bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypogonadism and gynecomastia under duloxetine
Authors: Weydt P. , Gahr M. , Schönfeldt-Lecuona C. , Connemann B.
Published: May 2011

Introduction/objectives/aims

Gynecomastia and hypogonadism can occur during treatment with a range of antidopaminergic drugs and is most likely to a medication induced increase in serum prolactin levels. However there is little evidence for an association between antidepressants and hypogonadism.

Methods

We report the case of a 23 year old male with a 3 year history of bulimia nervosa and recurring depression who had been treated with duloxetine for a period of 6 months during which he developed pronounced bilateral gynocomastia. Since serum prolactine and serum testosterone levels were normal and duloxetin was initially not considered causative, the drug was continued and bilateral gynecomastia was performed. 4 months later the patient again experienced tension and swelling in the breast.

Results

The endocrinologic exams revealed reduced serum testosterone levels and reduced testicular volume. Body weight was 63 kg, height 176 cm and a neurological exam, including olfactory testing and MR brain imaging was normal. Hypogonadotropic hypogonadism was diagnosed.

Discussion

Increased prolactin levels under antipsychotic medications are not uncommon. Some rare instances of gynecomastia have been reported under fluoxetine and venlafaxine, always associated with increased serum prolactin levels. In the present case the close tempral relationship between initiation of duloxetine and the development of gynecomastia and the recurrence under continued medication and resolution after termination of the medication suggests a possible causal relationship. The normal prolactin levels argue against anvolvement of prolactin in the pathogenesis. We suspect a prolactine independent mechanism.
Cardiovascular side effects, QT interval in patients treated with some selected antypsychotics. preliminary results
Authors: Wierzbinski P. , Kryszkowski W. , Florkowski A. , Galecki P.
Published: May 2011

Introduction

Treatment with antypsychotics is associated with cardiovascular side effects. This results from mechanism of action of antypsychotics. Arrhythmias are the serious side effects. Treatment with antipsychotics may prolong QTc and increase the risk of dangerous supraventricular and ventricular arrhythmias.

Objectives

The main aims of the research are the following: If Any antypsychotics agents may prolong QT interval? If monotherapy with olanzapine, zyprasidone, arypiprazole and politherapy with perphenazine and olanzapine may induce any arrhythmias?

Methods

Data for this study were collected from 65 patients hospitalized in the Department of Adult Psychiatry and treated with olanzapine and perphenazine (n = 10) and with olanzapine (n = 20), aripiprazole (n = 20), ziprasidone (n = 15). All patients had 12 leads ECG two times: before admitting the drugs and during the treatment. All ECG were assessed on the presence of any abnormalities and QTc was calculated manually by using Bazzet formula.

Results

Among treated patients no QTc prolongation was observed. There was no prolonged QTc over 450 ms in Male and 470 ms in female patients treated with antypsychotics in mono and politherapy. Potassium level in all patients was within the norm. Bradykardia (< 50/min) and tachykardia (>100/min) was not observed among participants.

Conclusions

Atypical antypsychotics such as olanzapine, arypiprazole, zyiprasidon are cardiovascular safe drugs. They did not induce dangerous for life arrhythmias especially ventricular arrhythmia (known as torsades de pointes), which can progress to ventricular fibrillation and sudden death. Politherapy with olanzapine and first generation agents perphenazine is a safe combination and did not induce any cardiovascular side effects.
Galantamine in long-term treatment formild cognitive impairment: Efficacy and safety
Authors: Zarra J. , Schmidt L. , Grecco B.
Published: May 2011

Introduction

To evaluate the efficacy of galantamine in patients with Mild Cognitive Impairment. So there is a possible benefit in the deficit in executive and cognitive cerebral function (cholinergic system) with treatment with Galantamine.

Purpose

Galantamine is a reversible, competitive cholinesterasa inhibitor that also allosterically modulates nicotine acetylcholine receptors. Inhibition of acetylcholinesterase, the enzyme responsible for hydrolisis of acetylcholine at the cholinergic cognitive impairment. To evaluate the efficacy, safety and tolerability of galantamine in long-term in Mild Cognitive Disorder.

Methods

A multicenter, open label, prospective, observational study enrolled 1028 patients, more 55 years old with Mild Neurocognitive Disorder (DSM IV criteria), during 30 months of treatment with galantamine 16 mg./day. Assessments included the MMSE, CDR, ADAS-GOG, FAQ, GCI, Trail making test, Global Deterioration Scale, and UKU scale of Adverse Effects.

Results

A total 1028 outpatients were treated with 16 mg./day galantamine during 30 months, the therapeutic response evaluated with CDR, MMSE and the tests and scales of function cognitive measuring, GCI and UKU scale of adverse effects, comparing the baseline to final scores.

Conclusion

Mild Cognitive Disorder is being examined, so there aren’t enought treatment for this. A long-term treatment (30 months) galantamine improves cognition and global function, behavioural symptoms and the general state well being of patients with MCD. With incidence of adverse effects not significant and a very good profile of safety, the final results of the study suggest that galantamine may be particularly appropiate in the Mild Cognitive Disorder.
Mild cognitive disorder and depression:treatment with association between galantamine and escitalopram
Authors: Zarra J. , Schmidt L.
Published: May 2011

Introduction

To evaluate the efficacy of galantamine-paroxetine association in patients with Mild Cognitive Disorder and Depression. So there is a possible relation between the deficit in executive and cognitive cerebral function and depression or relation between the serotonin system and cholinergic system in relation with disease comorbidity cognitive-depression.

