OBJECTIVE: We aimed to examine whether demographic characteristics (i.e., sex, age and education) correlate with total scores of the Czech version of the Beck Depression Inventory (BDI-II), understand the factorial structure of this scale, compare our results with findings of studies conducted in other countries and provide preliminary normative data for use in clinical practice. METHODS: Data of 450 participants were analysed using correlation analysis, non-parametric tests and confirmatory factor analysis (CFA). RESULTS: Women, and participants with lower education, tended to score higher than men, and participants with higher education. There was no significant relationship between age and total scores. CFA confirmed two factors: cognitive-affective and somatic. Czech participants scored lower than participants in other studies. Preliminary normative data are presented in the form of percentile values for the whole sample and stratified according to gender and education level. CONCLUSIONS: We recommend the usage of the BDI-II total score while taking into account also the cognitive-affective and somatic factor subscores. The comparison of our results with other foreign findings shows the need for the development of locally specific normative values for self-reported depression scales. KEY POINTS Women scored higher in the BDI-II than men. Participants with lower education scored higher in the BDI-II than participants with higher education. CFA confirmed two factors: cognitive-affective and somatic. Preliminary normative data for the Czech version of the BDI-II are stratified according to gender and education.

• Keywords
• Beck Depression Inventory, Depression, confirmatory factor analysis, factorial structure, normative data,
• MeSH
• Depression diagnosis   MeSH
• Depressive Disorder diagnosis   MeSH
• Adult MeSH
• Factor Analysis, Statistical MeSH
• Middle Aged MeSH
• Humans MeSH
• Psychiatric Status Rating Scales standards   statistics & numerical data   MeSH
• Psychometrics standards   statistics & numerical data   MeSH
• Sex Factors MeSH
• Educational Status MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

INTRODUCTION: Measuring early-life psychosocial stress is complicated by methodological challenges. This paper compares three survey instruments for the assessment of life in pregnancy/postpartum and investigates the effects of the timing of early-life stress for emotional/behavioral difficulties (EBD) of offspring during mid/late childhood and adolescence. METHODS: Observational data were obtained from the European Longitudinal Cohort Study of Pregnancy and Childhood (ELSPAC-CZ), which included 4811 pregnancies in two Czech metropolitan areas. We used data collected between 1991 and 2010 at 20 weeks of pregnancy (T1), after delivery (T2), at 6 months postpartum (T3), and at child's age of 7 years (T4), 11 years (T5), 15 years (T6), and 18 years (T7). Life stress was assessed with (1) the Edinburgh Postnatal Depression Scale (EPDS), (2) a stressful life events (SLE) count based on 42-item inventory, and (3) the SLE measure weighted by perceived stressfulness (PS). Each stress measure was administered at T1, T2, and T3. Child's EBD were assessed with the Strengths and Difficulties Questionnaire at T4, T5, T6, and T7. RESULTS: Each stress measure independently predicted long-term EBD. The best data fit was obtained in a model combining EPDS and SLE. Effect sizes for SLEs decreased between the first half of pregnancy and postpartum, while the effect of EPDS increased. DISCUSSION: SLE-based methods capture an aspect of perinatal stress not adequately assessed by EPDS. Combination of psychological distress measures and SLE-based measures is optimal in predicting EBD of the child. Stress measures based on SLE are suitable for early pregnancy, while self-reports of depressive symptoms may perform better in postpartum.

• Keywords
• Child psychological adjustment, Life events, Maternal stress, Postpartum, Pregnancy,
• MeSH
• Behavioral Symptoms epidemiology   etiology   MeSH
• Child MeSH
• Adult MeSH
• Cohort Studies MeSH
• Pregnancy Complications psychology   MeSH
• Humans MeSH
• Adolescent MeSH
• Infant, Newborn MeSH
• Depression, Postpartum diagnosis   epidemiology   MeSH
• Postpartum Period MeSH
• Prospective Studies MeSH
• Surveys and Questionnaires MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Stress, Psychological * MeSH
• Risk Factors MeSH
• Pregnancy MeSH
• Pregnancy Trimesters psychology   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Infant, Newborn MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Comparative Study MeSH

INTRODUCTION: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method. METHODS: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed. RESULTS: Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients. DISCUSSION: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.

• Keywords
• illness course, outcome, schizophrenia, staging,
• MeSH
• Adult MeSH
• Factor Analysis, Statistical MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Disease Progression * MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Schizophrenia classification   diagnosis   physiopathology   MeSH
• Sotos Syndrome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe MeSH
• Nigeria MeSH

Statistical theory indicates that hierarchical clustering by interviewers or raters needs to be considered to avoid incorrect inferences when performing any analyses including regression, factor analysis (FA) or item response theory (IRT) modelling of binary or ordinal data. We use simulated Positive and Negative Syndrome Scale (PANSS) data to show the consequences (in terms of bias, variance and mean square error) of using an analysis ignoring clustering on confirmatory factor analysis (CFA) estimates. Our investigation includes the performance of different estimators, such as maximum likelihood, weighted least squares and Markov Chain Monte Carlo (MCMC). Our simulation results suggest that ignoring clustering may lead to serious bias of the estimated factor loadings, item thresholds, and corresponding standard errors in CFAs for ordinal item response data typical of that commonly encountered in psychiatric research. In addition, fit indices tend to show a poor fit for the hypothesized structural model. MCMC estimation may be more robust against clustering than maximum likelihood and weighted least squares approaches but further investigation of these issues is warranted in future simulation studies of other datasets. Copyright © 2015 John Wiley & Sons, Ltd.

