Power spectral analysis of electrocardiogram is known to be a particularly successful tool in detection of autonomic instabilities in various disorders. The aim of 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 controls. Methods: We measured HRV in 31 panic disorder patients and 20 healthy controls. Patients were treated with psychotropics. Autonomic nervous system has been evaluated during orthostatic change in three positions (1 st-supine 5 minutes, 2 nd-standing 5 minutes, 3 rd-supine 5 minutes). Intensity of symptoms was assessed using CGI (Clinical Global Impression), BAI (Beck Anxiety Inventory) and BDI (Beck Depression Inventory), DES (Dissociative Experience Scale). The functioning of the ANS has been measured by the microcomputer diagnostic system that is using power spectral analysis which quantifies the heart rate variability. HRV was assessed using time domain, frequency domain, and nonlinear analyses. Results: There were highly statistically significant differences between panic patients and control group in all components of power spectral analysis in 2 nd and 3 rd VLF components and in HF components of 2 nd of experiment. We have found highly statistically significant negative correlations between level of dissociation measured by DES and some parameters of ANS. Conclusions: 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.

Host of studies have now examined QoL in patients with major depressive disorder and schizophrenia until recently few had specifically focused upon QoL in patients with bipolar disorder. The purpose of the present study was to find out the QoL data in patients suffering from bipolar disorder in clinical remission and examine the extent of the effects of the demographical and clinical data on QoL in these patients. The second aim was to compare the QoL data with the data of patients suffering from schizophrenia in clinical remission and with healthy controls. Data were obtained by using the quality of life questionnaire (Quality of Life Enjoyment and Satisfaction-Q-LES-Q) for 41 bipolar patients in clinical remission. The data of these subjects were compared with the data of 40 schizophrenic patients in clinical remission and with 40 healthy controls. There are statistically significant difference in comparison with schizophrenic patients, but not in comparison with healthy controls. There were higher mean scores in most Q-LES-Q summary scales in patients with bipolar disorder in comparison with schizophrenic patients and in some summary scales in comparison with healthy controls. Our results suggest the same or higher subjective quality of life in patients suffering with bipolar disorder in clinical remission in comparison with healthy controls and higher subjective quality of life in bipolar patients in clinical remission in comparison with schizophrenic patients in clinical remission.

There is a high prevalence of delirium in surgery intensive care unit (SICU) patients. We need to identify modifiable risk factors for prolongation of delirium in the surgery intensive unit (SICU). Methods: There was a prospective cohort study in setting of 12 bed surgery intensive care unit in university hospital. Patients were 140 consecutive delirious patients of mean age 68.21 + 12.07 years. The main outcome measure was duration of SICU delirium. We evaluated time, person, place orientation, situation and aggression at least 6 times a day. Some of the somatic parameters was measured continually-blood pressure (IBP), heart rate, respiratory rate, peripheral blood oxygen saturation. Other parameters such as body temperature were monitored every 1-4 hours. The laboratory blood tests were taken every day, they included: sodium, potassium, chlorides and phosphorus level, urea and creatinine level, hematokryt, red and white blood cell count, CRP, proteins, albumin, laboratory markers of renal and liver dysfunction. Results: Delirium occurred in 140 of 5642 patients (2.48 %). Most subjects with delirium had improvements in delirium following treatment in range of 12 to 240 hours with median of 48 hours and mean 65.61+38.09 hours. Statistical analysis shows that hyperactive subtyp of delirium, using of antipsychotics, alcohol abuse anamnesis, low level of potassium, were associated with increased delirium duration. Nevertheless there were statistically significant differences between duration of delirium in patients with and without hypotension and with and without alcohol abuse.

Background: Autonomic nervous system (ANS) dysfunction and reduced heart rate variability (HRV) have been reported in a wide variety of psychiatric disorders, but have not been well characterized in bipolar patiens in remission. We recorded cardiac activity and assessed HRV in bipolar outpatients in remission. Aims: Ascertain if ANS decrease with the age of the patient; ascertain relation between activity of ANS and level of dissociation, and other components (age of patients, and age of disorder, dosage of psychotropic medication). Methods: Autonomic nervous system (ANS) has been evaluated during orthostatic change in three positions (1-lie down 5 minutes, 2-stand up 5 minutes, 3-lie down 5 minutes). The functioning of the ANS has been measured by the diagnostic systems that are using the power spectral analysis which quantifies the heart rate variability (HRV) was assessed using time domain, frequency domain, and nonlinear analyses in 23 bipolar patients in remission. Results: We found highly statistically significant negative correlations between level of dissociation measured by DES and most of 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. Conclusions: Autonomic dysregulation is associated with bipolar disorder in remission and has relation to level of dissociation and probably to age of patiens and age of onset and duration of disorder.