Objective

To evaluate the therapeutic response in patients with comorbility between Mild Cognitive Disorder and Depression in treatment with Galantamine (acetylcholinesterase inhibitor) with Escitalopram (Selective serotonin reuptake inhibitors) and the two drugs associated.

Method

A group of 705 patients with symptoms of Mild Cognitive Disorder and Depression (DSM IV-TR criteria) were separated in 3 groups of 235 patients. Each group received different treatment in an 12 months period:

Group 1: Galantamine 16 mg/day.

Group 2: Escitalopram 10 mg/day.

Group 3: both drugs, same dose.

Results

The therapeutic response evaluated in Hamilton Scale for Depression (HAM-D), Montgomery and Äsberg Depression Rating Scale (M.A.D.R.S.), Mini Mental State Examination (M.M.S.E.) and Global Clinical Impression (G.C.I.) scores during 12 months. In the third group who received the two drugs associated, had much better response than the others and “brain enhancer”.

Conclusion

The group who received the association of the cholinergic agent Galantamine with antidepressant (SSRIs) Escitalopram had a relevant satisfactory therapeutic response: the best result, so there is a possible relation between the deficit in cholinergic systems and depression. Could be cerebral cholinergic systems deficit a generator of Depressive Disorder?
Atypical neuroleptics and glucose metabolism: A study project
Authors: Zeppegno P. , Carnevale Schianca G.P. , Prosperini P.L. , Porro M. , Feggi A. , Bartoli E. , Torre E.
Published: May 2011

Introduction

Metabolic syndrome and cardiovascular diseases are important causes of morbidity and mortality among patients with mental illness. Atypical antipsychotics are more associated with obesity, metabolic syndrome, abnormal glucose and lipid metabolism than first generation antipsychotics.

Objectives

To identify risk factors related to glucose metabolism in short, medium and long time treatment and find out which are related to neuroleptic therapy and which depends on genetic background and lifestyle. To follow up clinical and self-rated variations of the psychiatric symptoms.

Methods

We included psychotic or bipolar patients in treatment with only one typical (haloperidol) or atypical (clozapine, olanzapine, risperidon, aripiprazole, paliperidon) neuroleptic, drug-naïve or after a wash-out from previous therapy. Patients will be evaluated five times (at baseline and after 1, 3, 6, 12 months) with a blood sample (haemocrome, glucose, insulin, Hb A1C, thyroid hormones, liver and pancreatic function), BMI, Basal Metabolic Rate (BMR), OGTT, HOMA index, familiar and pharmacological history, SIDE and CGI.

Results

From blood exams and OGTT we will obtain data regarding variations of glucose metabolism and the possible relationship with neuroleptic medications. From SIDE questionnaire we will assess the impact of side-effects by the patient's perspective and with CGI the variations of symptom severity.

Conclusions

Our study will allow us to identify risk factors concerning glucose metabolism alterations related to antipsychotic medications.
Effects of a diminished serotonin synthesis on memory and impulsive aggression in adult ADHD
Authors: Zimmermann M. , Grabemann M. , Mette C. , Kraemer M. , Abdel-Hamid M. , Zepf F. , Wiltfang J. , Kis B. , Uekermann J.
Published: May 2011

Introduction

Numerous results from investigations including children with ADHD show associations between a diminished serotonin synthesis and memory impairments as well as higher aggression scores. The aim of the present study was the investigation of the association between a diminished serotonin synthesis, logical memory and impulsive aggression in male adult patients with ADHD.

Method

Twenty male adult patients with ADHD and twenty healthy controls were recruited for this double-blind within subjects crossover study. Subjects completed the Rapid Tryptophan Depletion (RTD) Test or a placebo condition (balanced amino acid load) on either one of two examination days. Clinical variables and general intellectual functioning were assessed. The neuropsychological test battery included the subtest logical memory from the Wechsler Memory Scale (WMS-R), self-assessment of aggression as well as the Point Subtraction Aggression Game (PSAG).

Results

Statistical analysis revealed significant memory impairments of ADHD patients, which were associated with severity of symptoms in early childhood as well as subjective aggression scores. Effects of the tryptophan depletion were not found, neither for the logical memory subtest nor performance in the PSAG.

Conclusions

In contrast to previous studies, these findings suggest that the serotonergic system as reflected by the RTD Test has no effect on memory performance or impulsive aggression. However, these results may be due to possible interactions of other catecholamine systems with the serotonergic system that were not controlled in this study. Therefore an additional study is needed to further explore the catecholamine systems and their effects on memory and impulsive aggression.
Augmentation with pregabalin in schizophrenia
Authors: Zink M. , Englisch S. , Esser A. , Enning F. , Hohmann S. , Schanz H.
Published: May 2011

Introduction

Anxiety is a core symptom of schizophrenia which elicits significant subjective burden of disease and contributes to treatment resistance in schizophrenia. Anxious syndromes might be attributed to incompletely remitted delusions, the negative syndrome, depressive episodes, panic attacks, social phobia, avoidance after hospitalization and down-tapering of benzodiazepine medication. Previous treatment attempts involved several strategies of combination and augmentation.

