Summary
The influence of social changes in transitional country and transitional times, among other things, have made changes in the structure of the patients seeking psychotherapeutic treatment. ...However, there has not been any research studying characteristics of patients in psychotherapeutic treatment. The aim of our study was to establish socio-demographic, clinical and psychodynamic characteristics of patients psychotherapeutically treated in the outpatient clinical setting.
Our sample consisted of 61 non-psychotic patients, randomly selected by the method of consecutive admissions and treated with psychoanalytic psychotherapy in the outpatient clinical setting. The study was conducted from January 2009 to January 2012 at the Mental Health Clinic, Clinical Center Niš. Mini International Neuropsychiatric Interview, Global Assessment of Functioning Scale and a Semi-structured interview for the Operationalized Psychodynamic Diagnosis were used for collecting data.
Our results have shown that patients treated with psychotherapy in the outpatient clinical setting have specific socio-demographic, clinical and psychodynamic characteristics. They are young, post-adolescent individuals, mainly with the diagnosis personality disorder and co-morbidity, with a moderate level of structural integration and individuation vs. dependency as the main psychological conflict. We suggest a long-term psychodynamic psychotherapy as the treatment of choice for patients with presented clinical and psychodynamic characteristics and operationalized psychodynamic diagnostic system as a valuable tool for establishing treatment focus and treatment planning.
The aim of this study was to evaluate the usage prevalence of herbal products (HP) and to ascertain the identity, mode and adverse effects of plant taxa used in self-medication practice for anxiety, ...depression and insomnia in patients with non-psychotic disorders originating from southeastern Serbia. Also, we compared HP users and non-users on the variables of socio-demographic characteristics, information source and origin of HP. The study was done by a face-to-face interview with a trained psychiatrist using a structured questionnaire administered to 136 adult patients suffering from non-psychotic mental disorders. A typical herbal-product user among non-psychotic psychiatric patients from southeastern Serbia is a middle-aged married woman, with a secondary level of education, unemployed and living in an urban area. Non-psychotic psychiatric patients, although not living predominantly in rural areas, were familiar with a variety of ethno-medicines and were often using HP primarily without the consultation of their psychiatrists/physicians. HP stated to be most frequently used for psychiatry-related symptoms included: Melissa officinalis, Mentha×piperita, Hypericum perforatum and Valeriana officinalis. The interviewees rarely stated adverse reactions related to the HP usage; however, this should not be generalized, since HP are known to vary in the content of their adverse reaction-causing constituents.
Working alliance, as a collaborative part of the therapeutic relationship has been proven to be one of the most powerful therapeutic factors in psychotherapy in general, regardless many technical ...differences between numerous psychotherapeutic modalities. On the other hand, transference is the basic concept of psychodynamic psychotherapy, and, according to the psychoanalytic theory and practice, it forms a major part of the therapeutic relationship. The aim of our paper was to determine the differences between the groups of patients with low, middle, and high working alliance scores and the dropout group in transference patterns, sociodemographic and clinical parameters, during the early phase of psychodynamic psychotherapy.
Our sample consisted of 61 non-psychotic patients, randomly selected by the method of consecutive admissions and treated with psychoanalytic psychotherapy in the outpatient clinical setting. The patients were prospectively followed during 5 initial sessions of the therapeutic process. The working alliance inventory and Core conflictual relationship theme method were used for the estimation of working alliance and transference patterns, respectively. According to the Working Alliance Inventory scores, four groups of patients were formed and than compared.
Our results show a significant difference between the groups of patients with low, middle, and high working alliance inventory scores and the dropout group on the variable--transference patterns in the therapeutic relationship.
Disharmonious transference patterns are more frequent in patients who form poor quality working alliance in the early phase of psychotherapy, or early dropout psychotherapy. It is of great importance to recognize transference patterns of a patient at the beginning of the psychotherapeutic process, because of their potentially harmful influence on the quality of working alliance.
Induced termination of unwanted pregnancy after 12th gestational week (late-term abortion) is legally restricted in Serbia as well as in many other countries. On the other hand, unwanted pregnancy ...very often brings women into the state of personal crisis. Psychiatric indications for legally approved late-term abortion on women's demand include only severe psychiatric disorders. The aim of this paper was to compare sociodemographic, psychological characteristics and claimed reasons for abortion in the two groups of women with late-term demand for abortion--the group of women satisfying legally prescribed mental health indications, and the group of women not satisfying these indications. The aim of the study was also to determine predictive validity of the abovementioned parameters for late-term abortion as the outcome of unwanted pregnancy.
A total of 62 pregnant women with demand for late-term abortion were divided into two groups according to the criteria of satisfying or not satisfying legally proposed psychiatric indications for late-term abortion after psychiatric evaluation. For the assessment of sociodemographic and psychological parameters sociodemographic questionnaire and symptom checklist-90 revised (SCL-90) scale were used, respectively. The outcome of unwanted pregnancy was followed 6 months after the initial assessment.
The obtained results showed a statistically significant difference between the groups in educational level, satisfaction with financial situation, elevated anxiety and distress reactions. Unfavorable social circumstances were the main reason for an abortion in both groups and were predictive for an abortion. A 6-month follow-up showed that women had abortion despite legal restrictions.
Pregnant women with psychiatric indication for late-term abortion belong to lower socioeconomic and educational level group compared to women without this indication who have more frequently elevated anxiety and distress reactions to unwanted pregnancy. It is necessary to have more accurate guidelines for mental health indications for legally approved late-term abortion, respecting social circumstances. Preventive measures are of great importance in order to lower the risk of illegally performed late-term abortions.
