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Traditional Chinese medicine (TCM) is a rich medical system dating back 2500 years . The philosophical underpinnings and theoretical framework emphasize the ideology of holism within the human body, and extend to the close relationship between the human body and nature . In the core theorem, balance is needed between the opposite influences on the body – Yin and Yang – to prevent disease and achieve good health . Energy flow, called Qi, streams along 12 different meridians throughout the body, which keeps the Yin and Yang forces balanced. “Yin” represents the concept of cold, slow, and passive, and “Yang” represents energy that is hot, fast, and active . Illness is caused by a disruption or blockage among the forces. Cultivating Yin/Yang harmony within the body and with nature is achieved through two main treatment modalities – herbal and manual treatment .
The interplay of geometry, spectral theory and stochastics has a long and fruitful history, and is the driving force behind many developments in modern mathematics. Bringing together contributions from a 2017 conference at the University of Potsdam, this volume focuses on global effects of local properties. Exploring the similarities and differences between the discrete and the continuous settings is of great interest to both researchers and graduate students in geometric analysis. The range of survey articles presented in this volume give an expository overview of various topics, including curvature, the effects of geometry on the spectrum, geometric group theory, and spectral theory of Laplacian and Schrödinger operators. Also included are shorter articles focusing on specific techniques and problems, allowing the reader to get to the heart of several key topics.
There are many controlled studies of Psychoeducation and Psychotherapy with differing type and length of treatment.
To find out the effects of a cognitive-psychoeducative group intervention
The aim of the study is to investigate the effects of a cognitive-psychoeducative group therapy (CPT) vs Treatment as usual (TAU) with additional information group in patients with ongoing stable pharmacotherapy on relapse prevention, compliance, coping-behaviour, illness concepts and quality of life.
Patients with BP I or BP II were diagnosed with MINI and treated either with 14 sessions of group-CPT (with 8 hours separate sessions for significant others) or got an information book for patients on bipolar disorder and 3 group-sessions of information and discussion with patients and relatives. Booster sessions were given for both groups after 6 and 9 months.Follow-up after 12 and 24 months. Evaluation was carried through on number and type of relapses, duration of inpatient episodes, with scales for mania and depression, WHO-QoL-BREV, Ilness-concept scale,Medication Attitude questionnaire (LAQ), Medication Compliance Questionnaire (MCQ), Coping (SVF-120).
100 patients with Bipolar disorder (76 BP I and 24 BP II) were treated (52 with CPT and 48 with TAU plus information group). After 14 weeks treatment there was an improvement in illness concepts and compliance in both groups.At 12-month follow-up there was a significant decrease in number of manic episodes in both groups, but for depressive episodes only in the cognitive-psychoeducative group.
CPT effective in relapse prevention, TAU+info effective against manic but not depressive relapses.
To improve the quality of psychotherapy, computer-assisted feedback and monitoring systems to evaluate continuously an ongoing course of therapy have gained increased importance in psychotherapy research. They can provide both therapists and the patients themselves with feedback about the progress of the treatment to date while psychotherapy is still taking place. The information gained from them can be used to match the treatment better to patients’ individual needs.
This work presents an Internet-based real-time monitoring method, the Synergetic Navigation System (SNS). This is based on a daily self-assessment by the patient, and is thus characterized by recording the therapy process at particularly narrow time intervals. The technology is illustrated by means of a single case example of a patient with obsessive-compulsive disorder who took part in a two-month inpatient behavioural therapy.
It can be shown that SNS time-series analysis enables the whole course of therapy to be depicted well, without any serious time delay, and it is possible to record phases in which therapeutic interventions are particularly effective (phases of critical instability).
On the one hand monitoring a psychotherapy is useful for psychotherapy research because it enables the dynamics of the therapy progress to be investigated better and it is possible to identify exactly which therapeutic intervention at which time produces what effect on the patient. On the other hand it is useful for the psychotherapist who is working mainly clinically, because the regular feedback enables him to match his therapy to the patient's specific needs.
