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• MeSH
• duševně nemocní MeSH
• duševní zdraví MeSH
• lidé středního věku MeSH
• lidé MeSH
• ošetřovatelství v psychiatrii * metody   MeSH
• paranoidní schizofrenie ošetřování   MeSH
• služby péče o duševní zdraví * MeSH
• týmová péče o pacienty MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

BACKGROUND: Negative symptoms (NS) represent a detrimental symptomatic domain in schizophrenia affecting social and occupational outcomes. AIMS: We aimed to identify factors from the baseline visit (V1) - with a mean illness duration of 0.47 years (SD = 0.45) - that predict the magnitude of NS at the follow-up visit (V3), occurring 4.4 years later (mean +/- 0.45). METHOD: Using longitudinal data from 77 first-episode schizophrenia spectrum patients, we analysed eight predictors of NS severity at V3: (1) the age at disease onset, (2) age at V1, (3) sex, (4) diagnosis, (5) NS severity at V1, (6) the dose of antipsychotic medication at V3, (7) hospitalisation days before V1 and; (8) the duration of untreated psychosis /DUP/). Secondly, using a multiple linear regression model, we studied the longitudinal relationship between such identified predictors and NS severity at V3 using a multiple linear regression model. RESULTS: DUP (Pearson's r = 0.37, p = 0.001) and NS severity at V1 (Pearson's r = 0.49, p < 0.001) survived correction for multiple comparisons. The logarithmic-like relationship between DUP and NS was responsible for the initial stunning incremental contribution of DUP to the severity of NS. For DUP < 6 months, with the sharpest DUP/NS correlation, prolonging DUP by five days resulted in a measurable one-point increase in the 6-item negative symptoms PANSS domain assessed 4.9 (+/- 0.6) years after the illness onset. Prolongation of DUP to 14.7 days doubled this NS gain, whereas 39 days longer DUP tripled NS increase. CONCLUSION: The results suggest the petrification of NS during the early stages of the schizophrenia spectrum and a crucial dependence of this symptom domain on DUP. These findings are clinically significant and highlight the need for primary preventive actions.

• MeSH
• antipsychotika * terapeutické užití   MeSH
• lidé MeSH
• multivariační analýza MeSH
• psychotické poruchy * diagnóza   farmakoterapie   MeSH
• schizofrenie * diagnóza   farmakoterapie   MeSH
• syndrom Nijmegen breakage * farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Schizophrenia (SZ) is associated with an increased risk of life-long cognitive impairments, age-related chronic disease, and premature mortality. We investigated evidence for advanced brain ageing in adult SZ patients, and whether this was associated with clinical characteristics in a prospective meta-analytic study conducted by the ENIGMA Schizophrenia Working Group. The study included data from 26 cohorts worldwide, with a total of 2803 SZ patients (mean age 34.2 years; range 18-72 years; 67% male) and 2598 healthy controls (mean age 33.8 years, range 18-73 years, 55% male). Brain-predicted age was individually estimated using a model trained on independent data based on 68 measures of cortical thickness and surface area, 7 subcortical volumes, lateral ventricular volumes and total intracranial volume, all derived from T1-weighted brain magnetic resonance imaging (MRI) scans. Deviations from a healthy brain ageing trajectory were assessed by the difference between brain-predicted age and chronological age (brain-predicted age difference [brain-PAD]). On average, SZ patients showed a higher brain-PAD of +3.55 years (95% CI: 2.91, 4.19; I2 = 57.53%) compared to controls, after adjusting for age, sex and site (Cohen's d = 0.48). Among SZ patients, brain-PAD was not associated with specific clinical characteristics (age of onset, duration of illness, symptom severity, or antipsychotic use and dose). This large-scale collaborative study suggests advanced structural brain ageing in SZ. Longitudinal studies of SZ and a range of mental and somatic health outcomes will help to further evaluate the clinical implications of increased brain-PAD and its ability to be influenced by interventions.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mozek patologie   MeSH
• prospektivní studie MeSH
• schizofrenie * MeSH
• senioři MeSH
• stárnutí MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

Visuospatial perspective-taking (VPT) is the ability to imagine a scene from a position different from the one used in self-perspective judgments (SPJ). We typically use VPT to understand how others see the environment. VPT requires overcoming the self-perspective, and impairments in this process are implicated in various brain disorders, such as schizophrenia and autism. However, the underlying brain areas of VPT are not well distinguished from SPJ-related ones and from domain-general responses to both perspectives. In addition, hierarchical processing theory suggests that domain-specific processes emerge over time from domain-general ones. It mainly focuses on the sensory system, but outside of it, support for this hypothesis is lacking. Therefore, we aimed to spatiotemporally distinguish brain responses domain-specific to VPT from the specific ones to self-perspective, and domain-general responses to both perspectives. In particular, we intended to test whether VPT- and SPJ specific responses begin later than the general ones. We recorded intracranial EEG data from 30 patients with epilepsy who performed a task requiring laterality judgments during VPT and SPJ, and analyzed the spatiotemporal features of responses in the broad gamma band (50-150 Hz). We found VPT-specific processing in a more extensive brain network than SPJ-specific processing. Their dynamics were similar, but both differed from the general responses, which began earlier and lasted longer. Our results anatomically distinguish VPT-specific from SPJ-specific processing. Furthermore, we temporally differentiate between domain-specific and domain-general processes both inside and outside the sensory system, which serves as a novel example of hierarchical processing.

