Pavel Mohr

• Head of Department at National Institute of Mental Health

Quoidbach, V., Mohr, P., Szulc, A., Catalan, A., Meyer-Lindenberg, A., Vita, A., Chaumette, B., Duarte, C., Arango, C., Dom, G., Bitter, I., Rybakowski, J., Samochowiec, J., Santos, J. V., Beezhold, J., Nordentoft, M., Howes, O., Fusar-Poli, P., Boyer, P., Falkai, P., Kéri, P., Toczyski, P., Galderisi, S., Dollfus, S., & Gaebel, W. (2025). Rethinki...

Background Rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) are autoimmune illnesses characterised by chronic inflammation demonstrating differential associations with psychiatric conditions. Objective In this matched-cohort study, we aimed to investigate whether the associations between these inflammatory illnesses and mental disorde...

Background: Sense of agency (SoA) is the subjective experience of causing and controlling one’s actions. Recent studies suggested that SoA can be influenced by external manipulation through neurostimulation methods, while others have linked it to gamma oscillations in the right inferior parietal lobule (IPL). Objective: This study aims to provide e...

Objective Postpartum depression (PPD) is a serious condition with debilitating consequences for the mother, offspring, and the whole family. The scope of negative outcomes of PPD highlights the need to specify effective diagnostics and treatment which might differ from major depressive disorder (MDD). In order to improve our clinical care, we need...

Background Recent years show an exponential increased interest (“renaissance”) in the use of psychedelics for the treatment of mental disorders and broader. Some of these treatments, such as psilocybin for depression, are in the process of formal regulation by regulatory bodies in the US (FDA) and Europe (EMA), and as such on the brink of real-worl...

Background Evidence suggests reduced survival rates following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in people with preexisting mental disorders, especially psychotic disorders, before the broad introduction of vaccines. It remains unknown whether this elevated mortality risk persisted at later phases of the pandemic...

Background Growing evidence indicate substantial psychiatric comorbidity in patients with inflammatory arthritis (IA) [1]. Mental disorders may, then, subsequently contribute to worsened therapeutic response in people with rheumatoid arthritis (RA) or axial spondyloarthritis (axSpA). Objectives • 1. To assess the occurrence of mental disorders in...

Purpose To describe temporal trends in inpatient care use for adult mental disorders in Czechia from 1994 until 2015. Methods Data from the nationwide register of inpatient care use and yearly census data were used to calculate (a) yearly admissions rates, (b) median length of stay, and (c) standardized inpatient-years for adult mental disorders (...

Background Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians’ treatment choices for post-traumatic stress disorder (PTSD). Methods The case-based analysis included 611 participants, who correctly classified the vignette as a case of PT...

A comprehensive handbook covering current, controversial, and debated topics in psychiatric practice, aligned to the EPA Scientific Sections. All chapters been written by international experts active within their respective fields and they follow a structured template, covering updates relevant to clinical practice and research, current challenges,...

This study investigated the Czech adults’ mental health following the COVID-19 pandemic and the potential influence of data collection methodology on prevalence estimates. Separately, it investigated changes in help-seeking and associated barriers. Data from representative surveys on Czech adults, conducted in November 2017 (n = 3,306), in May (n =...

Sense of agency je pocit, že jsem tím, kdo způsobil danou akci. V této studii jsme zkoumali efektnízkofrekvenční (1 Hz) a vysokofrekvenční (10 Hz, 20Hz) rTMS stimulace pravého dolního parietálního laloku na sense of agency a potenciální roli gamma oscilací v tomto procesu. Participanti (N=16) podstoupili rTMS stimulaci, po které následoval úkolna s...

Background The crosslink between rheumatic diseases (RD) and psychiatric disorders (PD) has been suggested, particularly due to systemic inflammation and the psycho-social impact of chronic painful experience in patients with RD. Objectives In the present study, we investigated the risk of subsequent hospitalization (1) for PD and (2) either for o...

Background: Schizophrenia is a severe psychiatric disorder with periods of remission and relapse. As discontinuation of antipsychotic medication is the most important reason for relapse, long-term maintenance treatment is key. Whether intramuscular long-acting (depot) antipsychotics are more efficacious than oral medication in preventing medicatio...

Objective Postpartum depression (PPD) is a serious condition with debilitating consequences for the mother, offspring, and the whole family. The scope of negative outcomes of PPD highlights the need to specify effective diagnostics and treatment which might differ from major depressive disorder (MDD). In order to improve our clinical care, we need...

