Bc. Lucie Špuláková Signs of epilepsy spectrum disorder in drug-dependent persons Diploma thesis Charles University in Prague, Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences Specialist in laboratory methods Objectives: The objective of this diploma thesis was to demonstrate the signs of epile- psy spectrum disorder in risk group of drug-dependent persons. Methods: We investigated the signs of epilepsy spectrum disorder by questionnaire survey - specifically by questionnaires Limbic System Checklist-33 (LSCL-33) and Complex Partial Seizure-like Symptoms Inventory (CPSI). We used statistical methods for results evaluation - the percentage comparison, chi-square test, and Spearman corre- lation coefficient. Results: The questionnaire survey demonstrated a significant shift towards abnormal values for both questionnaires. Abnormal score was achieved by 77 % respondents for questionnary LSCL-33, suspected score was achieved by 19 % respondents. Score for epilepsy spektrum disorder was achieved by 32 % respondents for questionnary CPSI and 45 % respondents showed unusual values. Conclusions: Signs of epilepsy spectrum disorder in drug-dependent persons was thus proved. The incidence is higher than in ordinary population and population of smokers. It was also...

Made available in DSpace on 2016-04-28T20:38:06Z (GMT). No. of bitstreams: 1 Tatiana de Freitas Munia Barbosa.pdf: 1470548 bytes, checksum: 904bf9649fde69ae79426f93b238aae6 (MD5) Previous issue date: 2012-05-14 / Nowadays, drug abuse is a subject that is heavily divulgated and discussed. The drug abuse have increased drastically since the sec. XX. Therefore, it‟s sure that there is a necessity for scientific study in this area, so we will have the knowledge and direction needed for treatments and preventions of drug dependence. This study aim to verify how therapy in group, with the family members of the drug dependence- while getting a deeper comprehension of this issue transferring the problem from the dependent to the family group- collaborates with the progress of the individual, in terms of more adhesion, as we consider the situation as a whole, and so we can get better results for the treatment. Realizing the importance of the family, this theme will be adopted by the view of systemic approach. This is a qualitative study with a mixed methodology character: family therapy, genograms and semi-structurated interviews, using as a base the narratives of the members, because we understand that the meanings are built socially. The study was done in a therapeutic community in São Jose do Rio Preto, state of São Paulo. Nine families participated of the study, and was realized eight sections in group. The results, showed how the members of the family was re-mean their narratives and their behavior throughout the sections. It became clear that the group therapy is very productive, because they pass through the same difficulties, seek for help in each other, talk through the experiences they have being through, and so they get stronger. Plus, the family member has to be seen and treated as the key-word in the treatment process of drug dependence, contributing to the improvement of the familiar relationship, increasing the possibility of the dependent motivated himself and keep in treatment / A dependência de drogas na atualidade é um fenômeno amplamente divulgado e discutido, visto que o consumo de drogas cresceu assustadoramente a partir do século XX. Portanto, fica evidenciada a necessidade da construção de estudos científicos nesta área, para a compreensão e direcionamento de ações preventivas e de tratamento. Esta pesquisa teve como objetivo estudar como a terapia familiar em grupo com os familiares dos dependentes ao gerar uma compreensão mais ampla do problema, então deslocado do membro dependente para o grupo familiar , colabora para o progresso do tratamento desse membro, em termos de maior adesão e melhores resultados do tratamento. Pelo fato de priorizarmos a importância da família, este tema será abordado sob o prisma do pensamento sistêmico. Assim, efetuamos uma pesquisa qualitativa de caráter multimetodológico: terapia familiar em grupo, genograma e entrevistas semiestruturadas, utilizando como base as narrativas dos participantes, pois compreendemos que os significados são construídos socialmente. O estudo foi desenvolvido em uma comunidade terapêutica na cidade de São José do Rio Preto, São Paulo. Participaram do estudo nove famílias e foram realizadas oito sessões em grupo com os familiares. Os resultados mostram como os participantes da pesquisa foram, por meio das narrativas, ressignificando seus comportamentos e suas mudanças nos grupos terapêuticos. Ficou evidenciado que a terapia em grupo é muito produtiva, porquanto os indivíduos enfrentam as mesmas dificuldades, se apoiam, compartilham as experiências vividas e com isto se fortalecem, e também que o familiar deve ser considerado e tratado como uma das peças-chave no processo de recuperação da dependência de drogas, contribuindo para a melhoria das relações familiares e ampliando a possibilidade de o dependente motivar-se e manter-se em tratamento

