bluuebunny/crossref_metadata_2025 huggingface dataset:
Collage Provoked an Insight in Patient with Borderline Personality Disorder
Authors: Knez R.
Published: March 2009

Aims:

To depict collage provoked an insight in female patient (31) suffering from borderline personality disorder following outpatient psychotherapy.

Methods:

Cut of images technique for making collage which later on was used during psychotherapy sessions.

Results:

The patient could easily identify herself with the collage's image of a girl on the toilet. During psychotherapy session we discovered that the toilet was a very important place in her childhood because it was the only place where she got the chance to be alone, where she felt safe and where her boundaries were respected by her parents. the second most important figure she described as her inside. She became aware of inner wild and aggressive nature because of the enormous pain which comes from her feeling of being used and cheated.

The predominant symptoms in patient were impulsive, uncontrolled actions and the oppositionality was very low. She described the position of a victim many times in life, but we couldn’t approach this experience in experiential way until we used collage technique. Patient identification with figures brought her to awareness of her feelings and helped her to recognize it later in everyday life situation; she learned how to deal with it, how to take the space she needs and how to protect her boundaries.

Conclusion:

The insight that she had using the collage technique moved her toward better understanding of the pattern of her actions and propelled her to different behavior which enabled her better social functioning and more satisfying life.
Specific Factors from Common Factors? Process and Change in Psychoanalytic Psychotherapy
Authors: Miranda F. Leao , Pires A. Pazo , Canta G.
Published: March 2009

The objective of this study consisted in developing a theory about the psychotherapeutic process in Psychoanalytic Psychotherapy and to verify the relevance of the common and specific factors. the participants were three psychoanalytical psychotherapists. Semi-structured interviews and 15 session's notes given by one of the therapists (one psychotherapeutic process of a 24 year old psychotic patient) were used and analysed according to the Grounded Theory method. A process called constant modification was found in the core of psychoanalytic psychotherapy, through which changes occur in the psychic functioning and in the relational style of the patient. This process functions at an intrapsychic and extrapsychic level. A model based on the concept of Enzymatic Catalysis was developed, in order to integrate and relate common factors (therapeutic bond), specific factors (therapeutic interventions), patient characteristics, therapist characteristics, external factors and therapeutic results to the central process. It was concluded that both common and specific factors contribute to the therapeutic process in a mutual dynamic.
Third Generation Cognitive-behavioral Therapy and Minfulness
Authors: Pinto A. , Cravador A. , Marques L. , Pinto-Gouveia J.
Published: March 2009

Objective:

To introduce mindfulness pointing out its potentialities when applied in the psychopatology scope.

Method:

The authors had proceeded to a research on this third generation cognitive therapy through the bibliographical retraction, from scientific articles and publications. Trying and describing what he is one practical regular one of Mindfulness.

Results:

The practice of Mindfulness Practical of Mindfulness divulged in multiple publications, disclosing to be about a new generation of the Cognitive Therapy. It describes its possible clinical applicability in some psycopathologic features, with bigger emphasis in the disturbances of the anxiety. It is proceeded a summary revision from some conceptual boardings and more recent scientific studies.

Conclusion:

Psicotherapeutic thechniques based in the practice of Mindfulness can be applied in clinical context complementing the cognitive theory based in the restructuring of the thought with the essential component of acceptance. However it would be very important to appear more randomized control trials that allow to prove its therapeutical effectiveness.
Working with the Relational World of the Preschool Child using Psychodynamic Group Therapy
Authors: Beebe D. , Repasky P. , Kowalik S.
Published: March 2009

For over forty years, Bellevue Hospital's Therapeutic Nursery Program has been addressing the emotional problems of New York City preschoolers, aged two to five years, with the help of their families and other caregivers. Typical psychiatric disorders treated in the Therapeutic Nursery Program include anxiety disorders (separation anxiety, generalized anxiety and posttraumatic stress disorder), disruptive behavior disorders (attention deficit hyperactivity disorder and oppositional defiant disorder), mood disorders, adjustment disorders and attachment disorders.

We have found that group psychotherapy provides a safe and secure place where, through psychodynamic intervention, children can repair dysfunctional relationships, identify and express a full range of emotions, resolve cultural differences and develop age appropriate skills.

Our Therapeutic Nursery Program employs a wide range of additional treatment modalities in order to reach the treatment goals. Individual or family sessions, as well as meetings with teachers and social service workers, are scheduled to address issues.

We have also found that dyadic or sibling work is often needed to stop or reverse the development of inappropriate family relationships.

One of our indications of a successful intervention is that either during or after their participation in the Therapeutic Nursery, children return to community-based daycare centers and preschools. We have also found that via participation in the Therapeutic Nursery program, families have opportunities to strengthen their ability to nurture their children, share successful parenting with other families and build pleasurable experiences with their children.
…And…Action!: Using Cinema and Film Clips in Partial Care/day Hospital Groups - Psychiatric Rehabilitation Settings
Authors: Ulus F.
Published: March 2009

Entertainment - education - empowerment through transactional analysis principles.

St. Vincent Hospital, Erie, Pennsylvania, intensive outpatient program experience: September 2005 - October 2007.