• MeSH
• elektrokortikografie * MeSH
• lidé MeSH
• mínění fyziologie   MeSH
• mozek fyziologie   MeSH
• schizofrenie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) diminishes auditory hallucinations (AHs). The aims of our study were a) to assess the efficacy of LF-rTMS in a randomized, sham-controlled double-blind alignment, b) to identify the electrophysiological changes accompanying the LF-rTMS, and c) to identify the influence of LF-rTMS on brain functional connectivity (FC). METHODS: Nineteen schizophrenia patients with antipsychotic-resistant AHs were randomized to either active (n = 10) or sham (n = 9) LF-rTMS administered over the left temporo-parietal region for ten days. The clinical effect was assessed by the Auditory Hallucination Rating Scale (AHRS). The localization of the differences in electrical activity was identified by standardized low resolution brain electromagnetic tomography (sLORETA) and FC was measured by lagged phase synchronization. RESULTS: AHRS scores were significantly improved for patients receiving active rTMS compared to the sham (median reduction: 40 % vs 12 %; p = 0.01). sLORETA revealed a decrease of alpha-2, beta-1,-2 bands in the left hemisphere in the active group. Active rTMS led to a decrease of the lagged phase connectivity in beta bands originating in areas close to the site of stimulation, and to a prevailing increase of alpha-2 FC. No significant differences in current density or FC were observed in the sham group. LIMITATIONS: Limitations to our study included the small group sizes, and the disability of LORETA to assess subcortical neuronal activity. CONCLUSIONS: LF-rTMS attenuated AHs and induced a decrease of higher frequency bands on the left hemisphere. The FC changes support the assumption that LF-rTMS is linked to the modulation of cortico-cortical coupling.

• MeSH
• elektroencefalografie MeSH
• halucinace terapie   MeSH
• lidé MeSH
• schizofrenie * MeSH
• transkraniální magnetická stimulace metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

Antipsychotika jsou základním pilířem léčby schizofrenie. V rámci bio-psycho-sociálního přístupu v léčbě schizofrenie tvoří psychofarmaka, repetitivní transkraniální magnetická stimulace (rTMS) či elektrokonvulzivní terapie (ECT) složku biologickou, která je doplňována na všech úrovních léčby psychosociálními intervencemi. Cílem léčby schizofrenie není pouze redukce pozitivních příznaků, jak tomu bylo v minulosti, ale dosažení funkční remise. Léčbu schizofrenie si lze představit jako postupné zdolávání schodů, kdy každá úroveň schodiště představuje specifický léčebný cíl. Léčba schizofrenie jedním antipsychotikem je spíše výjimkou. Častěji se jedná o sekvenci léčebných intervencí, které reagují na efekt, ale i snášenlivost léčby.

Antipsychotics are the mainstay of schizophrenia treatment. Psychopharmac, repetitive transcranial magnetic stimulation (rTMS) or electroconvulsive therapy (ECT) form a biological component that is supplemented at all levels of treatment with psychosocial interventions within the bio-psycho-social approach in the treatment of schizophrenia. The goal of schizophrenia treatment is not only the reduction of positive symptoms, as was the case in the past, but the achievement of functional remission. The treatment of schizophrenia can be thought of as a step-by-step climbing of stairs, where each level of the staircase represents a specific treatment goal. The treatment of schizophrenia with one antipsychotic is rather an exception. More often, it is a sequence of therapeutic interventions that respond to the effect but also tolerability of the treatment.

• MeSH
• antipsychotika aplikace a dávkování   klasifikace   terapeutické užití   MeSH
• kombinovaná farmakoterapie MeSH
• lidé MeSH
• nežádoucí účinky léčiv MeSH
• rizikové faktory kardiovaskulárních chorob MeSH
• rizikové faktory MeSH
• schizofrenie * farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Brexpiprazol je nové atypické antipsychotikum, působící jako modulátor serotoninu a dopaminu. V jeho mechanismu účinku se uplatňuje parciální agonismus na serotoninových receptorech 5-HT1A, antagonismus na serotoninových receptorech 5-HT2A, parciální agonismus na dopaminových D2 receptorech a antagonismus na noradrenergních receptorech typu α1B a typu α2C. Podle zmíněného účinku na dopaminové D2 receptory se řadí do skupiny parciálních dopaminových agonistů (DRPA). Do klinické praxe léčby schizofrenie byl uveden nedávno. Jeho profil je spojen s dostatečnou antipsychotickou účinností a velmi dobrou snášenlivostí. Nízký výskyt nežádoucích účinků je spojen s dobrou spoluprací v léčbě, s nižším rizikem vzniku relapsu onemocnění a s dobrým fungováním nemocných v běžném životě. Článek prezentuje soubor deseti kazuistik z klinické praxe, kdy byl brexpiprazol spojen s lepším léčebným výsledkem než aripiprazol. Ze sdělení vyplývá, že jednotlivá antipsychotika ze skupiny DRPA nejsou stejná a dokládá nezaměnitelnost brexpiprazolu v některých klinických situacích.

