War refugees and veterans have been known to frequently develop neuropsychiatric conditions including depression, post-traumatic stress disorder (PTSD), and anxiety disorders that tend to leave a long-lasting scar and impact their emotional response system. The shear stress, trauma, and mental breakdown from overnight displacement, family separation, and killing of friends and families cannot be described enough. Victims often require years of mental health support as they struggle with sleep difficulties, recurring memories, anxiety, grief, and anger. Everyone develops their coping mechanism which can involve dependence and long-term addiction to alcohol, drugs, violence, or gambling. The high prevalence of mental health disorders during and after the war indicates an undeniable necessity for screening those in need of treatment. For medical health professionals, it is crucial to identify such vulnerable groups who are prone to developing neuropsychiatric morbidities and associated risk factors. It is pivotal to develop and deploy effective and affordable multi-sectoral collaborative care models and therapy, which primarily depends upon family and primary care physicians in the conflict zones. Herein, we provide a brief overview regarding the identification and management of vulnerable populations, alongside discussing the challenges and possible solutions to the same.

• Klíčová slova
• PTSD, conflict, depression, neuropsychiatric effects, refugees, stigma, treatment,
• MeSH
• lidé MeSH
• ozbrojené konflikty psychologie   MeSH
• posttraumatická stresová porucha * epidemiologie   terapie   MeSH
• psychiatrie * MeSH
• uprchlíci * psychologie   MeSH
• veteráni váleční * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Sex and gender are increasingly recognized as major influencing factors in disorders across all medical specialties. Even though there is ample evidence of sex and gender differences in neuropsychiatric disorders, a sex and gender-differentiated approach has not yet been sufficiently applied to diagnostics and management. Therefore, there is an urgent need to establish general recommendations and guidelines toward precision and sex/gender medicine, with regard to dosage, tolerability, interactions and side effects, sensitivity of diagnostic tests, and distinct treatment strategies. This chapter illustrates the current knowledge about sex and gender aspects in neuropsychiatric disorders, providing a base not only to assist the clinician in the handling of specific pathologic entities, but also to sensitize medical practitioners to consider sex and gender in clinical decision-making. As such, the chapter is a call to action to physicians and researchers to produce more sex- and gender-stratified evidence, leading to an acceleration of guideline development. Such novel guidelines will provide a base for medical education, of both medical students and specialists, as well as a reference point for practitioners, toward precision medicine.

• Klíčová slova
• Alzheimer, Clinical trials, Gender, Neuropsychiatric disorders, Precision medicine, Sex differences,
• MeSH
• individualizovaná medicína * MeSH
• lidé MeSH
• sexuální faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

AIMS: To find out whether neuropsychiatric comorbidity (comMCI) influences spatial navigation performance in amnestic mild cognitive impairment (aMCI). METHODS: We recruited aMCI patients with (n = 21) and without (n = 21) neuropsychiatric comorbidity or alcohol abuse, matched for global cognitive impairment and cognitively healthy elderly participants (HE, n = 22). They completed the Mini-Mental State Examination and a virtual Hidden Goal Task in egocentric, allocentric, and delayed recall subtests. RESULTS: In allocentric navigation, aMCI and comMCI performed significantly worse than HE and similarly to each other. Although aMCI performed significantly worse at egocentric navigation than HE, they performed significantly better than patients with comMCI. CONCLUSIONS: Despite the growing burden of dementia and the prevalence of neuropsychiatric symptoms in the elderly population, comMCI remains under-studied. Since trials often assess "pure" aMCI, we may underestimate patients' navigation and other deficits. This finding emphasizes the importance of taking account of the cognitive effects of psychiatric disorders in aMCI.

