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Cognitive impairment is considered to be one of the central features of schizophrenia and it has been so since original descriptions of illness by Kraepelin and Bleuler. Deficits are already present at the first-episode of illness. Some researches conclude that deficits do not change over time, while others suggest that deficits can be reduced. The objective of this research is comparison of cognitive functions of psychotic patients who participated group psychotherapy with those ho did not.
In this paper, by means of Revised Beta Examination (measure of non-verbal intellectual ability) we observe changes in cognitive functioning of 29 psychotic patients who participated in the psychodynamic group psychotherapy within the Early Interventions Program and compare their cognitive achievements with results of matched 32 psychotic patients who received “treatment as usual”. Answers were analyzed qualitatively and quantitatively.
Improvement in cognitive functions was observed in both investigated and control group, but improvement in patients who are participants of long-term psychodynamic group psychotherapy was better than in the group of patients who were not treated in that manner with statistical significance.
Psychiatric hospital “Sveti Ivan” offers an extensive outpatient Early Intervention Program for psychotic patients in the critical period of their illness - up to five years from onset. The program includes psychoeducation workshops for the patients and their family members together, group psychodynamic psychotherapy for the patients and group psychotherapy for the family members. Our results indicate better effectiveness of Program when compared to “treatment as usual”.
Group psychotherapy along with psychopharmacological therapy and sociotherapy is an important and frequently applied therapeutic method. Numerous studies indicate that group psychotherapy affects the functioning in patients with psychotic disorders in terms of improving the cognitive, emotional and social functioning and generally contributes to a better quality of life (Kanas, 1996).
The aim of this study was to assess the impact of psychodynamic oriented group psychotherapy on the quality of life in patients with psychotic disorders and to compare the obtained results with the results of patients with psychotic disorders who did not participate in psychodynamic group psychotherapy.
Patients included in this study have completed psychotherapy group five years ago and were in regular outpatient treatment together with regular application of medication therapy. The applied method was Quality of Life Scale (Krizmanić, Kolesarić). Answers were analyzed qualitatively and quantitatively.
The quality of life in the group of patients who completed long-term psychodynamic group psychotherapy was better than in the group of patients who were not treated in that manner, although there are no statistically significant differences. The most important differences were in the area of intimacy, professional occupation and in the area of family relations.
It can be concluded that long-term psychodynamic group psychotherapy has a positive influence on quality of life of patients with psychotic disorders.
Involution old age limit is related to general health, cultural and economic living conditions.
Two stages of old age are currently recognized: early old age (65 to 75 years) and over 75 years - late old age period.
Old age period is the third life cycle period in which aging of the brain and eventual pathological changes with respective organic psychopathological onsets are finalized.
In many countries, number of the population over 65 years of age increases. The same applies for our country.
Term of psychic disorders includes miscellaneous psychic conditions, pathologic in terms of symptom intensity, personality and social behavior changes, and reflects on social life of the ill individual and its family.
Psychiatric syndromes and disorders in older population Rogina divides into two groups:
- disorders of emotional reacting and behavior, without manifestations of other organic brain or physical disorders and
- alternations caused by primary brain pathology, clinically presented as organic brain psycho-syndrome with different intensity and different pathogenesis etymology (cardiovascular, cerebro-vascular, neoplastic, metabolic, etc.)
A combination of physical illness and mental disorder is the most common cause of the first hospitalization in older age.
The spread of drug abuse in our country was influenced by many factors, and as the most important are the following social factors caused by changed conditions of life increase in delinquency and deviant behavior, and a new style of life, loss of cultural identity, conflict, feeling of insecurity and helplessness, which can be encouraged and by influential groups in the environment.
The aim of
1. The aim of this work is an indication of socio-demographic characteristics of addicts in our clinic, and view profiles addicts Šumadija district.
Material and methods
We used the following medical documentation:
Ø history of disease addicts
Ø protocols examined and treated addicts in this institution from 2002 - 2006. year.
