Research of psychiatrization: the identity of young people in the mirror of psychiatric Diagnosis | Tereza Kohútová
The Impact of Psychiatric Treatment on Adolescents’ Self-Concept and Self-Narrative
Author: Tereza Kohútová (1)
Supervisor: Jan Vevera (1)
(1) Department of Psychiatry, Faculty of Medicine in Pilsen, Charles University and University
Hospital, Pilsen
State-of-the-Art: Current literature indicates that psychiatric diagnosis can significantly influ
ence patients‘ self-perception and interpretation of life experiences. This effect is particularly
strong during adolescence, a critical period for identity formation. Diagnosis can disrupt per
sonal narrative, leading to feelings of difference, self-stigmatization, or identification with the
illness, but can also facilitate understanding and integration of difficulties into one’s life story.
Existing research is largely retrospective or cross-sectional and focuses on selected diagnoses.
Prospective qualitative studies tracking self-concept development from entry into psychiatric
care across neurotic disorder diagnoses remain limited. Understanding these processes may
inform more sensitive therapeutic approaches.
Objective: The study aims to explore how receiving a psychiatric diagnosis and starting treat
ment influence the self-narrative and self-concept of adolescents and young adults, and to un
derstand the processes through which psychiatric care shapes interpretation of experiences
and personal identity.
Material and Methods: The study employs a prospective longitudinal qualitative design. Data
are collected through a series of semi-structured in-depth interviews with adolescents who have
not previously received psychiatric treatment. Participants with primary diagnoses of organic
disorders (F0), substance use disorders (F1), psychotic disorders (F2), or intellectual disability
(F7) were excluded. Interviews focus on experiences of the diagnostic process, treatment, par
ticipants’ personal life and environment, and changes in self-perception over time. Data collec
tion occurs repeatedly over an 18-month period. Interviews are transcribed and analyzed using
thematic analysis to identify patterns of change in participants’ self-narrative and self-concept.
Results & Discussion: We hypothesize that initiation of psychiatric treatment in adolescents
will be associated with changes in sense of self-concept and self-narrative, particularly in rela
tion to receiving a psychiatric diagnosis and assuming the patient role. Interview analysis may
reveal diverse ways in which young people interpret their treatment experiences and integrate
them into their life story. We expect to identify factors that support adaptive understanding of
the diagnosis, as well as risk processes leading to self-stigmatization or over-identification with
the patient role. Findings may inform more sensitive therapeutic approaches and promote un
derstanding of treatment that is motivating and empowering for patients.
Conclusion: The study may enhance understanding of how psychiatric diagnosis and treatment
influence adolescents‘ self-perception. Findings could support more sensitive therapeutic ap
proaches and help prevent self-stigmatization and over-identification with the patient role.
Funding: The research is conducted within the Psychiatrization Research project, supported by
a grant from the Charles University Grant Agency (GA UK)
Typology and triggers of Aggression in organic mental Disorders: findings from a prospective study | Pavel Kubíček
Typology and Triggers of Aggression
Authors: Pavel Kubíček (1), Jan Vevera (1)
Supervisor: Jan Vevera (1)
(1) Department of Psychiatry, Faculty of Medicine in Pilsen, Charles University and University
Hospital, Pilsen
State-of-the-Art: A large proportion of patients with organic mental disorders exhibit agitated
or aggressive behavior. However, in clinical practice, these manifestations are often not distin
guished, and the triggers of problematic behavior (e.g., pain, frustration, change of environ
ment, or somatic comorbidity) are not systematically investigated. This often results in inap
propriate or ineffective treatment. This study shows that more accurate diagnosis and targeted
differentiation of these manifestations allows for a better understanding of their causes and
subsequent causal treatment.
Objective: The main objective of this study was to pilot test the systematic assessment of ag
gression in patients with organic mental disorders, classify incidents into impulsive, psychotic,
and psychopathic domains, and analyze their immediate triggers, consequences, and coping
strategies.
Material and Methods: Over a period of 14 months, incidents in the acute psychiatric ward for
adults in the Czech Republic were prospectively monitored. Only patients with organic mental
disorders (ICD-10 F00–F09) were included in the study. Aggressive behavior was recorded using
the Modified Outward Aggression Scale (MOAS). A violent incident was defined as a physically
aggressive attack against persons or property with a weighted score ≥ 3. Self-harm was analyzed
separately; autoaggression was not included. Assaults were classified into impulsive, psychotic,
or psychopathic domains using the Assault Interview Checklist. The Staff Observation Aggres
sion Scale (SOAS) was used to capture context, targets, consequences, and coping methods.