Three e’s in psycho-educational and open-ended group settings.

Medication for response - remission - recovery stages of behavioral health / mental illness.

Group movie therapy approach for rehabilitation stage [handling anger, alleviating anxiety, uplifting depression, formulating problem solving, improving judgment, helping to forgive and forgiven, experiencing with sense of humor, easing up suspicion and mistrust, promoting love and compassion, teaching assertive communication and relationship, overviewing prioritization, quieting down these trigger mechanisms in decreasing the morbidity of psychiatric syndromes].
Pilot Research: Evaluation of the Effectiveness of the Dance Movement Therapy (training) (movement-oriented Paradigm for Therapeutic Work with Groups)
Authors: Ustinova A.
Published: March 2009

In aim of assessment effectiveness new version of the Dance Movement training to elaborate adequate tools to state results of such type of therapy. Participants: mail and female, 35 (±15) years old were scored twice by psychological tests.

Original version was created by Conoshenko O. (1998) on the basis of Laban Analysis. the two main techniques were taken from Gabrielle Roth - “Body Jazz” and “Five Rhythms”. the primary purpose of this training program is to develop coping skills and enhance one's awareness of one's behaviour stereotypes through detection movement stereotypes.

It was proposed that higher scores of characteristics listed below should reflect the effectiveness of this training.

Testing has been conducted at first and last sessions (total 12 sessions). Control group, which included individuals with the same socio-demographic characteristics, has been interviewed twice also. But controls had not participated in the training.

So 16 individuals were scored by method of quick evaluation of common state of health (self-feeling), activity and mood (Doskin V.), method of investigation self-attitude (Stolin V., 1993), personal anxiety scale (Spilberger C., Hanin J.), method of diagnostics social frustration (Vasserman L.).

Statistical analysis data have revealed significant differences between compared groups. Those, who had participated in training, have demonstrated higher scores of the self-feeling and mood. Such aspects of self-attitude as internal contradiction and self-accusation have tendency to reduce. Additionally controls have maintained in their self-reports mastering in solving problem skills effectivelly due to managing one`s problems with a new skills acquired on the training.
Client-centered Psychotherapy Efficacy in Panic Disorder
Authors: Panait O.D. , Chirita A.L.
Published: March 2009

Background and aims:

Panic disorder has an overall prevalence rate of 2.1% with higher rates in women. Usually, the treatment includes pharmacotherapy (SSRI) and cognitive-behavioral therapy. But two thirds of the patients have a chronic pattern of evolution, with exacerbations and remissions. That is why we looked for another form of psychotherapy to help patients improve their quality of life.

Methods:

We evaluated 25 patients (17 female and 8 male), with the mean age of 27.8 years, for 48 weeks. They were treated with paroxetine 20 mg daily for 12 weeks and with weekly sessions of client-centered psychotherapy. They were evaluated with the Covi Anxiety Scale (CAS), the Panic and Agoraphobia Scale (PAS) and the CGIs (CGI-I and CHI-S).

Results:

At the beginning of the treatment the next mean values of the whole group were: CAS 12.9, PAS 50.4, CGI-S 5.3. after 12 weeks the mean values were: CAS 6.7, PAS 12.1 and the CGI-I 2. after 24 weeks the mean values were: CAS 4, PAS 4.3 and the CGI-I 1.3. at the end of the study the CGI-I was 1, the CAS 3 and the PAS was zero.

Conclusions:

Client-centered psychotherapy is an useful approach in patients with panic disorder.
The Pathogenic and Patopsychology Factors of Agorafobia and Panic Disorder Performing in Ukrainian Population
Authors: Mykhaylov B.
Published: March 2009

The high dynamics of sociotechnocratic development of modern society, improvement of the information technologies, scientific and technical achievements along with the improvement of the quality of life bring about the elevation of psychological and emotional tension, complication of an individual’s behavioral patterns, and put forward harsh requirements to the integrative activities of all mental processes as a whole.

The following system-creating factors require a basic revision of the role and function of psychotherapy in modern medicine:

1.

Evolution of concepts of psychosomatic and somatopsychic correlates.

2.

Changes in the morbidity structure.

3.

Resocialization of patients as an ultimate aim of the treatment process.

4.

“Internal” tendencies in development of psychotherapy itself.

5.

Psychological causes of diseases and factors of neurotization.

6.

Rigidity of professional doctrines and organizational ways of providing healthcare for the population.

Psychological and sociological factors of neurotization of Ukrainian population have a number of peculiarities:

•

sociopolitical instability of society;

•

economical and ideological instability of society;

•

loss of old ideals by the people and the lack of new ones;

•

looking up to religious, mystic, occult and para-scientific systems;

•

increase in the number of technological and natural disasters.