Brexpiprazole is a new atypical antipsychotic acting as serotonin and dopamine modulator. Its mechanism of action is based on partial agonism on serotonin 5-HT1A receptors, antagonism at serotonin 5-HT2A receptors, partial agonism at dopamine D2 receptors and antagonism at two noradrenergic receptors, type α1B and type α2C. Due to its effect on dopamine D2 receptors brexpiprazole belongs to dopamine receptor partial agonists (DRPA). It has been introduced to clinical practice in treatment recently. Its profile is characterized by good antipsychotic efficacy and outstanding tolerability. Low incidence of side-effects is associated with treatment compliance, minimalization of relapse risk and a good functioning in life. This article presents a set of ten case reports from clinical practice, in which brexpiprazole in comparison with aripiprazole was linked to better treatment results. This presentation shows that antipsychotics from a DRPA group are not identical and brings the evidence that brexpiprazole is unique in some clinical situations.

• Klíčová slova
• brexpiprazol, aripiprazol,
• MeSH
• agonisté dopaminu * aplikace a dávkování   terapeutické užití   MeSH
• antipsychotika MeSH
• dospělí MeSH
• kombinovaná farmakoterapie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nežádoucí účinky léčiv MeSH
• paranoidní schizofrenie farmakoterapie   komplikace   MeSH
• poléková akatizie MeSH
• psychotické poruchy farmakoterapie   komplikace   MeSH
• thiofeny * aplikace a dávkování   terapeutické užití   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

In this study, we aimed to determine whether childhood trauma moderated the relationship between inflammation and cognitive functioning in persons with first-episode schizophrenia spectrum disorders (SSDs). We included data from 92 individuals who participated in the nationwide Early-Stage Schizophrenia Outcome study. These individuals completed the Childhood Trauma Questionnaire, provided a fasting blood sample for high-sensitivity C-reactive protein analysis, and underwent extensive neuropsychological testing. The intervening effects of age, sex, education, smoking status, and body mass index were controlled. Results indicated that childhood trauma levels significantly moderated the relationship between inflammation and four cognitive domains: speed of processing, working memory, visual memory, and verbal memory. Inflammation also predicted verbal memory scores irrespective of childhood trauma levels or the covariates. Upon further exploration, the significant moderation effects appeared to be primarily driven by males. In conclusion, a history of childhood trauma may be an important determinant in evaluating how inflammation relates to the cognitive performance of people with first-episode SSDs, particularly in speed of processing, working memory, visual memory, and verbal memory. We recommend that future researchers examining the effect of inflammation on cognitive functioning in SSDs include trauma as a moderating variable in their models and further examine additional moderating effects of sex.

• MeSH
• kognice MeSH
• krátkodobá paměť MeSH
• lidé MeSH
• nepříznivé zkušenosti z dětství * MeSH
• neuropsychologické testy MeSH
• schizofrenie * komplikace   metabolismus   MeSH
• zánět MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• depresivní poruchy farmakoterapie   komplikace   MeSH
• dospělí MeSH
• lidé MeSH
• schizofrenie farmakoterapie   komplikace   MeSH
• těhotenství účinky léků   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství účinky léků   MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• komentáře MeSH

Contemporary society is characterized by rapid changes. Various epidemiological, political and economic crises represent a burden to mental health of nowadays population, which may at least partially explain the increasing incidence of mental disorders, including schizophrenia. Schizophrenia is associated with premature mortality by at least 13-15 years. The leading cause of premature mortality in schizophrenia patients is high incidence of cardiovascular diseases. The specific-cause mortality risk for cardiovascular diseases in schizophrenia patients is more than twice higher as compared to the general population. Several factors are discussed as the factor of cardiovascular diseases development. Intensive efforts to identify possible link between schizophrenia and cardiovascular diseases are made. It seems that sigma 1 receptor may represent such link. By modulation of the activity of several neurotransmitter systems, including dopamine, glutamate, and GABA, sigma 1 receptor might play a role in pathophysiology of schizophrenia. Moreover, significant roles of sigma 1 receptor in cardiovascular system have been repeatedly reported. The detailed role of sigma 1 receptor in both schizophrenia and cardiovascular disorders development however remains unclear. The article presents an overview of current knowledge about the association between schizophrenia and cardiovascular diseases and proposes possible explanations with special emphasis on the role of the sigma 1 receptor.

• MeSH
• kardiovaskulární nemoci * diagnóza   epidemiologie   MeSH
• kardiovaskulární systém * MeSH
• lidé MeSH
• schizofrenie * diagnóza   epidemiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH