Markers of predicting discharge from forensic psychiatric hospitals in Czechia.

BACKGROUND: Secure forensic hospital treatments are resource-intensive, aiming to rehabilitate offenders and enhance public safety. While these treatments consume significant portions of mental health budgets and show efficacy in some countries, their effectiveness in Czechia remains underexplored. Previous research has highlighted various factors influencing the likelihood of discharge from these institutions. Notably, the role of sociodemographic variables and the length of stay (LoS) in the context of forensic treatments has presented inconsistent findings across studies. METHODS: The study, part of the 'Deinstitutionalization project' in Czechia, collected data from all inpatient forensic care hospitals. A total of 793 patients (711 male, 79 female and 3 unknown) were included. Data collection spanned 6 months, with tools like HoNOS, HoNOS-Secure, MOAS, HCR-20V3 and AQoL-8D employed to assess various aspects of patient health, behaviour, risk and quality of life. RESULTS: The study revealed several determinants influencing patient discharge from forensic hospitals. Key assessment tools, such as HoNOS secure scores and the HCR-20 clinical subscale, showed that higher scores equated to lower chances of release. Furthermore, specific diagnoses like substance use disorder increased discharge odds, while a mental retardation diagnosis significantly reduced it. The type of index offense showed no influence on discharge decisions. CONCLUSION: Factors like reduced risk behaviours, absence of mental retardation diagnosis, social support and secure post-release housing plans played significant roles. The results underscored the importance of using standardized assessment tools over clinical judgement. A standout insight was the unique challenges faced by patients diagnosed with mental retardation, emphasizing a need for specialized care units or tailored programmes.

Aging Brain from a Lifespan Perspective.

Research during the last two decades has shown that the brain undergoes continuous changes throughout life, with substantial heterogeneity in age trajectories between regions. Especially, temporal and prefrontal cortices show large changes, and these correlate modestly with changes in the corresponding cognitive abilities such as episodic memory and executive function. Changes seen in normal aging overlap with changes seen in neurodegenerative conditions such as Alzheimer's disease; differences between what reflects normal aging vs. a disease-related change are often blurry. This calls for a dimensional view on cognitive decline in aging, where clear-cut distinctions between normality and pathology cannot be always drawn. Although much progress has been made in describing typical patterns of age-related changes in the brain, identifying risk and protective factors, and mapping cognitive correlates, there are still limits to our knowledge that should be addressed by future research. We need more longitudinal studies following the same participants over longer time intervals with cognitive testing and brain imaging, and an increased focus on the representativeness vs. selection bias in neuroimaging research of aging.

Fetal influence on the human brain through the lifespan.

Human fetal development has been associated with brain health at later stages. It is unknown whether growth in utero, as indexed by birth weight (BW), relates consistently to lifespan brain characteristics and changes, and to what extent these influences are of a genetic or environmental nature. Here we show remarkably stable and lifelong positive associations between BW and cortical surface area and volume across and within developmental, aging and lifespan longitudinal samples (N = 5794, 4-82 y of age, w/386 monozygotic twins, followed for up to 8.3 y w/12,088 brain MRIs). In contrast, no consistent effect of BW on brain changes was observed. Partly environmental effects were indicated by analysis of twin BW discordance. In conclusion, the influence of prenatal growth on cortical topography is stable and reliable through the lifespan. This early-life factor appears to influence the brain by association of brain reserve, rather than brain maintenance. Thus, fetal influences appear omnipresent in the spacetime of the human brain throughout the human lifespan. Optimizing fetal growth may increase brain reserve for life, also in aging.

Subtypes of brain change in aging and their associations with cognition and Alzheimer's disease biomarkers.

Structural brain changes underly cognitive changes in older age and contribute to inter-individual variability in cognition. Here, we assessed how changes in cortical thickness, surface area, and subcortical volume, are related to cognitive change in cognitively unimpaired older adults using structural magnetic resonance imaging (MRI) data-driven clustering. Specifically, we tested (1) which brain structural changes over time predict cognitive change in older age (2) whether these are associated with core cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers phosphorylated tau (p-tau) and amyloid-ß (Aß42), and (3) the degree of overlap between clusters derived from different structural features. In total 1899 cognitively healthy older adults (50 - 93 years) were followed up to 16 years with neuropsychological and structural MRI assessments, a subsample of which (n = 612) had CSF p-tau and Aß42 measurements. We applied Monte-Carlo Reference-based Consensus clustering to identify subgroups of older adults based on structural brain change patterns over time. Four clusters for each brain feature were identified, representing the degree of longitudinal brain decline. Each brain feature provided a unique contribution to brain aging as clusters were largely independent across modalities. Cognitive change and baseline cognition were best predicted by cortical area change, whereas higher levels of p-tau and Aß42 were associated with changes in subcortical volume. These results provide insights into the link between changes in brain morphology and cognition, which may translate to a better understanding of different aging trajectories.