Background At-risk mental state (ARMS) individuals are at high risk to develop psychosis. In addition to attenuated symptoms, ARMS is associated with cognitive and functional impairment. Aim Our study goal was to explore prevalence rates of ARMS, comorbidities, functioning, and cognitive performance among non-help seeking adolescents. Methods In...

Decision-making about pharmacotherapy of mental disorders during pregnancy and lactation is a source of uncertainty in clinical practice. Potentially deleterious effects of drugs on the fetus and the infant are much feared; but at the same time, negative impact of untreated mental disorder have to be taken into account. Discontinuation of long-term...

Background While shared clinical decision-making (SDM) is the preferred approach to decision-making in mental health care, its implementation in everyday clinical practice is still insufficient. The European Psychiatric Association undertook a study aiming to gather data on the clinical decision-making style preferences of psychiatrists working in...

Clinicians and researchers consider that there are a variety of symptoms that constitute negative symptoms in schizophrenia, and they may use different definitions for the same symptoms. These differences are also reflected in a variety of negative symptom rating scales. Both research and clinical work are negatively affected by the lack of consens...

Dopamine receptor partial agonists (DRPAs; aripiprazole, brexpiprazole, and cariprazine) constitute a novel class of antipsychotics. Although they share a similar mechanism of action, DRPAs differ in their pharmacodynamics, pharmacokinetics, drug interactions, or safety and tolerability. The antipsychotic efficacy of all three drugs was established...

Background The COVID-19 pandemic caused an unprecedented worldwide crisis affecting several sectors, including health, social care, economy and society at large. The World Health Organisation has emphasized that mental health care should be considered as one of the core sectors within the overall COVID-19 health response. By March 2020, recommendat...

Objectives To assess the prevalence of mental disorders during the second wave of COVID-19 pandemic in comparison with both, baseline and the first wave of the pandemic, and to identify disproportionally affected non-clinical subgroups. Material and methods We used data from three nationally representative cross-sectional studies and compared the...

Increased frontal midline theta activity generated by the anterior cingulate cortex (ACC) is induced by conflict processing in the medial frontal cortex (MFC). There is evidence that theta band transcranial alternating current stimulation (θ-tACS) modulates ACC function and alters inhibitory control performance during neuromodulation. Multi-electri...

Aripiprazole, brexpiprazole, and cariprazine constitute the DRPA (dopamine receptor partial agonists) subcategory of second-generation antipsychotics. Seemingly, they appear to be similar. However, they differ significantly in their pharmacodynamics, pharmacokinetics, drug interactions, efficacy, safety and tolerability, approved indications, dosin...

Aims The United Nations warned of COVID-19 related mental health crisis; however, it is unknown whether there is an increase in prevalence of mental disorders as existing studies lack a reliable baseline analysis or they did not use a diagnostic measure. We aimed to analyse trends in the prevalence of mental disorders prior to and during the COVID...

Background: At-risk mental state (ARMS) individuals are at high risk to develop psychosis. In addition to attenuated symptoms, ARMS is associated with cognitive and functional impairment. The findings are mostly based on research in help-seeking at-risk population. Our study aim was to explore prevalence rates of ARMS, comorbidities, functioning, a...

Background.: Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations...

Aim: Cognitive deficit in psychotic illness is intensively studied, different cognitive subtypes have been suggested. In recent years, there has been an increase in the number of studies in patients with schizophrenia and their relatives searching for endophenotypes of the disease. The aim of our study was to investigate cognitive performance and c...

Over the past decade, theta-burst stimulation (TBS) has become a focus of interest in neurostimulatory research. Compared to conventional repetitive transcranial magnetic stimulation (rTMS), TBS produces more robust changes in cortical excitability (CE). There is also some evidence of an analgesic effect of the method. Previously published studies...

Background The self-disturbances (SDs) concept is considered to be part of the Schneider’s first rank symptoms, i.e., thought-withdrawal, thought-insertion, thought-broadcasting, somatic-passivity experiences, mental/motor automatisms, disrupted unitary self-experience (Mishara et al., 2014). SDs were originally described by W. Mayer-Gross (1920),...

Diagnosis of schizophrenia has been tradition-ally linked to symptoms that can be described broadly as a disruption of the basic sense of self. These symptoms encompass, for example, symptoms of passivity as in the case of delu-sion of control, thought withdrawal, or auditory hallucinations, i.e. symptoms in which patients excessively over-attribut...

Brexpiprazole is a second generation antipsychotic, a partial agonist of serotonin 5-ht1a, dopamine D2 receptors and antagonist of noradrenergic α1B/2c and serotonin 5-ht2a receptors. Brexpiprazole showed efficacy in acute and long-term treatment of schizophrenia, agitation in alzheimer dementia and as an adjunct therapy to antidepressants in refra...

