The role of modifiable risk factors in the development of dementia in Central and Eastern Europe remains understudied. We aimed to examine the association between 12 risk factors and the incidence of dementia in the Czech Republic and estimate the proportion of new dementia cases that can be attributed to these risk factors. Data of 3805 Czech participants in the Survey of Health, Ageing, and Retirement in Europe (mean age: 70 years, median 6.5-year follow-up) were analyzed. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox hazard models for the association between the risk factors (low education, alcohol use, living alone, obesity, smoking, physical inactivity, high blood pressure, high cholesterol, diabetes mellitus, hearing loss, vision problem, and depression) and probable dementia diagnosis defined based on adapted Lang-Weir algorithm. We estimated the proportion of dementia cases attributable to each risk factor using weighted population attributable fractions (wPAFs). Four risk factors, low education (HR 1.72), depression (HR 1.42), diabetes mellitus (HR 1.53), and physical inactivity (HR 2.13), were significantly associated with dementia and accounted for the largest proportion of attributable risk. The total weighted PAF for all factors was 39.18%. If all risk factors for dementia were eliminated, almost 40% of dementia cases in the Czech Republic could be prevented. More systematic approach is essential for mitigating the adverse impact of risk factors on the incidence of dementia, such as improving education, preventing and treating depression and diabetes mellitus, and promoting physical.

• MeSH
• Dementia * epidemiology   MeSH
• Depression epidemiology   MeSH
• Retirement statistics & numerical data   MeSH
• Incidence MeSH
• Middle Aged MeSH
• Humans MeSH
• Proportional Hazards Models MeSH
• Risk Factors MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Health Surveys MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic epidemiology   MeSH

OBJECTIVES: The aim of the study was to describe alcohol consumption and its changes in the Czech Republic during the period of governmental restrictions related to the COVID-19 pandemic. To this goal, an overview of the governmental measures that may have affected alcohol consumption was compiled from various sources (mostly media reports). METHODS: The paper analyses three surveys where the group from Charles University, Prague, participated in design and execution: the European Study Group on Alcohol use and COVID-19 (ESAC) convenience online survey that (in Czechia) took place at the onset of the COVID-19 pandemic in Europe, in April through June 2020 (n = 1,434), a computer-assisted web interviews (CAWI) survey carried out in November 2021 (n = 790), and another CAWI survey carried out in November 2022 (n = 1,738). These are complemented by a brief overview of official data on alcohol sales between 2019 and 2021 in Czechia from two sources, Ministry of Finance of the Czech Republic and the Nielsen IQ market research company. RESULTS: Changes in alcohol use appeared to be distributed among the population unequally, when the pandemic influenced different population groups in a different way. In all three surveys, the majority of respondents reported no change in their drinking frequency or quantity. Decreases in alcohol use were more prevalent than increases. Most pronounced changes were detected in at-risk drinkers, who have increased their alcohol use. Official revenue data suggest a small reduction in total alcohol sales in 2019-2021. CONCLUSIONS: Our research results do not support the hypothesis that substantial and unexpected social and economic changes caused by the COVID-19 pandemic, along with corresponding measures, acted as stressors that would have caused the majority of people in Czechia changing their behaviour related to alcohol use; however, high-risk users increased their consumption.

• Keywords
• COVID-19, Czech Republic, alcohol consumption, anti-epidemic regulations, pandemic, risk alcohol drinking,
• MeSH
• COVID-19 * epidemiology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Pandemics MeSH
• Alcohol Drinking * epidemiology   MeSH
• Surveys and Questionnaires MeSH
• SARS-CoV-2 MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic epidemiology   MeSH

BACKGROUND: There has been a noticeable relative increase in psychiatric comorbidities among smokers as opposed to the general population. This is likely due to comparatively slower decrease in smoking prevalence among individuals with mental health conditions. This study aims to assess the prevalence trend of past or current mental health disorders in individuals seeking specialized smoking cessation assistance. METHODS: We conducted a retrospective single-centre observational study to assess the presence of mental disorders such as anxiety, depression, bipolar affective disorder, or schizophrenia in personal history of 6,546 smokers who sought treatment at the Centre for Treatment of Tobacco Dependence in Prague, Czech Republic between 2006 and 2019. The study examined the impact of gender, age, and the effect of successive years on the prevalence of the mental disorders using Poisson distribution regression. RESULTS: In the studied cohort, 1,743 patients (26.6%) reported having one or more mental disorders. Compared to patients without a psychiatric disorder, they exhibited similar levels of carbon monoxide in expired air (mean 17 ppm, SD 11 ppm) and scored one point higher on the Fagerström Test of Cigarette Dependence. Among smokers with a mental disorder, women were more prevalent (62%) than men (38%). The prevalence of mental disorders increased on average by 4% every year, rising from 23% in 2006 to 35% in 2019. CONCLUSIONS: Consistent with the observation that the prevalence of smoking among people with any mental disorder is higher and declining at a slower rate than in the general population, there is a steadily increasing percentage of these patients seeking specialized treatment over time. Professionals who offer tobacco dependence treatment should be aware of the upward trend in psychiatric disorders among smokers, as more intensive treatment may be needed. Similarly, psychiatric care should pay attention to smoking of their patients.