The Updating and Individualizing of Sleep Hygiene Rules for Non-clinical Adult Populations.

Sleep hygiene is essential for the prevention of somatic and mental disorders, including the prevention of sleep disorders. However, it does not typically address individual differences. The aim of this review is threefold: first, to outline the empirical evidence for particular components of sleep hygiene rules; second, to indicate the importance of individualized sleep hygiene application with regard to the varying degree of validity of sleep hygiene rules in the population; third, to highlight a new field of sleep hygiene, namely light hygiene. PubMed and Google Scholar were used to identify studies that were published between 2007 and 2022. A search was conducted for studies related to sleeping rules topics: sleep regularity, regular exercise, alcohol, caffeine, napping, relaxation and meditation, food intake and light exposure. In applying these sleep hygiene principles, it is essential to pay attention to individual variables such as age, genetic predisposition, health status, and substance (caffeine, alcohol) possible dependence.

The Associations of Adverse Childhood Experiences (ACEs) With Substance Use in Young Adults: A Systematic Review.

Introduction: Young adulthood is a transitional period between adolescence and adulthood. Due to the unique pressures of taking on a new social role and associated uncertainties, young adults are at heightened risk for drug and alcohol use. Furthermore, adverse childhood experiences (ACEs) increases the likelihood of using maladaptive coping strategies such as using substances to avoid or soothe negative emotions. The current review aimed to summarize the associations between exposure to ACEs before the age of 18 years and subsequent drug or alcohol use between the ages of 18 and 25 years. Methods: The review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search of the Web of Science, PubMed, and PsycINFO databases was conducted in February 2022. Results: The initial search yielded 7178 articles, with 777 duplicates. Consequently, 6401 titles were inspected for relevance. After reading the full text, 88 articles were included in the review. Conclusion: This review provides clear evidence that exposure to multiple ACEs is a robust risk factor for the use of alcohol, cannabis and other drugs by young adults. Poor self-regulation and maladaptive coping strategies were identified as mechanisms explaining this link; however, further detailed research is needed.

A Review Article on Exercise Intolerance in Long COVID: Unmasking the Causes and Optimizing Treatment Strategies.

There is a growing body of research on SARS-CoV-2 (PASC), previously known as the post-COVID syndrome, a chronic condition characterized by symptoms that persist after SARS-CoV-2 infection. Among these symptoms, feelings of physical exhaustion and prolonged fatigue are particularly prevalent and can significantly impact patients' quality of life. These symptoms are associated with reduced overall physical capacity, decreased daily physical activity, malaise after intense training, and intolerance to physical activity (IFA). IFA, described as a reduced ability to perform physical activities typical for the patient's age, can often lead to a sedentary lifestyle. Prolonged physical inactivity can cause deterioration in the overall physical condition and disrupt mitochondrial function, triggering a vicious cycle of gradual symptom worsening. The underlying causes of PASC remain unclear; however, several biochemical mechanisms have been discussed to explain the body's energy depletion, and a multidisciplinary approach that combines physical and cognitive rehabilitation and lifestyle interventions such as exercise and diet modifications has been suggested to improve the overall health and well-being of PASC patients. This critical review aims to review the existing research on the possible causes and links among chronic fatigue, reduced physical activity, and exercise intolerance in patients with PASC. Further research into the underlying causes and treatment of PASC and the importance of developing individualized treatment is needed to address each patient's unique health requirements.

Matrix metalloproteinases are associated with brain atrophy in cognitively unimpaired individuals.

Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) have been linked to age-related neurodegeneration and Alzheimer's disease (AD), but their role in normal aging is poorly understood. We used linear mixed models to determine if baseline or rate of yearly change in cerebrospinal fluid (CSF) levels of MMP-2; MMP-3; MMP-10; TIMP-123 (composite of TIMP-1, TIMP-2, and TIMP-3); or TIMP-4 predicted changes in bilateral entorhinal cortex thickness, hippocampal volume, or lateral ventricle volume in cognitively unimpaired individuals. We also assessed effects on the CSF AD biomarkers amyloid-ß42 and phosphorylated tau181. Low baseline levels of MMP-3 predicted larger ventricle volumes and more entorhinal cortex thinning. Increased CSF MMP-2 levels over time predicted more entorhinal thinning, hippocampal atrophy, and ventricular expansion, while increased TIMP-123 over time predicted ventricular expansion. No MMP/TIMPs predicted changes in CSF AD biomarkers. Notably, we show for the first time that longitudinal increases in MMP-2 and TIMP-123 levels may predict age-associated brain atrophy. In conclusion, MMPs and TIMPs may play a role in brain atrophy in cognitively unimpaired aging.

Artificial Intelligence: Deciphering the Links between Psychiatric Disorders and Neurodegenerative Disease.

Artificial Intelligence (AI), which is the general term used to describe technology that simulates human cognition [...].

Associations of neuroinflammatory IL-6 and IL-8 with brain atrophy, memory decline, and core AD biomarkers - in cognitively unimpaired older adults.

Concentrations of pro-inflammatory cytokines -interleukin-6 (IL-6) and interleukin-8 (IL-8) - are increased with age and in Alzheimer's disease (AD). It is not clear whether concentrations of IL-6 and IL-8 in the central nervous system predict later brain and cognitive changes over time nor whether this relationship is mediated by core AD biomarkers. Here, 219 cognitively healthy older adults (62-91 years), with baseline cerebrospinal fluid (CSF) measures of IL-6 and IL-8 were followed over time - up to 9 years - with assessments that included cognitive function, structural magnetic resonance imaging, and CSF measurements of phosphorylated tau (p-tau) and amyloid-ß (Aß-42) concentrations (for a subsample). Higher baseline CSF IL-8 was associated with better memory performance over time in the context of lower levels of CSF p-tau and p-tau/Aß-42 ratio. Higher CSF IL-6 was related to less CSF p-tau changes over time. The results are in line with the hypothesis suggesting that an up-regulation of IL-6 and IL-8 in the brain may play a neuroprotective role in cognitively healthy older adults with lower load of AD pathology.

Independent and sensory human mitochondrial functions reflecting symbiotic evolution.

The bacterial origin of mitochondria has been a widely accepted as an event that occurred about 1.45 billion years ago and endowed cells with internal energy producing organelle. Thus, mitochondria have traditionally been viewed as subcellular organelle as any other - fully functionally dependent on the cell it is a part of. However, recent studies have given us evidence that mitochondria are more functionally independent than other organelles, as they can function outside the cells, engage in complex "social" interactions, and communicate with each other as well as other cellular components, bacteria and viruses. Furthermore, mitochondria move, assemble and organize upon sensing different environmental cues, using a process akin to bacterial quorum sensing. Therefore, taking all these lines of evidence into account we hypothesize that mitochondria need to be viewed and studied from a perspective of a more functionally independent entity. This view of mitochondria may lead to new insights into their biological function, and inform new strategies for treatment of disease associated with mitochondrial dysfunction.

Burnout syndrome in the Czech Republic: The decreasing trend over the years.

Introduction: Burnout syndrome is a state of long-term work exhaustion that manifests on three levels: cognitive, physical and emotional. Research regarding burnout syndrome has spiked in recent years. Despite burnout syndrome not being a clinical diagnosis, it has been recognized as a significant reason for work absence or, in some cases, even work leave. This study examines trends in burnout in the Czech population. The main aim of this research was to fill in the burnout literature gap and document the burnout trend over the years. Our secondary aim was to see if there is awareness regarding burnout syndrome and whether, over the years, we will see an increasing or a decreasing trend in burnout prevalence. Methods: Data collection took place in three waves using the computer assisted web interviewing (CAWI) method. In 2014 n = 1,027, in 2017 n = 1,024, and in 2020 n = 1,000. Respondents were selected from the European National Panel. Because the target group was adults (18-65 years), an online survey was chosen. Internet penetration in this target population is sufficient, and it was not necessary to use a combination of methodologies. Results: The results suggest a decreasing tendency for burnout syndrome in the Czech Republic. Knowledge about burnout syndrome is increasing, suggesting that people are paying more attention to their mental health and the possible factors that might affect the severity of burnout syndrome. Conclusion: Overall, burnout threatens the general population, not only medical employees. It is a positive finding that over the years, there has been an increasing trend in awareness about burnout. It further shows that people have adopted certain precautions and steps to avoid burnout syndrome as the perceived threat from it gradually decreases.

