Psychiatria Danubina最新文献

The purpose of this study was to examine the differences in attachment dimensions and the perceived parental acceptance / rejection among adolescents with conduct disorder (CD) in comparison to the control group, and the contribution of the attachment dimensions and parental acceptance /rejection to the CD. The group of male and female adolescents with CD (N=97) and a control group of male and female adolescents with no signs of CD (N=97) participated in this study. Attachment and parental acceptance/rejection were determined in the relationship between adolescents and their mothers and fathers by using self-evaluation questionnaires. The results showed that subjects with CD had insecure (avoidance) attachment, perception of lower parental acceptance and higher parental rejection more often compared to controls. Higher levels of complex father rejection predicted CD. The main findings of this study indicated that the subjects with a conduct disorder felt less accepted and more rejected by parents compared to control group subjects. Complex father rejection was shown as a significant predictor of conduct disorder. Parental attachment may affect adolescents' perception of parental acceptance/rejection which may result in an expression of CD symptoms.

This review article explores the relationship between psychodynamic factors, personality organization, and loneliness. It focuses on extensive research into attachment styles, shame, pathological narcissism, and personality disorders. Insecure attachment styles, both anxious and avoidant, emerge as significant predictors of loneliness. Their effects are shown to be mediated by disconnection-rejection schemas and diminished emotional intelligence. The shame and pathological narcissism, especially narcissistic vulnerability, also correlate strongly with increased loneliness and decreased life satisfaction. Identity diffusion, a core concept in Kernberg's personality organization model, is closely linked to chronic, pervasive loneliness. Notably, individuals diagnosed with personality disorders report substantially higher levels of loneliness compared to the general population. The article also highlights a reciprocal relationship between loneliness and depression, particularly important among adolescents. Early relational experiences are emphasized as having a role in shaping social-emotional development and the experience of loneliness. Empathy was identified as a powerful factor against loneliness and its associated depressive symptoms. It serves as a mediator in the loneliness-depression relationship and as a crucial element in both clinical practice and community well-being. This holistic perspective deepens our understanding of human relationships in modern society and advises a holistic, empathetic approach to addressing loneliness and related mental health challenges.

The aim of this study was to compare the levels of thyroid hormones in children with ADHD and ADHD-NOS and to assess the relationship between ADHD symptom severity, anxiety symptom severity and thyroid hormone levels. The study was planned as a cross-sectional, retrospective study. The records of patients who applied to the study center in between January 2012 and January 2013 were screened and 205 ADHD and ADHD-NOS cases' records were evaluated. Both groups were compared according to thyroid hormon levels. The diagnosis of 205 patients' records and their comorbid psychiatric disorders was made clinically. ADHD symptom severity was assessed by Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S). Anxiety symptom severity was assessed by The Screen for Anxiety Related Emotional Disorders (SCARED). Groups were compared with parametric or non-parametric methods according to assumptions of normality. P was set at 0.05 (two-tailed). Among the whole sample, 99 (48.3 %) patients were ADHD, and 106 (51.7 %) patients were ADHD- NOS. The average age of the children in the ADHD group was 10.88 ± 3.02 years, and the average age of the children in the NOS-ADHD group 9.93 ± 2.49 years. Thyroid hormone levels were detected in 81 of 205 patients participating in the study. We found statistically significantly higher T4 levels in the ADHD group compared to the ADHD-NOS group (p=0.006). A statistically significant negative correlation between the total number of diagnoses and T4 level was noted (p=0.001). TSH levels correlated significantly with T-DSM-IV-S total score and symptom counts in the Hyperactivity subscale of this measure. Thyroid hormone levels may be affected in children with impairing ADHD symptoms and increased comorbidities. Our results should be supported with future studies.