Objective

Pregabalin, an antagonist at the α2δ-subunit of voltage-gated Ca2+-channels, modulates several neurotransmitter systems and was found able to alleviate anxiety in depression and other mental disorders.

Aim

In schizophrenia, this treatment option has not been evaluated before.

Method

Here, we report a case series of 11 schizophrenic patients who suffered from treatment-resistant anxiety and received augmentation with pregabalin.

Results

This observational investigation reveals that augmentation with pregabalin was able to significantly reduce scores on the Hamilton anxiety scale; furthermore, we observed improvements of psychotic positive and negative symptoms and mood as assessed by PANSS, SANS and CDSS. After augmentation, both a complete discontinuation of concomitant benzodiazepine (BZD) treatment as well as a dose reduction of antipsychotics could be achieved. We did not observe pharmacokinetic interactions or adverse events.

Conclusions

These observations suggest that treating anxious syndromes in schizophrenia with pregabalin can be effective and tolerable. Further investigations should differentiate schizophrenic sub-syndromes of anxiety and evaluate benefits and risks of pregabalin in comparison to placebo and active competitors.
Improving happiness recognition in human voice among people suffering from social anxiety
Authors: Bodner E. , Aharoni R.
Published: May 2011

Introduction

Previous studies have shown that in comparison to healthy people, patients with social anxiety (SA) identify fewer emotions of happiness in vocal expressions.

Objectives

(1)

To repeat previous studies on emotion recognition in SA patients;

(2)

To examine the effect of training on emotion recognition in SA patients.

Aims

(1)

To examine the effect of training in emotion recognition of non-verbally vocal musical improvisations on the ability of SA patients to identify happiness in verbal vocal spoken language.

(2)

To create a preliminary procedure for improving this ability in SA patients. Methods: 41 SA patients and 39 healthy controls aged 24–40, were examined. SA diagnosis was conducted according to the norms of the Liebowitz (1987) questionnaire. Half underwent an intervention that focused them on happiness recognition in non-verbally vocal musical improvisations, and half did not. The four groups were then compared on level of precision of emotion recognition (happiness, fear, anger, sadness and surprise) in spoken language sentences.

Results

A Multivariate analysis of variance showed that SA patients significantly identified fewer emotions of happiness in vocal expressions than healthy controls. SA patients who were trained demonstrated a similar precision level of happiness recognition in woman spoken language sentences as healthy controls (ps < 0.05).

Conclusions

Our findings demonstrate that short exposure (20 min) to non-verbally vocal musical improvisations immediately improves the ability of SA patients to recognize happiness in spoken language. Future studies can refine our procedure and examine its impact on SA patients over longer time periods (e.g., months).
Does a high degree of instability during psychotherapy enhance a positive therapy-response? - an evaluation of an in-patient behavior therapy of obsessive-compulsive disorder
Authors: Dold M. , Demal U. , Lenz G. , Schiepek G. , Aigner M.
Published: May 2011

Introduction

The study evaluates a central hypothesis of synergetic psychotherapy research according to which a marked instability in the psychotherapeutic process is associated with high response rates.

Methods

14 patients with obsessive-compulsive disorder (OCD) successfully completed an eight-week in-patient course of multi-modal behavior therapy with exposure exercises followed by response management. The instability during the course of the therapy was recorded by daily self-assessment by the patient using the Synergetic Navigation System (SNS), an Internet-based real-time monitoring procedure.

Results

There was a negative correlation between the degree of the instability and the percentage reduction in the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) (r = −0.395; P = 0.199), the “Global Severity Index” (GSI) of the symptom check-list (SCL-90-R) (r = −0.718; P = 0.013), the scale value for obsessive-compulsiveness in the SCL-90-R (r = −0.782; P = 0.004) and the remaining sub-scales of this data-gathering instrument.

Conclusions

An unstable progress of the psychotherapy causes a smaller reduction in symptoms than a stable one. The contradiction relative to the study hypothesis is possibly based on the special features of OCD, with a high level of patient insecurity when anticipating new, non-obsessive-compulsive ways of thought and behavior. The relationships between instability and reduction in symptoms appear to be diagnosis-specific.
Family history and its influence in the beginning and progress of mental disease
Authors: Doulgeraki G. , Graikiotis A. , Theodosi K. , Kavvadias N. , Pittara A. , Malatra M.
Published: May 2011

Introduction

Mental disease is faced during the past years as a result of various factors, such as the participation of the family which sometimes has a negative aspect in the course of the disease.

Objective

Through the study of 15 families of the patients who live in the Residential Unit of Aspropirgos, we present the role of the family environment in the appearance and process of the disease.