The effectiveness of gluten-free dietary interventions: A systematic review.

Celiac disease is a chronic autoimmune gastroenterological disorder in which the digestion of gluten leads to damage and constant inflammation in the small intestine. Moreover, there are associated physical and mental health problems related to celiac disease, i.e., a lower health-related quality of life and increased depression and anxiety symptoms. The only effective treatment for celiac disease is lifelong adherence to a gluten-free diet. However, researchers suggest that strict adherence to a gluten-free diet ranges from 42 to 80%, depending on the definition and method of assessment that was utilized. This review examines interventions designed for those who need to adhere to life-long dietary measures and their success in terms of increasing gluten-free dietary adherence and improving their health-related quality of life. In April 2022, the Scopus, Web of Science, PubMed and ProQuest databases were searched using the following terms: "coeliac disease" OR "celiac disease" AND "gluten free diet" AND "intervention" AND "health related quality of life" AND "diabetes." Eight studies were suitable for this review. The studies were used to analyze different intervention techniques and their impact on gluten-free dietary adherence, quality of life, and the reasons for dietary nonadherence. The studies revealed statistically significant improvements in the knowledge base regarding celiac disease and the gluten-free diet, dietary adherence and quality-of-life satisfaction immediately after the intervention and at a three-month follow-up. Some studies were also focused on behavioral and cognitive aspects of nonadherence to dietary measures.

Psychometric Properties of the Czech Version of the Vanderbilt ADHD Diagnostic Parent Rating Scale.

This study examined the psychometric properties of the Czech translation of the Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS), a tool used to assess ADHD symptoms. Data was collected online from parents of school-aged children and included questions related to their child's diagnosis or treatment. The results showed that while relying on professional judgment improved specificity and positive predictive value, it decreased negative predictive value. These findings indicate that the VADPRS scale is more accurate in identifying individuals with ADHD when professionals provide the diagnosis, but fewer true negatives are found. This is the first study attempting to describe the psychometric properties of this tool in the Czech Republic and assess its use as an additional tool for ADHD diagnosis. It is recommended that structured clinical interviews be used to increase the accuracy of ADHD diagnosis.

Potential Prion Involvement in Long COVID-19 Neuropathology, Including Behavior.

Prion' is a term used to describe a protein infectious particle responsible for several neurodegenerative diseases in mammals, e.g., Creutzfeldt-Jakob disease. The novelty is that it is protein based infectious agent not involving a nucleic acid genome as found in viruses and bacteria. Prion disorders exhibit, in part, incubation periods, neuronal loss, and induce abnormal folding of specific normal cellular proteins due to enhancing reactive oxygen species associated with mitochondria energy metabolism. These agents may also induce memory, personality and movement abnormalities as well as depression, confusion and disorientation. Interestingly, some of these behavioral changes also occur in COVID-19 and mechanistically include mitochondrial damage caused by SARS-CoV-2 and subsequenct production of reactive oxygen species. Taken together, we surmise, in part, long COVID may involve the induction of spontaneous prion emergence, especially in individuals susceptible to its origin may thus explain some of its manesfestions post-acute viral infection.

Prevalence of ADHD Symptomatology in Adult Population in the Czech Republic: A National Study.

BACKGROUND: ADHD is a common neurodevelopmental disorder frequently diagnosed between the ages 7 and 10 years. We measured ADHD symptomatology in a representative sample of the Czech population. MATERIAL AND METHODS: Data collection was performed in January 2019 through the European National Panel. The respondents completed a demographic questionnaire focusing on ADHD history and a standardized questionnaire, the Adult ADHD Self-Report Scale (ASRS) screener for ADHD symptomatology in adulthood. RESULTS: From the sample of 1,518 respondents, 3% of the respondents reported having been diagnosed with ADHD/hyperkinetic disorder in their lifetime. According to ASRS scoring, 119 respondents were classified as suspected ADHD. Overall, more males than females reported ADHD symptomatology. Age was also significantly associated with ASRS. Education status yielded no significant results. CONCLUSION: Our study documents that the prevalence of ADHD symptomatology in adults is comparable with that in Western countries despite the different historical and health care backgrounds.