• Keywords
• PANSS, factor analysis, hierarchical modelling, simulation,
• MeSH
• Factor Analysis, Statistical * MeSH
• Data Interpretation, Statistical * MeSH
• Humans MeSH
• Computer Simulation MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

BACKGROUND: Cortisol, along with other hormones of hypothalamo-pituitary-adrenal axis, belongs to one of the main factors influencing psychological and pathognomic factors, intelligence, and memory. METHODS: The aim of our study was to review a large battery of psychological, performance, IQ and memory tests as to their relation with cortisol, testosterone and estrogen levels in groups of 100 men and 93 women who attended the Central Military Hospital in Prague for regular entrance psychological examinations for military personnel. RESULTS: In men, we detected positive correlations between cortisol and emotional lability, and negative correlations with impulsivity, while in women hypochondria and psychopathology were negatively correlated, and aggression measured with the Meili selective memory test had a positive relation to cortisol level. Testosterone correlated positively with emotional liability and negatively with impulsivity in men, and negatively with hypochondria and psychasteny, indirect aggression, irritability and paranoia in women. Estradiol correlated positively with psychopathology in men, and negatively with phobia. It was positively correlated with negativism in women. No clear correlation was observed between the concentration of steroid hormones and psychomotor performance or intelligence. CONCLUSIONS: Concentrations of steroid hormones correlate with results of several psychological tests, the sign and magnitude of these correlations, however, very often differ in military men and women.

• MeSH
• Adult MeSH
• Mental Disorders blood   physiopathology   MeSH
• Estrogens blood   physiology   MeSH
• Hydrocortisone blood   physiology   MeSH
• Intelligence physiology   MeSH
• Intelligence Tests statistics & numerical data   MeSH
• Humans MeSH
• Military Personnel psychology   statistics & numerical data   MeSH
• Memory physiology   MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Psychomotor Performance physiology   MeSH
• Testosterone blood   physiology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Estrogens MeSH
• Hydrocortisone MeSH
• Testosterone MeSH

OBJECTIVES: The aim of our study is to measure very low frequency band (VLF), low frequency band (LF) and high frequency band (HF) components of R-R interval during orthostatic test in patients with panic disorder and a comparison with healthy controls. METHODS: We measured HRV in 31 patients with panic disorder and 20 healthy controls. Diagnosis was done according to the ICD-10 research diagnostic criteria confirmed with MINI (MINI international neuropsychiatric interview). Autonomic nervous system (ANS) has been evaluated during orthostatic change in three positions. Intensity of symptoms was assessed using psychiatric scales. RESULTS: There were highly statistically significant differences between panic patients and control group in all components of power spectral analysis in 2nd and 3rd VLF components and in HF components of 2nd. We have found highly statistically significant negative correlations between level of dissociation measured by DES and some parameters of ANS. We found negative correlations between the age of the patient and activity of ANS, and negative correlations between activity of ANS and duration and onset of disorder and dosage of antidepressants. CONCLUSION: These findings demonstrate a lower parasympathetic activity and higher sympathetic/parasympathetic ratio in panic disorder patients measured during the changes of postural position in comparison with healthy controls. Autonomic dysregulation is associated with panic disorder and has the relation with the level of dissociation, the age of patiens and age of onset of disorder.

• MeSH
• Antidepressive Agents pharmacology   therapeutic use   MeSH
• Autonomic Nervous System physiopathology   MeSH
• Dissociative Disorders physiopathology   MeSH
• Adult MeSH
• Electrocardiography drug effects   psychology   statistics & numerical data   MeSH
• Humans MeSH
• Panic Disorder drug therapy   physiopathology   MeSH
• Posture physiology   MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Heart Rate drug effects   physiology   MeSH
• Case-Control Studies MeSH
• Age Factors MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Antidepressive Agents MeSH

OBJECTIVE: The objective of this prospective, naturalistic study, conducted in first-episode psychosis patients from a Central-European population, was to assess the utility of Cytochrome P-450 2D6 (CYP2D6) genotype testing under normal clinical setting. METHODS: A total of 35 patients diagnosed for the first time with schizophrenia or acute schizophrenia-like psychotic disorder and treated with risperidone were enrolled in the study. These patients underwent sequentiation of the CYP2D6 gene and evaluations of symptoms and severity of adverse effects using the PANSS and UKU scales, respectively. Doses of antipsychotics and other co-medication were monitored as well. In statistical analysis, Fisher's exact test was used to compare ratios and the Wilcoxon rank-sum test was used in the comparison of continual variables. RESULTS: PM patients showed a significantly lower reduction in psychotic symptoms and a greater severity of psychotic symptoms following risperidone treatment and higher doses of antipsychotics not metabolized by CYP2D6, which were used as co-medication. CONCLUSIONS: Based on these results, patients with the PM genotype experiencing first-episode schizophrenia don't appear to be optimal recipients of risperidone treatment. However, as the main limitation of this study was the relatively small sample-size, replication with a larger scale study is needed to confirm these findings.