Following some socio-demographic characteristics of drug addicts treated in our clinic, we came to the profile of addicts Šumadija county:
Ø these are the people in the age of 20 - 30 years
Ø from the urban environment
Ø without rešenog marital status
Ø without the employment relationship
Ø hospital treated several times, who because of his behavior asocijalnog came into conflict with the law
2. The obtained profile of addicts should provide adequate treatment of this disease and to point out that drug addiction is a medical, but also a sociological problem.
3. Only adequate preventive measures such as teaching in elementary and secondary schools, in the form of various discussions, through the media where they would be included all the relative factors (SO, Red Cross, Center for social work, police, judiciary and others) can give results in the fight against this disease.
Burnout syndrome is psychological experience that produces physical,emotional and mental symptoms and signs,which is commonly observed in health care professionals. The stress is considered as the key factor in development of this syndrome.
To assesses the burnout syndrome in general practitioners and anesthesiologists in Belgrade,Serbia,regarding that both occupations are considered as highly stressful.
The sample consisted of 50 primare care physicians working in primary health care and 50 anesthesiologists at a University hospital in Belgrade.The burnout was assessed using Maslach Burnout Inventory,which addresses thre general scales-emotional exhaustion,depersonalization and reduced personal accomplishment.
The findings supported our hypothesis that this syndrome is highly prevalent among health care workers,espacially among anesthesiologists.
The burnout syndrome is a frequent disorder among health care workers, especially among with high work demand,susc as general practitioners and anesthesiologists.Therefore,prevention strategies should be planned and carefully implemented.
PTSD is dominant, but rarely the only psychological disorder that is present among individuals who have a history of exposure to traumatic event.
To examine morbidity in veterans 12 years after the war, with special emphasis on comorbidity of PTSD and other psychiatric disorders.
The study population consisted of 154 veterans who sought psychiatric treatment due to PTSD. The control group consisted of 77 war veterans who do not have PTSD, collected by snow balling method through veteran associations. The study used a general demographic questionnaire, the HTQ-version for BiH, and the MINI.
Veterans who sought psychiatric treatment due to PTSD, were experienced a significantly greater number of traumatic events (t = 5.66; P < 0.001) and achieved significantly higher scores on a scale of PTSD symptoms (t = 15.291; P < 0.001), perceived personal functionality (t = 12.491; P < 0.001) and the overall result of traumatic symptoms (t = 14.499; P < 0.001). Additionally, among veterans with PTSD there are significantly more of those who reported chronic somatic diseases (X2 = 17.988; P < 0.001), who met the criteria for the diagnosis of current depressive episode (X2 = 36.297; P < 0.001), previous depressive episode (X2 = 29.356; P < 0.001), depressive episode with melancholic features (X2 = 29.356; P < 0.001), dysthymia (X2 = 9.959; P = 0.007), the criteria for the diagnosis of panic disorder with agoraphobia (X2 = 5.490; P = 0.019), PTSD (X2 = 102.018; P < 0.001) and generalized anxiety disorder (X2 = 89.755; P < 0.001).
Although PTSD is the dominant cause for seeking psychiatric treatment in veterans, PTSD promotes a comprehensive psychiatric and somatic comorbidity, and predominated are anxious and affective disorders.
Within its sociotherapeutical programme St. John Psychiatric Hospital has been continuously since 1963 conducting the treatment and rehabilitation of psychiatric patients accommodated in heterogeneous families according to the Belgian model. Research conducted in the West as well as the experience gained at our hospital suggests that this sociotherapeutical method is very effective in the process of prolonged treatment, rehabilitation and resocialisation as well as the improvement of the quality of life of psychiatric patients. The ultimate objective of this investigation was to examine the quality of life of the groups of schizophrenic and depressive patients under observation, and the impact of a heterogeneous family, primary or secondary family and hospital ambient on the process of treatment and rehabilitation. The assumption is that in the process of prolonged treatment patients accommodated in heterogeneous families psychosocially function better and attain a higher quality of life than those who are under long-term outpatient treatment and live with the primary or secondary family or, alternatively, have been hospitalised. Applied was a comparative method of investigating groups of patients affected by schizophrenia and depression that were in the process of prolonged treatment accommodated in heterogeneous families, primary or secondary family, or those who were hospitalised. Individually assessed by way of appropriate questionnaires, completed by the very subjects, were the health-related quality of life and the subjective quality of life.