Objectives: Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics (MARTA). Methods: We measured serum 25-hydroxyvitamin D [25(OH)D] levels and body mass index (BMI) in patients with (≥1 months) and without long-term exposure to MARTA to evaluate the role of 25(OH)D d...

Table 1: Demographic parameters and performance in auditory verbal learning test depending on the 25(OH)D concentration Figure 1: Linear relationship between word delayed recall and 25(OH)D concentration REREFENCES 1) Annweiler C, et al. Vitamin D and brain volumetric changes: Systematic review and meta-analysis. Maturitas. 2014;78(1):30-9. 2) Shiv...

Background. Identification of individuals at high risk of psychotic disorder can help to prevent onset of the disorder. Objectives. To examine both psychometric characteristics of the Czech version of The Prodromal Questionnaire Brief Version (PQB) and prevalence of risk symptoms for psychosis among Czech adolescents. Sample and methods. The PQB wa...

Pregnancy and postpartum period are associated with happiness for most women and their partners. However, a significant number of women in the perinatal period develop anxiety or depressive symptoms, or more severe mental disorder. Perinatal mental disorders have significant negative effects on the woman, as well as on her family. In many countries...

Background: Neuroactive steroids (NAS) affect neurotransmitter systems and cognition; thus, they play role in etiopathogenesis of psychiatric disorders. Aims: The primary aim was to examine cognition and effects of NAS on cognitive functioning in first-episode psychosis patients and in their healthy siblings. The secondary aims were to verify wheth...

The character of cognitive deficit in schizophrenia is not clear due to the heterogeneity in research results. In heterogeneous conditions, the cluster solution allows the classification of individuals based on profiles. Our aim was to examine the cognitive profiles of first-episode schizophrenia spectrum disorder (FES) subjects based on cluster an...

Postpartum period is accompanied by an increased risk of onset of severe mental disorders that require intensive psychiatric care and may result in long-term separation of mother and baby. This may disrupt the whole family system. The most frequent cause of postpartum relapse of schizophrenia or bipolar disorder is discontinuation of drug treatment...

Transition to parenthood is accompanied by psychosocial changes in both new mother and father. There is a higher risk of exacer-bation or new onset of mental disorders in this period. Early attachment and healthy parent-child bond are determinants of infant´s undisturbed neurobehavioral development. Breastfeeding plays an important role in this pro...

Adult attention-deficit/hyperactivity disorder (aADHD) has recently been better recognized and treated in many European countries. In spite of this development, aADHD still features as a “hidden” comorbidity, often not diagnosed even in patients under psychiatric treatment for other psychiatric disorders. The aim of this study was to establish the...

Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and highe...

Background: No established treatment algorithm exists for patients with schizophrenia. Whether switching antipsychotics or early use of clozapine improves outcome in (first-episode) schizophrenia is unknown. Methods: This three-phase study was done in 27 centres, consisting of general hospitals and psychiatric specialty clinics, in 14 European c...

Background Positive findings on early detection and early intervention services have been consistently reported from many different countries. The aim of this study, conducted within the European Brain Council project “The Value of Treatment”, was to estimate costs and the potential cost- savings associated with adopting these services within the c...

Background: The aim of the European Brain Council project "The Value of Treatment" was to provide evidence-based, cost-effective policy recommendations for a patient-centered and sustainable coordinated care model for brain disorders. The first part of schizophrenia study examined the needs and gaps in the patients' care pathway. Methods: Descri...

The overweight is a side effect of treatment with Multi-acting Receptor Target Antipsychotics (MARTA). We measured 25(OH)D serum levels and body mass index (BMI) in patients with exposition of MARTA to evaluate the role of 25(OH)D deficiency (corrected for a mean annual level≤25 nmol/l) on BMI. The BMI was significantly higher in MARTA exposure 25(...

Rationale: Disruption of auditory event-related evoked potentials (ERPs) P300 and mismatch negativity (MMN), electrophysiological markers of attentive and pre-attentive cognitive processing, is repeatedly described in psychosis and schizophrenia. Similar findings were observed in a glutamatergic model of psychosis, but the role of serotonergic 5-H...

The overweight is a side effect of treatment with Multi-acting Receptor Target Antipsychotics (MARTA). We measured 25(OH)D serum levels and body mass index (BMI) in patients with exposition of MARTA to evaluate the role of 25(OH)D deficiency (corrected for a mean annual level≤25 nmol/l) on BMI. The BMI was significantly higher in MARTA exposure 25(...

