Search

Jonas Bocek,1 Dana Kamaradova Koncelikova,1 Jakub Vanek,1 Klara Latalova,1 Samuel Genzor,2 Jan Mizera2 1Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic; 2Department of Respiratory Medicine and Tuberculosis, University Hospital Olomouc, Olomouc, Czech RepublicCorrespondence: Jonas Bocek, Department of Psychiatry, University Hospital Olomouc, Zdravotníků 248/7, Olomouc, Czech Republic, Tel +420775992005 ; +420588443512, Email jonas.bocek@fnol.czIntroduction: The term “post-COVID-19 syndrome” describes a range of symptoms persisting beyond the acute phase of the disease. These symptoms predominantly include fatigue, muscle pain, shortness of breath, and psychological issues. Research additionally suggests the possibility of long-term neurological and psychiatric impairment associated with COVID-19.Methodology: The study included patients who visited the post-COVID outpatient clinic between April 2020 and June 2022. The examination included the detailed history taking, including the COVID-19 course, posteroanterior chest X-ray and pulmonary function tests. Anxiety level was assessed using the Beck Anxiety Inventory (BAI). The relationship between anxiety, demographic data, and course of the disease, need for hospital admission during the acute phase, oxygen therapy, post-inflammatory changes on the chest X-ray and lung function parameters was investigated.Results: This study included 1756 patients who experienced COVID-19 and visited a post-COVID outpatient clinic. The majority of individuals experienced a mild form of the infection. The results showed that younger age and female gender were associated with significantly higher anxiety scores. Inpatients had lower BAI values than those who were not hospitalized during acute phase. Patients with post-inflammatory changes on chest X-ray had surprisingly lower BAI values. Lower values of FEV1 (forced expiratory volume in 1 second), DLCO (diffusing capacity of the lungs for carbon monoxide), and KCO (carbon monoxide transfer coefficient) were associated with significantly higher BAI values. Female gender was associated with higher levels of anxiety. In contrast, higher FEV1 values reduced the risk of a pathological level of anxiety.Conclusion: In our study, the influence of age, gender, inpatient care during the acute phase of infection, the presence of post-inflammatory changes on the chest diagram and selected parameters of lung function (FEV1, DLCO, and KCO) were shown to be important factors in the assessment of anxiety symptoms in post-COVID patients.Keywords: post, COVID, anxiety, anxiety symptoms, associated factors, lung function parameters

Jakub Vanek,1 Jan Prasko,1– 4 Samuel Genzor,5 Kamila Belohradova,1 Jozef Visnovsky,1 Jan Mizera,5 Jonas Bocek,1 Milan Sova,5,6 Marie Ociskova1,4 1Department of Psychiatry, Faculty of Medicine and Dentistry of Palacky University, Olomouc, the Czech Republic; 2Institute for Postgraduate Education in Health Care, Prague, The Czech Republic; 3Department of Psychology Sciences, Faculty of Social Science and Health Care of Constantine the Philosopher University, Nitra, the Slovak Republic; 4Jessenia Inc. - Rehabilitation Hospital, Akeso Holding, Beroun, the Czech Republic; 5Department of Respiratory Medicine, Faculty of Medicine and Dentistry of Palacky University, Olomouc, the Czech Republic; 6Department of Respiratory Medicine, University Hospital and Faculty of Medicine of Masaryk University, Brno, the Czech RepublicCorrespondence: Jan Prasko, Department of Psychiatry, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 6, Olomouc, 77520, the Czech Republic, Tel +420 603 414 930, Email praskojan@seznam.czObjective: The study worked with depressive symptoms, anxiety score and cognitive functions in obstructive sleep apnea (OSA) patients treated with CPAP.Methods: Eighty-one subjects with OSA and without psychiatric comorbidity were treated with CPAP for one year and completed the following scales and cognitive tests: Trail Making Test, Verbal Fluency Test, d2 Test, Beck Depression Inventory-II and Beck Anxiety Inventory. MINI ruled out psychiatric disorder. At the two months check-up, subjects were re-evaluated for depressive and anxiety symptoms, and after one year of CPAP treatment, subjects repeated cognitive tests and scales. Data about therapy adherence and effectiveness were obtained from the patient’s CPAP machines.Results: The study was completed by 59 CPAP adherent patients and eight non-adherent patients. CPAP therapy effectiveness was verified in all patients by decreasing the apnea-hypopnoea index below 5 and/or 10% of baseline values. The adherent patients significantly improved depressive and anxiety symptoms. There was also an improvement in overall performance in the attention test; however, performance in many individual items did not change. The adherent patients also improved verbal fluency and in the Part B of the Trail making test. The non-adherent group significantly increased the number of mistakes made in the d2 test; other results were non-significant.Conclusion: According to our results, OSA patients’ mood, anxiety and certain cognitive domains improved during the one-year therapy with CPAP.Trial Registration Number: NCT03866161.Keywords: obstructive sleep apnoea, depression, cognitive functions, CPAP treatment, treatment efficacy, Trail Making Test, Verbal Fluency Test