• Keywords
• Comorbidity, Prevalence, Psychiatric disorders, Smoking cessation, Tobacco dependence, Treatment,
• MeSH
• Mental Disorders * epidemiology   MeSH
• Smokers MeSH
• Humans MeSH
• Tobacco Use Disorder * epidemiology   therapy   MeSH
• Prevalence MeSH
• Retrospective Studies MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH

The pandemic due to COVID-19 brought new risks for depression of health care workers, which may have differently influenced men and women. We aimed to investigate (1) whether health care workers in Czechia experienced an increase in depression during the COVID-19 pandemic, (2) which factors contributed the most to this change, and (3) whether the magnitude of the associations differed by gender. We studied 2564 participants of the Czech arm of the international COVID-19 HEalth caRe wOrkErS (HEROES) Study. Online questionnaire was administered to health care workers in summer 2020 (wave 0) and spring 2021 (wave 1). Depression was defined by reaching 10 or more points on the Patient Health Questionnaire. Logistic regression investigated the association of participant´s characteristics with depression and multivariable decomposition for non-linear models assessed, to what extent the characteristic explained the change in depression occurrence. The prevalence of depression increased twice during the pandemic (11% in wave 0 and 22% in wave 1). Stress accounted for 50% of the difference, experience of death due to COVID-19 for 15% and contact with COVID-19 patients for 14%. Greater resilience and sufficient personal protective equipment were strongly associated with lower occurrence of depression. The protective association of resilience with depression was stronger in men than in women. We conclude that interventions to promote mental health of health care workers in future health crisis should aim at decreasing stress and enhancing resilience. They should be delivered especially to individuals who have contact with the affected patients and may face their death.

• MeSH
• COVID-19 * epidemiology   MeSH
• Humans MeSH
• Pandemics MeSH
• Gastropoda * MeSH
• Anxiety MeSH
• Health Personnel MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic epidemiology   MeSH

The unpredictable spread of the COVID-19 pandemic, national lockdowns, and public health measures implemented in the Czech Republic had a negative effect on older adults' mental health and loneliness. The 2,631 older adults in 2020 and 2,083 older adults in 2021 used in this study formed a nationally representative sample of the Survey of Health, Ageing and Retirement in Europe (SHARE). Almost every third older adult experienced feelings of loneliness in both stages of the COVID-19 outbreak. Loneliness increased in 2021 in those individuals who reported their physical health as poor, who felt nervous, sad or depressed, and who had ever left their home since the outbreak. According to age-related drivers of loneliness, feelings of loneliness were prevalent (40% vs. 45%) among younger retirees in both waves. In both data sets, declared feelings of sadness or depression were the strongest sustainable predictor of loneliness (2020 and 2021 models, OR = 3.69; 95% CI [2.90, 4.69] and OR = 2.55; [1.97, 3.30]). Being a woman and feeling nervous equated with a higher likelihood of feeling lonely compared to counterparts. Policy makers should therefore aim to carefully improve psychosocial and health-related consequences faced by this vulnerable population during the pandemic and beyond.

• Keywords
• COVID-19, SHARE study, loneliness, mental health,
• Publication type
• Journal Article MeSH