The changes in morbidity structure testify that a considerable increase in psychologically caused, somatization, psychosomatic and neurosomatic diseases with chronic course, and in borderline states is seen in Ukraine over the last years, especially agorafobia and panic disorder. These illnesses are characterized by a wide psychoemotional range of symptoms with appropriate neurological, vegetative and somatic correlates.
Venlafaxine in the Treatment of Panic Disorder Comorbid with Depression
Authors: Shcherbakova I. , Bardenshtein L. , Krilatith V.
Published: March 2009

The novel antidepressant venlafaxine, acting as both a serotonin and noradrenaline reuptake inhibitor is generally effective for anxious and depressive symptomatology. Recently venlafaxine has been approved for use in treatment of panic disorder. the aim of this investigation is to determine the efficacy of venlafaxine in the therapy of panic disorder complicated by depressive symptoms.

Method:

Outpatients aged 19-52 (n=16, 2 male and 14 female), who met ICD-10 criteria simultaneous for panic disorder (with or without agoraphobia) and depressive episode mild severity were treated with venlafaxine in dose 75-150 mg/day (as monotherapy). the patients were evaluated with the Hamilton Rating Scale for Anxiety (HAM-A) and the Hamilton Depression Rating Scale (HDRS-21) at baseline and weekly during one month and over six months of continued therapy.

Results:

Baseline total HAM-A and HDRS scores were 23±7 and 24±5, accordingly. Clinical improvement was observed after about one week (HAM-A total: p< 0,01; HDRS total: p< 0,004). the reductions of total using scores from baseline to the end of week 4 were equivalent 78%. Percentage of patients free from panic attacks and depressive symptoms was 37%. after six months all the patients demonstrated panic-free and depressive-free status. the most frequent adverse events were nausea (6,2 %), somnolence (12,5%), which reduced to the end of week one.

Conclusion:

The venlafaxine therapy of panic disorder comorbid with depression is associated with significant improvement after four weeks of treatment. There was no difference in response using the rates (HAM-A, HDRS).
Psychological Defenses in Patients with Comorbid Panic Disorder and Alcoholism
Authors: Tsygankov D. , Agasaryan E. , Terekhova D.
Published: March 2009

The aim of this study was to examine psychological differences between various groups of patients with comorbid panic disorder and alcoholism (n = 214). We investigated the use of defense mechanisms by life style index of R. Plutchik. Patients of first group (who experienced there first panic attack during withdrawal of alcohol and then has stopped use of alcohol) significantly higher used projection, displacement and repression. Patients, who have originally suffered from panic attacks which they tried to release with the alcohol (second group), significantly higher used projection. Patients who experienced panic attacks only during ingestion of alcohol (third group), significantly higher used denial and repression. Patients with panic attacks during clinical remission of alcohol addiction, who used alcohol to weaken the panic symptoms, which resulted in the heavy alcoholism recurrence (fourth group), significantly higher used repression, projection and denial. So, there were differences between groups on preferred defense mechanisms. the results of the study can help in understanding the pathogenesis of comorbid panic disorder and alcoholism.

The study is supported by the President's grant ÌÊ-2670.
Comparison the Emotional Intelligence Components of Suicidal Patients and Non-clinical Samples
Authors: Ahmadian M. , Nezam T. Shamshiri , Badvee I. , Homayouni A.
Published: March 2009

Introduction and aim:

Based on emotional intelligence (EI) Theory it was expected that EI component differences would likely be obtained on variables including problem-solving, happiness, stress-tolerance, self-actualization, interpersonal relationship. So the purpose of the current study was compare the emotional intelligence (EI) components in suicidal patients and non-clinical samples.

Method:

A total of 60 participants took part in this study, including 30 patients (12 male, 18 femal) who had recently (in the past three days) attempted suicide, and 30 non-clinical participants. Sampling was arranged so that there were no significant differences among groups in age, education, gender or marital status. All participants completed the bar-on EI questionnaire (90 item version). the bar-on EI questionnaire can measure the ability to understand, interprete, and control ones emotions.

Data were analyzed using t-test and Chi square formula.

Results:

Findings of the current study indicated significant differences among groups on the EI levels. the two groups were differentiated on problem-solving ( T=-2.316 df=58, p< .05 ), happiness ( T=-3.065 df=58, p< .05 ), stress-tolerance ( T=-2.011 df=58, p< .05 ), and self-actualization ( T=-2.579 df=58, p< .05 ).

Conclusion:

The results of the current study are congruent with the other researchs in this field. Further studies are necessary to confirm these findings, but the results imply that Ei education program may be relevant to reducing risk of suicidal behavior in young peoples.
Differences in Personality Traits Evaluated by TCI According to Physical Illness
Authors: Al-Halabí S. , Herrero R. , Díaz-Mesa E.M. , Bascarán M.T. , Bousoño M. , García-Portilla M.P. , Saíz P.A. , Bobes J.
Published: March 2009

Aim:

To identify differences in personality traits (temperament and character) using Cloninger's typology according to the presence of physical illness (WONCA criteria).

Method:

404 subjects, without psychiatric pathology, from Asturias (Northern Spain) were included in the study [50% men; mean age (SD)= 40.5 (11.3)]. Assessments were made using an ad hoc interview (socio-demographic and clinical data), and the Spanish versions of the MINI International Neuropsychiatric Interview (DSM-IV criteria) (Sheehan et al., 1997), and the Temperament and Character Inventory (TCI) (Cloninger et al., 1994).