Jonas Bocek,1 Jan Prasko,1– 4,* Samuel Genzor,5,* Frantisek Hodny,1,* Jakub Vanek,1,* Pavol Pobeha,6,* Kamila Belohradova,1,* Marie Ociskova1,4,* 1Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic; 2Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic; 3Department of Psychotherapy, Institute for Postgraduate Training in Health Care, Prague, The Czech Republic; 4Rehabilitation Hospital Beroun, Jessenia Inc, Akeso Holding, Beroun, The Czech Republic; 5Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Palacky Olomouc and University Hospital, Olomouc, The Czech Republic; 6Department of Respiratory Diseases and Tuberculosis University Hospital and Faculty of Medicine and Dentistry Pavol Jozef Safarik University, Kosice, The Slovak Republic*These authors contributed equally to this workCorrespondence: Jan Prasko, Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital, I. P. Pavlova 6, Olomouc, 77520, The Czech Republic, Tel +420 603 414 930, Email praskojan@seznam.czAbstract: The overarching importance of sleep was further emphasized during the pandemic of COVID-19. The subjects infected by COVID-19 frequently experience sleep disturbances; some are long-lasting problems and decrease the quality of life. Insomnia is the most studied sleep disorder associated with COVID-19. Insomnia affects patients who have experienced an infection and the general population. Good sleep is important in maintaining mental and physical health, including immune system functions. The interconnections between insomnia, the immune system, and COVID-19 are complex. Insomnia triggers numerous immune system dysregulations and makes individuals more vulnerable to respiratory infections. This narrative review overviews the influence of the COVID-19 pandemic on the immune system through sleep disorders.Keywords: insomnia, COVID-19, circadian rhythms, immunity, sleep deprivation, mental disorders

We present a survey of 97 spectra of mainly sporadic meteors in the magnitude range +3 to -1, corresponding to meteoroid sizes 1-10 mm. For the majority of the meteors, heliocentric orbits are known as well. We classified the spectra according to relative intensities of the lines of Mg, Na, and Fe. Theoretical intensities of these lines for a chondritic composition of the meteoroid and a wide range of excitation and ionization conditions were computed. We found that only a minority of the meteoroids show chondritic composition. Three distinct populations of Na-free meteoroids, each comprising ~ 10% of sporadic meteoroids in the studied size range, were identified. The first population are meteoroids on asteroidal orbits containing only Fe lines in their spectra and possibly related to iron-nickel meteorites. The second population are meteoroids on orbits with small perihelia (q [less than or equal to] 0.2 AU), where Na was lost by thermal desorption. The third population of Na-free meteoroids resides on Halley type cometary orbits. This material was possibly formed by irradiation of cometary surfaces by cosmic rays in the Oort cloud. The composition of meteoroids on Halley type orbits is diverse, probably reflecting internal inhomogeneity of comets. On average, cometary dust has lower than chondritic Fe/Mg ratio. Surprisingly, iron meteoroids prevail among millimeter-sized meteoroids on typical Apollo-asteroid orbits. We have also found varying content of Na in the members of the Geminid meteoroid stream, suggesting that Geminid meteoroids were not released from their parent body at the same time. Keywords: Meteors; Meteoroids; Spectroscopy; Comets, composition; Asteroids, composition