OBJECTIVES: To assess the impact of COVID-19 illness and pandemic era on sleep, general health, health care, and social status in patients with epilepsy in the Czech Republic. METHODS: Our designed and approved questionnaire consisted of 23 questions. We focused on (1) patients' demographic and epidemiological data regarding COVID-19, (2) subjective assessment of sleep; (3) epilepsy, and (4) perception of general health during the first year of the COVID-19 pandemic in the Czech Republic from March 2020 to May 2021. We administered the questionnaires during outpatient visits or by phone calls in three major university Czech epilepsy centers (Ostrava, Brno, Pilsen). RESULTS: We enrolled 227 (100%) patients. The mean age (±SD) was 41.2 ± 14.82 years (min 18, max 86 years), and 138 (61%) were women. COVID-19 was confirmed using the PCR test method in 57 (25.1%) patients. In the pre-pandemic era, 62 (27.3%) patients reported sleep disturbances. Insomnia in 46 (74.2%) and excessive daytime sleepiness in 6 (9.7%) were the most mentioned sleep abnormalities. Nocturnal seizures predispose to sleep impairment (p = 0.014) and vivid dreams and nightmares (p = 0.033). COVID-19 infection significantly increased the risk of vivid dreams and nightmares in patients with diurnal seizures (p = 0.006). Sleep quality impairment and seizure frequency worsening [(p < 0.001) and (p = 0.001), respectively] were the most significant risk factors to perform general health deterioration regardless of having COVID-19 (p = 0.559). The most affected age group was 51+ years (p = 0.033). The three centers provided adequate outpatient care during the first year of the pandemic. The employment and social status of the patients remained unchanged (p = 0.074). CONCLUSIONS: COVID- 19 infection significantly increased the occurrence of vivid dreams and nightmares in patients with diurnal seizures. Sleep quality deterioration and seizure frequency worsening significantly negatively impacted general health performance.

• Keywords
• ASM, anti- seizure medication, COVID-19, coronavirus disease- 19, PwE, patients with active epilepsy,
• Publication type
• Journal Article MeSH

During the first wave of the COVID-19 pandemic in the spring of 2020, the government of the Czech Republic issued a nationwide ban on visitors to maternity wards. We studied whether the absence of a close person during labor due to this ban impacted perinatal indicators. This study was performed using an administrative observational questionnaire focused on absolute frequencies of events sent to maternity facilities across the Czech Republic. Completed answers were received from 33 facilities covering 4805 births during the study period in 2019 and 4514 births in 2020. The differences in individual parameters were tested using Pearson's chi-squared homogeneity test. There were no significant differences between the two periods in spontaneous pre-term births (p = 0.522) or in the number of cesarean sections (p = 0.536). No significant changes were seen in either local or systemic analgesia. Data showed a significantly shorter (p = 0.026) first stage of labor in 2020 compared to 2019, while there was no significant difference (p = 0.673) in the second stage of labor. There was no statistically significant difference found for newborn perinatal adaptation. There were also no significant differences in intrapartum maternal injuries. Overall, we found no significant differences in basic perinatal indicators during the first wave of COVID-19 in 2020 compared to 2019. Although the absence of a close person may cause stress for the laboring women, it does not impair objective clinical outcomes.

• Keywords
• COVID-19, birth companion, childbirth experiences, continuous childbirth support, women’s health,
• MeSH
• COVID-19 * epidemiology   MeSH
• Humans MeSH
• Infant, Newborn MeSH
• Pandemics MeSH
• Term Birth MeSH
• Labor, Obstetric * MeSH
• Pregnancy MeSH
• Delivery, Obstetric MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH

Restrictions related to COVID-19 changed the daily behavior of people, including the expression of violence. Although an increased incidence of violent behavior, especially domestic violence, was expected during the pandemic, retrospective analyses have yielded mixed results. Records of ambulance departures to address injuries caused by assaults in the Pilsen region, Czech Republic, during the restrictive measures during the national state of emergency were compared to data from 3 previous years using general linear models. The number and severity of assaults were analyzed for the whole sample and separately for patients of either sex, for residential or nonresidential locations, and for domestic violence. Controlling for the seasonal effects, the number of assaults decreased by 39% during the pandemic restrictions compared to the 3 previous years. No difference was found between the effects of restrictions on assaults resulting in an injury of a male or female patient. The decrease was specifically pronounced in the sample of assaults in nonresidential locations, while no effect of restrictions was observed in assaults in residential locations and domestic assaults. Pandemic restrictions were associated with a decreased incidence of violent assaults that required ambulance services. Although the incidence decreased especially in those assaulted outside of their homes, we found no support for an increase in domestic violence or violence against women. Pandemic restrictions may have served as a protective rather than a risk factor for assaults severe enough to warrant a call for ambulance services.

