Individual, Social, and Environmental Factors Associated with Different Patterns of Stimulant Use: A Cross-Sectional Study from Five European Countries.

INTRODUCTION: Amphetamine-type stimulants (ATSs) are the second most commonly consumed class of illicit drugs globally, but there is limited understanding of the precise factors associated with problematic versus controlled ATS consumption. This exploratory study aimed to identify which individual, social, and environmental factors are associated with different patterns of ATS use over time. METHODS: Cross-sectional surveys were conducted in Germany, England, The Netherlands, Poland, and the Czech Republic via face-to-face computer-assisted personal interviews to collect data on different user groups. 1,458 adults (18+) reported exposure to but no ATS use (n = 339); former rare/moderate ATS use (n = 242); current rare/moderate ATS use (n = 273); former frequent/dependent ATS use (n = 201); current frequent/dependent ATS use (n = 403). Extent of ATS/other substance use was assessed by number of consumption days (lifetime, past year, past month) and Severity of Dependence Scale. To identify factors associated with group membership, data were also collected on previous injecting drug use (IDU) and consumption setting/rules. Psychological distress was measured using the Brief Symptom Inventory, with additional data collected on self-reported adverse life events and physical/mental health. RESULTS: Currently, using frequent/dependent ATS users experienced more frequent unstable living conditions (27.5%) and psychological distress (59.8%) compared to other groups. A multinomial logistic regression showed that currently abstinent rare/moderate users were more likely to abstain from methamphetamine use {odds ratio (OR) = 2.48 (confidence interval [CI] = 1.32-4.68)} and from IDU (OR = 6.33 [CI = 2.21-18.14]), to avoid ATS use during working hours (OR = 6.67 [CI = 3.85-11.11]), and not to use ATS for coping reasons (OR = 4.55 [CI = 2.50-6.67]) compared to the reference group of currently using frequent/dependent users. CONCLUSIONS: People who use ATS frequently and/or at dependent levels are more likely to have experienced social and economic adversity compared to infrequent ATS users. On the other hand, there is a substantial share of users, which show a controlled use pattern and are able to integrate ATS use into their lives without severe consequences.

Health systems in the mirror of international comparisons.

The international comparison of health systems is a frequently used tool of health policy. It assumes that international experiences are, at least to some extent, transferable from one country to another. The aim of this article is to review selected methods of international comparison of health systems. At the same time, we ask the question of how useful each method is for the evaluation of the Czech health system.

Making the hospital care in the Czech Republic more effective through volunteering.

Volunteering in the health sector contributes to improving the quality of services and has positive benefits for the volunteers themselves and the health service providers, and especially for patients and their families, as well as for society. The aim of this article is to summarize the main findings of the evaluation of the project Efficiency of the hospital care system in the Czech Republic through volunteering (CZ.03 .3.X/0.0/0.0/15_018/0007517), which was implemented between 2019 and 2023 by the Ministry of Health of the Czech Republic. The evaluation of the project was based on a combination of quantitative research (questionnaire surveys focused on the target groups of the project) and qualitative methods (individual and group interviews). The internal and external impact evaluation of the project shows significant changes in the short term for patients and their family members who use volunteering in healthcare, as well as for healthcare professionals and providers. The development of volunteering in healthcare and its effective coordination is a suitable and proven tool to support and improve the psychosocial aspect of care for hospitalized patients and a way to achieve the desired goals of the healthcare system.

Seasonal and weekly fluctuations in alcohol use in the Czech Republic.

Sezónní a týdenní výkyvy v uzívání alkoholu patrí mezi doposud neanalyzované aspekty epidemiologického výzkumu uzívání alkoholu ceskou dospelou populací. Cílem studie je nabídnout deskriptivní a analytický pohled na sezónní a týdenní vzorce uzívání alkoholu u ceské dospelé populace. Výzkum byl realizován na reprezentativním vzorku 809 osob v rámci on-line setrení v prostredí Ceského národního panelu. Sledovanými promennými jsou uzívání alkoholu, sezónní uzívání a uzívání alkoholu v rámci dní v týdnu. Výsledky ukazují, ze nejcastejsí je konzumace v pátek, prípadne v sobotu, s výjimkou lidí v duchodovém veku, kterí alkohol uzívání rovnomerneji v rámci celého týdne. Z hlediska mesícu v roce je nejvyssí spotreba uvádena v léte (cerven, cervenec, srpen) a v prosinci. Respondenti s vyssím skóre dotazníku AUDIT uzívají alkohol více v letních mesících nez v prosinci. Výsledky výzkumu mohou prispet k lepsímu casovému zacílení preventivních i klinických aktivit.

Different phases of ATS use call for different interventions: a large qualitative study in Europe.

BACKGROUND: Amphetamine-type stimulants (ATS) are globally widely used. Scientific literature generally defines four phases of substance use (initiation, continuation, increase and decrease); however, there is limited understanding of what influences these different phases of ATS use. The ATTUNE study investigated which factors shape individual phases of use, or ATS use patterns. In this article, we report on these phases into and out of ATS use, and propose a set of recommendations for prevention, harm reduction and treatment of the different phases of ATS use. METHODS: Qualitative, semi-structured interviews (n = 237) were conducted in five different European countries with participants who had used ATS, varying from a few times in a lifetime to daily. RESULTS: Amphetamine and MDMA were the most commonly used ATS. Yet, types of ATS used differed between the countries. We found that people who use ATS have various motives for and dynamic patterns of ATS use with alternating phases of increase, continuation, decrease and sometimes dependence. Cessation was pursued in different ways and for diverse reasons, such as mental health problems and maturing out. Availability seemed not an issue, regardless of the type of ATS, phase or country. CONCLUSIONS: These findings demonstrate that tailor-made interventions are needed for the diverse types of people who use ATS and different phases or patterns of ATS use, to reduce possible harms of use. We recommended a set of interventions for the different ATS phases. These include drug checking services, peer-led information, self-management of ATS use, mental health support to help people cope with stressful life events and prevent uncontrolled use, and follow-up support after treatment.

Cost analysis of early rehabilitation after stroke in comprehensive cerebrovascular centres in the Czech Republic.

OBJECTIVES: The paper analyses real-world data on cost of treatment in patients after stroke hospitalized in early rehabilitation units within comprehensive stroke centres in the Czech Republic. This is the first study of the kind in the Czech Republic, while such information is extremely rare worldwide. Stroke treatment witnessed a dramatic development in the last years, when the main progress was due to establishment of specialized (comprehensive) stroke units incorporating also early rehabilitation. There is a general agreement among clinicians that early rehabilitation is beneficial for patients after stroke. METHODS: Costs of early rehabilitation after stroke were calculated by the micro-costing method alongside a pragmatic study in three Czech hospitals. Patients were transferred to specialized early rehabilitation units usually on 7th to 14th day after stroke onset and received four hours of interprofessional rehabilitation per day. RESULTS: The analysis of data collected during the prospective observational research of 87 patients proved significant differences between patients. The average costs of hospitalization were determined to be CZK 5,104 (EUR 194) per one day of intensive rehabilitation in seriously affected patients early after stroke. These costs differed significantly between hospitals (p-value < 0.001); the structure of direct costs was quite stable, though. About 60% of these costs were due to nursing and overhead, while no more than 15% were consumed by therapists. CONCLUSIONS: The treatment of patients after stroke in specialized stroke units proved to be beneficial for the patients increasing the number of those re-integrated in family and community life.

First alcohol treatment institutions in today's Czech Republic and Slovak Republic.

OBJECTIVE: Drawing on qualitative analysis of selected historical documents, the paper seeks to provide a definition of the general characteristics of the first institutional alcohol treatment facilities in today's Czech Republic and Slovakia, taking into account the historical context of the first half of the 20th century. An additional aim was to point out the importance of archival research and its contribution to understand the determinants of alcohol-related agenda and alcohol treatment. METHODS: The basic data platform was generated by analysis of historical documents pertaining to the subject matter under study and to institutional processes in different periods. The data was processed using the open coding method (as part of the grounded theory approach) and other specific methods based on the matching of data from scientific and professional literature and archives in different periods. Over 1,100 pages of text from relevant archival materials were analysed. This research is original, no such systematic analysis of historical documents on this subject matter has been conducted on such a scale with the intention of identifying the general correlates of the historical development of an alcohol-related agenda and alcohol treatment. RESULTS: The establishment of the first institutional facilities intended to provide treatment for alcohol dependency was based on the notion of addiction as a disease, which needs to be treated in dedicated facilities applying an individualised approach. The circumstances of the establishment of the facilities under analysis were similar. Their existence was made possible by distinguished personalities rather than a general belief and social pressure that the issue of alcohol addiction should be addressed. This also explains the fact that the occupancy of these facilities never reached their full capacity, that they were not self-reliant in economic terms, and that they did not readily resume their operation after 1945. CONCLUSIONS: The analysis of the establishment, operation, and dissolution of these facilities at the time reveals the discontinuity in the approach to alcohol abuse and its treatment in the context of the historical development and perception of alcohol-related problems in Czech and Slovak society in the first half of the 20th century. Significant social changes occurred after 1948. New legislative instruments were used to enforce treatment based on a principle that was different from the previous approaches. The results of our study also make it possible to reveal the intensity of apparent individual and institutional motives in the process of the development of alcohol treatment in historical terms and its projection into different post-war periods. The understanding of these correlates will help in designing additional trajectories of research into the effects of social and political changes on addiction treatment and thus identifying the intensity of the historical development and its influence on the perception of addiction treatment at present. These findings will also be of great importance for a historical comparative analysis, including overlaps with the development of recent theories, and will support the emergence of new areas of study for the social sciences.

Media portrayal of alcohol does not match its real harm effects in the Czech Republic.

OBJECTIVES: The Czech Republic ranks among countries with the highest alcohol consumption per capita. Several older studies discuss Czech media portrayal of health effects of alcohol, but we found no recent analysis of media portrayal of harms caused by alcohol consumption. Our analysis aims to fill this gap in. METHODS: The dataset of texts (n = 903) consisting of articles from press, radio, television and the internet published within a 30-day interval in 2017 (Newton Media computerized database) was coded and analyzed using mixed quantitative and qualitative approach to content analysis. The frequency of references to acute and long-term alcohol harms of various types were counted, and the results were compared to the classification of (alcohol) harms by the Independent Scientific Committee of Drugs (ISCD). RESULTS: The short-term intoxication effects in the areas of crime and road safety, in particular reports on traffic accidents, are over-represented, while topics describing the impact of alcohol use on health, family and society, as well as economic costs or environmental issues seem to be marginal. That corresponds to the fact that police and courts were the information source in more than half of the articles, while information sourced from physicians, sociologists and drug field professionals was rather scarce. CONCLUSIONS: Media portrayal of the harms caused by alcohol use does not match up to real harm effects on the society. In terms of public health, it is imperative to strengthen media presentation of the impact of alcohol use on health and social issues.

Public health response to methanol mass poisoning in the Czech Republic in 2012: a case study.

OBJECTIVES: The study focuses on the 2012 methanol outbreak in the Czech Republic. The main goal of the present study was to apply analytical and descriptive tools to selected qualitative and quantitative processes related to the 2012 methanol outbreak in the Czech Republic. The secondary goal was to study and evaluate in detail their potential for creating integrated conceptual national policies aimed at eliminating the risk of methanol poisoning in the future. METHODS: The presented qualitative analysis focused on the content of documents published by Czech public authorities - the Ministry of Health, the Ministry of the Interior, the Czech Agriculture and Food Inspection Authority, and the Regional Public Health Authorities - as well as the content of the relevant legal regulations. Moreover, statistical data concerning the number of hospitalisations and deaths due to the methanol intoxication were used to provide a background to a detailed description of the relevant facts. RESULTS: In procedural terms, most of the analysed measures focused on a strongly restrictive regulation of sales, regular information channels designed to protect consumers on the national as well as international level, and elimination of further health and economic risks stemming from the dangerous alcoholic products that had already entered distribution networks. The health, social and economic consequences of such activities are quantified at a highly aggregated level. The analysed institutional ties are evaluated also in the context of international documents: the European Action Plan to Reduce Harmful Use of Alcohol 2012-2020 and the Global Strategy to Reduce Harmful Use of Alcohol, and their current potential for steering public policies is assessed. CONCLUSION: The analysis and evaluation of procedural activities carried out after the methanol outbreak have laid the foundations for a multidimensional study that can contribute to integrated national policy concepts aimed at preventing these and similar negative health, societal and economic consequences. Six years after the methanol outbreak, national and regional health policies have reflected no findings concerning the experience of patients whose health was impaired due to methanol, and the economic cost of the event has not been calculated. The quality of life of these patients has greatly decreased due to permanent or partial incapacity and serious upheavals of their and their families' economic and social conditions. This opens the question of researching and evaluating multiple aspects of health, social and economic impacts of harmful use of alcohol and setting up processes to mitigate these impacts.

