Kazuistika se zaměřuje na kognitivně-behaviorálně vedenou terapii obsedantně-kompulzivní symptomatologie u chlapce s autismem a dalšími neurovývojovými poruchami v komorbiditě. Popisuje složitý klinický obraz poruchy a dlouhodobě vedenou terapii.
The case report focuses on Cognitive Behavioural Guided Therapy of obsessivecompulsive symptomatology in a boy with autism and other neurodevelopmental disorders in comorbidity. It describes the complex clinical picture of the disorder and longterm therapy.
- MeSH
- Antidepressive Agents administration & dosage therapeutic use MeSH
- Behavior Therapy methods MeSH
- Child MeSH
- Cognitive Behavioral Therapy methods MeSH
- Humans MeSH
- Neurodevelopmental Disorders diagnosis MeSH
- Obsessive-Compulsive Disorder * diagnosis psychology therapy MeSH
- Autism Spectrum Disorder diagnosis psychology therapy MeSH
- Family Relations MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Navrhovaná studie proveditelnosti využívá aplikaci „OCD dům“, vytvořenou v prostředí virtuální reality (VR) pro expoziční terapii u pacien- tů s obsedantně-kompulzivní poruchou (OCD). Metoda byla vyvinuta na základě dimenzionálního přístupu k symptomatologii OCD, který vyčleňuje čtyři podtypy: „kontaminace/čištění“, „symetrie/uspořádání“, „strach z poškození/kontrola“ a „hromadění“. Cílem probíhající studie proveditelnosti je ověřit účinnosti již dříve validované expoziční metody ve spojení s čichovou stimulací. Předpokládáme, že čichová stimulace během expozice ve VR zvýší vnímanou realističnost a potenciálně také intenzitu symptomů vyvolaných touto čichově obohacenou simulací.
The proposed feasibility study uses the application "OCD house" created in a virtual reality (VR) environment for exposure therapy in pati- ents with obsessive-compulsive disorder (OCD). The method was designed based on a dimensional approach to OCD symptomatology, which distinguishes four subtypes: 'contamination/cleaning', 'symmetry/ordering', 'fear of harm/checking' and 'hoarding'. An ongoing feasibility study aims to test the previously validated exposure method in combination with olfactory stimulation. We hypothesize that olfactory stimu- lation during exposure in VR will increase the perceived level of immersion in the environment and potentially also the assessed intensity of symptoms induced by this olfactory-enriched simulation.
- MeSH
- Olfactory Perception MeSH
- Adult MeSH
- Implosive Therapy methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Obsessive-Compulsive Disorder * therapy MeSH
- Software MeSH
- Statistics as Topic MeSH
- Feasibility Studies MeSH
- Virtual Reality Exposure Therapy * methods MeSH
- Anxiety therapy MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
Text představí ketaminem asistovanou psychoterapii (KAP) jako novou léčebnou modalitu v psychiatrii pro široké diagnostické spektrum. Tato metoda má odlišné charakteristiky i indikace od použití esketaminu či racemického ketaminu v off-label use u deprese. Je unikátní kombinací farmakologického i psychoterapeutického přístupu tím, že aktivně využívá změněný stav vědomí vyvolaný ketaminem k zásadní akceleraci a prohloubení psychoterapeutického procesu. Podkladem této akcelerace je indukce neuroplastického procesu, zvýšená schopnost učení, a tím pádem efektivnější psychoterapie. Metoda částečně navazuje jednak na objev rychlého antidepresivního a anxiolytického účinku ketaminu z přelomu tisíciletí, jednak na metodiku psychedelické psychoterapie 50. a 60. let 20. století. V současné době se rychle rozvíjí především v USA; v ČR implementuje tento model do zdravotní péče Psyon – Psychedelická klinika, ale v poslední době vznikají i další takto specializovaná pracoviště. Text je krátkým přehledem využití ketaminu v psychiatrii a souhrnem dosavadního výzkumu o použití ketaminu v psychoterapii, představí východiska KAP a odliší KAP od jiných přístupů práce s ketaminem.
The text introduces Ketamine-Assisted Psychotherapy (KAP) as a new therapeutic modality in psychiatry for a broad diagnostic range. This method has distinct characteristics and indications compared to the use of esketamine or racemic ketamine off-label for depression. KAP uniquely combines pharmacological and psychotherapeutic approaches by actively utilizing the altered state of consciousness induced by ketamine to significantly accelerate and deepen the psychotherapeutic process. The foundation of this acceleration lies in the induction of neuroplastic processes, enhanced learning capacity, and thereby more effective psychotherapy. The method partially builds on the discovery of ketamine's rapid antidepressant and anxiolytic effects from the turn of the millennium, as well as on the methodology of psychedelic psychotherapy from the 1950s and 1960s. Currently, it is rapidly developing, especially in the United States. In the Czech Republic, this model is being implemented into healthcare by Psyon – Psychedelic Clinic, and recently, other specialized centers have also emerged. The text is a brief overview of the use of ketamine in psychiatry and a summary of the current research on the application of ketamine in psychotherapy. It introduces the principles of KAP and distinguishes KAP from other approaches to working with ketamine.