There is a growing interest in the German thinker Arthur Schopenhauer (1788-1860), sometimes referred to as "the psychologist of the "will", but scarce empirical research has been conducted on the relevance of his philosophy for psychology and psychiatry. Following his death, philosophers, psychologists, psychiatrists, artists, writers, and natural scientists commended him. However, he was harshly criticized by others, notably by Friedrich Nietzsche and Martin Heidegger. Schopenhauer entitled his capital work as "The world as will and representation" (1818). His key concept is the "Will" which refers to the metaphysical source of all that exists. He considered deliberate human actions as a small part of the whole Will, which is mostly unconscious, blind, and purposeless. While the primeval Will is unknowable, the inner perception of our body in wishing is the closest approximation to the Will. Living beings have a "Representation" of the Will. With this construct, Schopenhauer explored most areas of knowledge in his time. The Will's nature, conceived as a tendency or imperative to exist, unavoidably leads to normative self-centeredness in all living beings, and often to egoism and malice in humans. Notwithstanding, he envisioned a path for individual (but not collective) salvation based on aesthetic contemplation, compassion, and asceticism. After describing his text's plan, we propose that selected contemporary constructs of psychotherapy may meet Schopenhauer's path to individual salvation. This sets the basis for approaching Schopenhauer to standard and novel psychotherapeutic and psychoeducational tools, as we illustrate here in selected aspects of clinical cases. The psychological correlates of the Will as postulated by Schopenhauer, and the sharp prose by which he referred to human motivations, are his key contributions to contemporary psychotherapy and psychoeducation. Since Schopenhauer funded his thought on the natural sciences, it may also enrich the integrative trends in contemporary psychiatry and psychology.

Progress in psychiatric treatment has led to important improvements in the quality of life of patients with severe mental illness (SMI). Nevertheless, the life expectancy of patients with SMI remains two decades shorter than that of the general population, and the most prevalent cause of death is cardiovascular disease. Given that the delivery of somatic care to a population of individuals with mental illness is specific, we developed a screening and intervention programme aimed at this vulnerable population. The "SOMA" programme is a complex somatic health intervention system consisting of screening and a set of interventions. Risk screening is evaluated automatically; the interventions include dietary intervention, healthy lifestyle education (HSE), physiotherapy, kinesiotherapy, and occupational therapy (KOP). The programme was introduced into the practice of the hospital, and its outcomes were monitored with a pilot population divided into 2 subprogrammes. CV risk factor prevalence study (n= 5481) as the most common CV risk factors identified hypertension (56.6 %) and smoking (55.7 %), high-risk patients proportion was 1364 (27 %). HSE (n=40) enrolled patients improved their body weight. KOP results show that patients with schizophrenia preferred physical activity less than others; 53 % of patients have no physical activity during hospitalization, and spontaneous physical activity depends on BMI in our sample. We observed improvement in cognitive functioning, perception of physical functions, or perceived limitations was comparable to the general population. Results show the usability of the program design; initial screening with two intervention branches can increase motivation for physical activity and adoption of health-promoting behaviors and support a recovery process in SMI patients. SOMA project is unique in the Czech environment, however, larger sample with longer observation period is needed.

The present study aims to explore the self-reported traumatic stress symptoms related to the impact of the COVID-19 outbreak and to investigate associations among trauma-related stress symptoms, demographic, work-related, and clinical characteristics in a sample of professionals drawn from psychiatric services in Greece. The following online questionnaires were used in this study. An I. self-reported questionnaire about demographic, work-related, and clinical characteristics, and II. the Impact of Event Scale, with modifications for COVID-19 (IES COVID-19). The research period was from June 5, 2021, to September 9, 2021, during which Greece had just emerged from a six month total lockdown. We included 363 employees of public mental health services (females 77%, mean age 44±9 years). More than half of the participants (54.5%) answered that they felt that their patients might not have been offered the optimal possible care due to measures against COVID-19 dissemination, in the workplace. Linear regression analysis revealed that female gender (β= 6.42, 95% CI: 3.01, 9.82, p<0.001), being divorced/separated/widowed (β= 5.31, 95% CI: 0.86, 9.77, p=0.02) and feeling that patients might not have been offered the optimal possible care due to measures against COVID-19 dissemination (β=4.40, 95% CI: 1.53 - 7.26, p=0.003) were found to be significant factors for total IES COVID-19. Challenges faced by those working in psychiatric and mental health services have received less attention and understanding, although they faced ethical dilemmas that have a significant impact on both patients and professionals, during the pandemic. These ethical dilemmas, in turn, may contribute to increased role stress and traumatic symptoms among mental health professionals.