Background: Biventricular pacing (BVP) from multiple left ventricular (LV) sites could enhance the efficacy of cardiac resynchronization therapy (CRT) by engaging a greater myocardial mass., Objectives: The goal of this study was to evaluate the acute hemodynamic effect of various multisite pacing (MSP) configurations against conventional BVP., Methods: Twenty patients with nonischemic dilated cardiomyopathy and left bundle branch block (mean age: 59 ± 14 years; LV ejection fraction: 27% ± 6%; native QRS: 171 ± 16 milliseconds) were investigated during a routine CRT implant procedure. In addition to conventional right atrial and right ventricular leads, 2 quadripolar leads were placed in the distant coronary venous branches. LV hemodynamics was evaluated by using a micromanometer-tipped catheter during atrioventricular BVP with 4 LV lead configurations: single-lead conventional BVP; single-lead multipoint pacing; triventricular pacing from distal dipoles of 2 LV leads; and maximum MSP (MSP-Max) from 4 dipoles of 2 LV leads., Results: Compared with right atrial pacing, any BVP configuration produced a significant increase in the maximal LV diastolic pressure rise (LVdP/dT Max ) (a median relative increase of 28% [IQR: 8%-45%], 25% [IQR: 18%-46%], 36% [IQR: 18%-54%], and 38% [IQR: 28%-58%], respectively; all, P < 0.001). MSP-Max but no other multisite BVP generated a significant increase of the maximal LVdP/dT Max than conventional BVP (P = 0.041). Increased LVdP/dT Max during MSP-Max was associated with greater LV diameter and lower LV ejection fraction, independently of the QRS width., Conclusions: The study shows the hemodynamic advantage of a novel dual-vein MSP-Max configuration that could be useful for CRT in patients with advanced LV remodeling., Competing Interests: Funding Support and Author Disclosures This work was funded by the research grant NV18-02-00080 of the grant agency AZV of the Ministry of Health of the Czech Republic. Dr Kautzner has received personal fees from Abbott, Bayer, Biosense Webster, Biotronik, Boehringer Ingelheim, Cath Vision, Medtronic, Pfizer, and ProMed CS for lectures, advisory boards, and consultancy. Dr Sramko has received speaker honoraria from Amomed, Bayer, Boehringer Ingelheim, Medtronic, and Pfizer. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Background: Prejudices against individuals with schizophrenia can interfere with diagnostic and treatment processes, particularly with the patient's further adaptation and reintegration. Self-stigma could have significant detrimental consequences for patients suffering from psychotic disorders, including schizophrenia., Method: This paper reviews findings about self-stigma connected to schizophrenia. The PubMed database used the keywords to find the papers published from January 1997 to March 2023, and 189 articles were included in the review process., Results: The schizophrenia-related stigma decreases patients' self-confidence, worsens their social functioning, and impedes daily functioning. Feelings of embarrassment are prominent in many patients with schizophrenia. Self-stigma predicts many unfavourable outcomes - more severe social anxiety and depressive symptoms, lower self-confidence, hopelessness, worse social functioning, lower quality of life, worse treatment cooperation, and lower adherence to medication adherence. Addressing self-stigma in psychoeducation or psychotherapy may increase the patient's stigma resistance and well-being. Self-help groups present an underutilised but potentially effective strategy., Conclusion: Stigma presents a common issue in patients with schizophrenia. Targeting the issue in clinical management or psychotherapy may be beneficial. Still, more high-quality intervention studies are needed.