Method

We observed the background of 15 patients of the Residential Unit. When they completed a month living in Aspropirgos, we completed their Personal and Social Performance Scale (PSP). At the same time, we accepted the patients’ families in four weekly sessions whose goal was to explore and cope effectively with the problems that led those patients to mental disease. Patients completed the same questionnaire in their 4th and 12th month of their stay in Aspropirgos while we continued to have monthly sessions with their families.

Conclusions

Patients presented a decrease of their functionality in their 4th month in the Residential Unit (around 30%), which was accompanied by the resistance of their families in the suggestions of the therapeutic group. When 4 months were completed we put more strict limits regarding the relationships of the patients with their families, we even forbidded their contact with members who provoked the most severe dysfunction in the patient. At the end of 12 months we concluded that there was an improvement of up to 50–60% compared to patients’ situation in the 4th month.
Experiential avoidance versus acceptance: Differentiating between primary and secondary disturbances in rational-emotive behavior therapy
Authors: Fernández-Jiménez E. , Castillo-Gordillo E. , Pastor-Morales J. , Sanz-Largo V. , Rivas-Marín F.
Published: May 2011

Introduction

Albert Ellis’ Rational Therapy, founded in 1955, evolved into Rational-Emotive Therapy (RET) in 1959; and finally as Rational-Emotive Behavior Therapy (REBT) in 1992. This evolution has showed, much more, its resemblance to Acceptance and Commitment Therapy (ACT) (Ellis, 2005). REBT highlights treatment of secondary disturbances (berating oneself for having symptoms), beyond primary ones (nosographical symptoms), because these are ways of control and experiential avoidance which foster suffering.

Objectives

To treat primary anxiety in a patient reducing his secondary disturbance through TREC.

Methods

Participants: A 40-year-old man diagnosed with Panic Disorder who attended a Public Mental Health Service. He was being treated with Alprazolam y Lorazepam, which he has taken before psychotherapy.

Design, materials and procedure: It's implemented a single-subject AB design during 4 months (7 therapeutic sessions). It's applied a weekly self-report to record panic attack frequency and variations in anxiolytics-taken. C Young (p < 0.01) was used for statistical analysis of data and the method of least squares to obtain trend line. 16 measures were registered at a weekly interval.

Results

Significant declining trends are observed in panic attack frequency (C = .750, Zo = 3.201, Zt = 2.240), and collaterally in anxiolytics-taking (Alprazolam: C = .811, Zo = 3.462, Zt = 2.240; Lorazepam: C = .801, Zo = 3.420, Zt = 2.240) from beginning of therapy.

Conclusions

Techniques targeting symptoms-extirpation induced intolerance and self condemnation feelings when patient didn’t achieve the wanted control (as way of destructive experiential avoidance -Luciano and Hayes, 2001). Treating these feelings (secondary disturbance), based on symptomatology acceptance (Ellis, 2005), decreased distress related to panic attacks and paroxysmal crisis frequency itself.
EMDR training for mental health therapists in postwar bosnia-herzegovina who work with psycho-traumatized population for increasing their psychotherapy capacities
Authors: Hasanovic M. , Pajevic I. , Morgan S. , Kravic N.
Published: May 2011

Introduction

After war 1992–1995 in Bosnia and Herzegovina (BH), whole population was highly psych-traumatized. Mental health therapists had no enough capacities to meet needs of population. They are permanently in need to increase their psychotherapy capacities. EMDR is a powerful, state-of-the-art treatment. Its effectiveness and efficacy has been validated by extensive research. National Institute for Clinical Excellence (NICE) recommended it as one of two trauma treatments of choice.

Aim

To describe non profit, humanitarian approach in sharing skills of Eye Movement Reprocessing and Desensitization (EMDR) to mental health therapists in BH from Humanitarian Assistance Program (HAP) of UK & Ireland.

Method

Authors described educational process considering the history of idea and its realization through training levels and process of supervision.

Results

Highly skilled and internationally approved trainers from HAP UK & Ireland came four times to Psychiatry Department of University Clinical Center Tuzla in BH where they provided completed EMDR training for 24 trainees: neuro- psychiatrists, residents of neuro-psychiatry and psychologists from eight different health institutions from six different cities in BH. After finishing training process, trainees are obliged to practice their EMDR therapy in daily practice with real clients under the supervision process of HAP UK & Ireland trainers to become certified EMDR therapists. Regarding big physical distance between supervisors and trainees, supervision will be realized via Skype Internet technology

Conclusion

Psychotherapy capacities of mental health psychotherapists in postwar BH could be increased with enthusiastic help of EMDR trainers from HAP UK&Ireland.
Attachment in adult patients with attention-deficit hyperactivity disorder (ADHD)
Authors: Abdel-Hamid M. , Heinrich V. , Sperber S. , Wiltfang J. , Kis B. , Uekermann J.
Published: May 2011

Introduction

Adult patients with ADHD suffer from marriage problems and increased divorce rates significantly more often. There are, however, only a few studies which analyse romantic attachment to a partner or romantic relationships among patients with ADHD in view of attachment theory.

Aims

The aim of the present study is to research if ADHD patients show a diminished quality of romantic relationships in comparison to a matched sample of healthy controls. Furthermore, correlations between ADHD specific characteristics and particular variables of partnership perception and psychosomatic discomfort were analysed within the ADHD subgroup.