Results & Discussion: Of the 31 aggressive incidents, impulsive incidents were the most com
mon (n = 74.2%, 23/31), psychotic incidents were less common (n = 25.8%, 8/31), and psycho
pathic incidents were not recorded (0%). SOAS documentation highlighted common triggers
such as confusion, refusal of medication, hygiene-related care, and delirium. Aggression was
predominantly verbal with minor physical manifestations (typically punching or kicking). Inci
dents were mostly directed against staff and rarely against other patients. The consequences
were generally mild. Impulsive incidents usually did not require medical treatment
and were resolved by verbal de-escalation, sometimes followed by brief isolation or mild re
straint, while sedatives were used as needed in cases of psychotic aggression.
Conclusion: Aggression in organic mental disorders is mainly impulsive and less often psychot
ic; no psychopathic attacks were observed. Triggers included confusion, treatment refusal, and
nursing care. Management ranged from de-escalation/brief restraint to antipsychotics in psy
chotic cases
Victimization of patients with gender identity disorders | Jakub Nešpor
Victimization of transgenders
Author: Jakub Nešpor (1)
Supervisor: Luděk Fiala (1)
(1) Department of Psychiatry, Faculty of Medicine in Pilsen, Charles University and University
Hospital, Pilsen
State-of-the-Art: Transgender and gender-diverse (TNB) individuals do not identify with their
sex assigned at birth (e.g., trans women, trans men, non-binary, or gender-fluid). In the Czech
Republic, past estimates were in fractions of a per mille; current estimates may be up to ten
times higher, but reliable epidemiological data are lacking. In the USA, ~150,000 youth and 1.4
million adults identify as transgender. Studies report significant healthcare barriers: 24 % expe
rienced unequal treatment, 19 % care refusal, and 33 % did not access preventive services. In a
study on healthcare experiences of TNB patients, 71 % reported at least one form of victimiza
tion. Clinical studies report PTSD prevalence of 9.8 % among transfeminine young adults.
Objective: The study aims to determine the prevalence of victimization in patients with gender
identity disorders using scales translated and validated by our team. A second aim is to identify
reasons for underdiagnosis of trauma consequences via qualitative focus group research.
Material and Methods: Data will be collected from 40 patients with gender identity disorders
at the LFP UK Psychiatric Clinic and outpatient visits with Prof. Fiala at PK FN Plzeň. Selection,
power analysis, and exclusion criteria ensure at least 28 valid participants, sufficient for the
primary hypothesis (victimization in one-third of patients, α=0.05, 90 % power, US Transgen
der Survey 2015: 71 %) and secondary hypothesis (lifetime PTSD 20 %, α=0.05, 90 % power, Val
entine et al. 2023: 49 %). Diagnoses of psychosis, gender identity disorders, and PTSD will be as
sessed via M.I.N.I. 5.0.0. and SCID modules; victimization and violence via MacArthur Interview,
MOAS, and CECA.Q. Qualitative focus groups with staff and patients, moderated externally, will
explore diagnostic barriers.
Results & Discussion: The project will provide the first systematic data on victimization among
patients with gender identity disorders (F64.0–F64.9). Quantitatively, we will determine the
prevalence of victimization and PTSD (expected in one-third and 20 % of patients). Qualitative
focus groups will identify barriers to diagnosing and treating trauma consequences. Findings will
support education of care users and the public via an online guide, optimize clinical procedures,
improve patient–clinician communication, and inform targeted therapeutic interventions.
Conclusion: The study will provide the first data on victimization and PTSD in patients with
gender identity disorders, identify diagnostic barriers, support patient and staff education, and
inform targeted therapeutic interventions and care improvement.
Funding: The project is not yet funded and is conducted under the auspices of the Psychiatric
Clinic, FN Plzeň
Evaluation of detransition in transgender patients | Daniela Kestlerová
Detransition in Transgender Patients
Authors: Daniela Kestlerová (1)
Supervisor: Fiala Luděk (1)
(1) Department of Psychiatry 1. LF UK a VFN, Prague, Czech Republic
State-of-the-Art: Current knowledge in transgender health care shows that detransition re
mains far less studied than transition itself. Available studies differ in their definitions of detran
sition, follow-up periods, and methodologies, which makes comparison of results and estima
tion of its actual frequency difficult. The literature therefore still lacks sufficiently robust data
from clinical practice. The proposed project focuses on determining the number of detransitions
among transgender patients and aims to contribute to a more accurate understanding of this
phenomenon, a better interpretation of existing findings, and the further development of in
formed clinical care.