Childhood School Performance in Adults Diagnosed with Attention-Deficit/Hyperactivity Disorder.

OBJECTIVE: Children with ADHD often tend to underperform in school. This partial study aimed to find out if the school experience of adults with higher ADHD symptomatology differs from those with lower and no ADHD symptomatology. METHOD: Based on the results of ASRS questionnaires, the respondents were divided into three groups (low, medium, and high) according to the manifested ADHD symptomatology. We explored their school experiences by looking at their grades for behavior at school, notes regarding their attendance, school expulsion, and other school experiences. RESULTS: Children with higher ADHD symptomatology were significantly more likely to be expelled, receive notes for bad behavior, disturbing or forgetting as well as receive reprimands from teachers. CONCLUSION: Our results show that children with increased ADHD symptomatology experience more difficulties with school behavior, they are frequently reprimanded, and they do receive more negative feedback regarding their attendance and tardiness from teachers.

Electroconvulsive therapy portrayal in contemporary video games.

Electroconvulsive therapy (ECT) is an important treatment modality in psychiatry, considered to be the most effective option for pharmaco-resistant affective and psychotic disorders. Despite its great efficacy, it still remains a rather controversial method, which hinders its full potential. It is feasible to say that in part, this controversy is caused by a largely negative image of ECT displayed through media. The depiction of ECT in movies has been studied and well documented in the past. The aim of our study was to provide an overview of how ECT is represented in video games - a form of media where ECT representation has been overlooked in scientific literature so far. As with movies, most of these portrayals are negative, depicting ECT as an obsolete, aggressive or torturous treatment method.

Post-Injection Delirium/Sedation Syndrome: A Case Report and 2-Year Follow-Up.

BACKGROUND Long-acting injectable (LAI) antipsychotics are one of the forms of therapy for severe mental illness. Post-injection delirium/sedation syndrome (PDSS) is a very rare but serious adverse effect following the application of an olanzapine in a long-acting form. The most common symptoms of the syndrome are sedation, delirium, dysarthria, ataxia, extrapyramidal symptoms, agitation, dizziness, or seizure. The predispositions, prevention, and exact mechanism of PDSS remain unclear. CASE REPORT We present a case report of a 30-year-old male patient experiencing PDSS, including the main symptoms of PDSS, diagnostic methods, olanzapine plasma concentrations, therapeutic process, and outcome. We then include a follow-up of the patient 2.5 years later. The patient did not have any long-term damage, had no disabilities, and no post-traumatic stress disorder following the event. We include information about his current medications, further use of LAI antipsychotics, and update about his everyday life. CONCLUSIONS PDSS is a life-threatening condition clinicians must be aware of, and the easiest precaution is a 3-h observation after the application of an injection. Because the predispositions, prevention, and exact mechanism of PDSS remains unclear, it is very important to report the rare cases of PDSS and conduct further research for the safety of our patients. The follow-up of the patient showed that the patient is doing well, he has no post-traumatic stress disorder following the event, and he did continue to use LAI antipsychotic medication.

HIV, HSV, SARS-CoV-2 and Ebola Share Long-Term Neuropsychiatric Sequelae.

Long COVID, in which disease-related symptoms persist for months after recovery, has led to a revival of the discussion of whether neuropsychiatric long-term symptoms after viral infections indeed result from virulent activity or are purely psychological phenomena. In this review, we demonstrate that, despite showing differences in structure and targeting, many viruses have highly similar neuropsychiatric effects on the host. Herein, we compare severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), human immunodeficiency virus 1 (HIV-1), Ebola virus disease (EVD), and herpes simplex virus 1 (HSV-1). We provide evidence that the mutual symptoms of acute and long-term anxiety, depression and post-traumatic stress among these viral infections are likely to result from primary viral activity, thus suggesting that these viruses share neuroinvasive strategies in common. Moreover, it appears that secondary induced environmental stress can lead to the emergence of psychopathologies and increased susceptibility to viral (re)infection in infected individuals. We hypothesize that a positive feedback loop of virus-environment-reinforced systemic responses exists. It is surmised that this cycle of primary virulent activity and secondary stress-induced reactivation, may be detrimental to infected individuals by maintaining and reinforcing the host's immunocompromised state of chronic inflammation, immunological strain, and maladaptive central-nervous-system activity. We propose that this state can lead to perturbed cognitive processing and promote aversive learning, which may manifest as acute, long-term neuropsychiatric illness.