Schizophrenia is a severe mental disorder that often affects young people of productive age. The illness disrupts daily functioning of patients, their social relationships, and can lead to permanent disability. In most cases, several years before the onset of the disease, a prodromal phase develops, which is characterized by proliferation of neurob...

Objective: To bring actual summary of knowledge about etiology and risk factors for development of postpartum depression, and modern methods of its prevention. Design: Review. Setting: National Institute of Mental Health, Klecany. Methods: Narrative review. Results: Both biological (sex and stress hormones, thyroid hormones) and psychosoci...

Objective: To bring actual summary of knowledge about diagnostics and modern trends in therapy of postpartum depression. Design: Review. Setting: National Institute of Mental Health, Klecany. Methods: Narrative review. Results: First assessment of depressive symptoms among puerperal women can be done by screening instruments. Baby blues an...

Negative symptoms have a significant negative impact on functional capacity of schizophrenia patients; management of negative symptom is one of the unmet needs. So far, there is no effective and reliable treatment of negative symptoms available. Most of the data are based on the post-hoc analyses of short-term studies, where negative symptoms were...

There is an increasing number of women, who plan to become or already are pregnant, and concurrently use psychotropic drugs for mental illness. Most of psychotropic drugs pass through the placenta to developing fetus and thus may affect the embryogenesis. On the other hand, untreated psychiatric disorder represents a risk factor of adverse pregnanc...

Winkler P1, Park A-LA2, Arteel P3, Boyer P4,Galderisi S4, Karkkainen H3, Ieven A5, Mohr P4 , Wasserman D4, Knapp M2, Tinelli M2, Gaebel W4. Schizophrenia: The socio economic impact of early intervention (EI) programmes http://www.braincouncil.eu/activities/projects/the-value-of-treatment

The analysis of potential risks associated with both untreated illness and drugs for fetus is necessary in treatment of women, who plan to become or already are pregnant. Antipsychotics, mood stabilizers and anxiolytics, all pass through the placenta to the blood circuit of the fetus and then cross the haematoencephalic barrier, affecting the devel...

Depression is a among the most common severe mental health disorder. It is more prevalent in females of every reproductive age, it occurs in 8–15% of pregnant women. Depression itself and its pharmacotherapy can have negative impact on fetus and/or infant. We review current published data on the effects of prenatal exposure to antidepressants on mo...

There is a trend of increasing prescription rates of psychotropic drugs in females of fertile age, including growing number of pregnant women. The main groups of psychotropics used in psychiatry are antidepressants, antipsychotics, mood stabilizers, and anxiolytics. Both drugs and untreated psychiatric disorders represent risk factors for adverse p...

Background and aims: It has been well established that long-term antipsychotic treatment prevents relapse, lowers number of rehospitalisations, and also effectively reduces violent behaviour. Although violent behaviour is not a typical manifestation of schizophrenia or other psychotic disorders, the diagnosis of psychosis increases the overall ris...

Depression is a common and debilitating disease that affects people from adolescence to old age. The impact of depression extends beyond the individual with depressive symptoms. Depression adversely affects the mental and physical health, and the social and financial welfare of the individual and society. We will address how factors including sex,...

Schizophrenia is a severe mental disorder, which affects 0.8-1.5% of the population. It is a clinically heterogeneous illness with highly variable course, typically episodic. Frequent relapses contribute to neurobiological impairment, functional and social decline, and poor treatment response. Schizophrenia has a substantial impact on patients, the...

Pharmacotherapy of mental disorders during pregnancy is often a source of uncertainty due to the potential impact of medication on the pregnancy course and outcome, as well as health of the fetus and newborn. Possible negative effects of psychotropic drugs include increased risk of teratogenicity (organ malformations), intrauterine death, fetal gro...

Families of patients with first episode of psychotic illness are exposed to numerous distress factors related to the care of their relative. It has been shown that these families experience higher levels of anxiety, depression, economic strain, and helplessness. According to the prior studies, long-term psychotic illness can also have negative impa...

Episodic retrieval is characterized by the subjective experience of remembering. Semantic memory, on the other hand, is a more structured record of facts, meanings, concepts and knowledge about the external world that we have acquired. The medial temporal lobe (MTL), especially the hippocampus and parahippocampal cortex, plays a central role in bot...

Introduction 25-OH vitamin D level is an immediate precursor metabolite of the active form of vitamin D that leads to expression of more than 200 genes. Aims The aim of our study was to examine 25-OH vitamin D deficiency (<50nmol/L) and its relationship to demographic factors in recently hospitalised patients with schizophrenia spectrum disorders...