Results:

154 (38.1%) subjects have at least one diagnosis of physical illness. Subjects with physical illness scored significantly higher in: i) temperament scales: harm avoindance (HA) (17.02 vs 15.76, t= -1.968; p= 0.050); fatigability and asthenia (HA4) (3.56 vs 2.82, t= -3.652; p< 0.000), ii) character scales: transpersonal (ST2) (3.91 vs 3.26, t= -2.900; p= 0.004). However, they scored significantly lower in: i) temperament scales: attachment (RD3) (5.18 vs 5.70, t= 2.346; p= 0.019), ii) character scales: responsibility (SD1) (5.57 vs 5.96, t= 1.984; p=0.048); purposeful (SD2) (5.43 vs 5.84, t= 2.092; p= 0.037); cooperativeness (C) (31.52 vs 33.26, t= 3.166; p< 0.000); social acceptance (C1) (6.50 vs 6.89, t= 2.536; p= 0.012); empathy (C2) (4.81 vs 5.18, t= 2.484; p= 0.013); compassion (C4) (7.44 vs 7.94, t= 2.190; p= 0.019); pure-hearted (C5) (6.55 vs 7.06, t= 3.225; p= 0.001). No other significant differences were found between the groups.

Conclusions:

Our data suggest that physical illness might influence personality traits in non-psychiatric population.
Gender Differences in Prevalence of Somatoform Disorders in Patients Visiting Primary Care Centers
Authors: Bener A.
Published: March 2009

Objective:

The aim of this study was to examine the gender differences in the prevalence of somatoform disorders among a sample of Qatari patients who were visiting primary health care (PHC) centres and to investigate the severity of most frequent somatic symptoms in these patients.

Method:

The first stage of the study was conducted with the help of general practitioners (GPs), using the 12-item General Health Questionnaire (GHQ-12). the second stage was carried out by a psychiatrist using the Clinical Interview Schedule (CIS). the survey was conducted among patients presenting to the primary health care centres over the period from January to July, 2007. 2320 subjects were approached and a total of 1689 patientsagreed to participate and responded to the questionnaire. among the screened Qatari patients, 404 patients, 211 males (52.2%) and 193 females (47.8%), were identified for clinical interview.

Results:

The prevalence rate of somatoform disorders among the total screened sample was 23.9%. the prevalence rate was slightly higher in women (24.2%) than in men (23.7%). Prolonged depressive reaction was significantly higher in women compared to men (p=0.003). There was a significant gender difference in certain psychiatric diagnostic categories such as depressive episode, recurrent depressive disorder, dysthymia and brief depressive reaction. Backache was the most common reported symptom in men, while headache was more common in women.

Conclusion:

Prevalence of somatoform disorders was slightly higher in Qatari women than in men. There was a significant difference found between men and women in certain diagnosis categories and somatic symptoms.
Personality Disorders in Consultation-liaison Psychiatry - an Empirical Investigation [P03-73]
Authors: Diefenbacher A. , Golombek U. , Strain J.J.
Published: March 2009

Up to now hardly any quantitative research regarding diagnosis of personality disorders in the environment of Consultation-Liaison Psychiatry and Psychosomatic Medicine is available.

The data of 3032 patients aged 17-65 years seen between 1988 and 1997 at the Mount Sinai Hospital in New York, NY, were recorded and analyzed using the Micro-Cares Database System.

19,7% (N=598) of patients exhibited a personality disorder. Out of those 7,7% distributed to Cluster A (Odd or Eccentric Behavior), 54,3% to Cluster B and 38,0% to Cluster C.

89% of patients with personality disorders showed at least one additional specific psychiatric disorder.

Patients with a personality disorder had a lower incidence of somatic disease, but exhibited a higher level in psychosocial impairment and a higher comorbidity in substance abuse. During the previous year they used psychiatric treatment more often and were in need of a more intense social and psychotherapeutical treatment.

The age group of 17-40 year old patients with a personality disorder was hospitalized shorter and had less of a lag between hospitalization and time of psychiatric consultation.

More reasons for a psychiatric consultation were given when patients with a personality disorder were referred.

In the environment of Consultation-Liaison Psychiatry and Psychosomatic Medicine every 5th to 6th patient requires a specific, psychiatric, psychotherapeutic or social treatment because of a personality disorder.

The classification of personality disorders into clusters did not yield an additional benefit.
Madness Around the Care of a Difficult Patient in the Hospital: Who Makes Who Ill?
Authors: Hristova-Ivanova P.
Published: March 2009

Miss S.G. is now 22 years old. Rejected by her entourage and by several foster home and adolescent institutions because of her hetero-aggressiveness, her death threats since she was 13 years old and her various suicide attempts, she was hospitalised in our service for adults in 2006 in order to no longer be able to leave. at the hospital, this young woman of slightly limited intellectually and a history of abandonment became a first-class aggressor, creating upheaval throughout the service.

Initially, she became aggressive towards patients at the slightest frustration and despite the reinforcement present, finally proceeded to attacking caregivers and the service's referring doctor. Her long stay in the service allowed her to divide the team. the escalation of her violent behaviour and the attack on the doctor finally led us to direct her to the specialised service for difficult patients, but at what price?!

The event and the exhausting care of this difficult patient provoked a deep institutional conflict that we have resolved with difficulty. We will present our thoughts on the limits of our role as carers in the care of border-line violent subjects who do not accept the care protocols. We esteem that the collaboration with other educational structures other than psychiatry is important for the management of these difficult clinical cases.

The departure of the patient to the specialised service allowed us to take a step back to obtain better cohesion and change her care protocol on her return.
Comparisonal Investigation of Rap Personality Disorder in Youngsters
Authors: Khanmohammadi A. , Homayouni A. , Nikpour G.A.
Published: March 2009

Introduction:

The study examine a new view in personality disorders named Rap disorder. in the domain we compare the youngster with and without disorder. the Rap disorder people are known with unusual hair model, nihilistic and anarchistic thinking, unusual and bizzarre behavior, reading of meaningfulness poet and sings, doing immoral behavior against society norms and so on.

Method:

Method research is Causative -Comparative (Ex post facto). 200 youngster,100 with the disorder and 100 without the disorder, were randomly selected and Eysenc's Personality Questionnaire (EPQ) was administered on them.

Results:

Findings showed the Rap youngster are high in extroversion and emotional instability than normal youngster.

Discussion:

It is recommended that the appropriate behavior education specially moral and religious education can avoid tendency to this behavior disorder and reduce the bad effects of the behavior in society.
Personality and Crime: Developing a Personality Profile for Criminal People
Authors: Khanmohammadi A. , Kalantarian M. , Alipour F. , Kordekheyli F. Mohammadi
Published: March 2009

Introduction and aim:

A review of available evidence indicate that crime features depend on many and variable factor. for example psychological, environmental, personality cal and so on. in psychology and psychiatry it seems personality plays important role in tendency to crime. So we aim to develop a personality profile for our crime sample. So we aim to develop a personality profile for our criminal sample.

Method:

38 male with history of crime and sent to jail were randomly selected and Eysence's Personality Questionnaire was administered on them. the questionnaire assesses personality on four dimension: Extroversion, Introversion, Neuroticism and lie detector.

Results:

Result showed the criminals have high score in Neuroticism and Extroversion and their profile shows critical situations that need treatment interventions.

Conclusion:

It is recommended to plan psychiatric interventions to reduce level of Neuroticism in them and direct them to better and social behavior.
“organic Personality Disorder” as Part of Early Neuropsychiatric Manifestations in Huntington’s Disease - a Case Report
Authors: Maia J.
Published: March 2009

Huntington's Disease (HD) is an inherited autosomal dominant disorder characterized by motor, cognitive and psychiatric symptomatology, being considered a paradigmatic neuropsychiatric disorder that includes all three components of the "Triadic Syndromes": dyskinesia, dementia and depression.

Firstly described in 1872 as an "Hereditary Chorea" by George Huntington only in 1993 was its responsible gene identified. A person who inherits the HD gene will sooner or later develop the disease. the age of onset, early signs and rate of disease progression vary greatly from person to person.

Neuropsychiatric symptoms are an integral part of HD and have been considered the earliest markers of the disease, presenting sometimes more than 10 years before a formal diagnosis is done. Patients may experience dysphoria, mood swings, agitation, irritability, hostile outbursts, psychotic symptoms and deep bouts of depression with suicidal ideation. Personality change is reported in 48% of the cases, with the paranoid subtype being described as the most prevalent. the clinical case presented illustrates a case of HD which started with insidious psychiatric symptoms and an important personality change.

Despite a wide number of medications being prescribed to help control emotional, movement and behaviour problems, there is still no treatment to stop or reverse the course of the disease. Furthermore, psychiatric manifestations are often amenable to treatment, and relief of these symptoms may provide significant improvement in patient's and caregivers quality of life.

A greater awarness of psychiatric manifestations of HD is essential to an earlier diagnosis and an optimized therapeutic approach.
Personal Disorders in Local Wars Participants with and Without Headache
Authors: Mikhaylova E.
Published: March 2009

It's known that personal disorders is very often pathology in local wars participants.

The aim of the current research was to study how the chronic pain syndrome (headache) influence to personality.

Materials:

162 patients (only men) had been investigated. They are divided into two groups according to age and local war in which they had got taking part: first group - the participants of Afghanistan's war (84 men, middle age 46,3±1,38), and second one - the participants of local war in Chechnya (78 men, middle age 32,7±1,54).

We used Leonhard's questionnaire to reveal the character's accentuation and second edition of International headache classification to determine headache type.

Results:

It seems that 113 patients suffer from cephalgia. Another 49 was a control. During the investigation of headache syndrome structure we have shown that most often patients suffer from posttraumatic headache (PH) - 61 men, and tension-type of headache (TTH) - 33 men.

The number of men having got 18 and more in one or several scales of Leonhard's questionnaire is reliable more in the first group both for PH (85,7% and 69,2%) and TTH (85,7% and 68,9%). There were no differences between headache subgroups. But in patients from control group (without headache) the expression of personality changes did not increase during the age (69,6% in first group, 73,1% in second). So chronic pain may be a risk factor for decompensation of personality changes.
Neurocognitive Basis of Impulsivity in Personality Disorders [P03-83]
Authors: Mudholkar S.
Published: March 2009

Aim:

1.