Objective: To determine the number of detransitions among transgender patients and contrib
ute to a better understanding of their occurrence in clinical practice, providing data to support
more accurate interpretation and evidence-based transgender health care.
Material and Methods: This retrospective multicenter study analyzes data from transgender
patients treated at two centers: the Department of Sexology, University Hospital Pilsen, and the
Sexological Institute, General University Hospital in Prague. Included were patients whose first
contact took place at one of these centers and who had undergone transition-related care for at
least 5 years. Medical records were reviewed to identify patients who requested detransition,
defined as discontinuation of transition, and, where applicable, the documented reasons for
this decision.
Results & Discussion: The study is expected to provide data on the frequency of detransition
among transgender patients at two Czech specialized centers and to identify the most common
ly documented reasons for this decision. The findings may help clarify how often detransition
occurs in long-term clinical practice and contribute to a more nuanced interpretation of this
phenomenon. Given the limited and methodologically heterogeneous evidence available, the
results may support better counseling, follow-up, and evidence-based clinical care.
Conclusion: This project will provide data on detransition among transgender patients in the
Czech Republic and help clarify its frequency and reasons in long-term clinical care, supporting
more informed and evidence-based transgender health care
From sample to signal: mAlDi-tof ms for rapid microbial identification without cultivation | Lucia Ďaďovská
Rapid Culture-Free MALDI-TOF MS Identification
Authors: Lucia Ďaďovská (1), Veronika Pašková (1)
Supervisor: Jaroslav Hrabák (1)
(1) Department of Microbiology, Faculty of Medicine in Pilsen, Charles University, Czech Republic
State-of-the-Art: Despite advances in Matrix-Assisted Laser Desorption/Ionization Time-of
Flight mass spectrometry (MALDI-TOF MS) for clinical microbiology, serotyping and detection
from clinical samples remain limited. We recently introduced a MALDI-TOF MS method for de
tecting microbial cell wall polysaccharides using a self-ionizable HD ligand (doi.org/10.3389/
fcimb.2025.1658802). The ligand binds saccharides and enables ligand-assisted ionization. Mi
crobial polysaccharides are excellent targets, being abundant, stable, and specific, as they con
stitute some of the microbial surface antigens. Here, we demonstrate this approach for direct
detection from clinical specimens without prior cultivation.
Objective: The hypothesis of the study was to demonstrate whether an innovative approach to
polysaccharide ionization for analyzing bacterial polysaccharides and other external structures
of the cell wall can facilitate bacterial identification and typing by MALDI-TOF MS directly from
clinical specimen.
Material and Methods: Analyses were performed with mono- and polysaccharide models
(glucose, lactose, β-D-glucan, galactomannan, lipopolysaccharides from G- bacteria, e.g., Es
cherichia coli O55:B5 and O111:B4) and overnight cultures of Escherichia coli, Streptococcus
pneumoniae, and Candida spp. Standards or a 1 µL bacteriological loop were diluted in 200 µL
serum or urine. After acid protein precipitation, samples were heated at 95 °C for 10 min, centri
fuged, and then cooled to 50 °C. The pH was adjusted to 3, followed by the addition of 2 µL of a
newly designed self-ionizable HDT ligand and 20-minute incubation. Detection was carried out
using LC-MS and MALDI-TOF MS.
Results & Discussion: We adapted the previously published method for direct detection of
microbial polysaccharides from clinical samples. We developed a novel derivatization agent, the
HDT ligand, with improved thermal stability over the original HD ligand and a simplified synthe
sis. The HDT enabled clear ionization of hexoses and hexose disaccharides, with characteristic
signals at m/z 481 and 643,respectively. Native glucose was detected in urine and serum; how
ever, microbial samples yielded markedly stronger glucose signals.
Conclusion: This refined MALDI-TOF MS assay allows direct identification of microbial polysac
charides in serum and urine without cultivation. The HDT ligand’s stability and efficient ioniza
tion support a rapid, cultivation-free strategy for microbial detection with strong potential for
clinical application.