• Klíčová slova
• Mild cognitive impairment, neuropsychiatric comorbidity, spatial memory, spatial navigation,
• MeSH
• amnézie epidemiologie   psychologie   MeSH
• kognitivní dysfunkce epidemiologie   psychologie   MeSH
• komorbidita MeSH
• lidé MeSH
• prostorová navigace * MeSH
• prostorová paměť MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Methylene blue is a long-established drug with complex pharmacology and multiple clinical indications. Its diverse mechanisms of action are most likely responsible for the large variety of its clinical effects. Of interest to psychiatrists, methylene blue has antidepressant, anxiolytic, and neuroprotective properties documented by both animal and human studies. Its stabilizing effect on mitochondrial function and dose-dependent effect on the generation of reactive oxygen species are of significant heuristic value. For these reasons, methylene blue holds promise as a proof-of-concept treatment of organic/neurodegenerative disorders and as a neuroprotective agent in general. In psychiatry, methylene blue has been used for over a century. It was tried successfully in the treatment of psychotic and mood disorders and as a memory enhancer in fear-extinction training. Particularly promising results have been obtained in both short- and long-term treatment of bipolar disorder. In these studies, methylene blue produced an antidepressant and anxiolytic effect without risk of a switch into mania. Long-term use of methylene blue in bipolar disorder led to a better stabilization and a reduction in residual symptoms of the illness. It is usually well tolerated, but caution is needed in the light of its inhibitory effect on monoamine oxidase A.

• MeSH
• antidepresiva terapeutické užití   MeSH
• bipolární porucha farmakoterapie   MeSH
• lidé MeSH
• methylenová modř terapeutické užití   MeSH
• neuroprotektivní látky terapeutické užití   MeSH
• strach účinky léků   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• antidepresiva MeSH
• methylenová modř MeSH
• neuroprotektivní látky MeSH

Apart from its role in motor coordination, the importance of the cerebellum in cognitive and affective processes has been recognized in the past few decades. Spinocerebellar ataxias (SCA) and Friedreich ataxia (FRDA) are rare neurodegenerative diseases of the cerebellum presenting mainly with a progressive loss of gait and limb coordination, dysarthria, and other motor disturbances, but also a range of cognitive and neuropsychiatric symptoms. This narrative review summarizes the current knowledge on neuropsychiatric impairment in SCA and FRDA. We discuss the prevalence, clinical features and treatment approaches in the most commonly reported domains of depression, anxiety, apathy, agitation and impulse dyscontrol, and psychosis. Since these symptoms have a considerable impact on patients' quality of life, we argue that further research is mandated to improve the detection and treatment options of neuropsychiatric co-morbidities in ataxia patients.

• Klíčová slova
• Agitation, Anxiety, Apathy, Depression, Friedreich ataxia, Neuropsychiatric symptoms, Psychosis, Spinocerebellar ataxia,
• MeSH
• Friedreichova ataxie * komplikace   MeSH
• komorbidita MeSH
• kvalita života MeSH
• lidé MeSH
• mozeček MeSH
• spinocerebelární ataxie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

OBJECTIVE: To determine current and lifetime psychopathology and assess quality of life (QoL) in offspring of a parent with bipolar disorder (BD). METHODS: We investigated 43 offspring of bipolar parents (high-risk offspring [HRO]) (mean age 12.5 ± 3.1; range 6.7-17.9 years) and 43 comparison offspring matched for sex, age, and IQ of healthy parents. Lifetime and current presence of Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) diagnoses were assessed using Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). We administered parent and self-report versions of General Behavior Inventory and the Screen for Child Anxiety-Related Emotional Disorders (SCARED). QoL was evaluated using the self-report questionnaire KIDSCREN-52. RESULTS: Thirty-seven HRO (86%) and 18 controls (42%) met DSM-5 criteria for at least one lifetime psychiatric diagnosis (adjusted OR = 7.20; 95% CI 2.27-22.81). Compared to controls, HRO had higher lifetime frequency of any mood disorder (33% vs. 2%, p < 0.001), anxiety disorder (60% vs. 14%, p < 0.001), and attention-deficit/hyperactivity disorder (26% vs. 5%, p = 0.01). After adjustment for confounders, only mood (OR = 13.05; 95% CI 1.41-120.60) and anxiety (OR = 9.69; 95% CI 2.75-34.31) disorders remained significantly more frequent in the HRO group. In comparison with controls, HRO scored lower in the following domains: QoL, social support and relationship with peers (p = 0.003; Cohen's d = 0.91), parent relationships and home life (p = 0.008; d = 0.67), as well as self-perception (p = 0.04; d = 0.55). CONCLUSIONS: In agreement with other studies, we found a higher rate of lifetime anxiety and mood disorders in children and adolescents at confirmed familial risk for BD. Reduction in QoL was already evident across a number of domains. Adult psychiatrists should incorporate into their assessment procedures targeted questions on the presence of psychopathology in offspring of their adult patients with severe mental disorders and child services should bridge with adult services providing accessible services to children of affected parents.

