• MeSH
• duševně nemocní klasifikace   MeSH
• duševní poruchy klasifikace   MeSH
• lidé MeSH
• pilotní projekty MeSH
• psychometrie metody   normy   MeSH
• stupeň závažnosti nemoci MeSH
• stupnice dopadu nemoci na kvalitu života MeSH
• Check Tag
• lidé MeSH

• MeSH
• duševně nemocní psychologie   MeSH
• lidé MeSH
• pilotní projekty MeSH
• průzkumy a dotazníky využití   MeSH
• ukazatele kvality zdravotní péče využití   MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Česká republika MeSH

The heterogeneous degradation of nitrogen dioxide (NO2) on five samples of natural Icelandic volcanic particles has been investigated. Laboratory experiments were carried out under simulated atmospheric conditions using a coated wall flow tube (CWFT). The CWFT reactor was coupled to a blue light nitrogen oxides analyzer (NOx analyzer), and a long path absorption photometer (LOPAP) to monitor in real time the concentrations of NO2, NO and HONO, respectively. Under dark and ambient relative humidity conditions, the steady state uptake coefficients of NO2 varied significantly between the volcanic samples probably due to differences in magma composition and morphological variation related with the density of surface OH groups. The irradiation of the surface with simulated sunlight enhanced the uptake coefficients by a factor of three indicating that photo-induced processes on the surface of the dust occur. Furthermore, the product yields of NO and HONO were determined under both dark and simulated sunlight conditions. The relative humidity was found to influence the distribution of gaseous products, promoting the formation of gaseous HONO. A detailed reaction mechanism is proposed that supports our experimental observations. Regarding the atmospheric implications, our results suggest that the NO2 degradation on volcanic particles and the corresponding formation of HONO is expected to be significant during volcanic dust storms or after a volcanic eruption.

• MeSH
• atmosféra * MeSH
• kyselina dusitá * MeSH
• oxid dusičitý MeSH
• prach MeSH
• sluneční záření MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• dělená strava,
• MeSH
• metody výživy trendy   využití   MeSH
• vaření MeSH
• Publikační typ
• kuchařské knihy MeSH
• obrazové publikace MeSH

• Konspekt
• Kuchařství. Potraviny. Vařená jídla
• NLK Obory
• zájmy a záliby
• nutriční terapie, dietoterapie a výživa

Objectives: The length of forensic stay (LoS) is a subject to country-specific legal and service systems. Therefore, the identification of common factors targetable by treatment is at the forefront of forensic psychiatric research. In this study, we present the first reports of forensic characteristics of patients from the Czechia. Methods: We conducted a retrospective analysis of data from 260 inpatients discharged from the Bohnice Hospital (Prague) and obtained a set of sociodemographic and clinical variables as well as the Health of the Nation Outcome Scale (HoNOS) and HoNOS-secure scores. Results: The following variables were identified as significantly associated with a longer LoS: older age, length of previous psychiatric hospitalization, olanzapine equivalent, clozapine treatment, psychosocial dysfunction, psychotic or paraphilic disorder diagnosis, and sexual offense. A shorter LoS was associated with being in a relationship, being employed before hospitalization, receiving personal support, and committing an index offense under the influence of substance. While the HoNOS score and HoNOS symptom subscale predicted a longer LoS, the HoNOS-secure subscale predicted a shorter stay. Conclusion: In the European context, our hospital has a relatively low LoS. The results are consistent with findings linking psychotic disorders and paraphilia with a longer LoS in forensic treatment. Higher doses of antipsychotic medication or clozapine prescriptions were associated with a longer LoS. The results show a high level of unmet needs in this population, highlighting the importance of the availability of follow-up service.

• Publikační typ
• časopisecké články MeSH

BACKGROUND: Secure forensic hospital treatments are resource-intensive, aiming to rehabilitate offenders and enhance public safety. While these treatments consume significant portions of mental health budgets and show efficacy in some countries, their effectiveness in Czechia remains underexplored. Previous research has highlighted various factors influencing the likelihood of discharge from these institutions. Notably, the role of sociodemographic variables and the length of stay (LoS) in the context of forensic treatments has presented inconsistent findings across studies. METHODS: The study, part of the 'Deinstitutionalization project' in Czechia, collected data from all inpatient forensic care hospitals. A total of 793 patients (711 male, 79 female and 3 unknown) were included. Data collection spanned 6 months, with tools like HoNOS, HoNOS-Secure, MOAS, HCR-20V3 and AQoL-8D employed to assess various aspects of patient health, behaviour, risk and quality of life. RESULTS: The study revealed several determinants influencing patient discharge from forensic hospitals. Key assessment tools, such as HoNOS secure scores and the HCR-20 clinical subscale, showed that higher scores equated to lower chances of release. Furthermore, specific diagnoses like substance use disorder increased discharge odds, while a mental retardation diagnosis significantly reduced it. The type of index offense showed no influence on discharge decisions. CONCLUSION: Factors like reduced risk behaviours, absence of mental retardation diagnosis, social support and secure post-release housing plans played significant roles. The results underscored the importance of using standardized assessment tools over clinical judgement. A standout insight was the unique challenges faced by patients diagnosed with mental retardation, emphasizing a need for specialized care units or tailored programmes.