Background: Borderline personality disorder (BPD) patients commonly suffer from nightmares. Still, the prevalence of this issue does not match the little clinical attention it usually receives. Nightmares impact sleep and daily functioning and may play a role in BPD symptomatology, including suicidality. Since BPD has been linked with high rates of suicide, the potential connection with suicidality is crucial to address., Aims: To create an up-to-date review of current knowledge on nightmares in BPD and to explore the links between nightmares, insomnia, and suicidality or self-harm in BPD patients., Method: This narrative review was conducted using the PubMed, Web of Science, and Google Scholar databases to search for articles published between January 1990 and October 2022, using the following key terms: 'borderline personality disorder' and 'nightmares' or 'insomnia' and 'suicidality' or 'self-harm' or 'self-injuring'. The final list consisted of 99 publications., Results: Sleep disturbances often occur in BPD patients. The prevalence of nightmares in BPD is higher than in general or clinical populations. Nightmares influence borderline personality traits and vice versa through emotional dysregulation, poorer sleep quality, nightmare anxiety, higher arousal, and worsened self-control. A link between nightmares and suicidal behaviour was established in some psychiatric conditions (depression, insomnia); studies on BPD are lacking in this area. Studies comparing nightmares in BPD to other disorders are also missing. There are some suggestions for pharmaceuticals or psychotherapy in treating nightmares, but their application to BPD needs more research., Conclusion: Sleep disturbance and nightmares are common among individuals with BPD yet underrepresented in research. Nightmares have been linked with suicidality in other conditions (depression, PTSD) but only indirectly in BPD. More clinical studies are needed to explore the phenomenon further.

Objective: Both panic disorder (PD) and obstructive sleep apnea (OSA) are frequent conditions that can be comorbid. This article reviews the current state of knowledge about the comorbidity of PD and OSA and the effectiveness of therapy in patients with this comorbidity., Method: Articles obtained via PubMed and Web of Science search were selected; the publishing date was between January 1990 and December 2022. The applied search terms were: obstructive sleep apnea; panic disorder; CPAP; antidepressants; anxiolytics; antipsychotics. Eighty-one articles were chosen by primary search via keywords. After a complete assessment of the full texts, 60 papers were chosen. Secondary papers from the references of the primary documents were investigated, evaluated for suitability, and included in the list of documents (n = 18). Thus, seventy-eight papers were incorporated into the review article., Results: Studies describe a greater prevalence of panic disorder in OSA patients. So far, there is no data on the prevalence of OSA in PD patients. Limited evidence is found regarding the influence of CPAP treatment on PD, and this evidence suggests that CPAP can partially alleviate PD symptoms. Medication used in PD treatment can significantly impact comorbid OSA, as explored in several studies., Conclusions: The relationship between the two conditions seems bidirectional, and it is necessary to assess OSA patients for comorbid panic disorder and vice versa. Both disorders can worsen the other and must be treated with a complex approach to ensure improvement in patients' physical health and psychological well-being.