According to recent findings, certain clinical symptoms of the patients suffering from affective and anxiety disorder can be related to dissociation. The aim of our study is to examine if the level of dissociation in bipolar affective disorder differ from the level of dissociation in healthy volunteers. Methods: 41 patients suffering from bipolar disorder (51.2 % females) and 198 healthy controls (71.2 % females) were included in the study. The patients with bipolar affective disorder in remission of the illness were recruited from the Outpatient psychiatric department of Psychiatry Clinic of University hospital Olomouc. Patients were psychiatrically assessed and the state of the disorder was evaluated by experienced psychiatrist. Only patients in remission of the disorder, evaluated as 1 or 2 points of clinical global impression-severity scale, were included into the study. All participants were assessed with the Dissociative Experiences Scale (DES). Results: The groups didn't differ in demographic variables like age, gender and education. Patients had significantly higher mean score on the DES and pathological DES than healthy controls. Conclusion: Our results suggest that the level of psychological dissociation in bipolar affective patients is higher than in healthy controls.

Background: Patients with obstructive sleep apnoea (OSA) are at increased risk of severe course of COVID-19. Vaccination remains to be the most effective prevention of complicated courses of infection. The best contemporary conservative treatment of OSA is continuous positive airway pressure (CPAP) therapy. Purpose: To compare vaccination acceptance and outcomes of COVID-19 infection between OSA patients adhering to the CPAP therapy and those who rejected CPAP and surgical therapy. Patients and Methods: Subjects were divided into two groups: group A (N = 167) were individuals with sufficient CPAP adherence (more than 4 hours per night on average) over the last 10 years. Group B (N = 106) were individuals who did not use the CPAP therapy at all and had no indications to surgical therapy. Results: Three patients in group B died, and one had a severe course of COVID-19. None of the patients in group A died or experienced a severe course of COVID-19. Group A had a significantly higher proportion of males (77.8% compared to 66% in group B) and all parameters of OSA severity. The vaccination status was similar among both groups, with a complete triple dose vaccination rate of 69.5% and 67.9% in groups A and B, respectively. Conclusion:The results show that the patients with OSA adherent to CPAP therapy were less likely to experience a severe course of COVID-19 or death than the OSA patients non-compliant with therapy, despite the former group having more severe OSA. This result underlines the importance of adherence to CPAP therapy in OSA.

The efficacy of the treatment of personality disorder was repeatedly been reported as less successful than the therapy of patients without personality disorder. Our study is designed to compare the short-term effectiveness of therapy in patient suffering with social phobia with and without personality disorder.MethodThe aim of the study was to asses the efficacy of the 6 week therapeutic program designed for social phobia (SSRIs and CBT) in patients suffering with social phobia and comorbid personality disorder (27 patients) and social phobia without comorbid personality disorder (26 patients). Patients were assessed in week 0, 2, 4, and 6 on the CGI, LSAS, BAI and BDI.ResultsPatients of both two groups improved in assessment instruments. The treatment efficacy in the patients with social phobia without personality disorder had been showed significantly better compared with the group with social phobia comorbid with personality disorder in CGI and LSAS. Also the scores in subjective depression inventory BDI showed significantly higher degrease during the treatment in the group without personality disorder. But the treatment effect between groups did not differ in subjective general anxiety scales BAI.ConclusionThe low frequency rTMS administered over the right dorso-lateral prefrontal cortex after 10sessions did not differ from sham rTMS that was add on serotonin reuptake inhibitors in patients suffering from panic disorder. Further studies are indicated to assess the efficacy of rTMS in panic disorder and to clarify the optimal stimulation characteristics.SupportedBy IGA MZ CR NT 11047-4/2010.

Several controlled studies indicate that cognitive behavioral interventions, in conjunction with antipsychotic medication, reduce positive psychotic symptoms in acute as well as chronic schizophrenia. However, a recent review found that CBT did not reduce relapse and readmission compared to standard care. Nevertheless there is a need for searching for new ways for the CBT therapy for acute psychotic patient.A central claim of narrative therapy is to “narrate” our lives. It means that we form narratives of the past and future these narratives do not only describe but also affect our lives. Psychotic patients have problem-saturated stories and the aim of the therapeutic work is both to articulate negative story and its effects upon the person and then to move on to the constructing and preferred narrative with more positive view on the story and consequently on the self, others and the world The CBT approach from Padesky has been adapted in narrative cognitive behavioral therapy to use with most patients suffering from psychosis. Patients are asked to state any negative beliefs they have about themselves, others, and world, and then are asked to describe how they would prefer all these things to be.In narrative cognitive behavioral approach the therapist searches, yields to surface and stabilize stories that don’t support patients troubleshooting experiencing of the reality, develop alternative stories that lead to new view of things, positive change of themselves - conception and to problem solving that is in contemporary context detected.