• MeSH
• deinstitucionalizace MeSH
• délka pobytu * MeSH
• dospělí MeSH
• duševní poruchy * terapie   MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• propuštění pacienta * MeSH
• soudní psychiatrie MeSH
• ústavy pro duševně nemocné * MeSH
• zločinci psychologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVES: The purpose of this study was to test whether a psychodynamically based group psychotherapeutic programme might improve symptoms, social functions, or quality of life in patients with schizophrenia spectrum disorders and to investigate factors that might predict clinical improvement or dropouts from the programme. DESIGN: A quantitative prospective cohort study. METHODS: We have investigated 81 patients with schizophrenia spectrum disorders who participated in a 9-month psychodynamically based psychotherapeutic day programme. The patients were assessed at the beginning and end of the programme, and then at 1-year follow-up. The assessment included psychotic manifestations (HoNOS), quality of life (WHOQOL-BREF), demographic data, and daily doses of medication. 21 patients dropped out from the programme, and 46 patients succeeded in undergoing follow-up assessment. RESULTS: The psychotic manifestations (self-rating version of HoNOS) and quality of life measured with WHOQOL-BREF (domains of social relationships and environment) were significantly improved at the end of the programme and at follow-up. However, the manifestations on the version for external evaluators of HoNOS were improved only at follow-up. Years of psychiatric treatment, number of hospitalizations or suicide attempts, and experience of relationships with a partner were negatively related to clinical improvement, whereas symptom severity, current working, or study activities were related positively. CONCLUSIONS: The results show that a group psychodynamic programme may improve the clinical status and quality of life of patients with schizophrenia spectrum disorders. This type of programme is more beneficial for patients with higher pre-treatment symptom severity and the presence of working or study activities. PRACTITIONER POINTS: A psychodynamically based group programme improves the clinical status and quality of life in patients with schizophrenia spectrum disorders. Data indicate that changes on the subjective level are detectable by the end of the programme, while changes on the objective level are detectable at follow-up assessment. Symptom severity and working or study activities are positively related to the clinical improvement in this type of programme, while a high number of years in psychiatric treatment or psychiatric hospitalizations are negatively related. The doses of medication (antipsychotics or antidepressants) show no significant relationship to clinical improvement.

• MeSH
• denní péče o pacienty MeSH
• dospělí MeSH
• hodnocení výsledků zdravotní péče * MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• následné studie MeSH
• psychodynamická psychoterapie metody   MeSH
• psychotické poruchy terapie   MeSH
• schizofrenie terapie   MeSH
• skupinová psychoterapie metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Splitting describes fragmentation of conscious experience that may occur in various psychiatric disorders. A purpose of this study is to examine relationships between psychological process of splitting and disturbed cognitive and affective functions in schizophrenia and borderline personality disorder (BPD). METHODS: In the clinical study, we have assessed 30 patients with schizophrenia and 35 patients with BPD. The symptoms of splitting were measured using self-reported Splitting Index (SI). As a measure of semantic memory disorganization we have used verbal fluency test. Other psychopathological symptoms were assessed using Health of the Nation Outcome Scale (HoNOS). RESULTS: Main results show that SI is significantly higher in BPD group than in schizophrenia, and on the other hand, verbal fluency is significantly lower in schizophrenia group. Psychopathological symptoms measured by HoNOS are significantly higher in the BPD group than in schizophrenia. Significant relationship was found between verbal fluency and the SI "factor of others" (Spearman r = -0.52, p<0.01) in schizophrenia patients. CONCLUSIONS: Processes of splitting are different in schizophrenia and BPD. In BPD patients splitting results to mental instability, whereas in schizophrenia the mental fragmentation leads to splitting of associations observed as lower scores of verbal fluency, which in principle is in agreement with Bleuler's historical concept of splitting in schizophrenia.

• MeSH
• dospělí MeSH
• hraniční porucha osobnosti psychologie   MeSH
• lidé MeSH
• neparametrická statistika MeSH
• neuropsychologické testy MeSH
• schizofrenie (psychologie) * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: Dissociation likely plays a key role in schizophrenia and borderline personality disorder (BPD), although empirical studies that compare specific manifestations of these symptoms in schizophrenia and BPD are rare. In this context, the purpose of this study was to compare the occurrence of dissociative and other psychopathological symptoms in these disorders, and to assess the possible influence of antipsychotic medication on the dissociative symptoms. METHODS: We assessed 31 patients with schizophrenia and 36 patients with BPD. Dissociative symptoms were measured by the Dissociative Experiences Scale (DES), symptoms related to stress and traumatic experiences were assessed using the Trauma Symptom Checklist-40 (TSC-40), and other psychopathological symptoms were measured with the Health of the Nation Outcome Scales (HoNOS). We also assessed actual daily doses of antipsychotic medication in chlorpromazine equivalents in all participants. RESULTS: The results show that symptoms of traumatic stress measured by the TSC-40 had significantly higher scores in the BPD group. The data also show that dissociative symptoms (DES) were significantly correlated with symptoms of traumatic stress (TSC-40) and with symptoms assessed by the HoNOS. Remarkably significant correlations were found between levels of antipsychotic medication and the DES and between antipsychotic medication and the depersonalization/derealization component of the DES in BPD patients. CONCLUSION: The results support an important role of dissociative processes in schizophrenia and BPD and suggest a significant relationship between manifestations of dissociative symptoms in BPD and antipsychotic medication.