Aims: The standard deviation of activation time (SDAT) derived from body surface maps (BSMs) has been proposed as an optimal measure of electrical dyssynchrony in patients with cardiac resynchronization therapy (CRT). The goal of this study was two-fold: (i) to compare the values of SDAT in individual CRT patients with reconstructed myocardial metrics of depolarization heterogeneity using an inverse solution algorithm and (ii) to compare SDAT calculated from 96-lead BSM with a clinically easily applicable 12-lead electrocardiogram (ECG)., Methods and Results: Cardiac resynchronization therapy patients with sinus rhythm and left bundle branch block at baseline (n = 19, 58% males, age 60 ± 11 years, New York Heart Association Classes II and III, QRS 167 ± 16) were studied using a 96-lead BSM. The activation time (AT) was automatically detected for each ECG lead, and SDAT was calculated using either 96 leads or standard 12 leads. Standard deviation of activation time was assessed in sinus rhythm and during six different pacing modes, including atrial pacing, sequential left or right ventricular, and biventricular pacing. Changes in SDAT calculated both from BSM and from 12-lead ECG corresponded to changes in reconstructed myocardial ATs. A high degree of reliability was found between SDAT values obtained from 12-lead ECG and BSM for different pacing modes, and the intraclass correlation coefficient varied between 0.78 and 0.96 (P < 0.001)., Conclusion: Standard deviation of activation time measurement from BSM correlated with reconstructed myocardial ATs, supporting its utility in the assessment of electrical dyssynchrony in CRT. Importantly, 12-lead ECG provided similar information as BSM. Further prospective studies are necessary to verify the clinical utility of SDAT from 12-lead ECG in larger patient cohorts, including those with ischaemic cardiomyopathy., Competing Interests: Conflict of interest: J.K. reports personal fees from Biosense Webster, Biotronik, Medtronic, Abbott, Boehringer Ingelheim, Cath Vision, Pfizer, and ProMed CS for lectures, advisory boards, and consultancy. P.M.v.D. is an owner of ECG Excellence BV and Peacs BV. Other authors have nothing to declare., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objectives: Obsessive-compulsive disorder (OCD) has been connected to various psychosocial factors that might influence its onset and course. Developmental factors, such as parenting styles or early adverse experiences, and adult attachment have been listed as examples. However, the research on the interconnections of these factors brought mixed results. The study explores the relationship between demographic, clinical, and selected psychosocial factors and the severity of adult OCD., Method: Eighty-seven pharmacoresistant inpatients with OCD were admitted between October 2019 and August 2022 for a 6-week cognitive behavioural therapy inpatient program in the psychotherapeutic department. The participants completed the following scales at the start of the hospitalisation: the self-report Yale-Brown Obsessive-Compulsive Scale (Y-BOCS-SR), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire-Short Form (CTQ-SF), PBI (Parental Bonding Instrument), ECR-R (Experiences in Close Relationships - Revised), and a demographic questionnaire. A skilled psychologist administered Mini International Neuropsychiatric Interview (MINI) to confirm the OCD diagnosis and Hamilton Anxiety Rating Scale (HAMA)., Results: OCD patients with more severe adverse childhood experiences (ACEs) showed earlier onset of the disorder and more pronounced attachment anxiety, depressive symptoms, and dissociation and subjectively rated the severity of the disorder as more severe. Physical abuse and physical neglect were related to the severity of specific OCD symptoms. Maternal care negatively correlates with clinician-rated anxiety, patient-rated depressive symptoms, and dissociation. The maternal and paternal control positively correlated with patient-rated anxiety and depression. Attachment anxiety negatively correlated with the age of onset and positively with the severity of the clinician-rated anxiety and the patient-rated anxiety, depressive symptoms, and dissociation., Conclusions: Early adverse experiences, perceived parental styles, and adult attachment anxiety could play a significant role in the symptoms of anxiety, depression, and dissociation. The connection with the specific obsessive-compulsive symptoms is less apparent. Still, adverse childhood events and adult attachment anxiety seem to influence the age of OCD onset.

Objective: Our study aimed to screen for obstructive sleep apnoea (OSA) in a clinical population of psychiatric patients with affective disorders and risk factors for OSA using screening devices in psychiatric clinical environments., Methods: Inpatients admitted with mood disorders in an inpatient psychiatric department were selected via inclusion and exclusion criteria and assessed for the risk factors of OSA. The inclusion criteria were: a diagnosis of an affective disorder confirmed by two independent psychiatrists, snoring or apnoeic pauses witnessed during regular night check-ups by nurses, and BMI > 25 kg/m2. The exclusion criteria were: a comorbid psychotic disorder, previously diagnosed OSA, intellectual disability, organic mental illness, acute coronary syndrome, acute or chronic heart failure, acute pulmonary diseases, a history of stroke, neuromuscular disorders, or a myorelaxant treatment. All included patients underwent overnight monitoring by a screening device SomnoCHECK Micro Cardio. A certified somnologist assessed obtained data., Results: A total of 32 subjects (23 women and nine men) were included in the study. The mean age was 49.8 ± 8.8 years. Most participants had major depressive disorder (n = 23); another nine individuals had bipolar disorder. Diagnostic criteria for OSA were found in 50% of the sample, specifically in 88% of men and 33% of women. The correlation analysis identified several risk factors and variables., Conclusions: This pilot study showed an increased risk of OSA in patients with mood disorders. Psychiatric patients with identified risk factors should be routinely screened for obstructive sleep apnoea and referred to proper treatment.