The abuse of anabolic androgenic steroids (AAS) is becoming increasingly common and may result in a range of physiological as well as psychological effects such as altered behavior in terms of increased aggression, cognitive dysfunction and addictive behavior. AAS comprise testosterone and its derivatives, of which nandrolone is one of the more common. Previous studies have shown nandrolone-induced effects in male rats on peptide levels within the Substance P (SP) system and the dynorphinergic system; these effects may be linked to some of the reported behavior alterations. The studies presented in this thesis aimed to investigate the mechanisms underlying these peptide alterations and also to further investigate neuropeptidergic effects attributed to nandrolone administration. The results display significant effects on the enzymatic conversion of SP and Dynorphin A into their bioactive metabolites SP(1-7) and Leu-enkephalin-Arg6, respectively, as a result of nandrolone treatment. More profound investigations on the dynorphinergic system displayed effects on the kappa opioid receptor density in various brain regions. There was also a significant increase in the expression of the gene transcript of prodynorphin in the hippocampus, a brain region associated with cognitive processes. In addition, impaired spatial learning and memory in the Morris water maze task following nandrolone administration was encountered. The results provide further understanding regarding neuropeptidergic mechanisms underlying AAS-induced behavioral effects.

Bc. Žaneta Jakubová, Specialist in laboratory methods Signs of epilepsy spectrum disorder in persons with psychostimulants addiction Diploma thesis Charles University in Prague, Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences, Background: The aim of this diploma thesis is to study the occurrence of symptoms of epileptic spectrum disorder in psychostimulant subjects and to demonstrate the effect of psychostimulants on the occurrence of this disorder. Methods: For questionnaire survey was used to collect the data, in which probands submitted a total of 3 questionnaires. Input anamnestic questionnaire to obtain general information, the remaining two are focused on symptoms of epileptic spectrum disorder - Complex Partial Seizure-like Symptoms Inventory (CPSI) and Limbic System Checklist-33 (LSCL-33). Statistical methods of percentage comparison, chi-square test and unpaired t-test were used for evaluation. Results: Unusual scores and scores for epileptic spectrum disorder reached a total of 60 % of respondents in the CPSI. In the LSCL-33 questionnaire, a suspect and abnormal score reached 100 % of respondents. Conclusions: Both hypotheses have been demonstrated, namely that psychostimulants influence the occurrence of symptoms of epileptic spectrum disorder and that...

L’épidémie du VIH a bouleversé le rapport de la médecine à l’individu et inversement. D’une part, la forte stigmatisation associée à la contamination par le virus a rendu le vécu de la maladie plus complexe que pour toute autre pathologie. D’autre part, la chronicisation de l’infection impliquant une prise en charge complexe à base d’une multithérapie au long cours a contraint les soignants à s’interroger plus en profondeur sur la relation intime du patient à son traitement, et tout particulièrement sur l’observance thérapeutique. L’idée de ce travail de thèse est de poursuivre une argumentation en faveur d’une nouvelle approche moins paternaliste de l’observance aux antirétroviraux, incluant un partage des savoirs entre le médecin et le patient, et de l’appliquer à des populations de patients dont les comorbidités compliquent la prise en charge telles que la dépendance aux opiacés et l’infection par le virus de l’hépatite C. A travers une série d’articles, nous avons montré que la prise en compte de la perception du patient vis-à-vis des soins permettait de mieux comprendre la non-observance aux traitements. Chez les personnes traitées pour leur dépendance, la non-observance peut être définie comme l’injection du traitement de substitution ou la consommation d’opiacés illicites. La diminution ou l’arrêt de ces pratiques est un processus long, souvent ponctué de rechutes et elles peuvent être le reflet d’une prise en charge inadaptée. Les résultats de ce travail ont permis de mettre en évidence l’effet positif d’un accès à des soins adaptés, à travers une prise en charge de la pathologie mais aussi la réduction des risques liés à la non-observance. Il s’agit là de promouvoir une relation plus délibérative entre le médecin et le patient. / The epidemic of Human Immunodeficiency Virus (HIV) has profoundly changed the relationship between medicine and humans and vice versa. On the one hand, the intense stigmatization associated with HIV infection has made the disease more complex than for any other pathology. On the other hand, the chronicization of infection has forced care providers to investigate in greater detail the intimate relationship between patient and treatment, and more particularly, the therapeutic adherence. My research work aimed to investigate this latter argument in greater detail, favoring a less paternalistic approach toward therapeutic adherence in HIV-infected patients and applying this approach to multi-treated populations with comorbidities such as drug dependence and hepatitis C. Through several articles, we tried to put in evidence that a model of care that includes patient’s perception about care may lead to better understand non-adherence to treatment (ongoing drug use, drug injection or treatment diversion). In fact, injection cessation or reduction of opioid consumption in dependent individuals is a non-linear process which could take a long time, and which is often punctuated with relapse. Our findings showed the positive impact of access to adequate care to treat not only the disease but also the harm related to non adherence to treatment. The idea is to promote a more deliberative relationship between physician and patient, including a harm reduction approach.

Background: Women with substance abuse problems have distinctive features and face many difficulties arising from their gender specificities. Among them, motherhood is significantly represented, which, combined with the abuse of addictive substances, fundamentally changes its profile, from experience, to the way these women relate to their children. These ways are burdened with many experiences, processes and emotions, which subsequently block the establishment of appropriate education. Aim: The aim of the thesis was to find out whether women with addiction problems feel guilty and shy in relation to their children, or map out where these feelings come from and what forms them. Another key objective was to reveal whether these feelings could create barriers in relation to the child, and especially in education. The last goal of the thesis was to evaluate whether, in addition to these determinants, other variables occur, or which ones are entering into the process of remediation. Methodology: Data collection took place in spring 2019 in the Therapeutic Community Karlov. A semi-structured interview was conducted with clients and specific observed situations of maternal interactions with the child were described. Research sample: The sample was created by 5 clients of the Therapeutic Community...