• Publikační typ
• časopisecké články MeSH

Cíle: Cílem této studie je odpovědět na otázky, které byly stanoveny v rámci interní kvantitativní dopadové evaluace pilotního projektu Podpora vzniku Center duševního zdraví I. Otázky byly zaměřené na snížení hospitalizačních dnů u zkoumaného vzorku, zlepšení klinických ukazatelů včetně kvality života související se zdravím a bezpečnost. Metody: Studie je založená na longitudinálním šetření v podobě prospektivní ko-hortové studie. V rámci pilotního provozu pěti CDZ byla po dobu 18 měsíců sbírána data pomocí klinických nástrojů GAF, HoNOS a AQoL. Dále byla využita data o čerpání hospitalizační psychiatrické péče z Národního registru hrazených zdravotních služeb. Byla provedena statistická analýza. Vedle výsledků kvantitativní evaluace jsou uvedeny tři krátké kazuistiky vývoje a fungování CDZ. Výsledky: Do studie bylo zařazeno celkem 441 klientů, kteří během pilotního provozu využili služby CDZ. Příjemci péče tvořili značně heterogenní skupinu. Zastoupení pohlaví bylo v podstatě vyrovnané. Oproti běžné populaci byly více zastoupeny nižší stupně vzdělání. Z hlediska diagnostického asi čtyři pětiny tvořily osoby s diagnózou z kategorie F2. Asi polovina pacientů se léčila déle než 10 let. Zdrojem největší části pacientů, asi dvou čtvrtin, byly psychiatrické ambulance. Podle dat z Národního registru hrazených zdravotních služeb došlo u pacientů ke snížení počtu hospitalizačních dnů po vstupu do CDZ o 70 %. U skupiny pacientů, kteří služby CDZ využívali po dobu 12 měsíců, bylo zjištěno signifikantní zlepšení v doménách fungování, symptomů a kvality života související se zdravím. Služby CDZ jsou podle výsledků bezpečné pro veřejnost i jejich uživatele. Diskuse: Díky evaluaci projektů CDZ disponujeme prvními informacemi o dopadu tohoto nového typu služby. Za přesvědčivé lze označit pozitivní změny u příjemců péče, slibné se zdá zjištěné snížení počtu hospitalizačních dnů po zahájení spolupráce. Tato zjištění zároveň bude vhodné ověřit na větším množství dat a za využití sofistikovanějších výzkumných designů. Otázka, zda zavedení CDZ do systému péče přinese ekonomické úspory, zůstává otevřená. V tomto případě je třeba sledovat více druhů nákladů, nejen přímé zdravotní výdaje.

Objective: The aim of this study is to answer the questions that were identified in the internal quantitative impact evaluation of the pilot project Support for the Establishment of Community Mental Health Centers I. Methods: The study is based on a longitudinal research in the form of a prospective cohort study. As part of the pilot project of five CMHC, data were collected for 18 months using the clinical assessment tools GAF, HoNOS and AQoL. Furthermore, data of the use of inpatient psychiatric care from the national health registers were used. Statistical analysis was performed. In addition to the results of the quantitative evaluation, three short case studies of the development and functioning of CMHC are presented. Results: A total of 441 clients who used CMHC services during the pilot project were included in the study. Recipients of care formed a highly heterogeneous group. Gender representation was essentially balanced. Compared to the general population, lower levels of education were more represented. From a diagnostic point of view, about four-fifths were people with a diagnosis of category F2. About half of the patients were treated for more than 10 years. The source of the largest part of patients, about two quarters, were psychiatric clinics. According to data from the national health registers, patients had a 70% reduction in the number of days in inpatient care after entering the CMHC. In the group of patients who used CMHC services for 12 months, there was a significant improvement in the domain of functioning, symptoms and health-related quality of life. According to the results, CMHC services are safe for the public and their users. Discussion: Thanks to the evaluation of CMHC projects, we have the first information about the impact of this new type of service. The positive changes in the recipients of care can be described as convincing, the observed reduction in the number of hospitalization days after the start of cooperation seems promising. At the same time, it will be appropriate to verify these findings on a larger amount of data and using more sophisticated research designs. The question of whether the introduction of CMHC into the care system will bring economic savings remains open. In this case, it is necessary to monitor more types of costs, not just direct medical expenses.

• MeSH
• komunitní psychiatrická střediska * MeSH
• lidé MeSH
• prospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH