Previous functional brain imaging studies have described various and contradictory activation fin... more Previous functional brain imaging studies have described various and contradictory activation findings in patients with panic disorder (PD). Our study focused on patients with a chronic PD, who were investigated and treated in a conventional manner, which represents the real PD patients in clinical practice. Continuing their medication, patients were included in a six-week cognitive-behavioral therapy (CBT) program in the psychiatry department. At the onset of the study, participants underwent clinical evaluation using standard scales and were examined using fMRI while listening to verbal threat-related stimuli contrasted to neutral words. According to the therapeutic outcome, they were subsequently divided into two groups, responders, and nonresponders and the two groups were mutually compared. In non-responders compared to responders, we found increased pre-treatment activation in dorsolateral prefrontal cortex bilaterally, left orbitofrontal cortex, left frontal eye field, right ...
Standardized low-resolution electromagnetic tomography (sLORETA) is a new quantitative EEG method... more Standardized low-resolution electromagnetic tomography (sLORETA) is a new quantitative EEG method for determining distribution of neuronal electrical activity in the form of three-dimensional images of current density of the cerebral cortex. Unlike standard quantitative EEG, it allows noninvasive and detailed localization of neuronal generators responsible for surface EEG with zero localization error. The study aimed at finding electrotomographic differences between patients with panic disorder who respond well to cognitive behavioral therapy (CBT) and those with an inadequate response and to determine factors predicting a response to treatment. The study comprised 24 patients diagnosed with panic disorder with or without agoraphobia (ICD-10 F41.0). The severity of symptoms was measured with the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Sheehan Anxiety Scale, subjective and objective Clinical Global Impression (CGI) and Dissociative Experiences Scale (DES). Addi...
The aim of our study is to measure very low frequency band (VLF), low frequency band (LF) and hig... more 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. 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. 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 betwee...
Alarming somatic symptoms and in particular the cardiovascular symptoms, are the characteristic f... more Alarming somatic symptoms and in particular the cardiovascular symptoms, are the characteristic features of panic attacks. Increased cardiac mortality and morbidity have been proposed in these patients. Power spectral analysis of electrocardiogram R-R intervals is known to be a particularly successful tool in the detection of autonomic instabilities in various clinical disorders. Heart rate variability (HRV) has been found to be the outcome of rapidly reacting cardiovascular control systems. 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 experiment in patients with panic disorder before and after treatment and compares it with healthy controls. We assessed heart rate variability in 19 patients with panic disorder before and after 6-weeks treatment with antidepressants combined with cognitive behavioral therapy (CBT) and in 18 healthy controls. Diagnosis was done acco...
Autonomic nervous system (ANS) dysfunction and reduced heart rate variability (HRV) have been rep... more 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 patients in remission. We recorded cardiac activity and assessed HRV in bipolar outpatients in remission. 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) 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. We found highly statistically sig...
ABSTRACT The letter writing is a psychoterapeutic strategy, which can help to the patients to cop... more ABSTRACT The letter writing is a psychoterapeutic strategy, which can help to the patients to cope with the relationship to the significant people from their childhood.Method The purpose of writing letters is to experience and to understand their own feelings, to cope with strong emotional experiences, which are related to the injuries in the childhood. We present specific examples of the letters from our patients in last 15 years of our experience, when this technique is mainly used in patients with personality disorders, affective and anxiety disorders.ResultsThe letter-writing process is carried out in a safe atmosphere of the therapeutic relationship, where the patients can learn to deal with these emotions. Then the result is a profound change in beliefs about themselves and others. The basic types of therapeutic letters are these four: not censured letter, emphatic letter from the “other side”, the letter to the “inner child” of the significant person and the letter “visit-card”. In not censured letter the patients primarily reflect the negative feelings that hurt them in childhood. The emphatic letter from the “other side” is the ideal answer the patients would have wanted to get away from the significant person; patients formulate the particular wishes and expectations, which meet in a fictional response (encouraging self-confidence, assurance of love, respect). The “visit-card” letter is the censured letter in “adult to adult” mode, written with respect for oneself and significant person, directed towards reconciliation.SupportedBy IGA MZ CR NT 11047-4/2010.
Previous functional brain imaging studies have described various and contradictory activation fin... more Previous functional brain imaging studies have described various and contradictory activation findings in patients with panic disorder (PD). Our study focused on patients with a chronic PD, who were investigated and treated in a conventional manner, which represents the real PD patients in clinical practice. Continuing their medication, patients were included in a six-week cognitive-behavioral therapy (CBT) program in the psychiatry department. At the onset of the study, participants underwent clinical evaluation using standard scales and were examined using fMRI while listening to verbal threat-related stimuli contrasted to neutral words. According to the therapeutic outcome, they were subsequently divided into two groups, responders, and nonresponders and the two groups were mutually compared. In non-responders compared to responders, we found increased pre-treatment activation in dorsolateral prefrontal cortex bilaterally, left orbitofrontal cortex, left frontal eye field, right ...
Standardized low-resolution electromagnetic tomography (sLORETA) is a new quantitative EEG method... more Standardized low-resolution electromagnetic tomography (sLORETA) is a new quantitative EEG method for determining distribution of neuronal electrical activity in the form of three-dimensional images of current density of the cerebral cortex. Unlike standard quantitative EEG, it allows noninvasive and detailed localization of neuronal generators responsible for surface EEG with zero localization error. The study aimed at finding electrotomographic differences between patients with panic disorder who respond well to cognitive behavioral therapy (CBT) and those with an inadequate response and to determine factors predicting a response to treatment. The study comprised 24 patients diagnosed with panic disorder with or without agoraphobia (ICD-10 F41.0). The severity of symptoms was measured with the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Sheehan Anxiety Scale, subjective and objective Clinical Global Impression (CGI) and Dissociative Experiences Scale (DES). Addi...
The aim of our study is to measure very low frequency band (VLF), low frequency band (LF) and hig... more 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. 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. 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 betwee...
Alarming somatic symptoms and in particular the cardiovascular symptoms, are the characteristic f... more Alarming somatic symptoms and in particular the cardiovascular symptoms, are the characteristic features of panic attacks. Increased cardiac mortality and morbidity have been proposed in these patients. Power spectral analysis of electrocardiogram R-R intervals is known to be a particularly successful tool in the detection of autonomic instabilities in various clinical disorders. Heart rate variability (HRV) has been found to be the outcome of rapidly reacting cardiovascular control systems. 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 experiment in patients with panic disorder before and after treatment and compares it with healthy controls. We assessed heart rate variability in 19 patients with panic disorder before and after 6-weeks treatment with antidepressants combined with cognitive behavioral therapy (CBT) and in 18 healthy controls. Diagnosis was done acco...
Autonomic nervous system (ANS) dysfunction and reduced heart rate variability (HRV) have been rep... more 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 patients in remission. We recorded cardiac activity and assessed HRV in bipolar outpatients in remission. 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) 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. We found highly statistically sig...
ABSTRACT The letter writing is a psychoterapeutic strategy, which can help to the patients to cop... more ABSTRACT The letter writing is a psychoterapeutic strategy, which can help to the patients to cope with the relationship to the significant people from their childhood.Method The purpose of writing letters is to experience and to understand their own feelings, to cope with strong emotional experiences, which are related to the injuries in the childhood. We present specific examples of the letters from our patients in last 15 years of our experience, when this technique is mainly used in patients with personality disorders, affective and anxiety disorders.ResultsThe letter-writing process is carried out in a safe atmosphere of the therapeutic relationship, where the patients can learn to deal with these emotions. Then the result is a profound change in beliefs about themselves and others. The basic types of therapeutic letters are these four: not censured letter, emphatic letter from the “other side”, the letter to the “inner child” of the significant person and the letter “visit-card”. In not censured letter the patients primarily reflect the negative feelings that hurt them in childhood. The emphatic letter from the “other side” is the ideal answer the patients would have wanted to get away from the significant person; patients formulate the particular wishes and expectations, which meet in a fictional response (encouraging self-confidence, assurance of love, respect). The “visit-card” letter is the censured letter in “adult to adult” mode, written with respect for oneself and significant person, directed towards reconciliation.SupportedBy IGA MZ CR NT 11047-4/2010.
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