Blanka Kores Plesnicar

• Managing Director at University Psychiatric Hospital Ljubljana

Aim To evaluate the incidence, severity and characteristics of aggressive behaviour in patients hospitalized in acute psychiatric wards, as well as the association between patient characteristics and the incidence of recurrent aggressive behaviour. Methods A multicentre prospective study included all twelve acute wards in Slovenian psychiatric hos...

Depression is a common mental disorder with a high burden of disease worldwide and requires effective treatment. On behalf of the General Advisory Council for Psychiatry, clinical recommendations were formed to help clinicians make decisions to improve the treatment of patients with unipolar depressive disorder; several international guidelines ser...

Introduction: The Dynamic Assessment of Situational Aggression (DASA-IV) scale provides a daily assessment of the risk of aggression in an individual patient in the inpatient setting. Based on the score obtained, the registered nurse guides and directs the staff in adapting interventions to de-escalate and prevent the occurrence of aggression. The...

Background: Spiritual care can improve the cognitive ability and the associated activities, and help raise self-esteem and self-sufficiency in older people with dementia. It creates hope, helps find purpose and inner peace, and improve their sense of satisfaction with life. Thus, spirituality is a crucial element in providing nursing care for older...

Alcohol dependence is a chronic mental disorder that leads to decreased quality of life for patients and their relatives and presents a considerable burden to society. Incretin hormones, such as glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) are endogenous gut-brain peptides, which can travel across the blood...

Objective Most guidelines for the management of aggressive behavior in acute psychiatric patients describe the use of de-escalation as the first-choice method, but the evidence for its effectiveness is inconsistent. The aim of the study was to assess the effect of verbal and non-verbal de-escalation on the incidence and severity of aggression and t...

This chapter presents the growing evidence that suggests that pharmacogenetic variability contributes to interindividual differences in response to antipsychotics and related adverse effects. The data from pharmacokinetic studies, candidate gene approach, and genome-wide association studies and their metaanalyses supported the identification of cli...

Purpose: Management of aggressive behaviour in patients with psychiatric diagnoses presents a challenge and burden for health staff. The present study compared two psychiatric institutions (the Department of Psychiatry of the University Medical Centre Maribor and the University Psychiatric Clinic Ljubljana) in terms of frequency and consequences of...

We investigated two functional polymorphisms in NLRP3 inflammasome genes (NLRP3 rs35829419 and CARD8 rs2043211) and their association with alcohol dependence and related anxiety, depression, obsession-compulsion, or aggression in 88 hospitalised alcohol-dependent patients, 99 abstinent alcohol-dependent participants, and 94 controls, all male Cauca...

Aim To illuminate family members experiences with the spiritual care provided to their family members living with dementia in nursing homes. Design A qualitative research design utilizing phenomenological hermeneutical approach. Methods Data were gathered by conducting twelve in-depth interviews with family members of older people living with dem...

Depressive disorders in pregnancy are common and generate concerns regarding their treatment. The effects of untreated maternal depressive symptoms on preterm birth, low birthweight, fetal growth restriction and postnatal complications are well known. When left untreated, depressive disorders continue postpartum and have a big impact on the patient...

A case of a middle-aged male, suffering from acute psychosis while in self-isolation due to COVID-19 (coronavirus disease 2019) is presented. The patient required urgent hospital admission due to psychosis, which was only possible to COVID-19 unit of the Department of Infectious Diseases at the time. After transfer to psychiatric hospital, stool sa...

Introduction: Alcohol dependence is the most prevalent addiction disorder that develops gradually as an interplay of individual and social factors. It impacts the quality of life of affected individuals. The purpose of this study was to examine the quality of life of alcohol-dependent people at different stages of treatment compared to individuals...

Background: Spiritual care is a component of holistic nursing care, and it is a crucial element in providing person-centred care of older people living with dementia. The review aimed to find a deeper meaning and provide a profound interpretation of the role of spirituality from the perspective of older people living with dementia. Methods: The sys...

Introduction: Attitudes of nursing employees towards mechanical restraint are directly connected to their incidence. The purpose of this research was to examine the attitudes of psychiatric nursing staff towards the use and administration of mechanical restraints. Methods: The cross-sectional descriptive study was conducted using a structured Heyma...

Background: Suicide is a complex action of suicidal methods and peripheral factors with seemingly threatening components representing actual cause for the suicidal actions. It is especially those, apparently unimportant factors that represent a crucial milestone in the network of all the other, personal, cultural, genetic and biochemical factors,...