- MeSH
- Depression drug therapy therapy MeSH
- Mental Disorders drug therapy classification therapy MeSH
- Hallucinogens pharmacology therapeutic use MeSH
- Ketamine * pharmacology therapeutic use MeSH
- Combined Modality Therapy methods MeSH
- Humans MeSH
- Obsessive-Compulsive Disorder drug therapy therapy MeSH
- Feeding and Eating Disorders drug therapy therapy MeSH
- Psychotherapy * methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
INTRODUCTION: PAdverse Childhood Experiences (ACEs) are associated with an increased risk of mental health issues in general, but their relationship with panic disorder (PD) and obsessive-compulsive disorder (OCD) has received less attention compared to borderline personality disorder (BPD). Dissociative experiences are significant predictors of increased symptoms, reduced treatment adherence, and poor prognosis in several psychiatric conditions, including PD, OCD, and BPD; still, their impact remains underexplored. This part of the study focuses on the overall efficiency of psychotherapeutic programs on treatment-resistant patients diagnosed with PD, OCD, and BPD (or combined), as well as the relationship between ACEs, dissociation rates, and treatment results. METHOD: The study was conducted under standard conditions in an inpatient psychotherapy unit that specialized in anxiety, affective disorders, and personality disorders. Patients were hospitalized for 6 weeks and treated with a comprehensive CBT program and pharmacotherapy. The study included patients diagnosed with PD, OCD, or BPD (or combined). Two independent psychiatrists confirmed the inclusion and exclusion criteria. Patients were assessed using the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Clinical Global Impression Scale - Severity (CGI-S), Dissociative Experience Scale (DES), and Childhood Trauma Questionnaire (CTQ-SF). RESULTS: A total of 349 out of 357 patients completed the study. The average age of patients was 33.33 ± 11.59 years. After the 6 week treatment, there was a statistically significant decrease in mean scores across all assessed scales. Changes in any scale during treatment did not correlate with the total CTQ-SF score or sub-scores. The relative change in CGI-S showed a statistically significant negative correlation with the total dissociation score on the DES scale at the beginning of treatment but not with pathological dissociation assessed by the DES-T questionnaire. Statistically significant decreases in mean CGI-S scores were observed in patients with a single diagnosis of PD, OCD, and BPD. Among comorbid groups, significant changes were observed only in patients with comorbid OCD and BPD. No statistically significant change in mean BDI-II scores was observed in patients with comorbid PD and OCD or comorbid OCD and BPD. CONCLUSIONS: Our analysis showed that treatment led to a significant decrease in the severity of depressive symptoms assessed by BDI-II and anxiety symptoms assessed by BAI in patients with PD, OCD, and BPD. This decrease was not statistically significant in patients with comorbid disorders, suggesting that the presence of multiple diagnoses may affect treatment efficacy. ACEs did not correlate to treatment results, but dissociation rates were linked with poorer treatment outcomes.
- MeSH
- Dissociative Disorders * therapy psychology MeSH
- Adult MeSH
- Inpatients MeSH
- Borderline Personality Disorder * therapy psychology MeSH
- Cognitive Behavioral Therapy * methods MeSH
- Combined Modality Therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Obsessive-Compulsive Disorder * therapy psychology MeSH
- Panic Disorder * therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
INTRODUCTION: Panic disorder (PD), obsessive-compulsive disorder (OCD), and borderline personality disorder (BPD) are associated with various psychosocial factors that may influence their onset and psychopathology. Dissociation encompasses a wide range of manifestations, from benign experiences to severe mental health issues. Research comparing childhood trauma and dissociation, general psychopathology, and the onset of the disorder among patients with PD, OCD, and BPD has not yet been published. RESULTS: The severity of dissociative symptoms negatively correlated with the onset of the disorder, whereas it positively correlated with the disorder's overall severity and general symptomatology. Patients with more severe childhood trauma had an earlier onset of the disorder and more severe depressive and dissociative symptoms. They rated higher on the overall severity of the disorder. Physical abuse and neglect were associated with more severe PD, OCD, and BPD. Patients with BPD had higher levels of dissociation than those with PD or OCD. BPD was also connected with more severe childhood trauma than PD and OCD patients. Comorbidity exacerbated the severity of the psychiatric disorders. CONCLUSIONS: Childhood trauma and dissociation play a significant role in anxiety and depressive symptoms in patients with PD, OCD, and BPD.