Methods

We recruited 39 patients with ADHD and compared them with a matched sample of healthy controls. Self-estimation measures were used to examine the quality of attachment, dimensions of attachment, love styles, psychosomatic discomfort and ADHD specific symptoms.

Results

In comparison to the control sample, adult ADHD patients show a significantly reduced quality of relationships. ADHD patients rank themselves as more scared of attachment and showing more avoidance of interpersonal relationships in general as well as romantic relationships. They also feel less romantic love. ADHD specific characteristics correlate moderately with the attachment dimensions “Fear” and “Avoidance”, the love style “Mania” and psychosomatic discomfort.

Conclusions

This study lends further support to the assumption that adult patients with ADHD show an impaired quality of attachment, increased fear and avoidance of relationships as well as less romantic love. The results strongly underline the necessity to account for individual attachment styles in psychotherapy of ADHD.
Intensive cognitive-behavior therapy group for social phobia. Program and effectiveness
Authors: Holas P.
Published: May 2011

This poster is aiming at presentation of program together with some data on effectiveness of intensive cognitive-behavior group psychotherapy (CBGT) for social phobia (SP) carried out in Center for Psychotherapy at the 2nd Department of Psychiatry Medical University of Warsaw. Intensive CBGT for social phobia has been conducted in Center for Psychotherapy for five years. Therapy lasts 12 weeks, five days a week, with two sessions each day. Therapeutic program consists of 4 modules: I. A standard cognitive therapy for SP based on Clark and Wells model (1986); II. A behavior module with primary focus on exposition and behavioral experiments; III. An interpersonal and assertiveness training and IV. Mindfulness training which focus on increasing mindfulness and acceptance skills and is based on MBCT and ACT exercises. Preliminary data on efficacy of the program carried out on 40 patients (17 F, 23 M) suffering from SP, reveled a significant reduction of SP and other neurotic symptoms, together with decreasing of depression and anxiety measures. What is interesting, we have found that intensive CBGT led to change in defense mechanisms, a concept belonging to a psychodynamic approach, with decrease in neurotic and immature mechanisms. In conclusion, intensive CBGT seems to be an effective treatment for SP, that changes not only symptoms but also some of the underlying dysfunctional personality mechanisms, but more studies with different methodologies are needed.
Learning outcomes for nurse students in mental health fieldin Northern Norway
Authors: Holm S.G.
Published: May 2011

Introduction

The nurse students have 8 weeks in practice in Mental Health Care in the community mental health care and district psychiatric centres (DPS). The course objectives are common for the nurse students. In this learning period in practice they are followed up by nurses in practice. The student, nurse and the teacher meet each other three times during the practice period.

Objective

The main question for this study was: Did the nurse students experience the possibility of reaching the intended learning outcomes in the Mental Health field course (12 credits)?

Aim

Was to gain knowledge about the intended learning outcomes nurse students could reach in practice.

Method

An explorative study design was chosen for the pilot study. The data came from 26 students who were secondary years nurse students.

Results

The result shows that of 16 learning outcomes, 5 differed; Knowledge in mental health nursing, Care Management, Treatment, The legal aspects of Mental Health Care, and Administration of drugs. The students experienced that they could not fully reach the learning outcomes. The findings are discussed based upon theory in communication, caring and learning.

Conclusions

Based on this result, we need to reconsider some aspects of the role of the faculty members and the role of the clinical preceptors in this course.
Family therapy preventing the bipolar patient against recurrent episode : A case series
Authors: Hsu H.C. , Lin P.Y. , Takashi Y.
Published: May 2011

Bipolar disorder is a chronic, recurrent disorder, and its dysfunction has been correlated with poor outcomes and increased risk of recurrence. The main purpose of the family therapy model at issue is to prevent the bipolar patient against recurrent episode.

The focuses of the therapy sessions are on the apples drawn by the patient(DDAA), the patient, and the patient-parent relationship. Keywords are gathered from every participant during the therapy session. Besides, the subjects to have verbalized meaningful ideas or successful experiences are immediately, intensely praised by applause during the session. DAILY DRAW AN APPLE(DDAA) homework is that the patient has drawn an apple on a calendar everyday and shares with parents about the apple as well as the patient's feelings of the day. The participants of the family therapy are the patient, parents, and the therapists. The frequency of the model is once monthly. Each session consists of the 10 minutes pre-session, the 60 minutes family therapeutic session, and the 30 minutes post-session. It needs to be emphasized that the frequency of re-hospitalization definitely decreased after receiving therapy.

Finally, positive transference was demonstrated in the high attendance rate, in their excitement in receiving the applause, and in their collaboration in presenting the keywords. With the aid of the family therapy, they have been almost free from affective symptoms, and the hostile dependent tie with their parents having been steadily improved. To prevent the bipolar patient against recurrent episode has been achieved in the five cases family therapy presented here.
Short-term psychotherapy in complex treatment of non-psychotic depressive spectrum disorders
Authors: Zhebentyaev V.A. , Igumnov S.A.
Published: May 2011

The aim of this investigation was to study the effectiveness of a combination of differentiated short-term psychotherapy and pharmacotherapy with antidepressants.