Problematic and risky sexual behaviour under the influence of alcohol among university students.

OBJECTIVE: The objective of this research was to determine the prevalence of problematic and risky sexual behaviour after alcohol consumption and the correlation between this prevalence and sex, behavioural factors, problematic drinking, and alcohol consumption characteristics. METHODS: A survey of students was carried out at four faculties. Data were gathered via internet and self-administered paper-pencil questionnaires. The analysis employed Pearson's chi-squared test, gross odds ratios and logistic regression to calculate the adjusted odds ratios (OR) and their confidence interval (CI). RESULTS: Problematic drinking was detected by the CAGE test. Sixteen percent of students reached the CAGE score of 2, which indicates a potential threat of addiction, while 6% of students reached even higher problematic scores (3 or 4). Among those respondents who did drink alcohol, 23% had unprotected sex and 21% had sex which they later regretted. There were some differences between male and female respondents with men reporting more instances of risky behaviour. Among university students, problematic and risky sexual behaviour after alcohol use is associated with sex, the intensity of problematic drinking, first drunkenness, the place of alcohol use, and attitude to alcohol use. CONCLUSIONS: Problematic drinking and risky sexual behaviour after alcohol consumption exist among students and deserve special attention and response in the form of suitable measures. Problematic and risky sexual behaviour after alcohol consumption among university students is associated with behavioural factors and characteristics of alcohol use that allow a targeted approach to preventive efforts.

Mortality Amenable to Health Care in European Union Countries and Its Limitations.

AIM: The concept of amenable mortality is intended to assess health care system performance. It is defined as "premature deaths that should not occur in the presence of timely and effective health care". The purpose of paper is to analyse differences in amenable mortality across European Union countries and to determine the associations between amenable mortality and life expectancy at birth. METHODS: This is a cross-country and time trend analysis. Data on deaths by cause, and five-year age groups were obtained from the World Health Organization database for the 20 European Union countries, throughout the period from 2002 to 2013. The rates of amenable mortality were expressed by the age-standardised death rates per 100,000 inhabitants. We applied the method of direct standardisation using the European Standard Population. RESULTS: Throughout the explored period, the statistically significant variations of the age-standardised death rates in a relation to the European Union average fluctuated from 78.7 per 100,000 inhabitants (95% CI 72.4-84.9) in France to 374.3 per 100,000 inhabitants (95% CI 350.8-397.7) in Latvia. The leading causes of amenable mortality were ischaemic heart disease, cerebrovascular diseases, and colorectal cancer that accounted for, respectively, 42.2%, 19.5%, and 11.3% of overall amenable mortality. As expected, statistically significant strong negative relationship (R2=0.95; ρ=-0.98) between amenable mortality and life expectancy at birth was proved by linear regression. The concept has several limitations relating to the selection of causes of death and setting age threshold over time, not consideration actually available health care resources in each country, as well as differences in the prevalence of diseases among countries. CONCLUSIONS: We found an explicit divide in amenable mortality rates between more developed countries of Western, Northern and Southern Europe, and less developed countries of Central and Eastern Europe. Increasing of amenable mortality may suggest deterioration in health care system performance.

Time Trend, Age and Sex Distribution of Deceased from Diabetes Mellitus at the Regional Level in the Slovak Republic.

AIM: To describe the time trends, age and sex distribution of death from diabetes mellitus (E10-E14) as a significant part of endocrine, nutritional and metabolic diseases (E00-E90), during 1996-2014 in the Slovak regions, and to estimate the influence of social characteristics on mortality. METHODS: Secondary data on deaths during 1996-2014 were gathered from the National Health Information Center in the Slovak Republic. The total crude death rate per 100,000 of the standard Slovak population and age-standardized death rate per 100,000 of the standard European population were calculated by direct standardization. Multilevel logistic regression analysis was performed. RESULTS: Deaths from diabetes mellitus account for 91.6% of deaths registered in the endocrine, nutritional and metabolic diseases Chapter. The age-standardized death rate per 100,000 of inhabitants decreased from 19.2 in 1996 to 15.3 in 2014 in the Slovak Republic, although a massive increase of up to 32.5 was reported in 1999. The highest age-standardized death rates per 100,000 inhabitants were typical for the Kosice, Nitra and Trencín regions. On the other hand, the lowest counts were recorded in the Bratislava region. Mortality from diabetes mellitus starts to be evident in the 45-49 year age-group in both sexes. The median age of death for women is lower in the 75-79 year age-group in comparison to men although the total crude death rate for men in lower age groups is higher. After age 80 the situation is reversed. The odds of dying due to endocrine, nutritional and metabolic diseases decreases by 0.4% each year. The odds of dying are lower by 17% and 12.3%, respectively, in the Zilina and Presov regions compared to Bratislava region. Women have a higher probability of dying by 38% in contrast to men, and married couples by 16.7% than singles. Age is proved to be an insignificant factor. CONCLUSIONS: In spite of the declining trend of mortality from diabetes mellitus, it is necessary to reduce the risk of its incidence by healthier food consumption and physical activity.