Background: Coercive measures are containment methods used in psychiatry to curb patients' disruptive and aggressive behaviours towards themselves, others or objects. The prevalence of the practice of coercive measures in psychiatry is directly related to the attitudes of the staff. When discussing these attitudes, nurses are often particularly si...

In psychiatric hospitals, involuntary admission and treatment without prior patient’s consent and the use of coercive measures are in certain circumstances necessary; in most countries, these conditions are regulated by law. Nevertheless, various factors still lead to differences between countries and hospitals in terms of involuntary admission rat...

This chapter presents reports from ten mid-size European countries. Authors from Austria, Croatia, Norway, Poland, Portugal, Romania, Sweden, Slovakia, Slovenia and Turkey report about the situation in their countries. In all countries, various activities have been performed in order to fight against stigma. These included national and local campai...

Background: Dopaminergic system plays an important role in antipsychotic response. Functional single nucleotide polymorphisms (SNPs) can change dopamine receptor expression or dopamine disposition and thus influence response to antipsychotic treatment. Subjects and methods: 138 schizophrenia patients were stratified in the treatment-resistant an...

The existing antipsychotic therapy is based on dopamine hyperfunction and glutamate hypofunction hypotheses of schizophrenia. Adenosine receptors (ADORA) have a neuromodulatory role and can control dopaminergic and glutamatergic systems. To elucidate the effect of ADORA polymorphisms on psychopathological symptoms and adverse effects in patients wi...

Quality relationship between a doctor and a patient with mental disorder is pivotal to successful treatment. The doctor, the patient and the environment contribute numerous factors to this relationship. There are also ethical and legal aspects to consider, and above all, it is intrinsically linked with the patient's trust. However, the relationship...

Antibiotic consumption in psychiatric hospitals is low compared to general hospitals when the consumption is measured in defined daily doses (DDD) per 100 patient days. Measured in DDD per admission, however, the consumption of antibiotics in general and psychiatry hospitals may almost be the same.Antibiotics have several drug–drug interactions (DD...

Five patients in a geropsychiatric unit of a psychiatric hospital became abruptly ill with pneumonia caused by Streptococcus pneumoniae serotype 6A. Four other residents were colonized with the same serotype, which has previously not been reported in association with pneumonia outbreaks. Furthermore, serotype 6A is not included in all vaccine types...

Each day clinical practice tries to follow the idea and principles of personalized medicine. Besides predicting an individual's sensibility or predisposition for developing schizophrenia, pharmacogenetic and pharmacogenomic approaches attempt to define and acknowledge important indicators of clinical response to antipsychotics namely their efficacy...

BACKGROUND: Genes involved in the serotonin pathway may determine the susceptibility to alcohol dependence and its severity. The present study explored whether specific polymorphisms in the serotonin pathway could be associated with alcohol dependence or alcohol-related psychopathological symptoms. METHODS: The cohort comprised 101 currently and 1...

Heritability plays an important role in the development and expression of alcohol dependence. The present genetic association study explored the role of TPH2 polymorphisms and their haplotypes to investigate its role in alcohol dependence and comorbid psychopathological symptoms. The sample included 101 subjects currently diagnosed as alcohol abuse...

This study aimed to explore the influence of two genetic polymorphisms of the 5-hydroxytryptamine 1A receptor (5-HT1A) and solute carrier family 6, member 4 (SLC6A4) genes on the clinical symptoms and treatment resistance in Slovenian patients with schizophrenia. A total of 138 patients with schizophrenia were evaluated using the Positive and Negat...

Schizophrenia is one of the most severe mental disorders. In the long run, it may extensively affect one's mentality, self-image, and perception of the environment. It impairs everyday functioning and may cause significant disablement. It is characterised by phenotypic and genotypic heterogeneity that is becoming increasingly recognisable. However,...

This study investigated the associations between single nucleotide polymorphisms in the neurodevelopmental Disrupted In Schizophrenia 1 (DISC1 ), neuregulin 1 (NRG1), brain-derived neurotrophic factor (BDNF) and NOTCH4 genes and the clinical symptoms and the occurrence of treatment-resistant schizophrenia in the Slovenian population. We included 13...

The present study explored whether specific single-nucleotide polymorphisms in alcohol metabolic pathway are associated with alcohol dependence or alcohol-related psychopathological symptoms. Three groups of male unrelated subjects were included: 101 currently alcohol-dependent patients, 100 formerly alcohol-dependent subjects and 97 healthy contro...

