Our aim was to determine (a) how parents deal with experiences like having a son missing in war, and (b) what expectations they have in terms of outcomes. This qualitative study included 29 parents ...of 21 sons gone missing in war. We used content analysis singling out narrative patterns and coded these. We assessed intercoder reliability using Krippendorff’s alpha coefficient. Items passing the Krippendorff’s alpha threshold of ≥.50 were verified using Cronbach’s alpha. Three of five coders showed acceptable intercoder agreement on 23 of the 173 identified topics (13.3%; Krippendorff’s alpha: .50-.82). Cronbach’s alpha coefficient confirmed intercoder reliability of .7903. Fathers’ narratives differ from mothers’. Statistics are a valuable tool for identifying specific motifs in grieving narratives of parents who have lost their child. Content analysis can provide insights without interfering with authentic personal experience sparing interviewees from reliving the traumatizing experience.
In the course of group analytic psychotherapy, where we discovered the power of the therapeutic effects, there occurred the need of group analytic psychotherapy researches. Psychotherapeutic work in ...general, and group psychotherapy in particular, are hard to measure and put into some objective frames. Researches, i. e. measuring of changes in psychotherapy is a complex task, and there are large disagreements. For a long time, the empirical-descriptive method was the only way of research in the field of group psychotherapy. Problems of researches in group psychotherapy in general, and particularly in group analytic psychotherapy can be reviewed as methodology problems at first, especially due to unrepeatability of the therapeutic process.
The basic polemics about measuring of changes in psychotherapy is based on the question whether a change is to be measured by means of open measuring of behaviour or whether it should be evaluated more finely by monitoring inner psychological dimensions. Following the therapy results up, besides providing additional information on the patient's improvement, strengthens the psychotherapist's self-respect, as well as his respectability and credibility as a scientist.
The treatment of psychiatric disorders often consists of a combined approach that integrates both pharmacotherapy and psychotherapy. Unfortunately, psychiatric texts and the educational process in ...psychiatry training do not adequately address the combined approach. There is a lack of information concerned with the psychological aspect of prescribing medications. This is striking since many patients require both treatments. There is an inevitable psychological aspect of the administration of medication in psychiatry, and the meaning ascribed to the prescription of drugs has an impact on doctor-patient relationship. Understanding the psychodynamic issues is crucial for the success of psychopharmacology. Psychodynamic psychopharmacotherapy represents an integration of biological psychiatry and psychodynamic insights and techniques. This approach recognizes that many of the core discoveries of psychoanalysis are powerful factors in the complex relationship between the patient, the illness, the doctor, and the medications. Scientific pharmacotherapy is, as it should be, based upon patients' responses to treatments of specific target conditions. Enduring personality traits are being increasingly incorporated as targets for pharmacotherapy. However, in the real world of psychiatric practice we see that transference issues and a patient's character or set of personality traits have a greater impact on the selection, dosage, tolerability, and treatment outcome than is generally recognized or admitted. In contemporary psychiatry, a psychodynamic perspective must be preserved. Without it, meaning will be lost, and both diagnostic understanding and informed treatment planning will suffer.
Teške opekline i njihovo liječenje spadaju među najbolnija iskustva koja osoba može doživjeti. Emocionalne potrebe bolesnika s opeklinama dugo su bile zasjenjene naglaskom na preživljavanje. danas, ...kada je stopa preživljavanja neusporedivo veća nego u prošlosti, porasla je i potreba za psihološkim i psihosocijalnim angažmanom u radu sa žrtvama teških opeklina. Bolesnik prolazi različite faze prilagodbe i suočava se s emocionalnim izazovima koje prate tjelesni oporavak. prilagodba na opeklinsku ozljedu uključuje složenu međuigru između bolesnikovih osobina prije nastanka opekline, okolinskih čimbenika, te prirode same opekline i potrebne medicinske skrbi. prilagodba podrazumijeva usvajanje nove predodžbe o sebi i svom tijelu, nove slike tijela i sebe. dakako da psihijatrijsko i psihološko liječenje mora biti ukomponirano u centre za liječenje opeklina u sklopu multidisciplinarnog timskog liječenja. psihološki i psihoterapijski treba se baviti problemom gubitka, žalovanjem, prihvaćanjem slike tijela i sebstva, a u psihijatrijskom smislu stanjima delirija, akutnim stresnim poremećajem, posttraumatskim stresnim poremećajem, anksioznošću, depresijom i drugim psihijatrijskim poremećajima. Stručnu pomoć i podršku treba pružiti i članovima bolesnikove obitelji. U nekim slučajevima psihosocijalno liječenje nikad ne završava, već traje i godinama poslije sanirane opekline.
Severe burns and their treatment are among the most painful experiences a person can have. Emotional needs of burn patients have long been overshadowed by the focus on survival. Today, when the ...survival rate is much higher than in the past, the need of psychological and psychosocial engagement in working with victims of severe burns has emerged. A patient undergoing various stages of adjustment is faced with emotional challenges that accompany physical recovery. Adapting to burn injury involves a complex interplay between patient characteristics before the occurrence of burn, environmental factors, and the nature of the burns and medical care required. Adaptation implies adoption of new ideas about themselves and their body, new body image and new self image. Psychiatric and psychological treatment must be incorporated in burn treatment centers within a multidisciplinary treatment team. Psychology and psychotherapy should address the problem of loss, grief, acceptance of body image and self image, in terms of psychiatric conditions of delirium, acute stress disorder, posttraumatic stress disorder, anxiety, depression and other psychiatric disorders. Technical assistance and support should be provided to the patient family members. In some cases, psychosocial treatment never ends; it takes years, later related to rehabilitated burns.