Risk of Dying from Cancer by Socio-demographic Indicators in the Slovak Republic.

AIM: Cancer mortality distribution was investigated by detailed neoplasms groups, age, sex, marital status of deceased, and regions in the Slovak Republic, and examined how these determinants influence the odds of dying due to cancer. METHODS: A retrospective analysis of cancer mortality statistics registered in the Slovak Republic during the years 1996-2014. For this time period, data was available only on the underlying subgroups of cancer deaths, place of death, age, year, sex, and marital status. Binary logistic regression was applied for odds of dying calculation influenced by these socio-demographic factors. RESULTS: The most common are deaths from malignant neoplasms of digestive organs in males as well as females. The biggest difference among both genders is recognized in malignant neoplasms of lip, oral cavity and pharynx, where deaths among males are on average 7.9 times higher in comparison to females. As for place of death the Bratislava region reports the highest level of cancer mortality stated at 25.22% of all deaths, on the contrary the Banská Bystrica region reports only 21.40% of all deaths. Age has a negative influence on odds of dying due to neoplasms compared to all other causes of death by 1.7%. In all regions compared to the reference Bratislava region, the odds of dying from neoplasms are lower. Being female diminishes the odds of dying due to neoplasms by 25.7% compared to males. Yearly the relative ratio of dying from neoplasms increases with respect to all other causes of death. When single people are set as the reference category, the relation of the probability of death from cancer to the probability of death due to other causes of death is higher for married, divorced and widowed persons. CONCLUSIONS: The results should be taken into account when comparing risk of dying due to cancer among people with the mentioned sociodemographic characteristics. Health policy makers should consider place of death and cancer types while planning hospital care units.

[A note on application of the WHOQOL-BREF questionnaire on quality of life in the Czech enviroment]. / Poznámka k pouzití dotazníku kvality zivota WHOQOL-BREF v ceském prostredí.

In the Czech environment, the WHOQOL-BREF (WHO Quality of Life-BREF) questionnaire has been rather frequently used for quality-of-life assessment in the case of different diseases or different health limitations. The questionnaire exists in two Czech translations with different wording. The differences are so considerable that they might cause interpretation shifts in research based on this instrument. Also the reverse scales in three questions may cause problems, because processing of these scores is not described correctly in some methodological materials. The authors recommend to strictly use the version published by Dragomirecká and Bartonová of the Prague Psychiatric Centre.

[Controversies around QALYs]. / Kontroverze okolo QALY.

The paper summarizes the criticisms of the QALY concept utilization in health-economic evaluations that has been growing stronger in the last years. Despite of its limitations, the QALY concept has been routinely used in many countries incl. the Czech Republic. However, some states disapproved QALYs as an optimizing criterion at the level of their political decisions. The critical reflection concerns both the theoretical and the experimental issues. Based on a literary review, fundamental arguments against the concept are summarized, and a synthesis of material objections is presented. The critical arguments focus on the foundations of the QALY concept in the economic theory, some ethical principles, inconsistencies and technical imperfections of the quality-of-life measurement tools used in QALY calculations, the substitution rule, differences between various diagnoses, and disregarding some other important parameters. As a whole, the critics´ arguments can be judged as quite strong. The future will show whether the critical arguments summarized in this paper will lead to a development of alternative tools that have a potential of eliminating imperfections in QALYs, and consequently provide more complex data for the decision process.Key words: cost-effectiveness - health technology assessment - HTA - QALY - utility measure for medical interventions.

[Cross-border healthcare in European Union and Czech Republic]. / Preshranicní zdravotní péce v Evropské unii a CR.