Background. Approximately 30 % of patients with schizophrenia do not achieve remission upon antipsychotic treatment. The purpose of this article is to present the differences between treatment resistant and treatment responsive patients in Slovenian population.Methods. The prospective study included 138 patients diagnosed with schizophrenia accordi...

In this article we suggest guidelines for the diagnostic process with appropriate investigations to be carried out. Part of the guidelines is intended for pharmacotherapeutic treatment and ranges from already established treatment of cognitive decline to treating behavioral and psychological changes. These have a significant impact on the quality o...

Objectives: Previously, oxidative damage has been associated with severity of clinical symptoms and supplementation with antioxidants and essential polyunsaturated fatty acids (EPUFAs) was proposed to have beneficial effects in schizophrenia. We evaluated the effects of supplementation with EPUFAs and vitamin E in patients treated with haloperidol...

Modern development trends in psychiatry incorporate greater care for patients and above all individualisation of therapeutic approaches. Therapeutic drug monitoring (TDM) for phenotyping and genotyping of drug metabolism are possible determinants of improved treatment efficacy, reduced adverse effects of psychotropic drugs, and enhanced treatment c...

Depression is a severe and usually recurrent mental disorder which often leads to a significant impairment of everyday functioning, a reduced quality of life, and also great suffering of the patients. The treatment of a depressive disorder is not only limited to acute treatment; it also requires prolonged management. Patient compliance is of utmost...

Izvleček Izhodišča. Zasvojenost od alkohola je zelo pogosta in kompleksna bolezen. Zasvojeni od alkohola imajo veliko tveganje za pojav sopojavne psihiatrične motnje. Metode. V prvi tovrstni slovenski raziskavi smo preverili prisotnost in izraženost simptomatike najpogostejših sopojavnih duševnih motenj pri zasvojenih od alkohola. Vključili smo tri...

In this study the role of oxidative stress in schizophrenia was investigated by evaluating the relationship of oxidative stress markers with neurochemistry, psychopathology, and extrapyramidal symptoms. Antioxidant activity of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, and concentrations of malondialdehyde, prote...

Export Date: 18 October 2014

There is a growing body of evidence confirming the involvement of oxidative stress and inflammation in pathogenesis of schizophrenia. Inter-individual variation in antioxidant capacity caused by different genetic profile could potentially influence patient's susceptibility to oxidative damage. In this study we evaluated the polymorphisms of mangane...

Background: Cancer chemotherapy is associated with numerous side effects, one of them being cognitive impairment, which is poorly known and insufficiently recognised in clinical practice. Memory, concentration, attention, and executive function deficits are associated with chemotherapy, hormone therapy, and also with treatments using biological res...

Stigma is the most powerful obstacle to the development of mental health care. Numerous activities aiming to reduce the stigma of mental illness and the consequent negative discrimination of the mentally ill and their families have been conducted in Europe. Descriptions of many of these activities are not easily available, either because there are...

The global financial and economic crisis starting in 2007 led to a deterioration of several socio-economic determinants of mental health. The aim of this cross-sectional study was to examine the impact of the present economic crisis on the depression and anxiety levels of the employed in the private and public sector in Slovenia. Altogether 1592 em...

Increasing evidence indicates that oxidative damage exists in schizophrenia. Available literature about possible mechanisms of oxidative stress induction was reviewed. Furthermore, possibilities of measuring biomarkers of schizophrenia outside the central nervous system compartment, their specificity for different types of schizophrenia and potenti...

Slovenia is one of the countries with the highest national suicide rates (30/100,000/year). The rate of suicide attempts is accordingly high, for both adolescents and adults. Suicidal children and adolescents from the four North-eastern regions of Slovenia are hospitalised at the Child and Adolescent Psychiatry Unit of the General Hospital Maribor....

The glutamatergic system may be relevant to the pathophysiology of psychosis and to the effects of antipsychotic treatments. We investigated a set of 62 SNPs located in genes coding for subunits of glutamatergic receptors (GAD1, GRIA1, GRIA3, GRIA4, GRID2, GRIK1, GRIK2, GRIK3, GRIK4, GRIN2B, GRM1 and GRM4), and the transporter of glycine (SLC6A5),...

The objective of this prospective study was to characterize the metabolism of risperidone to (+)- and (-)-9-hydroxyrisperidone in vivo and to evaluate the influence of CYP2D6 genotype. A population pharmacokinetic modeling approach was used to estimate the interindividual variability of the pharmacokinetic parameters in 50 hospitalized patients wit...

