biopsies were carried out on 45 patients; the average number of tissue specimens was 3±1. The diagnostic yield of the stereotactic biopsy was 92%. Overall major morbidity directly related to stereotactic biopsy of brain lymphoma was 6.1% (3 cases) including 4.1% mortality (2 cases). Both deaths after the stereotactic procedure were due to intracranial hemorrhage and subsequent complications and both these patients had a history of treatment of systemic lymphomas. In one patient the stereotactic biopsy was complicated by a brain abscess which was successfully treated.

CONCLUSION: Stereotactic biopsy is still a mandatory diagnostic procedure for primary brain lymphomas, with an acceptable risk of complications. However, according to our results, the risk of complications can be higher in patients who have previously been treated for secondary lymphomas....

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Journal Article 2014; 35(7): 594-601 PubMed PMID: 25617882 Citation  Keywords:  Adolescent, Choice Behavior, Dominance-Subordination, Europe, Female, Humans, Male, Masochism:psychology, Reproduction, Sadism:psychology, Sexual Behavior:psychology, Sexual Partners:psychology, Surveys and Questionnaires, Urban Population, Young Adult,.   

OBJECTIVES: Equality between partners is considering a feature of the functional partnerships in westernized societies. However, the evolutionary consequences of how in-pair hierarchy influences reproduction are less known. Attraction of some high-ranking women towards low-ranking men represents a puzzle.

METHODS: Young urban adults (120 men, 171 women) filled out a questionnaire focused on their sexual preference for higher or lower ranking partners, their future in-pair hierarchy, and hierarchy between their parents.

RESULTS: Human pairs with a hierarchic disparity between partners conceive more offspring than pairs of equally-ranking individuals, who, in turn, conceive more offspring than pairs of two dominating partners. Importantly, the higher reproductive success of hierarchically disparate pairs holds, regardless of which sex, male or female, is the dominant one. In addition, the subjects preferring hierarchy disparity in partnerships were with greater probability sexually aroused by such disparity, suggesting that both the partnership preference and the triggers of sexual arousal may reflect a mating strategy.

CONCLUSION: These results challenge the frequently held belief in within-pair equality as a trademark of functional partnerships. It rather appears that existence of some disparity improves within-pair cohesion, facilitating both cooperation between partners and improving the pairs' ability to face societal challenges. The parallel existence of submissivity-dominance hierarchies within human sexes allows for the parallel existence of alternative reproductive strategies, and may form a background for the diversity of mating systems observed in human societies. Arousal of overemphasized dominance/submissiveness may explain sadomasochistic sex, still little understood from the evolutionary psychology point of view....

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