- MeSH
- Dissociative Disorders * psychology epidemiology MeSH
- Child MeSH
- Adult MeSH
- Borderline Personality Disorder * psychology epidemiology MeSH
- Comorbidity MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Adverse Childhood Experiences psychology MeSH
- Obsessive-Compulsive Disorder * psychology epidemiology MeSH
- Panic Disorder * psychology epidemiology MeSH
- Severity of Illness Index MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
N-acetylcysteín (ACC) je acetylovaný variant aminokyseliny L-cysteín a primárne sa používa ako špecifické antidotum pri predávkovaní paracetamolom. Ďalšie indikácie jeho aplikácie zahŕňajú prevenciu exacerbácie chronickej obštrukčnej choroby pľúc, zmiernenie príznakov chrípky, liečbu pľúcnej fibrózy, liečbu neplodnosti u pacientok so syndrómom polycystických ovárií rezistentným na klomifén, ďalej pri liečbe autizmu, Alzheimerovej choroby, bipolárnej afektívnej poruchy, schizofrénie, obsesívno-kompulzívnej poruchy a drogovej závislosti. Okrem toho ACC môže zohrávať úlohu aj ako chemoprevencia malignít, doplnok pri eradikácii Helicobacter pylori a pri profylaxii straty sluchu vyvolanej podávaním gentamicínu u hemodialyzovaných pacientov. Napriek určitej kontroverzii sa ACC odporúča aj na prevenciu poškodenia obličiek vyvolaného kontrastom počas zobrazovacích procedúr. Podľa súčasných odporúčaní sa ACC má profylaticky podať pred vyšetrením, resp. výkonom s použitím kontrastnej látky u pacientov, ktorý majú chronickú obličkovú chorobu a najmenej jedno z nasledujúceho: diabetes mellitus, srdcové zlyhávanie, vek viac ako 74 rokov, užívajú nefrotoxické liečivá, čaká ich perkutánna koronárna intervencia alebo objem kontrastnej látky, ktorá im má byť podaná, je viac ako 19 ml.
N-acetylcysteine (ACC) is an acetylated variant of the amino acid L-cysteine and is primarily used as a specific antidote for paracetamol overdose. Other indications for its application include prevention of exacerbation of chronic obstructive pulmonary disease, relief of flu symptoms, treatment of pulmonary fibrosis, treatment of infertility in patients with polycystic ovary syndrome resistant to clomiphene, moreover, in the treatment of autism, Alzheimer's disease, bipolar affective disorder, schizophrenia, obsessive-compulsive disorder and drug addiction. In addition, ACC may also play a role as a chemoprevention of malignancies, an adjunct in the eradication of Helicobacter pylori and in the prophylaxis of gentamicin-induced hearing loss in hemodialysis patients. Despite some controversy, ACC is also recommended for the prevention of contrast-induced renal injury during imaging procedures. According to current recommendations, ACC should be given prophylactically before the examination, or procedure with the use of contrast material in patients who have chronic kidney disease and at least one of the following: diabetes mellitus, heart failure, age over 74 years, are taking nephrotoxic drugs, are awaiting percutaneous coronary intervention, or the volume of contrast material to be administered, is more than 19 ml.
AIM: The paper describes the characteristics of relationship obsessive-compulsive disorder (R-OCD), including the types of obsessions and compulsions, the common triggers and the impact on psychological well-being and relationship functioning. It also offers basic cognitive-behavioural strategies to help patients change their attitudes towards obsessive thoughts and reduce compulsive behaviours. METHODS: This article is a narrative review of the literature and case studies on R-OCD. To search for relevant sources, we used PubMed, PsycINFO and Web of Science databases with the keywords "relationship obsessive compulsive disorder", "R-OCD", "relationship OCD" and "partner-focused OCD". We included only studies published in English from January 1990 to June 2023. The paper provides examples of how basic cognitive-behavioural strategies help individuals with R-OCD. RESULTS: People with R-OCD experience intrusive thoughts about whether they have the right feelings for their partner, whether their partner loves them, whether the relationship is suitable or whether their partner has flaws. These thoughts trigger the urge to perform various rituals to alleviate anxiety, such as repeated checking, reassurance or comparison. However, this behaviour leads to disruption of the relationship and long-term maintenance of the anxiety. Examples of basic cognitive-behavioural strategies can be applied in clinical practice to help individuals change their attitudes towards relational obsessive thoughts and reduce compulsive behaviours.
