Many modalities of cognition are affected in schizophrenia. The most common findings include dysfunctions of episodic and working memory and of executive functions. Although an inverse correlation between cortisol level and memory function has been proven, few studies have focused on the relationship between cortisol level and cognitive impairment in patients with schizophrenia. In an open, naturalistic, prospective study, consecutively hospitalized males diagnosed with first-episode schizophrenia, hypothalamic-pituitary-adrenal axis activity (afternoon cortisol levels, post-dexamethasone cortisol levels) was evaluated before and at the end of acute treatment. Psychopathology was assessed using the positive and negative syndrome scale (PANSS). Cognitive functions (memory, attention, psychomotor, verbal fluency, and executive functions) were tested after symptom alleviation using a neurocognitive test battery. In the total sample (n = 23), significant decreases in total PANSS score (including all subscales), afternoon cortisol levels, and post-dexamethasone cortisol levels occurred during the course of treatment. It was found that higher afternoon cortisol levels at the beginning of treatment were significantly related to impaired performance in memory functions. Afternoon cortisol levels were not significantly associated with other measured cognitive functions. No correlation was discovered between cognitive functions and post-dexamethasone cortisol levels. The determination of afternoon cortisol levels may serve to detect potential candidates for specific cognitive intervention immediately after the first psychotic breakthrough.

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AbstraktSourozenectví je jedním z nejvýznamnějších vztahů v lidském životě. Tento vztah může být velmi specifický, má-li jeden ze sourozenců vývojové postižení. Zdraví sourozenci potom, stejně jako jejich rodiče, bývají konfrontováni s řadou stresových a náročných situací, které u nich vedou ke zvýšenému výskytu psychických obtíží. Za účelem podpory a naplnění potřeb této skupiny byl vytvořen program STEPS -Skupinový terapeuticko-edukační program pro sourozence dětí s postižením. Pilotním během intenzivní alternativy tohoto programu prošlo pět sourozenců dětí s Williamsovým syndromem. Cílem článku je podat základní informace o prvním běhu programu a poskytnout tak podnět pro další rozvoj podpory rizikové a v naší zemi doposud opomíjené skupiny -sourozenců dětí s postižením. AbstractSibship is one of the most important relationships in life. However, this relationship may be very specific if one of the siblings suffers from a developmental disorder. In such a case healthy siblings are confronted with a similar number of stressful and challenging situations as their parents. These stressors lead to an increased incidence of mental health problems in this population. In order to support and fulfil the needs of healthy siblings, STEPS program (Group Therapeutic Program for Siblings of Children with Disabilities) was developed. Five siblings of children with Williams syndrome have participated in piloting of an intensive alternative of this program. The aim of this article is to provide basic information on the pilot of this program and provide suggestions for further development of support for at-risk and in our country neglected populationsiblings of children with disabilities.

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