Background Animal models can be used to mimic human conditions of psychopathology, and also as pre-clinical models to evaluate candidate drugs. With hormonal treatment it is possible to produce behavior in the rat which corresponds to the mental symptoms of pre-menstrual syndrome (PMS), and pre-menstrual dysphoric disorder (PMDD). PMS affects 25-30 % of all women in fertile age and 3-8% are diagnosed with the more severe condition PMDD. The cardinal mental symptoms are; irritability, mood-swings, depression, anxiety, fatigue, insomnia, difficulties with concentration and memory and learning difficulties. The symptoms of PMS/PMDD occur in the luteal phase in conjunction with increasing concentrations of progesterone (P4) and P4-metabolites. In anovulatory cycles the symptoms are absent. The hormones which produce the monthly reoccurring negative symptoms on mood are foremost the neuroactive metabolites; allopregnanolone (ALLO) and tetrahydro-deoxycorticosterone (THDOC). ALLO is produced by the corpus luteum, but can also be synthesized in the brain, both ALLO and THDOC can also be released from the adrenal cortex during stress. These steroids are active on the inhibitory GABA neurotransmitter system through the GABAA receptor, and the effects are similar to that of alcohol and benzodiazepines. These steroids have strong sedative and hypnotic effects. A paradox is that some individuals seem to react with negative mood on sex steroids while all fertile women have the cyclical steroid changes during the menstrual cycle. Some individuals are more sensitive to neuroactive steroids with influences of personality, heritability and stress factors. Aims The thesis aims were to develop pre-clinical animal models of PMS/PMDD and to investigate induction of ALLO tolerance, individual sensitivity to neurosteroids and the interactions between chronic social stress and neurosteroids. Methods In these studies male and female Wistar rats were used to test steroid hormone effects on learning and memory and behaviors analogous to negative mood symptoms. This was accomplished through hormonal treatment and a subsequent withdrawal period from P4 (P4) + estradiol (E2) (PEWD), or ALLO. To assess tolerance, memory and learning in the Morris water maze (MWM) was studied. Anxiety-like behaviors were tested with the elevated plus maze (EPM), open field test (OFT), and the intruder test (IT). The EPM or OFT was used to classify the rats as high or low responders on risk-taking and explorative behavior (HR/LR). For social ranking order assessment the tube test (TT) and food competition test (FCT) were used. Chronic social stress was accomplished through co-habituation with two older rats (chronic subordination stress). In female rats the estrous cycle followed using staining of vaginal smears. Concentration of corticosterone (CORT) was measured by radio-immuno-assay (RIA). Results In the MWM ALLO pre-treatment produced tolerance to the acute negative ALLO effects. Both male and female rats showed behavioral correlations between the EPM and OFT tests, and correlations were also seen in CORT levels. Individuals with the stable trait of high risk-taking and explorative behavior (HR) were more sensitive to PEWD induction of anxiety-like behavior. These animals also showed decreased CORT levels during withdrawal. Chronic subordination stress enhanced the response to PEWD on measures of locomotor activity and social anxiety-like behavior. Conclusions It is possible to induce tolerance to the negative ALLO effects on learning and memory. The animal models of anxiety-like behavior show an individual PEWD response profile where HR rats are more sensitive. Exposure to chronic social stress enhanced the PEWD response. Hence there are both inherent and environmental factors behind the behavioral response to steroid hormones in rats. / Stress- och könshormoners verkningar på centrala nervsystemet

This diploma thesis deals with the psychosocial problems of patients treated for chronic hepatitis C. The aim of the thesis was to map the problems arising during this treatment and to divide them into biological, psychological, and social problems and problems leading to a change in the patient's quality of life. The disease is also assessed in relation to risky behaviour - a history of substance dependence. The work should also show how the individual components of the multidisciplinary team are involved in intervention during treatment. In the first part of the thesis, I describe the theoretical issues of hepatitis C as a consequence of intravenous drug dependence, and I deal with quality of life, the multidisciplinary team and psychosocial care with the help of professional literature. In the empirical part, I chose qualitative research through the interviewing method using the semi-structured interview technique. The research sample consisted of eight clients of the infectious disease ward treated for or shortly after chronic hepatitis C. The data analysis was evaluated by the data categorization method. The results showed a very demanding, mainly physically, course of treatment with a significant impact on the mental and social function of the patient. The reason why the clients had turned to addictive substances was varied, from a curiosity in youth, through addiction as a consequence of trauma from sexual abuse in childhood, to addiction as a consequence of leaving a children's home without the adequate social preparedness and assistance. The components of the multidisciplinary team that intervened the most were healthcare, psychiatry, psychology - psychotherapy, the District Social Security Administration, and the Labour Office. This work identifies the issues that are not widely spoken of. It has shown us that not only addiction to addictive substances is dangerous for the individuals, but that the health problems do not end even after the treatment of their addiction, and the clients have to undergo a rather demanding treatment in order to eliminate these problems. However, on a society-wide level, it is desirable that as many of these clients as possible be treated with a positive result, even if they are drawing large amounts from the general health insurance. The results could serve as materials for the prevention of socio-pathological phenomena, for educational activities in schools or for institutions in, for example, K-centres, which provide help to addictive substance users.