In this study we wanted to determine the efficacy and tolerability of venlafaxine extended release in patients with major depressive disorder. 161 patients with major depressive disorder were included in an open-label, multicentre clinical study. All patients were treated with venlafaxine extended release in flexible doses ranging from 75 to 325 mg...

Background: Consultant-liaison psychiatry represents a link between somatic medicine and psychiatry, its care being focused on patients with somatic illnesses and concomitant mental problems and disorders. It has an important role in an integral and quality treatment of patients. It is often underestimated and undeveloped. Conclusions: There is eve...

Antipsychotics are the lodestar in the treatment of schizophrenia despite the variability of the therapeutic response and drug-induced adverse effects (especially extrapyramidal symptoms, gain weight, and metabolic disturbances). More and more data are supporting the notion that genetic factors - as well as often overlooked personal and environment...

Polymorphic multidrug resistant protein 1 (MDR1) transports drugs against a concentration gradient across the blood-brain barrier and reduces their accumulation in the brain. MDR1 may therefore influence antipsychotic brain availability contributing to inter-individual differences in treatment response and adverse effects, regardless of plasma conc...

The purpose of this study was to asses the attitude of undergraduate midwifery students towards teaching other women in methods of breast self-examination (BSE). PARTICIPANTS AND METHODS.: The study was performed at the beginning and at the end of students' study at the Faculty of Health Sciences in Ljubljana, Slovenia. It was carried out during th...

Depression is one of the leading causes of global disease burden. In addition, depression is frequently associated with troublesome physical symptoms, such as fatigue, sleep disturbances and appetite changes, and also with painful physical symptoms, like back pain, headache, fibromyalgia and others. Depression and pain have a reciprocal relationshi...

Multiple myeloma (MM) remains largely incurable, although traditional chemotherapy and new compounds have been shown to produce a clinical response. Clinical studies were performed to determine the effectiveness of interferon-alpha (IFN-alpha) in MM, which has also recently been shown to function as a survival factor for MM cells. The effects of di...

Multiple myeloma (MM) remains largely incurable, although traditional chemotherapy and new compounds have been shown to produce a clinical response. Clinical studies were performed to determine the effectiveness of interferon-alpha (IFN-alpha) in MM, which has also recently been shown to function as a survival factor for MM cells. The effects of di...

Depression is a leading course of morbidity and mortality. The majority of depressed patients seek attention first from their primary care physician, who mostly prescribes pharmacological treatment alone. There is evidence that integrating physical exercise into therapy can improve treatment outcomes for many patients with depression or anxiety. In...

Electroconvulsive therapy (ECT) is largely historical but is still in use. Modern psychiatry requires careful selection of patients in whom ECT will be performed. The indications for ECT treatment are limited, and the selection criteria should be strictly followed. The advantages and the disadvantages of the methods are discussed here. Despite the...

One of the most challenging problems in clinical psychiatry are inter-individual differences in clinical response to antipsychotic treatment. Several studies were investigating the impact of the polymorphic cytochrome P450 2D6 gene (CYP 2D6) on the psychopathological and extrapyramidal symptoms, but the results were conflicting. There is a lack of...

Metachromatic leukodystrophy (MLD) is a metabolic disease that has recently been investigated as a model for the study of psychosis. We report on two sisters with adult-type MLD who developed psychiatric symptomatology, but differed in their expression of psychotic and depressive symptoms. Association studies have indicated that polymorphisms in ge...

Slovenia, with an area of 20 000 km ² and a population of 2 million, is one of the smallest members of the European Union. It gained its independence from Yugoslavia in 1991. The country has a gross domestic product (GDP) of US$27 300 per capita. (Largely because of its historical links with Western Europe, Slovenia has a higher GPD compared with o...

The serotonin transporter (5-HTT) plays an important role in serotonergic neurotransmission. In the present study, we investigated the effects of the 44 bp insertion/deletion polymorphism in the promoter region of 5-HTT gene (5-HTTLPR) on symptomatology of psychosis and clinical response to antipsychotic drugs. In total 56 patients acutely treated...

Multidrug resistant protein (MDR1) gene codes for P-glycoprotein (P-gp) that transports drugs against a concentration gradient across the blood–brain barrier and reduces their bioavailability in the brain. Most second generation antipsychotics are P-gp substrates and differential entry of antipsychotics into the brain might explain interindividual...