• MeSH
• Alleles MeSH
• Antipsychotic Agents adverse effects   therapeutic use   MeSH
• Cytochrome P-450 CYP2D6 genetics   MeSH
• Adult MeSH
• Genotype MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Prospective Studies MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Psychotic Disorders drug therapy   genetics   MeSH
• Risperidone adverse effects   therapeutic use   MeSH
• Schizophrenia diagnosis   drug therapy   genetics   MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Antipsychotic Agents MeSH
• Cytochrome P-450 CYP2D6 MeSH
• Risperidone MeSH

OBJECTIVES: The early course of schizophrenia is highly variable. We assessed outcomes of patients with first-episode schizophrenia at 7-year follow-up. METHODS: Consecutively hospitalized male patients were included if they were experiencing their first admission for first-episode schizophrenia and were reassessed at 1-, 4- and 7-year follow-ups. The psychopathology was evaluated using the PANSS, relative decrease of PANSS and remission status based on severity of core symptoms. RESULTS: Forty-four of 76 patients were reassessed three times. At the end of index hospitalization 73% of patients achieved remission; however, after 1, 4 and 7 years, the percentage had dropped to 50, 50 and 52%, respectively. When compared post-hoc there was no significant difference in PANSS and response to treatment between remitters and non-remitters during the index hospitalization; however, a significant difference in psychopathology emerged first after 1, 4 and 7 years. All patients who had not achieve remission after 1 year also failed to achieve remission after 4 and 7 years. CONCLUSIONS: Response to treatment during the first psychotic break-through may not be a decisive indicator for the outlook of the disease. Our data suggest that when deterioration occurs, it does so early after the first episode.

• MeSH
• Antipsychotic Agents therapeutic use   MeSH
• Adult MeSH
• Hospitalization MeSH
• Humans MeSH
• Young Adult MeSH
• Follow-Up Studies MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Schizophrenia diagnosis   drug therapy   MeSH
• Severity of Illness Index MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Antipsychotic Agents MeSH

OBJECTIVE: To verify whether high-frequency rTMS applied above the area of the left prefrontal cortex in 15 stimulation sessions with maximum stimulation intensity is able to modify negative symptoms of schizophrenia in a double-blind, randomized controlled study. METHODS: Twenty-two patients with schizophrenia stabilized on antipsychotic medication with prominent negative symptoms were included in the trial. They were divided into two groups: eleven were treated with effective rTMS and eleven with ineffective "sham" rTMS. The ineffectiveness of the sham rTMS was achieved through the stimulation coil position. Stimulation was applied to the left dorsolateral prefrontal cortex. The stimulation frequency was 10 Hz. Stimulation intensity was 110% of the motor threshold intensity. Each patient received 15 rTMS sessions on 15 consecutive working days. Each daily session consisted of 15 applications of 10-second duration and 30-second intervals between sequences. There were 1500 stimuli per session. RESULTS: During real rTMS treatment a statistically significant decrease of negative symptoms was found (approximately 29% reduction in the PANSS negative symptom subscale and 50% reduction in the SANS). No adverse events occurred during therapy except for a mild headaches. In sham rTMS treatment a decrease of negative symptoms was also identified, but to a lesser extent than in real rTMS (about 7% in negative subscale PANSS and 13% in SANS). The change in SANS achieved statistical significance. Mutual comparison revealed a greater decrease of negative symptoms in favor of real rTMS in contrast to sham rTMS. CONCLUSION: The augmentation of rTMS enabled patients to experience a significant decrease in the severity of the negative symptoms. Our results support the therapeutic potential of rTMS at higher frequency for negative symptoms of schizophrenia.

• MeSH
• Antipsychotic Agents therapeutic use   MeSH
• Adult MeSH
• Double-Blind Method MeSH
• Combined Modality Therapy MeSH
• Humans MeSH
• Prefrontal Cortex physiology   MeSH
• Psychiatric Status Rating Scales statistics & numerical data   MeSH
• Schizophrenic Psychology * MeSH
• Schizophrenia diagnosis   drug therapy   therapy   MeSH
• Severity of Illness Index MeSH
• Transcranial Magnetic Stimulation * MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Randomized Controlled Trial MeSH
• Names of Substances
• Antipsychotic Agents MeSH