Magister Psychologiae - MPsych / The outcome of child abuse, i.e. physical, emotional and/or sexual, and child neglect is multifactorial. The severity, duration and nature of abuse and the child’s vulnerabilities are all contributory factors with regards the outcome of abuse. Children who are traumatized are likely to be profoundly affected. Studies have shown and nearly every researcher agrees that early childhood traumas lie at the root of many emotional and psychological illnesses. It has been noted that drug abuse is a major problem in the Western Cape. This thesis explored the relationship between subjectively perceived childhood trauma and drug dependence in an in-patient treatment-seeking sample of adults in the Cape Town Metropolitan Area in the Western Cape. This thesis presents the results of a measure of childhood trauma, namely the Childhood Trauma Questionnaire [CTQ] and a measure of drug dependence, the Drug Use Disorder Identification Test [DUDIT]. The sample consisted of 52 participants and included both males and females. Only participants who were identified as drug dependent were included in the study. Patients who were actively psychotic and/or alcohol dependent were not included in the study. Ethical clearance was obtained from the University of the Western Cape’s higher degree ethical committee. The anonymity of the participants, the importance of responding openly and honestly and the sensitive nature of the questions were highlighted during the test administration. Questionnaires were administered in accordance with the guidelines stipulated in the respective manuals. The data was analysed through correlation. The study found a positive correlation between childhood emotional abuse and drug dependence, and childhood physical abuse and drug dependence.

La consommation de drogues est répandue au Canada, et on estime qu’environ un Canadien sur cinq développera une dépendance au cours de sa vie. Les personnes vivant ou ayant vécu avec une dépendance aux drogues (PVVDD) font souvent l’expérience d’interactions stigmatisantes dans le système de santé, qui peuvent être exacerbées par des facteurs socioculturels. Cela peut affecter leur sentiment d’efficacité face aux décisions de santé et les empêcher d’exercer leur agentivité au quotidien. Ce projet de recherche explore les compréhensions de divers groupes de parties prenantes par rapport à la légalisation du cannabis, la consommation de drogues, la dépendance aux drogues et la prise de décision volontaire. Trois groupes ont été interrogés par des entrevues semi-dirigées : les PVVDD, les cliniciens travaillant auprès de PVVDD et les membres du public. Les données, analysées par des méthodes qualitatives cohérentes avec l’éthique pragmatiste inspirée de Dewey, ont démontré que les parties prenantes canadiennes avaient une opinion positive de la légalisation du cannabis au Canada, mais que leurs jugements moraux variaient en fonction du groupe. Les résultats ont aussi démontré que les participants avaient une compréhension complexe de la dépendance aux drogues et de la prise de décision volontaire que ne reflètent pas les modèles prédominants. L’identification des dimensions morales en jeu peut informer la pratique de l’éthique clinique dans les problèmes éthiques incluant des PVVDD. De plus amples recherches sur l'interaction de ces aspects dans des problèmes et dilemmes concrets qui émergent dans les relations de soins sont nécessaires. / Drug use is common in Canada, and it is estimated that one in five Canadians will develop a drug use problem in their lifetime. People with a lived experience of drug dependence (PWLE) often experience stigmatizing interactions in the healthcare system, which can be exacerbated by other layers of stigma based on socio-cultural factors. This can impact their sense of self-efficacy related to health decisions and prevent them from exercising agency in everyday life. This research project explores the understandings of various stakeholder groups in relation to cannabis legalization, drug use, drug dependence and volitional decision-making. Three groups were interviewed using semi-structured interviews: PWLE, clinicians working with PWLE and members of the public. The results, analyzed through qualitative methods consistent with Dewey’s pragmatist ethics, showed that Canadian stakeholders had a positive opinion of cannabis legalization in Canada, but that their moral judgments varied according to group. The results also showed that participants had a complex understanding of drug dependence and volitional decision-making that did not mirror the predominant models. Identifying the moral dimensions at play can inform clinical ethics practice in ethical problems including PWLE. Further research into the interplay of these aspects in concrete problems and dilemmas that emerge in care relationships is needed.