Psychiatry-Interpersonal and Biological Processes最新文献

Objective: The current meta-analysis investigates the efficacy of psychotherapy during psychiatric hospitalization and examines the moderating role of diagnosis and therapeutic approach.

Methods: We conducted systematic searches in literature databases, including PubMed, PsycInfo, and Google Scholar. In total, 37 samples were included for the meta-analysis with a total of 4,443 patients. The primary outcome was the standardized mean differences in clinical status measured by symptomatic and functional measures.

Results: The meta-analysis of 22 samples without a control group resulted in the upper end of the medium effect size for the overall effect of treatment during psychiatric hospitalization that included psychotherapy (k = 22, Cohen's d = 0.70, and 95% Cl 0.36 to 1.04). The meta-analysis of 15 samples with a control group resulted in the upper end of the low effect size for the contribution of psychotherapy to the improvement of patients' clinical status measured by symptomatic and functional measures (k = 15, Cohen's d = 0.43, and 95% CI 0.06 to 0.81). No significant effects were uncovered for psychotherapy orientation. Diagnosis was found to moderate the contribution of psychotherapy in an inpatient setting to the improvement of patients' clinical condition.

Conclusion: Psychotherapy during psychiatric hospitalization may be an effective treatment. Across the various samples, psychotherapy has a moderate effect on the reduction of psychiatric symptoms beyond the overall effect of ward treatment.

Objectives: Our main hypothesis in this study was that patients with social anxiety disorder (SAD) and comorbid attention deficit hyperactivity disorder (ADHD) had lower empathy levels than those without ADHD. Also, after controlling for the severity of SAD and depression, we hypothesized that ADHD symptoms contributed to lower levels of empathy in SAD patients.Methods: 72 patients (46 females, 32 males) with SAD between the ages of 18-65 years were divided into two groups as those with (n = 32) and those without ADHD (n = 40). Participants were evaluated using the Liebowitz Social Anxiety Scale (LSAS), Turgay's Adult Attention-Deficit/Hyperactivity Disorder, Beck Depression Inventory (BDI), and Empathy Quotient. In this study, Mann Whitney-U test, Spearman correlation test, logistic and multiple regression analysis were used.Results: Education level (U = 371.5, p = .002) and empathy scores (U = 259.5, p < .0001) of SAD patients with ADHD were significantly lower than those without ADHD. BDI (U = 206.5, p < .0001), LSAS total (U = 454.5, p = .036), fear (U = 457.0, p = .038), and avoidance scores (U = 453.0, p = .034) were higher in SAD patients with ADHD than those without ADHD. Low levels of empathy (B = - 0.119, Exp(B) = 0.895, p = .014) and high severity of current depression (B = 0.119, Exp(B) = 1.127, p = .001) were significantly associated with comorbidity between SAD and ADHD. ADHD-inattention (β = -0.369, Exp(B) = -0.541, p = .004), and depression (β = -0.262, Exp(B) = -0.212, p = .036) negatively predicted empathy levels.Conclusions: Our findings may provide some evidence for the contribution of ADHD-inattention and depression to poor empathy in SAD patients. Therefore, it is recommended that symptoms of ADHD-inattention and depression should be carefully evaluated in SAD patients with low empathy.

Objective: Adult gang members have higher substance misuse and Adverse Childhood Experiences (ACE) prevalence than non-gang involved individuals. The authors aimed to understand UK gang membership demographics and estimate substance misuse and ACE prevalence among a community-based sample of children and young people (CYP) contrasting three groups; gang members, periphery and non-gang involved.Method: The authors used the 2006 Offending, Crime and Justice Survey (OCJS) cross-sectional dataset, containing gang involvement, ACE exposure and substance misuse data, sampling 2,443 individuals aged 13-17 years. Gang membership was self-identified. Gang periphery was CYP identifying as gang involved according to the Eurogang Youth survey questionnaire, but not self-identifying as members. Other CYP were non-gang involved.Results: Gang periphery participants were significantly more likely to misuse all substance types than non-gang involved CYP. The substance misuse likelihood was greatest for gang peripherals, then members, then non-gang involved. Gang periphery and members were significantly more likely to have been a victim of serious assault, less serious assault, any assault, any violence and to have committed any violent act in the last year than non-gang involved.Conclusions: This is the first study comparing ACE exposure and substance misuse prevalence among the UK, community-based CYP sample. Current research highlights younger children with complex needs, including girls, risk gang involvement and requires tailored support to enable safe exit from gangs. Factors relating to gang involvement, ACEs and substance misuse are interlinked and complex, demanding a holistic approach to support across education, children's social services, health and criminal justice settings.

This paper illustrates the beneficial effect of a positive benevolent transference in the development of an internalized representation of the therapist/analyst in a variety of patients in psychodynamic treatments ranging from consultation to psychoanalysis itself. This is described in patient presentations. In those who have had substantial early nurturant life experience and now find themselves in a dysphoric state due to crisis, the effect lies in the transference reactivation of these positive object relations that relieve their distress. In those who have been deprived of such early experience, the positive transference may emerge during the intensive work of psychoanalysis and may lead to the internalization of a new positive object representation of the analyst generated in the transference that persists after termination of treatment. In both of these situations, the patient discovers a sense of greater harmony with self and the world. The special conditions that permit and facilitate this process are described since this does not occur in all psychodynamic interventions.

Objectives: Individuals with treatment-refractory disorders have high comorbidity. There is little information on whether recovery is possible and how long it might require. We focused on the individual's recovery using a broad measure of psychopathology, regardless of the variety of disorders present.Methods: We recruited 226 adults [mean age 31.0, SD = 10.3; 75.2% female] entering residential treatment for treatment-refractory disorders to delineate their course and outcome. Individuals received periodic Longitudinal Interval Follow-along Evaluation interviews for symptoms and functioning variables for up to 14 years. Periodic psychodynamic and relationship vignette interviews were rated with the Psychodynamic Conflict Rating Scales (PCRS) for a subgroup of 54 subjects. Outcome variables included modeled rates of change, final scores, time to recovery, and time to attaining healthy adaptive functioning, using Kaplan-Meier estimates from time-to-event analyses.Results: Recovery of PCRS Pathological Functioning occurred in 12 (22%) of 54 subjects rated: median time-to-recovery = 11.63 years (CI: 9.64- upper number not calculable). Eight (14.81%) subjects also developed healthy adaptive functioning, with the time-to-attainment for the first quartile at 10.95 years (CI: 7.87 - upper bound not calculable). Recovery from psychopathology was significantly associated with a median percentage recovered in the domains of symptoms (64.29%), functioning (87.50%), and psychodynamic functioning (50%). Although attaining healthy adaptive functioning was less common, it was highly associated with already achieving recovery from dynamic psychopathology, [OR = 57.40, CI 5.80 - 567.83, p = .0001].Conclusions: These results provided convergent validation of recovery in psychodynamic psychopathology. Some recovered individuals also attained healthy adaptive functioning, which took somewhat longer.