Methods

The study was implemented in a clinical randomized clinical trial. Experimental group consisted of 44 patients whose treatment is differentiated short-term psychotherapy, developed on the basis of the received data, in combination with standard pharmacotherapy. Comparison group comprised 35 patients whose treatment consisted of cognitive therapy in combination with standard pharmacotherapy. In short-term depressive reactions set a techniques include:

a)

psychological relaxation sessions,

b)

exposition techniques,

c)

cognitive therapy for correction of vulnerable personality traits.

With prolonged depressive reaction applied psychotherapy aimed at correcting avoid personality traits in various modalities.

Results

As compared to the group of comparison for certain the subscales of depressed mood (р < 0,01) became better anymore, middle insomnia (р < 0,001), retardation (р < 0,05), anxiety psychic (р < 0,001) and anxiety somatic (р < 0,001), general somatic symptoms (р< 0,05), paranoid symptoms (р < 0,01) and depersonalization (р < 0,05). According to the questionnaire of SCL - 90 in the experienced group the scales of Global Severity Index GSI (р < 0,05), somatic symptoms (р < 0,05), anxiety (р < 0,05), depression (р < 0,05) and phobic anxiety (р < 0,05) reduced more quickly.

Conclusions

Catamnestic study has shown, that in the experienced group steadier parameters symptomatic improvement, social functioning and use of received psychotherapeutic experience in life are observed (р < 0,05).
Turning each patient into clinical research project through lifetrack
Authors: Ishizuka Y.
Published: May 2011

Objective

To demonstrate how an on-going psychotherapy practice can be turned into a perpetual research project by tracking progress (or lack thereof) of each patient through daily self-rating on 41 parameters. The author has treated 1,213 patients over the last 20 years, showing that psychiatric symptoms (such as anxiety, anger, physical symptoms, depression, and psychosis) can be predictably eliminated by transforming personality through ‘Breakthrough Intimacy’ - closeness between committed couples far greater than their previous maximum experience, usually without drugs and often within 6 months.

Method

Lifetrack therapy works with the patient and his/her partner in three-way teamwork, bringing them far closer than ever before, guided by their own daily self-rating on 41 parameters that allow accurate graphic tracking via Internet of subtle changes in their personalities and dynamic mental status during each therapy session. The therapist actively helps the couple to think, feel, and act in such ways that their closeness will increase, provoking and overcoming waves of symptom spikes (defense) until they disappear by exhaustion, as the couples undergo personality transformation.

Results

Of the 1,213 patients treated over the last 20 years, 50% reached a level of adjustment beyond their previous best level according to their own daily self-rating. Patients with partners (871) did 4 times better (61.4% vs. 15.2%) than singles (342). Ot those who did not drop out of therapy during the first month, 78% of patients with partners (659) reached their previous maximum of 10, while only 11% of those without partners did so.
Emotional processing of traumatic emotions and early experiences using the therapeutic letters, role playing and imagination in borderline and other difficult patients
Authors: Jelenova D. , Kovacsova A. , Diveky T. , Kamaradova D. , Prasko J. , Grambal A. , Sigmundova Z. , Bulikova B.
Published: May 2011

In many patients cognitive reconstruction helps to understand their problems in life and symptoms of stress or psychiatric disorders. Change in the thoughts and beliefs help them to feel better. But there are many patients who suffer with strong traumatic experiences deep in their mind and typically dissociate them or want to avoid them voluntarily. There is typical for patients suffering with dissociative disorders, borderline personality disorder and many people with various psychiatric disorders who were abused in childhood. The processing of the traumatic emotions from childhood can be helpful in the treatment of these patients. For the help is important:

a) Understanding what was happen in childhood

b) Making clear of repeated figures of maladaptive behaviors, mostly in interpersonal relations

c) Making a connection between childhood experiences and here and now emotional reactions on various triggers

d) Experiencing repeatedly the traumatic memories and elaborate them with imaginal coping.

We describe:

- how to map and elaborate emotional schemas

- Socratic questioning with the patients with traumatic memories

- how to work with traumatic experiences from childhood in borderline personality disorder.

Supported by the research grant IGA MZ CR NS 10301-3/2009
Cognitive behavioral psychotherapy supervision - what works?
Authors: Kljenak D.
Published: May 2011

Introduction

Substantial empirical support for cognitive behavioral therapy (CBT) effectiveness in the treatment of various psychiatric disorders has been demonstrated. Adequate training in CBT results in improved therapist competence and patient outcomes. Essential part of the training in CBT is a clinical supervision. A review of theoretical perspectives on CBT supervision is provided. Commonly encountered obstacles in CBT supervision are illuminated with case examples.

Objectives

At the end of the presentation participants will be able to describe a theoretical approach to CBT supervision, list common obstacles encountered in CBT supervision and describe strategies to effectively address these obstacles.

Aims

The aim of the presentation is to encourage CBT psychotherapy supervisors to reflect on the supervisory methods they use and increase their ability to provide effective CBT supervision.

Methods

The literature on successful CBT supervision is reviewed. This case based presentation will illustrate strategies for addressing commonly encountered roadblocks in supervision.