Cognitive dysfunctions have been well established in patients with schizophrenia (SZ). Recent studies also showed persistent cognitive impairments in patients with bipolar disorder (BD) in all phases of the disorder including the remission phase. Specific cognitive domains have been considered as candidate endophenotypes in SZ and BD. The aim of this study was to investigate the diagnostic specificity of neurocognitive deficits BD and SZ patients during a stable phase of the illness.
40 patients with schizophrenia (20 female, 30.4 ±8,1 years) were compared with 40 bipolar patients (27 female, 34.7±10.4 years) and 43 healthy volunteers (24 female, 34.7 ± 8.7 years). Executive functions (WCST), attention (CPT), immediate and delayed verbal memory (VLMT) and verbal fluency (RWT) were assessed. Differences in neurocognitive functions between diagnostic groups were analysed for each domain by analyses of covariance (ANCOVA analysis with age, education, IQ, gender and medication as covariates).
SZ and BD patients performed worse than control subjects in the WCST (p<0.001), VLMT (p<0.01) and in the CPT (p<0.03). There was no significant difference in the WCST and VLMT between SZ and BD patients. However, in the CPT, SZ patients showed a significantly greater impairment than BD patients (p<0.001). In BP patients deficits in the CPT were associated with the number of illness episodes.
The findings are comparable to previous results suggesting that the specific profile of the deficits seems to differ between the diagnosis, while the same underlying domains describe neurocognitive functioning in both groups.
Neurocognitive deficits are known as a core feature in bipolar disorder (BPD). Persisting neurocognitive impairment is associated with low self-reported quality of life and low psychosocial functioning. Current findings indicate the importance of adjunctive psychosocial interventions in the treatment of BPD patients to enhance symptomatic and functional outcome.
To assess whether functional outcome in patients with BPD is affected by cognitive psychoeducational therapy, clinical parameters and cognitive impairment.
To identify potential predictors of functional outcome, global clinical impression and early recurrence in patients with BPD.
Using a neurocognitive test battery 43 patients with BPD in euthymic state were compared to 40 healthy controls. Patients were assigned to two treatment Conditions cognitive psychoeducational therapy over 14 weeks (n = 19, 12 female, age) and treatment-as-usual (n = 24, 14 female). Predictors for functional disability, global clinical impression and early recurrence including clinical and cognitive variables as well as treatment conditions were examined using logistic regression.
Compared to healthy controls patients with BPD showed lower performance in executive function (p < 0.01) and sustained attention (p < 0.001). Cognitive psychoeducation (p < 0.05) and subthreshold depressive symptoms (p < 0.05) were predictors for occupational functioning. Age (p < 0.05), delayed verbal memory (p < 0.05) and word fluency (p < 0.05) predicted global clinical impression. Recurrence in the follow-up period of 12 months was predicted by delayed verbal memory (p < 0.05).
Patients with BPD seem to benefit from cognitive psychoeducational training mainly in areas of working life. The extent of cognitive impairment appears to impact clinical outcome and recurrence rate.
The influence of repetitive transcranial magnetic stimulation (rTMS) on mood in healthy people is uncertain, as former studies show divergent results. Previous studies in healthy volunteers focused exclusively on the immediate effect of a single session of rTMS on mood.
The aim of this study was to analyse the influence on mood of a series of 9 High Frequency (HF) rTMS stimulations of the left dorsolateral prefrontal cortex (DLPFC).
44 young healthy male volunteers were randomly assigned to receive 9 sessions of active HF-rTMS (n = 22) or sham rTMS (n = 22) over the left DLPFC. Each session in the active group consisted of 15 trains of 25 Hz starting with 100% of motor threshold. Sham stimulation was performed following the same protocol, but using a sham coil. The variables of interest were the Beck Depression Inventory (BDI) and Visual Analogue Scales (VAS) which quantified “mood”, “enjoyment” and “energy”.