Whether patients with personality disorders of borderline and antisocial type have a specific pattern of neurocognitive deficits.

2.

Whether impulsivity measured with clinical rating scales is related with performance on neuropsychological tests of risk taking which is sensitive to ventrofrontal cortex lesions.

Method:

20 patients and their age, sex and IQ matched controls participated in the study. Each patient and control was administered validated clinical rating scales in order to:

1.

Ascertain the diagnosis with respect to DSM-IV criteria (Structured Clinical Interview for DSM: Personality Disorder.

2.

Obtain a measure of clinical impulsivity (Barratt Impulsiveness scale).

3.

Ascertain the presence of heritable personality traits (Dimensional Aspects of Personality Pathology Disorder-Basic Questionnaire).

4.

Exclude other major psychiatric disorders (Clinical Psychopathology Rating Scale).

They were administered National Adult Reading Test (NART) to estimate IQ.A battery of neuropsychological tests of memory and executive function specifically sensitive to frontal (dorsal or ventral) or temporal lobe damage were administered from Cambridge Automated Neuropsychological Test battery (CANTAB).

Results:

On Neuropsychological testing patients fared poorly on tests sensitive to planning and risk taking compared to controls. Patients had high mean scores on Barratt impulsiveness scale. the high scores were associated with performance on Tower of London, Bechara test and paired associated learning. Impulsivity was associated with anxiousness and rejection traits of DAPP-BQ. There was a co-relation between some basic dispositional traits of DAPP-BQ with performance on Bechara, Gambling and Paired Associated Learning tests.

Conclusion:

Personality disordered patients show broad range of neurocognitive deficits on test s sensitive to frontal cortex.
the Disorders of Emotional and Volitional Spheres in Preschool Children with Speech Pathology
Authors: Shuvarova S. , Sevastyanov V. , Borisova E. , Leontyeva N.
Published: March 2009

Objective:

To study the peculiarity of emotional and volitional spheres in preschool children with speech pathology.

Methods:

250 children aged from 2 to 7 years old with speech pathology were examined. the following kinds of speech disorders were educed: impressive speech disorders - 9,2 %, expressive speech disorders - 31,2%, mixed speech disorders - 59,6 %. Due to the seriousness of the speech disorders the children were divided into 3 groups.

Results:

The educed disorders develop in the following psychopathological syndromes: neurotic, autism-like, hyperdynamic. in 62% of children with impressive speech disorders the autism-like syndrome was marked, and in 38 % both the autism-like and the hyperdynamic syndromes. in 74 % of children with expressive speech disorders the hyperdynamic syndrome was marked and in 26 % the neurotic syndrome. All the 3 syndromes were educed in children with mixed speech disorders however if in the structure of speech disorder a sensorial component prevailed then the autism-like syndrome was found. with the predominance of a motor component there were both hyperdynamic and neurotic syndromes. Direct dependence of intensity of these syndromes on seriousness of speech disorders was educed.

Conclusions:

The results of the research show, that children with speech pathology at preschool age have already the disorders of emotional and volitional spheres which influences the development of the personality of a child and contributes to the reinforcement of negative forms of reaction.
Suicidal Ideation in Italian Elderly. Preliminar data from the “Faenza Project”
Authors: Atti A.R. , Modenese A. , Bellini M. , Moretti F. , Cesano S. , Bernabei V. , Ferrari B. , Dalmonte E. , De Ronchi D.
Published: March 2009

Aims:

To evaluate prevalence rate of suicidal ideation among Italian elderly and to investigate possible socio-demographic and psychopathological features of suicide attempters in a population-based study.

Methods:

461 subjects (mean age 85 years; 52.9% women; 49.2% widow) were interviewed using the Revised Cambridge Examination for Mental Disorders in the Elderly. the presence of suicidal ideation was assessed by the Scale for Suicide Ideation. the association between suicidal ideation and its correlates was analysed by Logistic Regression Model estimating Odds Ratios and 95% Confidence Intervals (OR, 95%CI).

Results:

Eighteen (3,8%) persons refused to answer to questions concerning suicide thoughts. Only one participant declared to have attempted suicide (a 92 years-old men, widow, living on his own and complaining about depressive feelings). Overall suicidal ideation prevalence was 7.3%: wish to die (3.8%) and not worth living (13%). Gender, age, education, marital and socio-economic status were similar in subjects with and without suicidal ideation. Subjects with suicidal ideation had fewer family contacts, were less satisfied of their general health status and had a higher number of depressive and anxiety symptoms. However, when all these conditions were tested in the same model, only depressive symptoms were still significantly associated with suicidal ideation (OR, 95%CI=9.6, 3.3-27.9).