This study was a retprospective review on use of electroconvulsive therapy (ECT) in a Military Medical Academy, Belgrade, Serbia. Aim of the study was to determine demographic and clinical predictors of ECT outcome.
The study subjects were 120 patients (59 male and 61 female) treated with bilateral ECT over the period 2000-2004. Data extracted from clinical records included demographic variables (age, sex, education and heredity of psychiatric illness) and clinical characteristics (diagnosis, duration of illness, episode duration, comorbid psychiatric disorders, presence of psychosis, previous hospitalizations, and ECT variables). As outcome measure was used Clinical Global Impression (CGI) scale.
The significant sex difference was found concerning age and diagnosis. Female patients were much older (mean age=46.9 years, SD=14.3) compared to male patients (mean age=35.4 years, SD=14.1), with much longer duration of illness (mean=88.7 months, SD=95.8), compared to male patients (51.9 months, SD=58.1). After a clinical course of ECT, 52.5% of all patients were rated as "much", and 40% as "very much" improved on the CGI. Statistically significant predictors of remission were sex and the number of previous hospitalizations.
Significant improvement after use of electroconvulsive therapy was associated with sex and the number of previous hospitalizations, but not with age or duration of illness or presence of psychosis.
We are witnessing increased divorce rate, and consequently the need to resolve problems related to child custody. According to some data, every third marriage results in disintegration. The child often becomes an object and tools in resolving this complex issue.
Family environment is a natural environment of a child, one of the crucial factors in process of child's socialization. Basic generator of named socialization is a family atmosphere conditioned by predominant feelings in domestic relations. These relations are realized within the mother-child-father triangle adjoined by other members of the family. The evolution of civilization leads to changes in behavior and concept of human rights.
Divorce proceeding itself is one of the rights of both parents, i.e. adult members. From legal point of view, position of minors is passive, defensive. Therefore, divorce may be presented as exercising divorce rights consumed by adults. The most dramatic conflict in divorce proceeding is so called child custody, used by the parents as figurehead for exercising rights on their child.
During the course of exercising parental rights, there are some parents where we can identify a competence and confrontation of equal rights or conflict of individual parental rights.
An expert being summoned to the court in divorce proceeding, related to issues of child custody is most frequently a psychologist, psychiatrist, social worker by its vocation, and seldom, pedagogue or psychotherapist.
Family, school and society are somewhat similar to the palace- If you take away a stone from its foundation, everything starts to collapse.
Torture is considered as physical or mental harassment, torment, causing pain, injuries and humiliation of an innocent person occurring during the shorter or longer period of time.
Is human emotional behavior based on primary biological mechanism that human inherited not only from close animal predecessors, but also significantly more distant kinds on evolutionary ladder?
Results of researches indicate that aggressiveness is stable pattern of behavior in children and young people. Aggressive behavior of humans decreases over the years, although certain types of personalities preserve stability of aggressive behavior.
Psychological profile of torturer includes diagnostical category of antisocial personality disorder.
Mental consequences resulting from torture are depression, psychosomatic reactions, aggression, state of anxiety. The contribution of victimology is significant, particularly from aspect of “selecting” psychopathological reaction. It is also important whether the torturer is known to be victims or it is a stranger. It is understandable that consequences are much more severe with people who had unfortunate to be tortured by known person.
The most common psychopathological reactions are:
1. Fear lived during the torture.
2. Depressive reaction.
3. Aggression - which may not be demonstrated in adequate manner, may be shifted to other people, which may create interpersonal disputes, before all for the victim and represents one of physical consequences resulting from torture.