Currently, the cross-border healthcare still represents a marginal part of the Czech healthcare system's performance, though. Compared to the total healthcare expenditures in the Czech Republic that accounted for CZK 299.9 billion in 2014, the costs of the treatment provided to Czech patients abroad constitute mere 0.27%, and the (subsequently refunded) costs of the treatment provided to foreign patients in the Czech Republic 0.24%.Although data on changes in the volume and reimbursements of healthcare due to the Directive 2011/24/EU have not been published yet, we can expect rather evolutionary than revolutionary development of cross-border healthcare volumes. Taking into account all available data, we can conclude that the cross-border healthcare, as specified by the directive currently in force, is important in our conditions above all in relation to our neighbours, i. e. Germany, Austria, Slovakia and Poland.Key words: cross-border healthcare, patient mobility, international reimbursements EU health policy, Directive 2011/24/EU.

[The management of chronic diseases in international comparison]. / Management chronických onemocnení v mezinárodním srovnání

The goal of this overview paper is to offer the international (European) evidence in the field of chronic diseases condition. Chronic conditions counting more that 60% of all deaths worldwide and about 90% of all deaths in the Czech Republic. Population development in developed countries is characterized by increasing live expectancy and by growing population in higher age groups namely in age more that 65 years. In the same time the population faced the consequences of unhealthy live style like eatings habit or physical inactivity. Thanks these factors as well as thanks increasing expectations and available medical technologies the costs of chronic conditions are increasing. More attention is currently paid to the integrated management of chronic condition based on self-management, use of ITC as well as use family support and community based approach.

New species of Rhamphomyia (Diptera: Empididae) from Turkey with a key to species of the Middle East and adjacent territories.

Rhamphomyia (s. str.) academica sp. nov. (Turkey) and R. (s. str.) soukupi sp. nov. (Turkey) are described and illustrated. Rhamphomyia (Lundstroemiella) cimrmani Barták, 2006, is re-described and the female is newly described. The first records of Rhamphomyia (s. str.) argentata von Röder, 1887 and R. (Pararhamphomyia) intersita Collin, 1960 are reported from Turkey. A key to species of Rhamphomyia from the Middle East is presented.

Cephenemyia stimulator and Hypoderma diana infection of roe deer in the Czech Republic over an 8-year period.

A survey of naso-pharyngeal and subcutaneous myiasis affecting roe deer (Capreolus capreolus) was conducted in the Czech Republic over an 8-year period (1999-2006). A total of 503 bucks and 264 does from six hunting localities were examined. The sampling area comprised predominantly agricultural lowlands and a mountain range primarily covered by forest. Since 1997, the deer have been treated each winter across the board with ivermectin (150 mg/kg, CERMIX® pulvis, Biopharm, CZ). Parasites found were the larvae of Hypoderma diana and Cephenemyia stimulator. There were no significant differences in warble fly infection among captured animals in the individual hunting localities. Overall, 146 (28.8%) of 503 animals (bucks) were infected with Cephenemyia stimulator larvae; body size of the second instar larva reached 13-18 mm. The prevalence ranged from 16.1 to 42.9% per year, and the mean intensity from 6 to 11 larvae per animal. Additionally, a total of 264 roe deer (does) were examined for H. diana larvae, and 77 (29.1%) were found to be positive; body size of the second instar larva reached 17 mm. The prevalence ranged from 18.8 to 50.0% per year, and the mean intensity from 13 to 22 larvae per animal. The results showed that the bot flies, Cephenemyia stimulator as well as H. diana, are common parasites in roe deer in the Czech Republic, and that through the help of treatment (ivermectin), it is possible to keep parasite levels low. The body weights of infected and non-infected H. diana deer did not differ significantly.

Species of Bicellaria Macquart (Diptera: Hybotidae) of Europe, with descriptions of four new species.

Species of the genus Bicellaria (Diptera: Hybotidae) of Europe are reviewed. Altogether four new species are describes, viz B. andorra sp. nov. (Andorra, France), B. italica sp. nov. (Europe), B. kocoureki sp. nov. (Bulgaria), and B. setipalpus sp. nov. (Italy). Bicellaria dispar Oldenberg, 1920 is redescribed and lectotype is designated. Bicellaria bisetosa Tuomikoski, 1936 is newly synonymized with B. uvens Melander, 1928. Illustrations of male terminalia and a key to all known European species are provided.