We found a significant reduction of the BDI score in the active group (GLM, p < 0.001) whereas no significant changes of the BDI score were caused by sham stimulation (GLM, p = 0.109). We did not find significant differences caused by active or sham stimulation in VAS scales except for the VAS labelled lively/gloomy immediately after stimulation. The active group was found to be more “gloomy” (p = 0.001).
Our data support the hypothesis that a 9-day long series of HF-rTMS of the left DLPFC improves mood, analysed by BDI in healthy young men.
The purpose of this study was to investigate the degree of agreement among parents, teachers and adolescents with respect to the Child Behavior Checklist (CBCL), the Teacher's Report Form (TRF), and the Youth Self Report (YSR). In addition we evaluated the suitability of these three forms (CBCL, TRF and YSR) in terms of their contribution to understanding internalizing and externalizing disorders in youths being referred to a child and adolescent unit of a psychiatric care facility.
A total of 611 patients aged 11–18 years (mean age 13.0, SD 1.6) were assessed using the CBCL, the TRF and the YSR.
Intraclass coefficients (ICC) showed low to moderate agreement among informants. Furthermore, the level of agreement was generally less among patients suffering from internalizing disorders than for young patients who displayed externalizing disorders. Logistic regression revealed that the TRF internalizing syndrome scale, the CBCL internalizing syndrome scale and gender were relevant prognostic factors for the occurrence of internalizing disorders in youth. The YSR internalizing syndrome scale, on the other hand, was not a relevant factor among adolescents of a clinical target population. Likewise, only the TRF externalizing syndrome scale, the CBCL externalizing syndrome scale and gender were relevant prognostic factors for the occurrence of externalizing disorders in youth.
Particularly the CBCL and TRF are useful instruments in assessing internalizing and externalizing disorders in adolescents referred to a mental health setting.
The study evaluates a central hypothesis of synergetic psychotherapy research according to which a marked instability in the psychotherapeutic process is associated with high response rates.
14 patients with obsessive-compulsive disorder (OCD) successfully completed an eight-week in-patient course of multi-modal behavior therapy with exposure exercises followed by response management. The instability during the course of the therapy was recorded by daily self-assessment by the patient using the Synergetic Navigation System (SNS), an Internet-based real-time monitoring procedure.
There was a negative correlation between the degree of the instability and the percentage reduction in the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) (r = −0.395; P = 0.199), the “Global Severity Index” (GSI) of the symptom check-list (SCL-90-R) (r = −0.718; P = 0.013), the scale value for obsessive-compulsiveness in the SCL-90-R (r = −0.782; P = 0.004) and the remaining sub-scales of this data-gathering instrument.
An unstable progress of the psychotherapy causes a smaller reduction in symptoms than a stable one. The contradiction relative to the study hypothesis is possibly based on the special features of OCD, with a high level of patient insecurity when anticipating new, non-obsessive-compulsive ways of thought and behavior. The relationships between instability and reduction in symptoms appear to be diagnosis-specific.
The clinical observation suggests a relation between alcoholism and dysregulation of the hypothalamus-pituitary-gonadal hormone axis. Chronic alcohol abuse leads to hypogonadism and sexual dysfunction. Testosterone and the genetics of the androgen receptor [AR] are related to impulsivity as well as appetite/hunger, both associated with addiction.
This study investigated whether the length of a CAG trinucleotide repeat within the coding region of the AR is associated with alcoholism in general and whether it is linked to craving during withdrawal. Moreover, we concentrated on finding possible mediators of the observed effects.
We included 112 male inpatients who were admitted for detoxification treatment and who were compared to 50 age-matched controls. To measure the extent of craving we used the Obsessive Compulsive Drinking Scale (OCDS) on the day of hospital admission. For laboratory analysis we used whole blood (genetics) and serum (protein quantification).
The group of patients (21.6 ± 3.7 repeats) did not differ significantly from the control group (21.3 ± 3.3 repeats, p = 0.632) in terms of the number of CAG repeats. We found a significant negative correlation for the AR repeat length regarding OCDS-to (R2 = 0.053, p = 0.016) and OCDS-obs (R2 = 0.058, p = 0.011). Carrying out a path analysis of the mediating effect of leptin on the association between the number of CAG repeats of the AR and alcohol craving we found that direct effects (r = −0.144) accounted for 60% and indirect leptin-mediated effects (r = −0.096) for 40% of the total effect.
Today, the impact of the sexual hormone axis seems to be underestimated in alcoholism.
Patients with a first episode psychosis (FEP) have repeatedly been shown to have gray matter (GM) volume alterations. Some of these neuroanatomical abnormalities are already evident in the at-risk mental state (ARMS) for psychosis. Not only GM alterations but also neurocognitive impairments predate the onset of frank psychosis with verbal learning and memory (VLM) being among the most impaired domains. Yet, their interconnection with alterations in GM volumes remains ambiguous.
To evaluate associations of different subcortical GM volumes in the medial temporal lobe with VLM performance in ARMS and FEP patients.
Data were collected within the prospective Früherkennung von Psychosen (FePsy) study, which aims to improve the early detection of psychosis. VLM was assessed using the California Verbal Learning Test (CVLT) and its latent variables Attention Span (AS), Learning Efficiency (LE), Delayed Memory (DM) and Inaccurate Memory (IM). Structural images were acquired using a 3 Tesla magnetic resonance imaging scanner.
Data from 59 ARMS and 47 FEP patients were analysed. Structural equation models revealed significant associations between the amygdala and AS, LE and IM; thalamus and LE and IM; and the caudate, hippocampus and putamen with IM. However, none of these significant results withstood correction for multiple testing.
Although VLM is among the most impaired cognitive domains in emerging psychosis, we could not find an association between low performance in this domain and reductions in subcortical GM volumes. Our results suggest that deficits in this domain may not stem from alterations in subcortical structures.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
After touching on his own experiences, Barrie Kosky points out that operetta lost the continuity of its tradition in World War II. He calls for a radical investigation into operetta performance practice. He describes operetta as a Jewish art form not only because most of the composers, librettists and performers were Jewish but also because operetta itself is about assimilation, irony and disconnectedness. This tradition was interrupted because many Jewish artists went into exile or died in the war. After the war, everything subversive, erotic, ironic and contemporary became harmless, nostalgic, and arianized. But over the last ten years, new understanding has grown, and a new young audience is discovering operetta. Kosky maintains an operetta needs a fabulous score and must work on different levels as a combination of ‘serious but ironic’. Operetta needs characters, scenes and situations that can reveal performers’ virtuosity in mixing singing, dancing, speaking and acting. Kosky sees subversiveness and campy queerness as inherent in operetta. It appears in Offenbach’s political awareness as well as in the new definition of gender in the Weimar operetta. Kosky says new operetta requires composers and librettists familiar with the tradition but who should avoid copying operetta of the past.
We study dynamical systems
with a compact metric space
, a locally compact,
-compact, abelian group
and an invariant Borel probability measure
. We show that such a system has a discrete spectrum if and only if a certain space average over the metric is a Bohr almost periodic function. In this way, this average over the metric plays, for general dynamical systems, a similar role to that of the autocorrelation measure in the study of aperiodic order for special dynamical systems based on point sets.
This article presents computer supported “language production experiments” (LPEs) as a method for the investigation of syntactic variation. It describes the setup for the investigation of numerous syntactic phenomena and provides a sample study of the German GET passive across Austria. It also suggests that LPEs offer possibilities for the targeted investigation of linguistic variation in various ways. They may be used to explore speakers’ individual linguistic repertoires and an according corpus setup can be used to examine e.g., interspeaker patterns of variation. LPEs also enable researchers to investigate which linguistic factors control or influence syntactic variation.