• Keywords
• COVID-19, aggression, ambulance, lockdown, violent assault,
• MeSH
• Aggression MeSH
• COVID-19 * epidemiology   MeSH
• Domestic Violence * MeSH
• Humans MeSH
• Pandemics MeSH
• Retrospective Studies MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

BACKGROUND: The Overall Anxiety Severity and Impairment Scale (OASIS) is a transdiagnostic measure that assesses severity and impairment associated with anxiety disorders. However, its psychometric properties were primarily examined in English-speaking or western countries. Therefore, this study aims to examine its psychometric parameters in the Czech Republic. METHODS: A large representative sample (n = 1738), a clinical sample (n = 57) and a retest sample (n = 20) were used. In addition to the OASIS, conventional measures of anxiety, depression, personality traits, self-esteem, life satisfaction, and other scales were also administered. Moreover, we examined the latent structure, reliability, validity, and the cut-off score for the Reliable Change Index (RCI) and the Clinically Significant Change Index (CSI). RESULTS: Higher anxiety was found in females, religious non-church members, and students. The Confirmatory Factor Analysis supported the adequate fit of the unidimensional solution: x2(4) = 3.20; p < 0.525; CFI = 1.000; TLI = 1.000;RMSEA = 0, SRMR = 0. The measurement equivalence examination indicated that the OASIS measures anxiety invariantly between males and females. The validity of the OASIS was supported by positive associations with neuroticism, depression, perceived stress, guilt, shame, and the established anxiety measures. The internal consistency was excellent (Cronbach's alpha = 0.96, McDonald's omega = 0.96). The test-retest reliability was acceptable (r = 0.66). The cut-off for the CSI is 6 and the RCI is 5.32. CONCLUSIONS: The OASIS represents a reliable and valid instrument for assessing anxiety in adults. Due to its shortness, excellent psychometric properties, and percentile norms, it is especially useful for short and accurate screening of anxiety and mapping therapeutic changes in clinical practice.

• Keywords
• Anxiety, Assessment, Measurement, OASIS, Psychometrics,
• MeSH
• Adult MeSH
• Humans MeSH
• Surveys and Questionnaires MeSH
• Psychiatric Status Rating Scales MeSH
• Psychometrics methods   MeSH
• Reference Standards MeSH
• Reproducibility of Results MeSH
• Anxiety * diagnosis   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

Poor mental health is a growing concern among young people during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to assess the associations of Internet addiction with depressive symptoms, anxiety symptoms, and stress in higher education students during the COVID-19 pandemic, as well as to examine these mental health problems in the context of study-related characteristics. The research sample consisted of 3,099 participants from the Czech Republic (CZ: 1,422) and Slovak Republic (SK: 1,677). The Internet Addiction Test (IAT), the Generalized Anxiety Disorder (GAD-7) scale, the Patient Health Questionnaire for depressive symptoms (PHQ-9), and the Perceived Stress Scale (PSS) were used to measure mental health problems. The analyses also included demographic data (gender and age) and study-related characteristics (form of study, degree of study, field of study, distance between college and home, and housing during the semester). Based on the results of frequency and descriptive analyses, the prevalence of mental health problems was high. The most serious levels of Internet addiction (IAT cut-off point ≥ 50), to which attention should be paid, were found in 3.5% of Czech and 6.2% of Slovak students. Using the standard cut-off point of GAD-7 ≥ 10, 14.1% of Czech and 11.6% of Slovak students were identified with anxiety symptoms. Regarding the PHQ-9 with the cut-off point ≥ 10, 23.4% of Czech and 19.1% of Slovak students had depressive symptoms, which should be addressed. Using the PSS cut-off point ≥ 27, 12.9% of Czech students and 9.1% of Slovak students perceived high stress. The quantile regression analysis showed that Internet addiction was positively associated with anxiety symptoms, depressive symptoms, and stress in all of the analyzed cases (p-value < 0.001). In terms of study-related characteristics, the binomial logistic regression analysis revealed that risk factors for mental health problems in Czech and Slovak students were mainly full-time form of study and living away from home during the semester. Internet addiction, anxiety symptoms, depressive symptoms, and stress are issues that require increased attention, and professionals and policy-makers should implement interventions to effectively prevent and help students with psychological problems.

• Keywords
• GAD-7, IAT, PHQ-9, PSS, college, mental health problems, young people,
• MeSH
• COVID-19 * epidemiology   MeSH
• Depression epidemiology   MeSH
• Humans MeSH
• Adolescent MeSH
• Internet Addiction Disorder epidemiology   MeSH
• Pandemics * MeSH
• Stress, Psychological epidemiology   MeSH
• Students psychology   MeSH
• Anxiety epidemiology   MeSH
• Anxiety Disorders epidemiology   MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH