Libuse Starkova

V průběhu poslednich několika desetileti se významně prohloubil nas pohled na poruchy přijmu potravy. Cilem clanku je přibližit soucasne poznatky o původu, zakladni charakteristice a lecbě nemoci, jejichž reprezentanty jsou mentalni anorexie a bulimie.

The authors present the results of their catamnestic evaluation of the first few patients (diagnosis of schizophreny; atrophic process posttraumatic and Alzheimer's dementia), in whom implantation of neuronal embryonal tissue into the brain was performed in the last few years. They warn against excessive publicity and optimistic appraisal by neurosurgeons because psychiatric examinations after some time fail to confirm the success of the operation.

The authors report on the administration of incisive neuroleptic drugs in child psychiatry. The drugs were applied in schizophreny, obsessive syndromes and especially in tics. They administered pimozide, haloperidol, penfluridol and isofloxythepin. The results were often better than in the case of sedatives. The authors believe that incisive neuroleptic drugs deserve greater application in these indications as well as in child psychiatry.

The authors report their own experiences of treatment with incisive neuroleptic drugs in child psychiatry (haloperidol, pimozide, penfluridol, sulpiride). An attention was paid to side effects of the treatment, especially to a possible side effect of cardiovascular character, namely that pimozide might block Ca channels. The authors made a control check of ECG and report the findings. The results of the treatment of various disorders (tic disorders, psychosis, obsessive- compulsive diseases, autism) are very good. The authors never came across the picture of serious side effects e.g. of tardive dyskinesis.

Kanner's infantile autism is conceived as a psychosis of early childhood manifested clinically as schizophrenic syndrome with dominating extreme spontaneous isolation of the child (autism). The authors attempted a catamnestic investigation of 20 patients where their diagnosis was made during hospitalization. In 17 cases it was possible to confirm this diagnosis after a certain time interval, in two patients oligophrenia was confirmed and only in one child disharmonious personality development. In patients with a confirmed diagnosis of Kanner's infantile autism the actual psychopathology of rational abilities was tested (a defective intellect was confirmed in all investigated children), social relations of the patients and the level of speech development. Attention was also paid to psychopharmacotherapy. The majority of junior patients, but only four of the senior patients, are in families. Senior patients and sometimes also preschool children with partial speech development are in social care institutions where the defect of the disease proper is potentiated by negative aspects of the asylum. Kanner's infantile autism is a serious disease which affects the entire mental development of the child, not only the emotional development. In the sphere of therapy, and in particular psychopharmacotherapy, much remains to be done, psychiatric intervention is frequently only at the diagnostic and follow-up level of the disease.

The authors have made an anonymous survey among Czechoslovak psychiatrists on the prescription of psychopharmaca in select psychiatric diagnoses. The first place is occupied by haloperidol, perfenazin and chlorpromazine in hallucinatory paranoid syndromes, amitriptyline and clomipramine in depressions. The authors also wanted to find out which drugs were regarded as unsuitable by each psychiatrist. The replies varied considerably. In comparison with a similar survey made ten years ago, the methods of treatment relatively persist and novelties are rather wished for than really administered.

The development of child neuroses must have certain rerequisites, in particular disposition (temperamental characteristic), an adverse situation in early childhood and a provoking conflict proper or a traumatic situation. To hysterical neuroses apply similar findings as to these disorders in adults; a hysterical neuroses is not always evidence of a hysterical nature. Psychogenic disorders in children may differ, the character of these complaints is not always typical. The complexity of the diagnostic process is demonstrated on two case--histories from which it is apparent that long--term treatment and examinations in somatic departments do not rule out the detection of the psychogenic aetiology of the somatic disorder. The first case--history is that of a twelve-year-old girl treated from the age of two years with antiepileptic drugs, in recent years the condition is compensated without treatment. After a conflict with a girl friend she developed pain in the hip joint which eventually resulted in the inability of spontaneous movement. After several months hospitalization at the orthopaedic department she was transferred to the psychiatric department where after hypnotherapy the conversion syndrome receded but the patient developed another psychopathological syndrome, impaired sexual identification. The second case--history is that of a twelve-year-old boy a re-trained left-handed with manifestations of balbuties. On account of sudden manifestations of torticollis leading to prolonged absence at school he repeated the class, for another three years he was treated by neurologists without effect. After admission to the psychiatric department he was treated by psychotherapy and placebo with a marked effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Tics belong to the most frequent hyperkineses of child age. Their prevalence is reported as 4-28%. In our literature tics are still listed in the group of child neuroses although their organic aetiology is generally accepted. Tics are considered a continuum of complaints from transient tics in childhood to Touretté's disease (Gilles de la Tourette syndrome). As part of a catamnestic investigation 131 children with tics were followed up, all hospitalized at the paediatric department of the psychiatric clinic in Olomouc in 1968-1988. A prognostic evaluation was possible in 63 patients at the age of 15-29 years (group B). In the majority of patients the tics manifested themselves first at the age of cca 7 years. The group comprised a large percentage of children with the diagnosis ADDH (58.9%). Dynamic comparison revealed that in recent years the number of children in this group with tics increased. Evaluation of the therapeutic approach before hospital admission during hospitalization and during subsequent ambulatory treatment provided evidence of the further development of the disease, as the development of symptoms and increasing impact of psychosocial consequence frequently called for administration of incisive neuroleptics in ambulatory treatment, administered in subsequent years. The greatest proportion of patients terminated ambulatory treatment at the age of 10-15 years which, however, did not reflect regression of complaints. Prognostic evaluation provided evidence that 38% of the patients recovered completely by the time of the check-up examination, 62% have occasional complaints (relapses persisting for several days), only 14% have permanent manifestations of tics. Some patients need event in adult age prolonged maintenance pharmacotherapy.

Prace hovoři o zkusenostech s metylfenidatem v lecbě ADHD (hyperkineticka porucha), ziskaných za 10 let prace v ambulanci. Popisuje cestu od opatrných kroků na pocatku k běžne preskribci metylfenidatu v soucasnosti. Metylfenidat byl použit v monoterapii i v lekove kombinaci. Prace je doplněna kazuistikami.

Bariatricka chirurgie je relativně novým oborem, který řesi morbidni obezitu chirurgickými prostředky. Cilem clanku je poskytnout informace o teto rychle se rozvijejici medicinske disciplině a diskutovat otazky, ktere se týkaji psychiatricko-psychologických souvislosti vcetně poruch přijmu potravy.

Dusevni porucha způsobuje stigmatizaci. Důsledkem stigmatizace je diskriminace. Destigmatizace a zlepseni kvality pece se staly jednim z hlavnich temat psychiatrie v poslednich deseti letech. Jak je to ale se stigmatizaci u děti a adolescentů, kteři trpi psychickou poruchou? Cilem prace je přinest přehled zakladnich informaci o stigmatizaci v pedopsychiatrii a zamyslet se nad jejimi důsledky i cestami prevence.

This study describes the range of service provision and explores differences in treatment approaches and therapeutic aims, in the 12 countries participating in the European Union collaborative COST B6 Adolescent Project into the treatment of adolescent anorexia nervosa (AN). Following a number of group meetings, two questionnaires were administered, completed and returned by e‐mail. The first questionnaire examined features of the services provided, including details of the numbers of patients seen, inpatient admission criteria and aspects of patient management. The second questionnaire contained a list of 13 therapeutic aims, asking respondents to rank in order the six they considered most important in the first weeks of treatment. There was broad agreement between services concerning the need to offer a full spectrum of services in a range of settings. Nevertheless, there were significant differences in approaches, chiefly concerning the readiness to admit to hospital, the use of ...