Conclusion:

The worldwide aging of the population deserves attention to psycho-geriatric medicine. Study on suicide in late-life are of interest to detect elderly at risk and to emphasize this increasing phenomenon.
Time and Psychopathology OD Depression in Old Age
Authors: Coelho C.L. Maia , Bastos C.L.
Published: March 2009

Two fundamental aspects of intuitive cultural conceptions of the passage of time - cyclical and continuous - are related here to medical therapy and psychopathology, from a critical perspective of the condition of depression in old age as a modern construct. Although inspired by anthropological perspectives, this article is based on daily clinical experience and takes a phenomenological attitude. in predominantly cyclical cultural perceptions of time the ageing process is part of an eternal movement, and families perpetuate themselves in their descendants, their traditions, ties with the land, or in the practice of family crafts and skills. Cultural transformations that give rise to more directional approaches to the passage of time tend toward growing emphasis on individual roles in social history. the more difficult the change from fatalist, repetitive, traditional and eternally cycling Weltanschauungen, on the one hand, to others, based on individualizing, bureaucratizing, planning-based and successive concepts, the greater are the chances of unsuccessful old age and the medicalisation of this failure.
Charles Bonnet Syndrome and Vitamin b12 Deficiency: A Case Report
Authors: Bourgeois V. , Desbordes M. , Rochard-Bouthier M.-F. , Follet M. , Allio G. , Guillin O. , Haouzir S.
Published: March 2009

Visually impaired patients may experience complex visual hallucinations, a condition known as the Charles Bonnet syndrome (CBS). in the elderly, vitamin B12 deficiency has been implicated in various psychiatric conditions such as dementia, depression, delirium.

Here we report the case of 78 years old women with low vision due to bilateral glaucoma and unilateral cataract who was admitted in our psychogeriatric unit for complex and repetitive visual hallucinations (male characters, visions of her childhood), localized in external space that occurred acutely, inducing emotional distress and paranoia in response to the imagery. She had no past history of any psychiatric disorder. Psychiatric and physical exam, lab test, neuropsychological testing, EEG and brain CT scan ruled out visual hallucination due to dementia, epilepsy, delirium, psychosis. Therefore, criteria for CBS diagnosis were fulfilled.

Emotional distress was so intense that risperidone (1 mg/day) was started that permitted better insight within few days. Plasma vitamin B12 was low (< 44 pmol/L) unless normal red blood cell count. Supplementation with vitamin B12 (1mg/day) was started and plasma vitamin B12 increased within 1 month (198 pmol/L). in the same time, visual hallucinations disappeared and riperidone was stopped. Three month later, supplementation with vitamin B12 was stopped and visual hallucinations reappeared as plasma vitamin B12 was 87 pmol/L. Therefore, vitamin B12 alone (1 mg/day) was administered again and the CBS disappeared within 2 weeks.

To our knowledge, this is the first report of CBS associated with vitamin B12 deficiency successfully improved by vitamin B12 supplementation.
Diogenes Syndrome and Pathological Hoarding Behaviour: A Case Report
Authors: Castro L.C. , Ribeiro O.
Published: March 2009

Background:

Diogenes syndrome is the combination of severe self-neglect, domestic squalor, social withdrawal, a tendency to hoard excessively, and refusal of help, in elderly patients.

Aim:

To report a case of Diogenes’ syndrome underlying the impact of pathological hoarding behaviour in the quality of life of the patient. to discuss the pathological hoarding behaviour (syllogomania) in the context of this specific behavioural disorder.

Methods:

Case study and review of the literature.

Results:

The subject of this case study is a 78-year-old man with Diogenes syndrome. Hoarding behaviour is the major presentation symptom in this case, along with domestic squalor and social withdrawal. He has marked obsessive personality traits, no insight for his morbid condition and an attitude of refusal of treatment.

Discussion:

The literature reveals high comorbidity of Diogenes syndrome with psychiatric and somatic disorders. Some authors raise the possibility that obsessive-compulsive disorder may be the cause of hoarding rubbish in those cases of Diogenes syndrome in which hoarding exists and cannot be better explained by other psychopathology. other authors hypothesise Diogenes syndrome as a reaction to stress in elderly people with certain personality characteristics or as the end stage of a personality disorder. the ethiopathogeny of Diogenes syndrome remains unclear and there is no consensus about diagnostic criteria. It is a relevant area for future research, contributing for a better comprehension of the differential diagnosis of pathological hoarding behaviour and late life psychopathology.
Mild Cognitive Impairment and Intellectual Activity in the Elderly
Authors: Chenderes R.M. , Podea D.M. , Nanu P.D. , Mila C.
Published: March 2009

Objective:

The aim of this study is to identify the correlation between mild cognitive impairment (MCI), educational status and intellectual activity in elderly patients.

Material and methods:

The study comprises 40 elderly patients diagnosed with MCI. the diagnosis of MCI was established applying to all patients MMSE (Mini Mental State Evaluation). Also a Clock Drawing Test (CDT) was applied. A MMSE score between 28-21points was considered as MCI.

We consider that a patient has intellectual activities if he performs at least one of the following: reading a book or a newspaper, solving puzzles or mind games.

The exclusion criteria were: patients with moderate and severe cognitive impairment and patients with no educational level.

Results and discussions:

The average of age was 69.65 years. the average of MMSE score was 24.65 points. the correlation between MMSE and CDT is significant at the 0.01 level. the MMSE and CDT scores are smaller as the educational level is lower. 3 subjects have fourth grade education, 17 subjects have eighth grade education, 16 subjects have high-school education and 4subjects have college education. the patients with small scores at cognitive evaluation have no intellectual activity in the present. the intellectual activity is in direct relationship with high educational level; patients with high-school and college education are performing intellectual activities in the present.