• Klíčová slova
• bipolar affective disorder, high-risk offspring, psychiatric disorders in offspring, quality of life,
• MeSH
• bipolární porucha * MeSH
• dítě postižených rodičů psychologie   statistika a číselné údaje   MeSH
• dítě MeSH
• hyperkinetická porucha epidemiologie   MeSH
• kvalita života * MeSH
• lidé MeSH
• mladiství MeSH
• poruchy nálady epidemiologie   MeSH
• psychiatrické posuzovací škály MeSH
• rizikové faktory MeSH
• studie případů a kontrol MeSH
• úzkostné poruchy epidemiologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVE: This study aimed to examine differences in the clinical presentation of very-early-onset (VEO) and early-onset (EO) bipolar disorder (BD) not fully explored previously. METHODS: We selected two groups of subjects with BD from the Maritime Bipolar Registry based on age at onset of first major mood episode (VEO with onset prior to age 15 years; EO ranging from 15 to 18 years) and compared them with a reference group (onset after 18 years of age). There were 363 subjects (240 with bipolar I disorder and 123 with bipolar II disorder; mean age 44.2 ± 12.8 (SD) years), with 41 subjects in the VEO and 95 in the EO groups. RESULTS: In comparison with the EO and reference groups, more subjects in the VEO group developed major depression as an index episode (88% for the VEO group versus 61% for the EO group and 54% for the reference group), and had an unremitting clinical course (65% versus 42% and 42%, respectively), rapid cycling (54% versus 34% and 28%, respectively), and comorbid attention-deficit hyperactivity disorder (17% versus 1% and 3%, respectively); a higher proportion of the VEO group had first-degree relatives with affective disorders compared with the EO and reference groups (0.41 versus 0.32 and 0.29, respectively), and they had lower scores on the Global Assessment of Functioning scale (mean scores of 64 versus 70 and 70). Overall, the EO group was similar to the reference group on most measures, except for increased suicidal behavior VEO 53%, EO 44% and reference group 25%). The results of polychotomous logistic regression also support the view that VEO BD represents a rather specific subtype of BD. CONCLUSIONS: Our results suggest the recognized correlates of early-onset BD may be driven by subjects at the lowest end of the age at onset spectrum.

• Klíčová slova
• bipolar disorder, childhood ADHD, early course, early onset, first mood episode, rapid cycling,
• MeSH
• bipolární porucha * diagnóza   epidemiologie   psychologie   MeSH
• depresivní porucha unipolární diagnóza   epidemiologie   psychologie   MeSH
• dospělí MeSH
• hyperkinetická porucha * diagnóza   epidemiologie   psychologie   MeSH
• komorbidita MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• poruchy nálady diagnóza   epidemiologie   psychologie   MeSH
• psychiatrické posuzovací škály MeSH
• psychopatologie MeSH
• rodina psychologie   MeSH
• věk při počátku nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Kanada epidemiologie   MeSH

The efficacy of dopamine (DA) agonists in the treatment of motor symptoms of Parkinson's disease (PD) has been clearly demonstrated. It has also been documented that DA agonists may have both a positive and a negative impact on neuropsychiatric symptoms in PD patients. This paper will focus on the effects of DA agonists on depressive and cognitive symptoms of PD.

• MeSH
• agonisté dopaminu terapeutické užití   MeSH
• deprese diagnostické zobrazování   farmakoterapie   etiologie   MeSH
• klinické zkoušky jako téma MeSH
• kognitivní poruchy komplikace   diagnostické zobrazování   farmakoterapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• neuropsychologické testy MeSH
• Parkinsonova nemoc komplikace   diagnostické zobrazování   MeSH
• psychiatrické posuzovací škály MeSH
• radioisotopová scintigrafie MeSH
• radioizotopy jodu farmakokinetika   MeSH
• senioři MeSH
• tropany farmakokinetika   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• 2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane MeSH Prohlížeč
• agonisté dopaminu MeSH
• radioizotopy jodu MeSH
• tropany MeSH