SUMMARY
Since the time of Freud’s “Project for psychology as natural science” in 1895, at the dawn of psychoanalysis as the theory and therapy, psychoanalysis and psychotherapy in general have been ...attempting to establish and develop their biological roots. Numerous external and internal limitations and resistances have been limiting and opposing this process for almost a century. The last two decades brought a significant change in this view, especially following the development of contemporary neuroimaging techniques with their dynamic and functional features and growing interest for mental processes on behalf of neuroscience. The aim of this paper was to review scientific articles on recent advances in the field of neurobiology of psychotherapy, especially neurobiological underpinnings of psychotherapeutic relationship, and point to the new perspectives this knowledge brings. Recent advances in neurobiology and psychotherapy research open the way for the integration of psychotherapy and neurobiology. With this regard, science could contribute to closing the mind-brain gap which has been artificially dividing a human being for centuries. An integrated field enables new scientific perspective for both disciplines with multilayered understanding of mind-brain functioning.
Consequences of individual adverse childhood experiences for adult mental health have been precisely studied during past decades. The focus of past research was mainly on childhood maltreatment and ...neglect. The aim of this paper was to determine association between multiple adverse childhood experiences and psychiatric disorders, as well as their correlation to the degree and type of aggressiveness in adult psychiatric patients.
One hundred and thirteen psychiatric outpatients were divided into three diagnostic groups: psychotics, non-psychotics and alcoholics and compared with fourty healthy individuals. Adverse childhood experiences data were gathered retrospectively, using the Adverse childhood experiences questionnaire and explanatory interview. Aggressiveness was assessed using Buss-Perry Aggression Questionnaire. The Student's t test, ANOVA and correlational analysis were used for evaluation of statistical significance of differences among the groups. A value p < 0.05 was considered statistically significant.
Our results showed that the mean number of adverse childhood experiences in each group of psychiatric patients, as well as in the whole group of patients, was statistically significantly higher than in the group of healthy individuals (p < 0.001); there was a statistically significant difference in score of physical aggressiveness between the patients exposed to adverse childhood experiences and those who were not exposed to them (p < 0.05); scores of physical aggressiveness were in positive correlation with the number of adverse childhood experiences (p < 0.05). The highest mean score of adverse childhood experiences was evidenced in the group of patients with psychotic disorders.
Multiple adverse childhood experiences are significantly associated with psychotic disorders, nonpsychotic disorders and alcohol dependence in adulthood and their presence is important morbidity risk factor for psychiatric disorders. They are in positive correlation with physical aggressiveness of the patients from these diagnostic groups.
Chest pain often indicates coronary disease, but in 25% of patients there is no evidence of ischemic heart disease using standard diagnostic tests. Beside that, cardiologic examinations are repeated ...several times for months. If other medical causes could not be found, there is a possibility that chest pain is a symptom of psychiatric disorder. The aim of this study was to determine the presence of psychiatric syndromes, increased somatization, anxiety, stress life events exposure and characteristic of chest pain expression in persons with atypical chest pain and coronary patients, as well as to define predictive parameters for atypical chest pain.
We compared 30 patients with atypical chest pain (E group) to 30 coronary patients (K group), after cardiological and psychiatric evaluation. We have applied: Mini International Neuropsychiatric Interiview (MINI), The Symptom Checklist 90-R (SCL-90 R), Beck Anxiety Invetory (BAI), Holms-Rahe Scale of stress life events (H-R), Questionnaire for pain expression Pain-O-Meter (POM). Significant differences between groups and predictive value of the parameters for atypical chest pain were determined.
The E group participants compared to the group K were younger (33.4 +/- 5.4: 48.3 +/- 6,4 years, p < 0.001), had a moderate anxiety level (20.4 +/- 11.9: 9.6 +/- 3.8, p < 0.001), panic and somatiform disorders were present in the half of the E group, as well as eleveted somatization score (SOM > or = 63-50%: 10%, p < 0.01) and a higher H-R score level (102.0 +/- 52.2: 46.5 +/- 55.0, p < 0.001). Pain was mild, accompanied with panic. The half of the E group subjects had somatoform and panic disorders.
Somatoform and panic disorders are associated with atypical chest pain. Pain expression is mild, accompained with panic. Predictive factors for atypical chest pain are: age under 40, anxiety level >20, somatization > or =63, presence of panic and somatoform disorders, H-R score >102, and a lack of positive diagnostic test of coronary disease. Defining of these parameters could be useful for early psychiatric evaluation of persons with atypical chest pain.
The aim of the paper was to determine specific spontaneous changes in psychological and behavioral parameters in patients who had a myocardial infarction compared to non-coronary patients during a ...period of six months after hospitalization. Thirty-three hospitalized patients with acute myocardial infarction (group K) and 30 hospitalized non-coronary patients (group C) were compared and than followed up for six months for the following psychological parameters: intensity of anxiety, intensity of depression, intensity of aggression, exposure to stressful life events; and risk health behaviors - alcohol consumption, cigarette smoking and lack of physical activity. On admission, anxiety and depression were more pronounced in group K, as well as the exposure to stressful life events. After six months, the level of aggression in group K was lower compared to the initial measurement (p<0,05), exposure to stressful events was also lower (p<0.01), while physical activity was more frequently practiced (p<0.01). Anxiety and depression remained increased. In group C, such changes were not demonstrated after six months. Increased anxiety and depression as well as decreased aggression and exposure to stressful life events six months after acute myocardial infarction were psychological changes specific of coronary patients, not reported in the group of non-coronary patients.
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