Results

Having a theoretical framework for CBT supervision enhances supervisors’ ability to provide successful supervision.

Conclusions

Review of theoretical approaches to CBT supervision, the description of commonly encountered obstacles and strategies to manage them during the supervision creates platform for reflection on the supervisory methods used by the participants.
Psychodynamic group psychotherapy reduces severity of depressive symptoms indepedently of personality trait neuroticism
Authors: Małyszczak K. , Pacan P. , Pawłowski T. , Kiejna A.
Published: May 2011

This study assessed whether decrease in depressive symptoms after group psychodynamic psychotherapy was due to change in neuroticism score.

Patients were treated with group psychodynamic psychotherapy lasting 12 weeks. Every working day patients had 2 therapeutic sessions of 1,5 hour each. Personality trait neuroticism was measured with Eysenck Personality Questionnaire - Revised (EPQ-R), depressive symptoms with Depression Scale of Symptoms Checklist 90 - Revised (SCL-90-R) questionnaire.

Of 139 patients included in the study, 110 patients (79.1%) completed it. They were 37 men and 78 women, all with mean age of 34.25 years old. 64 patients were diagnosed with a neurotic disorder (ICD-10/F4), 28 with a personality disorder (F6), 15 with both a personality and a neurotic disorder and 3 with depression (F32) with personality disorder. In total 53 patients were on medication, mainly selective serotonin reuptake inhibitors.

Initial mean neuroticism score was 18.9, and after treatment it was 17.6. This difference is statistically significant as a change (t = 2.88, p = 0.005), but not as an independent mean value (t = 1.9, p = 0.06). Difference in severity of depressive symptoms is far more considerable: before treatment 2.08, after treatment 1.61, and it is statistically significant in comparison as dependent (t = 5.29, p = 0.000001), as well as independent (t = 3.53, p = 0.0005).

Looking at proportion of the change, neuroticism score dropped by 7%, whereas depressive symptoms score dropped by 22.6%. We can say that change of depressive symptoms severity is caused mainly by other factors than change in personality trait neuroticism score.
A therapist's communications and interventions in group psychotherapy of paranoid patients
Authors: Manojlovic S. , Nikolic-Popovic J. , Nikolic G.
Published: May 2011

Group psychotherapy of paranoid patients implies gradualism in achieving therapeutic goals. Establishing reality is the first therapeutic goal, and acquiring insight and understanding of the current conflicts in the situation here-and-now connected with conflicts from the past in the situation there-and-then is the second one. Five Small psychotherapeutic groups of paranoid patients were included in our study. We measured the participation of the therapist's communications in group communication structure and the structure of the therapist's interventions. The therapist's communications in the group were determined using Bales’ category system. The therapist's interventions were determined according to the Scale of therapist's interventions. We made two measurements: at the beginning and after a period of two months. The total score of the therapists’ communications in the first measuring (38.2%) was significantly higher than in the second measuring (25.79%) (p < 0.01). In the structure of the therapists’ communications, a high level of the emotionally positive communications was maintained in the first (55.45%), as well as in the second measuring (41.17%). Explanations, clarifications and alternative solutions could be found in the beginning of the group therapist's interventions. The most frequent therapist's interventions in the second measurement were interpretations and confrontations. In the therapeutic process, members of the group were taught to observe communication and to search for its meaning together. The group responded to the reality of its world and defined reality for every single member. Communications brought new meanings to old experiences and enabled the acquisition of new experiences with meaning.
Social implications of group psychotherapy on chronic psychoses
Authors: Mitric B.
Published: May 2011

Introduction

Center for mental health is establishrd in May of year 2005. enter for mental health promotes the mental health care in the community.

Objective

To evaluate the effect of group psychotherapy on chronic psychoses, ambulatory treated in Mental Health Center in Kotor, Montenegro.

Aims

The influence of effect of group psychotherapy on chronic psychoses in the development of optimal socialization.

Method

The group consist of patients who werw coming for regular check-ups in our health center during previous 5 years. The group in semi-opened and it is heterogeneous in respect to gender and age. The effect is estimated by observing the behavior of group dynamics.

There werw 8 regular members in this group and additional ones who participated occasionally, on suggestion of their psychiatrist.

Results

During the initial group meetings it was noticed that the patients are not familiar with each other, even though they werw previously treated in our local psychiatric hospital and are inhabitants of a same, smail town. They didn t communicate with each other and didn t even know each others names. They ewrw distrustful toward new group members and could.t think of the questions to ask whwn the new members werw presented to them, After six months, group members formed friendship relationships.