One of the key research agenda of the field of aging is investigation of presymptomatic Alzheimer's disease (AD). Furthermore, abnormalities in brain glucose metabolism (as measured by FDG-PET) have been reported among cognitively normal elderly persons. However, little is known about the association of FDG-PET abnormalities with neuropsychiatric symptoms (NPS) in a population-based setting. Thus, we conducted a cross-sectional study derived from the ongoing population-based Mayo Clinic Study of Aging in order to examine the association between brain glucose metabolism and NPS among cognitively normal (CN) persons aged > 70 years. Participants underwent FDG-PET and completed the Neuropsychiatric Inventory Questionnaire (NPI-Q), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Cognitive classification was made by an expert consensus panel. We conducted multivariable logistic regression analyses to compute odds ratios (OR) and 95% confidence intervals after adjusting for age, sex, and education. For continuous variables, we used linear regression and Spearman rank-order correlations. Of 668 CN participants (median 78.1 years, 55.4% males), 205 had an abnormal FDG-PET (i.e., standardized uptake value ratio < 1.32 in AD-related regions). Abnormal FDG-PET was associated with depression as measured by NPI-Q (OR = 2.12; 1.23-3.64); the point estimate was further elevated for APOE ɛ4 carriers (OR = 2.59; 1.00-6.69), though marginally significant. Additionally, we observed a significant association between abnormal FDG-PET and depressive and anxiety symptoms when treated as continuous measures. These findings indicate that NPS, even in community-based samples, can be an important additional tool to the biomarker-based investigation of presymptomatic AD.

• Klíčová slova
• Agitation, Alzheimer’s disease, FDG-PET, anxiety, apathy, cognitively normal persons, depression, neuroimaging, neuropsychiatric symptoms,
• MeSH
• apolipoproteiny E genetika   MeSH
• deprese diagnostické zobrazování   patofyziologie   MeSH
• fluorodeoxyglukosa F18 metabolismus   MeSH
• kognice fyziologie   MeSH
• kognitivní dysfunkce komplikace   MeSH
• lidé MeSH
• mozek diagnostické zobrazování   MeSH
• neuropsychologické testy MeSH
• pozitronová emisní tomografie MeSH
• průřezové studie MeSH
• psychiatrické posuzovací škály MeSH
• psychomotorický neklid * diagnostické zobrazování   patofyziologie   psychologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stárnutí * MeSH
• úzkost * diagnostické zobrazování   patofyziologie   psychologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• apolipoproteiny E MeSH
• fluorodeoxyglukosa F18 MeSH

Bilingualism (BL) is increasing around the world. Although BL has been shown to have a broad impact-both positive and negative-on language and cognitive functioning, cognitive models and standards are mainly based on monolinguals. If we take cognitive performance of monolinguals as a standard, then the performance of bilinguals might not be accurately estimated. The assessment of cognitive functions is an important part of both the diagnostic process and further treatment in neurological and neuropsychiatric patients. In order to identify the presence or absence of cognitive deficit in bilingual patients, it will be important to determine the positive and/or negative impact of BL properties on measured cognitive performance. However, research of the impact of BL on cognitive performance in neuropsychiatric patients is limited. This article aims to compare the influence of the language (dominant-L1, second-L2) used for assessment of verbal cognitive performance in two cases of bilingual neuropsychiatric patients (English/Czech). Despite the fact that the two cases have different diagnoses, similarities in working memory and verbal learning profiles for L1 and L2 were present in both patients. We expected L1 to have higher performance in all measures when compared with L2. This assumption was partially confirmed. As expected, verbal working memory performance was better when assessed in L1. In contrast, verbal learning showed the same or better performance in L2 when compared with L1. Verbal fluency and immediate recall results were comparable in both languages. In conclusion, the language of administration partially influenced verbal performance of bilingual patients. Whether the language itself influenced low performance in a given language or it was a result of a deficit requires further research. According to our results, we suggest that an assessment in both languages needs to be a component of reasonable cognitive assessment of bilingual patients.

• Klíčová slova
• bilingualism, cross-language comparison, neuropsychiatric disease, verbal cognition,
• MeSH
• dospělí MeSH
• duševní poruchy diagnóza   MeSH
• kognice * MeSH
• krátkodobá paměť * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mnohojazyčnost * MeSH
• neuropsychologické testy MeSH
• verbální učení * 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
• kazuistiky MeSH
• práce podpořená grantem MeSH