The aim of our study was to evaluate vitamin D3 supplementation in recently hospitalized psychiatric patients with 25-OH vitamine D insuficiency (<75nmol/l). We assessed serum 25-OH vitamin D level in 20 patients (50% men, 80% with psychotic disorders, 20% with affective disorders, mean age 33.3±11.8 years) before vitamin D supplementation. The med...

Long-acting injectable antipsyhcotics (LAI) play important role in the maintenance treatment of schizophrenia. LAI proved to be effective in relapse prevention, improve adherence to medication. Four second-generation antipsychotics are currently available as LAI: risperidone, olanzapine, paliperidone, and aripiprazole. LAI are typically administere...

Objective: Anxiety and mood disorders (AMD) are the most frequent mental disorders in the human population. They have recently shown increasing prevalence, and commonly disrupt personal and working lives. The aim of our study was to analyze the spectrum of circulating steroids in order to discover differences that could potentially be markers of a...

The aim of our study was to describe occurence of 25-OH vitamin D deficiency in recently hospitalised patients with schizophrenia. We assessed serum 25-OH vitamin D level in 20 patients (75% men, mean age 33.2±10.7 years) with schizophrenia. The mean serum level was 37.2±29.9 nmol/l. Eighty percent patients with schizophrenia suffered from 25-OH vi...

Depression and anxiety disorders are highly prevalent in women. Although several studies have reported altered circulating steroids accompanying various mental disturbances, knowledge about alterations in the peripheral steroid pattern in such pathologies is incomplete. Therefore, we attempted to add to this knowledge using the simultaneous quantif...

Risperidon je metabolizován na 9-hydroxy-risperidon (paliperidon), který má podobnou farmakologickou účinnost jako risperidon. Obě látky tvoří účinnou antipsychotickou frakci. Terapeutické hladiny celkového risperidonu jsou 20-60ng/ml, nad 120 ng/ml je dávka označována za toxickou a dávka nad 1800 ng/ml je potenciálně letální (Hiemke et al., 2011)....

The Poster presented associations between the clozapine and olanzapine daily dose and blood level in hospitalised patients with psychotic disorders. Sixty three patients were treated with clozapine (mean daily dose 408±208 mg, min. 50 mg, max. 1000 mg, median 400mg). Fifty two patients were treated with olanzapine (mean daily dose 23±6 mg, min. 10...

The loudness dependence of the auditory evoked potential (LDAEP) is an easily accessible and non-invasive electrophysiological method of assessing neuromodulatory effects of monoamines, specifically serotonin, on central nervous system. Previous studies showed that the LDAEP can be a useful tool in clinical practice in predicting the therapeutic ef...

It has been shown recently that steroids may play important role in the pathophysiology of mental disorders, including schizophrenia, through modulation of various neurotransmitter systems. Neuroactive steroids are substances produced either outside or within the CNS (neurosteroids), nongenomically affecting nervous system. Neuroactive steroids hav...

Reduced levels of vitamin or its metabolites have been reported in various psychiatric disorders. Insufficient levels of vitamin D in depressive patients have been confirmed by many authors, but there have been conflicting results in subjects with anxiety disorders. In the present cross-sectional study, levels of calcidiol were determined in groups...

The mood and behavior of individuals result from an orchestra of many factors. Among them steroids play an important role; however, only several common hormones have been investigated in this respect. It has been demonstrated that some steroid metabolites long considered merely the products of steroid hormone metabolism in fact possess considerable...

Administration of long-acting injectable antipsychotics (LAI) may secure adherence with prescribed medication and thus reduce relapse and rehospitalization rates in schizophrenia. Despite their obvious benefits, LAI remain underutilized in clinical practice. The aim of our study was to examine the role of LAI in treatment of psychotic disorders in...

Acute agitation can be a clinical manifestation and complication of schizophrenia or bipolar disorder, posing a risk for a patient, others, and medical staff. Treatment of choice are antipsychotics, preferrably oral formulation. In addition to tablet and solution form, inhalation administration can be now used. Loxapine inhalation powder (Adasuve®)...

Depressive disorder results in significant functional impairment. Cognitive deficits are one of the causes of this disruption. There is a lower degree of impaired cognition in depression than in dementia or psychotic disorders; however, it is not just a state marker, but also trait marker. Cognitive dysfunctions in major depression can be observed...

Aim To record and measure the nature and severity of stigma and discrimination experienced by people during a first episode of schizophrenia and those with a first episode of major depressive disorder. Methods The Discrimination and Stigma Scale (DISC-12) was used in a cross-sectional survey to elicit service user reports of anticipated and experi...