Conclusions:

Patients with actual intellectual activity have the highest MMSE and CDT scores.

Intellectual activities are protective factors against cognitive impairment.

This paper represents the screening part of a grant PNCDI2 41-057/2007 from the Romanian Ministry of Education and Research.
Dementias, Gender and Education: A Research with Eldery Patients
Authors: Coelho C.L. Maia , Bastos C.L.
Published: March 2009

Based on assessment of dementia in elderly patients, the study analyzed the relationship between gender and the level of education in verbal and performance dimension results. the WAIS-III and the Zülliger tests were employed in 10 males and 10 females. Results indicated that male subjects with higher education presented lower scores in the performance subtest when compared to verbal subtest. the female sample, with lower level of scholarship, no differences was detected. A covariance analyses indicated that education level was the responsible variable for this difference. Depressive traits in the male sample are based on the devaluation that the disease causes in the social role.
Evolution of the Elderly Admissions in an Acute Psychiatric Unit over the Last Decade
Authors: Touzon R. , Rico-Villademoros P. , Garnica E.
Published: March 2009

Aims:

To describe and then compare the admissions of elderly in the last decade, to see if there have been significant changes regarding both the diagnosis and the number of admissions.

Methods:

Medical records of patients over 70 years admitted in an acute psychiatric unit in the course of 1997 and 2007 have been reviewed. the number of admissions in elderly patients is compared to the number of admissions in any age. Diagnosis in the elderly between 1997 and 2007 is also compared.

Results:

In the last decade the percentage of patients over 70 who enter our unit has increased. with regard to their diagnoses, depressive disorders and the "others" category have decreased, increasing, however, the bipolar disorder, dementia and other psychoses.

Conclusions:

Since the population pyramid tends towards older ages, it seems logical that the number of admissions in elderly patients increase, as it has been shown in our research.

The fall in the diagnosis of “others” and the rise of diagnosis such as Dementia, Bipolar disorders and other psychosis might be due to a better diagnosis of these pathologies.
Description of the Elderly Psychiatric Admissions in Recent Years [P03-100]
Authors: Rico-Villademoros P. , Touzon R. , Garnica E.
Published: March 2009

Aims:

To analyze the characteristics of the admissions of elderly patients in an acute psychiatric unit in recent years, to see if there have been any changes in the number, the average stay or in their referral from the hospital.

Method:

Details of all admissions in a psychiatric unit for acute patients aged over 65 since 1999 are collected by means of a computer system. the number of admissions, the average length of stay and where they go when discharged are taken into account.

Results:

In recent years the number of patients over 65 entering our unit has remained relatively stable. the average stay time remains high over all the studied years. It is proved that a large number of patients need to be moved to residences or other assistive devices when discharged.

Conclusions:

Despite the increase in elderly population, the number of patients over 65 who enter this unit has not significantly increased. their average stay remains always high over the years. It is striking the number of patients who can no longer go home when discharged, once they have been admitted.
Preliminary Data from Famidem Survey: Can we assume who is at Risk Regarding Informal Caregiving in Dementia?
Authors: Pereira M. Gonçalves , Silva J. Alves da , Carmo I. , Papoila A.L. , Cardoso A.M. , Conceição C. , Gomes M. , Neves M.M.A. , Neves A. , Santos L. , Mateos R.
Published: March 2009

Background and aims:

In meridional European countries such as Portugal, informal caregivers are almost always close relatives, either key-relatives (those more involved) or not. There are few systematic comparisons between the experience of key-relatives/primary caregivers (PC) and other/secondary caregivers (SC) in psychogeriatrics. We present some preliminary data from the FAMIDEM (Families of People with Dementia) survey.

Methods:

Non-randomised cross-sectional study comparing two related samples of caregivers (PC versus SC) of 41 patients with DSM-IV dementia from outpatient practices in Lisbon (Portugal). Caregivers’ assessments included: Zarit Burden Interview, Caregiver Activity Survey (CAS), Positive Aspects of Caregiving, GHQ-12, Social Network Questionnaire and Dementia Knowledge Questionnaire.

Results:

Patients’ mean age was 78,7 years (SD 7,9). 24 (58,5%) were women and 58,5% had Alzheimer disease.PC were older than SC (p=0,000) and tended to live with the patient (p=0,000). They reported less emocional support (p=0,021) but higher objective burden-CAS (p=0,002). Regarding all other outcome variables, significant differences between groups were not found. Within the global sample, comparing spousals (n=23) and adult children/other relatives (n=59) yielded interestingly different preliminary results, eg higher GHQ-12 levels (p=0,010).

Conclusions:

The experience of caregiving is possibly different regarding PC and SC, but further research is warranted in order to define who really is at risk. Being a spouse may be much more determinant, although most spouses are PC as well. for the moment, it seems prudent not to exclude SC from risk assessments. the final FAMIDEM results, even lacking generalizability, will probably provide interesting clues.