Torture prevention is problem of individuals, community and society as whole.
Degradation of authorities in one society leads to moral erosion, and on its part, to torture on all functioning levels.
Goal of contemporary psychiatric treatment is improvement of the quality of life of the mentally ill. Being that quality of life is of special importance for the process and final result of the mental condition, it is very important to identify factors that are responsible for the improvement or deterioration of the quality of life of the patients. Purpose of this research is a discovery of the difference in the quality of life in patients with various type of schizophrenia treated in the hospital environment. QOL was assessed with 30 female schizophrenics classified in accordance with ICD X criteria. LQOLP and BPRS were used. Paranoid schizophrenics treated in the hospital environment have higher objective and lower subjective QOL in regard to other schizophrenics.
PTSD-veterans’ spouses often become indirect victims of their partner’s dysfunction, confronting many stressors including relationship crisis, rearrangement of family roles, social isolation and adjustment to clinical course of disease.
Compare levels of caretaker burden and burnout in partnership relations of PTSD and non-PTSD veterans’ spouses, particularly in situation where the spouses have PTSD themselves.
Test group consisted of 154 veterans who are undergoing treatment for war psychotraumatisation caused PTSD at the Clinical hospital Mostar, and their spouses. Control group consisted of 77 war veterans without PTSD, and their spouses. The General demographic questionnaire, Harvard Trauma Questionnaire (HTQ), the Experience of Subjective and Objective Burden and Maslach Burnout Inventory were used in research.
PTSP-veterans’ spouses had significantly higher results on al subscales of the caretaker burden questionnaire and partnership relations burnout questionnaire. When both partners have PTSD, the burden of subjective demands and subjective stress, and burnout in partnership are significantly higher in comparison with the couples where only the veteran has PTSD or when partners don't have PTSD. The difference wasn't found in the objective burden when both partners have PTSD in comparison with the case when only the veteran has PTSD.
PTSD-veterans’ spouses in comparison with the non-PTSD veterans’ spouses are exposed to more objective burden of life, burden of partner's subjective demands and subjective perception of stress overburden, and their burnout is also higher. The burden of subjective demands, subjective stress and burnout are even more prominent when the spouse has PTSD.
Schizophrenia remains a severe disorder that is associated with a poor outcome in a large subgroup of patients. Major efforts should be made to improve treatment, especially in the long-term psychopharmacotherapy. In this study, we followed 10 patients on the post- hospital ambulatory treatment with long acting Risperidone (LAR) during the six months period.
We discussed the results according to: age, schizophrenia type, LAR- dose (25 mg, 37.5 mg, 50 mg), relapse with hospitalization, and therapeutically compliance (meaning satisfaction with the therapy and regular two- weeks controls), also the improvement on the CGI score.
The CGI improvement scores were significant, as so as compliance with the therapy. Only two patients have relapsed during the study. These results encourage us to believe that many more patients will benefit from the advantages of a second generation of long acting preparations, like Rispolept Consta is.
Early intervention in first episodes of psychotic disorders is very important in therapeutic treatment because first three to five years is considered to be critical period in the course of illness (Birchwood, 2002), because it significantly determinates patient's future cognitive, social and emotional functioning and also reflects on theirs family functioning.
Psychiatric hospital «Sveti Ivan» in Zagreb has started the programme which is consisted of psychoeducation for patients and their family members, and psychodinamic group psychotherapy for patients and group psychotherapy for family members.
In order to improve patient 's follow-up we also investigated cognitive functioning in different phases of treatment, object relations, separation and individuation and empathy.
Considering that stigma related to mental disease leads to decrease of self-esteem, loneliness and reduction of quality of life, we applied self-esteem questionnaire, loneliness scale, SF 36 and perceived social support questionnaire.
In this paper partial preliminary results of our programme with group psychoteraphy after first six months-period by using Scale of emotional empathy, Rosenberg Self-Esteem Scale and UCLA Loneliness Scale (short version) will be presented.