Background: The fecal immunochemical test (FIT) is a common colorectal cancer screening modality in the USA but often is not followed by diagnostic colonoscopy., Aims: We investigated the efficacy of patient navigation to increase diagnostic colonoscopy after positive FIT results and determined persistent barriers to follow-up despite navigation in a large, academic healthcare system., Methods: The study cohort included all health system outpatients with an assigned primary care provider, a positive FIT result between 12/01/2016 and 06/01/2019, and no documentation of colonoscopy after positive FIT. Two non-clinical patient navigators engaged patients and providers to encourage follow-up, offer solutions to barriers, and assist with colonoscopy scheduling. The primary intervention endpoint was completion of colonoscopy within 6 months of navigation. We documented reasons for persistent barriers to colonoscopy despite navigation and determined predictors of successful follow-up after navigation., Results: There were 119 patients who received intervention. Of these, 37 (31.1%) patients completed colonoscopy at 6 months. In 41/119 (34.5%) cases, the PCP did not recommend colonoscopy, most commonly due to a normal colonoscopy prior to the positive FIT (19, 46.3%). There were 41/119 patients (34.5%) that declined colonoscopy despite the patient navigator and the PCP order. Male sex and younger age were significant predictors of follow-up (aOR = 2.91, 95%CI, 1.18-7.13; aOR = 0.92, 95%CI, 0.87-0.99)., Conclusions: After implementation of patient navigation, diagnostic colonoscopy was completed for 31.1% of patients with a positive FIT result. However, navigation also highlighted persistent multilevel barriers to follow-up. Future work will develop targeted solutions for these barriers to further increase FIT follow-up rates in our health system., (© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

Introduction: Discrimination of ventricular and supraventricular arrhythmias remains one of the major challenges for appropriate implantable defibrillator (ICD) therapy delivery. The electrogram vector timing and correlation (VTC) algorithm was developed for such rhythm discrimination. The VTC algorithm differentiates normally conducted supraventricular beats from abnormally conducted ventricular beats by comparing the timing and correlation of rate and shock channel electrograms., Methods and Results: Rate and shock channel electrograms of sinus rhythm and induced arrhythmias were collected from 93 patients during ICD placement. The algorithm was developed using data from 50 patients and prospectively tested in a software model with the remaining 43 patients. A sinus rhythm reference was formed by averaging complexes of the shock channel signal aligned by the peak amplitude of the rate channel. Eight features measuring the amplitude and timing of shock channel signal characteristics were extracted from the reference for comparison. When a high-rate rhythm was detected, the VTC algorithm computed the correlation of the arrhythmia complex features with the reference. Rhythms with a sufficient number of uncorrelated beats were classified as ventricular tachycardia (VT). In a dual-chamber implementation, the VTC algorithm is integrated with ventricular and atrial rate comparison (V>A) and stability above an atrial fibrillation rate threshold. The test set consisted of 117 arrhythmias. Dual-chamber sensitivity was 100% (81/81 VT) and specificity was 97% (35/36 supraventricular tachycardia). Single-chamber analysis demonstrated 99% sensitivity and 97% specificity., Conclusion: The VTC algorithm demonstrated high sensitivity and specificity in discriminating between ventricular and supraventricular arrhythmias.