Funding: GAUK 550225, the Czech Health Research Council grant Nr. NW24-09-00464 and the
project National Institute of Virology and Bacteriology (Programme EXCELES, ID Project No. LX
22NPO5103) – Funded by the European Union – Next Generation EU.
Comparison of Quantitative cerebrospinal fluid cytology using manual counting and the sysmex Xn–1000 | Simona Kukrálová
Comparison of CSF Cytology: Manual vs XN-1000
Authors: Simona Kukrálová (1,2), Pavel Brož (1,2), Jana Černá (1), Klára Koldušková (1), Eliška Naušová
(1), Jana Ženková (1), Daniel Rajdl (1,2) & Jaroslav Racek (1,2)
Supervisor: Pavel Brož (1,2)
(1) Faculty Hospital in Pilsen, Institute of Clinical Biochemistry and Haematology, Pilsen, Czech
Republic
(2) Faculty of Medicine in Pilsen, Charles University, Czech Republic
State-of-the-Art: Cerebrospinal fluid (CSF) cytology is critical for diagnosing neurological
diseases, traditionally performed by manual cell counting in a Fuchs–Rosenthal chamber. This
method is time-consuming and dependent on skilled personnel. Automated haematology
analysers such as the Sysmex XN-1000 offer faster results in body fluid mode, potentially im
proving laboratory workflow. However, their accuracy—especially for differentiating cell types
like polymorphonuclear cells (PMNc) and in samples with interfering elements—is debated.
Comparing manual and automated methods helps define limitations and clinical reliability of
automation in routine CSF analysis.
Objective: The study aimed to compare quantitative CSF cytology results obtained by manual
counting in a Fuchs–Rosenthal chamber with those from the Sysmex XN-1000 analyser, focusing
on accuracy, agreement, and limitations of both methods.
Material and Methods: A total of 89 CSF samples from patients aged 10 days to 80 years were
analysed. Manual counting was performed using the F–R chamber, while the Sysmex XN–1000
measured cell counts in body fluid mode. Statistical comparisons in Medcalc software includ
ed the Shapiro–Wilk test, Wilcoxon test, Bland–Altman plots, Mann–Whitney test, and Cohen’s
kappa coefficient. Statistical significance was defined as P < 0.05.
Results & Discussion: There were no statistically significant differences between the F–R
chamber compared to Sysmex in mononuclear cells. Data presented as median [min–max]):
10 [1–724]/µl vs. 9 [0–670]/µl resp. (P = 0.1286); and in red blood cells: 36 [0–18,091]/µl – vs.
0 [0–34,000]/µl resp. (P = 0.5412). However, there were statistically significant changes in pol
ymorphonuclear cells (P = 0.0002) using the F–R chamber – 0 [0–1,428]/µl in comparison with
Sysmex – 1 [0–1,008]/µl. Cohen’s kappa analysis demonstrated a very good strength of agree
ment (K = 0.89) in the classification of oligocytosis and pleocytosis.
Conclusion: The Sysmex XN–1000 is a fast and efficient tool for CSF cytology but it has limi
tations, especially in differentiating PMNc in siderophage–rich neonatal samples. Although it
improves workflow, manual verification remains crucial for diagnostic accuracy.
Funding: This work was supported by the Ministry of Health, Czech Republic – Conceptual De
velopment of Research Organisation (FNPI – 00669806) and by the Cooperatio Program, re
search area Medical Diagnostics and Basic Medical Sciences
NMDA receptor blockade by mK801 Disrupts cA1 ensemble stability beyond
baseline representational Drift | Siddharth Baindur
Enhanced representational drift in psychosis model
Authors: Siddharth Baindur (1,2), Susan Leemburg (1,2), Karel Blahna (1,2), Karel Jezek (1,2)
Supervisor: Karel Jezek (1,2)
(1) Department of Pathological Physiology, Faculty of Medicine in Pilsen, Charles University
(2) Biomedical Center, Faculty of Medicine in Pilsen, Charles University
State-of-the-Art: Memories emerge from coordinated activity of large neuronal populations
whose collective dynamics should remain stable enough to support retrieval while flexible
enough to encode new experiences. Disturbances of this balance might result in hallucinations.
In hippocampus, memory patterns evolve over time through representational drift, where en
semble memory pattern gradually changes while its spatial structure is preserved. NMDA-de
pendent plasticity is thought to regulate this balance between stability and flexibility. MK801 -an
NMDAR blocker used as a model of psychosis, offers an opportunity to test this phenomenon.