The influence of anxiety and depression on cardiovascular disease is well-known in terms of chronic cardiovascular and ischemic states. It happens mostly through diminished cardiac vagal modulation ...and greater procoagulant activity in depressed patients. But the impact of emotional factors in acute cardiac events is not estimated enough. From the clinician's point of view, there are an increasing awareness concerning external circumstances and external triggering in sudden cardiac death, that is caused by malignant ventricular arrhythmias or myocardial infarction. A number of external, i.e. exogenous factors in everyday life can be implicated in triggering such events. Including heavy physical activity, emotional stressors, meteorologic variables, air pollutants, chronobiologic phenomena, food ingestions, coffee, alcohol etc., emotional stress seems to be among the most often triggers of sudden event. There is a wide range of everyday situations and activities that involves activation of sympathetic nervous system, and emotional stressors are described as trigger caused by sympathetic arousal. Acute emotional arousal can trigger life-threatening arrhythmias and the mechanisms of that risk have been recognized. Acute episode of emotional distress (and notably anger-like stress) may trigger ventricular ectopic beats and tachycardia, as well as acute myocardial infarction. These sudden phenomena can be the result of the endogenous response to external risk of acute emotional stress. Sudden death without antecedent angina, suggesting cardiac arrhythmia, as well as deaths preceded by chest pain, suggesting coronary occlusion were observed in many studies that have led to estimates that between 20 and 40 percent of sudden cardiac deaths are precipitated by acute emotional stressors.
This review clarifies the fact that basal ganglia diseases are psychiatric as much as neurological diseases. It illustrates psychiatric aspects in Parkinson's disease and other hereditary basal ...ganglia diseases such as Wilson's disease, Huntington's chorea and others. In these diseases, psychological disorders can be difficult to diagnose, whether they are concomitant with the primary (neurological) disease, they are its consequence, or they are the result of a specific pharmacotherapy prescribed for these disease, etc. Thus, the choice of appropriate psychopharmacotherapy for these disorders represents a very subtle problem.
The treatment of psychiatric disorders often consists of a combined approach that integrates both pharmacotherapy and
psychotherapy. Unfortunately, psychiatric texts and the educational process in ...psychiatry training do not adequately address the
combined approach. There is a lack of information concerned with the psychological aspect of prescribing medications. This is
striking since many patients require both treatments. There is an inevitable psychological aspect of the administration of medication
in psychiatry, and the meaning ascribed to the prescription of drugs has an impact on doctor-patient relationship. Understanding the
psychodynamic issues is crucial for the success of psychopharmacology.
Psychodynamic psychopharmacotherapy represents an integration of biological psychiatry and psychodynamic insights and
techniques. This approach recognizes that many of the core discoveries of psychoanalysis are powerful factors in the complex
relationship between the patient, the illness, the doctor, and the medications.
Scientific pharmacotherapy is, as it should be, based upon patients’ responses to treatments of specific target conditions.
Enduring personality traits are being increasingly incorporated as targets for pharmacotherapy. However, in the real world of
psychiatric practice we see that transference issues and a patient's character or set of personality traits have a greater impact on the
selection, dosage, tolerability, and treatment outcome than is generally recognized or admitted.
In contemporary psychiatry, a psychodynamic perspective must be preserved. Without it, meaning will be lost, and both
diagnostic understanding and informed treatment planning will suffer.
Despite advances in psychiatry, treatment outcomes are still a big problem, and are not always substantially better than it was in the past time. Treatment resistance remains a serious psychiatric ...problem. One of the reasons for that is that the pendulum has swung from a psychodynamic framework to a biological one, and the impact of meaning (i.e. the role of psychodynamic and psychosocial factors in treatment-refractory illness) has been relatively neglected. Dynamic factors in psychopharmacology play a pivotal role in pharmacological treatment responsiveness. There is a small but impressive evidence base that shows that psychological and interpersonal factors play that role. Psychodynamic psycho pharmacotherapy combines rational prescribing with tools to identify irrational interferences with effective use of medications, i.e. to resolve the problems of the pharmacological-treatment resistance. Psychodynamic psychopharmacology represents an integration of biological psychiatry and psychodynamic insights and techniques.
The advent of benzodiazepines in the 1960s provided their wide use in neurology and psychiatry. They proved to be myorelaxant and anticonvulsive therapy in neurology; their anxiolytic and hypnotic ...properties have made them the treatment of choice for insomnia and anxiety problems; they have also been used in alcohol withdrawal and in anesthesia, and for a wide range of treatments in other clinical branches. However, reports giving rise to a prescription controversy including abuse, harmful effects, intoxication and dependence toward addiction appeared soon. On the other hand, the revolutionary appearance of selective serotonin reuptake inhibitors (SSRIs) overshadowed benzodiazepines. According to recommendations of many scientific and professional institutions, the use of benzodiazepines has been gradually excluded or reduced or limited to short-term use. However, clinical experience showed that benzodiazepines are frequently used for long-term treatment, and there are many reasons for this, e.g., prescribing tradition, patient preference, difficulties associated with benzodiazepine withdrawal (even in patients taking low doses) because they have a rapid clinical onset of action, and good efficacy with few initial adverse effects. Moreover, SSRIs as alternative drugs are associated with incomplete therapeutic response and more uncomfortable adverse effects. Some authors therefore point out that the rationale for the shift from benzodiazepines to SSRIs is inappropriate.
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