DRD(1) and DRD(2) receptor gene variants have been associated with clinical aspects of schizophrenia; however only specific features were analyzed in different samples. To assess the complex interaction between genetic and clinical factors, we studied the possible cross-interactions between DRD1 and DRD2 dopamine receptor gene polymorphisms, sympto...

The adult type of metachromatic leukodystrophy can manifest itself as motor or as psycho-cognitive form, the latter is very similar to schizophrenia. We report on two sisters with adult metachromatic leukodystrophy who display symptoms of both forms. Presented are genotype analyses and 4-year follow-up data regarding clinical manifestations as well...

There is a long-recognized association between alcohol consumption and aggressive behavior. This study was designed to examine aggression in a group of socially well-adapted recovered alcoholics (RA). The question addressed was whether the treatment, together with long-term abstinence from alcohol, could reduce aggression and hostility in RA. A gro...

Poor response to antipsychotics treatment and extrapyramidal side effects (EPS) are the most challenging problems in the treatment of schizophrenia. Several studies were investigating the impact of polymorphic cytochrome P450 2D6 gene ( CYP2D6) on EPS but the results were conflicting. There are practically no clinical studies of long-term treatment...

Depressive disorder is the most common psychiatric disorder all over the world. It is frequently a chronic disease with high rates of recurrence and impairment of physical and social functioning. Depression also all too frequently complicates physical illness. Unfortunately, depression can often go undiagnosed and untreated. Appropriate treatment e...

The Charles Bonnet syndrome is a condition in which individuals experience complex visual hallucinations without evident psychopathology or disturbance of normal consciousness. Although it can affect people of any age, it is more frequent among the elderly. It occurs mostly in people with damaged sight, as a result of peripheral eye pathology or pa...

Background: The role of simple reaction time in schizophrenia has been extensively reported to date in professional literature. However, most studies have examined basic reaction time under static conditions using a single measurement. The aim of the present study was to establish whether any changes occur in simple reaction time during treatment...

Background. Antipsychotics and also some other psychiatric and some non-psychiatric drugs are known to cause extrapyramidal symptoms. Some of these symptoms, e.g. tardive dyskinesia, may be irreversible and may have an important influence on the quality of life. Various factors are involved in the etiopatogenesis of extrapyramidal symptoms. Genetic...

Tres exposiciones y un episodio de reexposición de angioedema producido en tratamiento con risperidona - Volume 9 Issue 3 - B. Kores Plesnicar, S. Vitorovic, B. Zalar, M. Tomori

The study investigated which psychosocial factors distinguish adolescent smokers from non-smokers, and examined the most important factors correlated with smoking. A cross-sectional survey carried out by means of a questionnaire which, in addition to items on family, school, healthy habits, drug abuse and suicidal behaviour, also included a scale o...

This study investigated psychosocial risk factors in adolescents and assessed gender differences in the frequency of their occurrence. A specially designed questionnaire, which included validated scales for the evaluation of depression (Zung Self-rating Depression Scale) and self-esteem (Rosenberg Self-Esteem Scale), was administered to a represent...

Lithium is widely used, and most of its side effects are well established and recognized. Persistent neurologic sequelae or dysfunctions are not common, but they are serious side effects. They usually persist after acute toxicity following accidental or suicidal overdose or during maintenance therapy, when toxicity is more insidious. The irreversib...

Background. Huntington disease occurrs rarely, it can be encountered not only by neurologists and psy- chiatrists but also by other medical practitioners. Its characte- ristic features are involuntary movements, cognitive disorders and gradual development of dementia. Diagnosis is given on the basis of these clinical features, positive familial ana...

Background. »Lost illusions« about conventional medicine, together with the orientation towards the »natural« way of life, lead into ever increasing use of alternative or com- plementary ways of treatment. Herbal medicines are entering into psychiatric practice with the intention of treatment (mostly self-treatment) psychiatric symptoms. Side effec...

Background. Antipsychotics and also some other psychiatric and some non-psychiatric drugs are known to cause extrapyramidal symptoms. Some of these symptoms, e.g. tardive dyskinesia, may be irreversible and may have an im- portant influence on the quality of life. Various factors are involved in the etiopatogenesis of extrapyramidal symptoms. Genet...

It has been suggested that genetic polymorphisms modifying oxidative stress may influence the response to antipsychotic treatment. In the present study we investigated the influence of polymorphisms in the genes coding for Catalase (CAT), Manganese Superoxide dismutase (MnSOD) and Cytochrome P450 17-hydroxylase (CYP17) on the response to acute anti...