However, it remains unclear to what degree NMDAR disruption primarily affects single-neuron
information code, stability and organization of population-level representations.
Objective: To examine how NMDA receptor blockade affects hippocampal CA1 network dynam
ics by comparing natural representational drift and changes in ensemble stability and spatial
coding following pharmacological perturbation.
Material and Methods: GCaMP6f-expressing mice were implanted with GRIN lens into hip
pocampal CA1 to visualize their single cell activity during navigation in different environments
across four days. Day 0 consisted of familiar-environment recording to set the baseline spatial
representation. Days 1–3 mice were exposed to familiar and multiple novel environments to
quantify the physiological memory coding properties. On Day 4, the same behavioral sequence
was performed, but animals received an NMDAR blocker MK-801 (0.2mg/kg). Recorded cells
were sorted across all days and parameters as spatial firing maps, spatial information, including
their similarity, were quantified. Data recorded with and without the MK-801 injection were
compared.
Results & Discussion: Familiar-track representations exhibited gradual representational drift,
with session-to-session ensemble correlations slowly decreasing across days while remaining
relatively stable within each day. Novel-track exposures produced distinct representations that
remained internally consistent across trials. MK-801 (day4) produced a pronounced reduction in
similarity between post-injection sessions and prior familiar representations. Despite this pop
ulation-level destabilization, spatial modulation and neural firing rates persisted. Place fields
remained detectable but were broader and less spatially precise.
Conclusion: NMDAR blockade with MK-801 produced a pronounced destabilization of neuronal
ensemble representations beyond baseline representational drift, in both familiar and novel en
vironments. This highlights a key role for NMDA-dependent mechanisms in maintaining stable
network representations.
Funding: Supported by GACR-26-23770S and SVV-263774
Neural code during memory retrieval in hippocampal networks cA3 and cA1 | Amritesh Suresh
Neural code during memory retrieval in hippocampus
Authors: Amritesh Suresh (1,2), Swaantje Anna Leemburg (1,2), Siddarth Baindur (1,2), Karel Jezek(1)
Supervisor: Karel Jezek (1)
(1) Biomedical Center, Faculty of Medicine in Pilsen, Charles University
(2) Department of Pathological Physiology, Faculty of Medicine in Pilsen, Charles University and
University Hospital, Pilsen
State-of-the-Art: Hippocampus plays a central role in spatial navigation and memory. It stores
a complex representation of the surrounding environment in its CA3 and CA1 subnetworks,
which is considered as substrate of memory traces. Our previous experiments characterised
the dynamics of transition between memory traces in the CA3. We identified a profound compe
tition between memory patterns, resulting in rapid, frequent shifts paced by local 6-12 Hz EEG
oscillations. We also discovered a transient overexpression of the newly activated CA3 memory
trace, as the increased number of neurons became briefly coactive. However, it remains unclear
whether these phenomena are specific to CA3 memory processing or whether similar dynamics
are projected outside of the hippocampus through its output network CA1.
Objective: To compare the dynamics of memory trace recall in neuronal networks of dorsal
hippocampal CA1 and CA3.
Material and Methods: Population of individual neuronal activity was recorded using multiple
microelectrodes implanted into dorsal hippocampal CA1 and CA3 in rats, while performing the
teleportation paradigm (Jezek et al., 2011). Animals explored an arena with two sets of light cues
that were abruptly switched to induce a rapid transition between the respective spatial memory
representations. Individual spikes were cell-sorted, and the respective memory patterns were
identified. Dynamics of transition between the patterns were analysed using custom written
MatLab scripts. Electrode placement was later confirmed using histology examination at the
end of the experiment.
Results & Discussion: Recordings from CA1 and CA3 were obtained during the rapid transitions
between spatial representations using the teleportation paradigm. Consistent with previous
findings, CA3 activity showed overexpression. In contrast, CA1 population activity did not exhib
it a comparable overexpression. The absence of this effect in CA1 may be related to its distinct
circuit organisation, particularly the lack of recurrent collateral connectivity and the presence of
strong feed-forward inhibitory inputs that may prevent excessive activation.
Conclusion: Transient overexpression of spatial representations was observed in CA3 but not in
CA1 during recall after environmental transitions. These findings suggest region-specific mech
anisms of spatial memory retrieval in the dorsal hippocampus, potentially related to differences
in network architecture.
Funding: GACR-26-23770S and SVV-263774