Since the hospital treatment has the influence on the reduction of quality of life of mentally ill patients, the intention of contemporary psychiatric management would be to provide appropriate psychiatric assistance and to reduce hospital treatment as much as possible. Current treatment of mentally ill in Serbia is conducted in conditions of insufficiently developed community psychiatric treatment. Therefore, the aim of this research was to investigate the causes which led to extended treatment of in hospital patients on ‘Acute psychoses department of Special psychiatric clinic’, which is one among the five biggest psychiatric hospitals in Serbia. Duration of in hospital treatment was analyzed in 298 female patients who were consecutively admitted to the department within one year period, with regard to clinical, demographic, social and economical factors. Obtained results show that among the type and severity of disease, the critical role of extension of in hospital treatment play, some demographic, social and economic factors as well. Results gained were discussed in detail during the research.
A structured psychoeducation is a method of treatment of patients and their families with the approved therapeutical effect.
Background and Aims:
In our hospital psychoeducation is a part of early interventions directed to first episodes of psychotic patients (that includes first 5 years of psychosis). Duration of the programme is one year and it has been influenced by simmilar experiences in Great Britain and PORT˘s recommendations (Sshizophrenia Patient Outcomes Research Team). A specific quality of the programme is collaboration of group psychotherapy approach conducted by group analysts and psychoeducation conducted by cognitive-behavioral therapists. All therapists involved in the programme have been supervised monthly by proffesionals.
The psychoeducation is common for all patients and their family members.
Number of hospitalisations, cognitive, emotional and social functioning, changes of basic beliefs and present symptoms have been estimated during the programme.
The aim of the poster presentation is to evaluate the efficacy of treatment and rehabilitation of patients that participate in the programme together with pharmacotherapy in order to achieve better treatment efficacy. Patient that have been involved in the both psychoeducation and pharmacotherapy are compared to patients treated with drugs only. Questionnaires that measure self-esteem and loneliness have been used.
Results and Conclusions:
Since actual psychoeducation ends at the end of this year, the first results of two first grades are expected at the beginning of 2008.
Therapeutic factors in group psychotherapy could result with symptomatic, behavioral, and personality changes. According to Yalom (1985), therapeutic factors are: instillation of hope, universality, imparting of information, altruism, the corrective recapitulation of the primary family group, development of socializing techniques, imitative behavior, interpersonal input, interpersonal output, group cohesiveness, catharsis and existential factors. Their importance varies during group process.
Although therapeutic factors of group psychotherapy with nonpsychotic patients are well investigated, there are few studies regarding group psychotherapy with psychotic patients.
In this paper we will present investigation of therapeutic factors by Yalom's questionnaire in different phases of group psychodinamic oriented psychotherapy with psychotic patients, respectively in patients who have participated in gruop psychotherapy for less than six months and in those that have participated in group psychotherapy for more than five years. We expect the results of this study to contribute to better understanding of group process with psychotics and to the development of guidelines for the definition of more specific therapeutic strategies.
Schizophrenia is a chronic mental disease which provokes repulsion of the social and environment of the patients. Stigmatism of schizophrenia patients is one of the couses that they are hospitalised much more frequently in comparison to other categories of psychiatric patients.The aim of this work is to determine, on the basis of detailed analises of numerous characteristics recognizable socio-demografic profile of schizophrenia patients depending on the number of their rehospitalization.The analises comprised 60 hospitalised female SCH patients who were clasified in accordance with ICD X criteria.Depending of the number of rehospitalization all patients were clasified in several groups:group 2-10 rehospitalization,group 11-20 rehospitalization,group 21-30 rehospitalization,and a group which comprised patients with more than 31 rehospitalization.Except the number of rehospitalization a special attention was paid to the length of periods between two rehospitalization and the length of each rehospitalization(which was connected to certain socio-demographic characteristics of hospitalized SCH patients.This problem has been disscused in detail in this work.