Conclusions

Evaluation of the effect of group psychotherapy is fascilitating the development of optimal socialization as well as optimal interpersonal relationships within group, in respect to the nature and progression of mental disorder.
Psychotherapy in ukraine, problems and prospects
Authors: Mykhaylov B.
Published: May 2011

The psychotherapeutic care in Ukraine is carried out in structure specialized psychiatric, psychoneurological and somatic hospitals and polyclinics of public health services. Since independence, Ukraine still has inefficient public health care system, with its unbalanced structure of services, especially in mental health care. In 2008 parameters of mental illness and disturbances of behavior was 243,3 per 100 thousand population and in comparison with 1990 decreased per 2,5%. Maximal parameters of mental illness and disturbances of behavior in 1995 consisted 263,1 per 100 thousand population. In structure of parameters of mental illness and disturbances of behavior, in 2008 (72,7 % or 176,1 per 100 thousand population) prevailed nonpsychotic. The basic organizational unit of the psychotherapeutic care is the cabinet of psychotherapy, which common number on 1.01.2009 year was 223, from them at the psychiatric network 134 (61 %), at the somatic - 89 (that makes about 39 %). The psychotherapeutic care is carried out within the limits of medical and psychological model. Thus since 1997 the speciality medical psychology and a staff of the doctor-psychologist is entered. From now on in a medical network medical psychologists with medical (85 person) and psychological (315 person) base education in parallel work. The psychotherapeutic network requires immediate expansion, especially in somatic treatment-and-prophylactic hospitals and polyclinics. The staff could be taken from psychiatrists after reduction psychiatric beds which would pass a training for a new profession on corresponding faculties and chairs of psychotherapy of postgraduate education organizations.
The autoperception of intelligence in group psychotherapy of paranoid patients
Authors: Nikolic-Popovic J. , Manojlovic S.
Published: May 2011

Self-perception, as a part of self - concept, is a form of perception where the object being observed and the observer are one and the same. The self-concept is a cognitive structure and it mediates between social structures and behavior. In group psychotherapy, a therapist's interventions are focused on the replacement of a false paranoid identity (where the overestimation of one's own intelligence is part of the false image one has of himself) with a real one. Six psychotherapeutic groups of paranoid patients were studied. The methodological procedure known as the analysis of relations was used. It is a combination of the sociometric questionnaire and the test of social perception. The degree of appropriateness of auto-perception of intelligence is evaluated. The determination of the auto-perception of intelligence was carried out by comparing real ranks (from the real IQ) and the ascribed ranks (on the basis of the selected positions where the patient marked his own intelligence to be). The results for all the groups are consistent: there is a definitive (both in terms of the number and the degree) overestimation of one's own intelligence. It can be found at the basis of the paranoid pathology expression where we find the parallel nature of the projection of the introject of the aggressor and the introject of narcissistic superiority, partially incorporated into the unreal self concept. Psychotherapy at this level of solidly fixated conceptual categorization with a “falsification” of perceptual data is of crucial importance for the “dissolution” of the paranoid state.
Equine assisted therapy for patients with severe chronic psychiatric disorders
Authors: Nurenberg J.R. , Schleifer S.J.
Published: May 2011

Animal assisted therapy (AAT) is being used increasingly for patients with syndromes not responding adequately to traditional therapies (severe stress/anxiety reactions, interpersonal deficits, limited verbal skills, trauma, and violence). Some have suggested that larger animals, such as horses, may be more effective therapy enhancers for some patients than commonly employed smaller animals. We have been developing an AAT protocol at a 500 bed state psychiatric hospital in NJ, supported by observations of dramatic functional improvement with equine facilitated therapy (EFT) in some highly regressed or violent patients. Logistic issues in establishing an equine program in a psychiatric hospital include site development, animal/therapist selection and training, safety and liability; scheduling, and hospital staff integration with the equine therapists. EFT technique modifications have addressed the needs and limitations of chronic, highly regressed or violent patients. A clinical research project comparing 10 weekly EFT and canine-facilitated (CFT) group sessions in >100 patients is nearing completion. The background, principles, and practices of EFT will be reviewed as will its relative benefits compared with AATs such as CFT.

Research findings will compare AAT groups and standard therapies with respect to psychological, behavioral, and functional outcomes (e.g., violent and regressed behaviors, hospital discharge). Clinical value vs costs, including unique benefits associated with AAT subtypes, will be presented.
Can the lack of unconditional positive regard change the correct diagnose and the decision of treatment? case report
Authors: Sarpe M.C. , Ladea M.
Published: May 2011

Carl Rogers, one of the founders of humanistic approach in psychology, sees people as basically good and healthy. He considers mental health as the normal progression of life, and believes that mental illness and criminality are distortions of that natural tendency.

Rogers felt that a good therapist must have three very special qualities: Congruence, Empathy and Respect -- acceptance, unconditional positive regard towards the client. These qualities are “necessary and sufficient”.

We present the case of an 18-year-old adolescent with distressing thoughts of killing someone, a colleague or a family member, and compulsions like the wish to be restrained to the bad so that he couldn’t hurt someone. He was first diagnosed with premorbid symptoms of a psychotic disorder by a psychologist, and he was recommended to begin antipsychotic treatment. We subsequently diagnosed him with obsessive-compulsive disorder due to the fact that he felt repulsion and remorse for having these thoughts. He began the treatment with selective serotonin reuptake inhibitors and Rogersian therapy.

We intend to demonstrate that the lack of acceptance and unconditional positive regard as well as communication problems with the patient can interfere with giving the correct diagnose and decision of treatment.

“If I accept the other person as something fixed, already diagnosed and classified, already shaped by his past, then I am doing my part to confirm this limited hypothesis. If I accept him as a process of becoming, then I am doing what I can to confirm or make real his potentialities”, Carl Rogers.