Welcome Messages Address from the Conference Patron Mrs. Selina Tsang Wife of the Chief Executive, Hong Kong SAR It is my honour and pleasure to serve as Patron of the 3rd Asia Pacific Regional Conference of the International Association for Suicide Prevention. Thanks to the International Association for Suicide Prevention, The Hong Kong Jockey Club Centre for Suicide Research and Prevention and The University of Hong Kong for organizing the Conference in conjunction with the World Health Organization. Suicide is a complicated yet preventable public health problem. Today we strive to build caring and harmonious societies, in the midst of rapid changes and stresses of modern life, to help reduce the suicide rate. This Conference brings together experts, clinicians, and researchers from within and outside the region to share knowledge and experience of suicide prevention, and to promote international and interdisciplinary collaboration in developing effective intervention programmes and innovation solutions. I look forward to continued joint efforts across ethnic, cultural and professional boundaries to prevent suicide. I wish this Conference every success and our many friends from overseas an enjoyable stay in Hong Kong. Address from the President of the IASP Professor Brian Mishara Director, Centre for Research and Intervention on Suicide and Euthanasia Professor, Psychology Department, University of Quebec, Montreal, Canada On behalf of the International Association for Suicide Prevention, I would like to invite you to participate in the 3rd Asia Pacific Regional Conference of the International Association for Suicide Prevention. The Conference theme: Suicide Research and Prevention in Times of Rapid Change in the Asia Pacific Region: Opportunities and Challenges, is of great importance, since sixty percent of the over one million suicides each year occur in Asia. Throughout the Asia Pacific Region, suicide has become a major disease burden in terms of economic loss and health costs. This Conference will provide an opportunity for practitioners and researchers to share experiences in effective suicide prevention strategies that are adapted to specific cultural contexts. It will provide a forum for academics, mental health professionals, crisis workers, volunteers and suicide survivors to identify promising new prevention and intervention methods and to encourage the development of effective and evidence-based preventive measures in Asian Pacific countries. This is a special opportunity for healthcare professionals, researchers, practitioners and policy planners to share the state of the art knowledge on best practices and to meet colleagues from the region who are concerned with suicide prevention. There will also be an opportunity for suicide survivors and persons concerned with postvention activities to share information on how to best reduce the tragic burden of suicide. Suicide can be prevented. However, successful prevention programmes involve the active participation of many people from different backgrounds. Please consider attending this important Regional Conference and sharing your experiences and wisdom with your colleagues. Address from the Conference Chairman Professor Paul S.F. Yip Director, The Hong Kong Jockey Club Centre for Suicide Research and Prevention, Faculty of Social Sciences, The University of Hong Kong Today as we face the scourge of rising suicides across Asia, the time for preventive action is now. That is why it is our great honour to welcome you to the 3rd Asia Pacific Regional Suicide Prevention Conference. Indeed, while countries in the Asia Pacific Region are experiencing rapid economic and political changes, suicide has become one of the most pressing yet most overlooked public health problems. Suicide is among the leading causes of death in many countries in this region and is the leading cause of death among young people. More than half of all suicides occur in this region with its large population size. The impact of effective suicide prevention strategies would be a significant reduction in the overall number of suicides. For that reason, this Conference is an important and timely opportunity for us to have more fruitful discussions on how to prevent suicides, taking into account the specific Asian and Pacific cultural contexts, and to do a better job overall in the life-saving business. We hope that this Conference will give birth to new, innovative ideas and joint collaborative efforts to combat the suicide epidemic for this region and globally. The Hong Kong Jockey Club Centre for Suicide Research and Prevention of The University of Hong Kong is honored to take part in this meaningful event which offers the potential to save lives not only in Hong Kong but also throughout the region and across the globe. Let us all work together to make a better world and to make a difference in suicide prevention. We look forward to meeting you for this special and important meeting in Hong Kong. Keynote Addresses Dr. Shigeru Omi, Regional Director for the Western Pacific, World Health Organization Shigeru Omi obtained his doctorate in molecular biology of the hepatitis B virus at the Jichi Medical School, Japan. He has served as Deputy Director in the Office of Medical Guidance and Inspection, Bureau of Health Insurance in the Ministry of Health and Welfare, Japan before joining WHO Western Pacific Regional Office in Manila, Philippines in 1989. In 1999, Dr. Omi assumed the position of WHO Regional Director for the Western Pacific. During the 1st term as Regional Director, he played the lead role in combating the outbreak of severe acute respiratory syndrome (SARS). He spearheaded efforts to contain SARS by both tackling the medical issues and addressing the sensitive political concerns inherent in such events. Dr. Omi was elected to a second term as Regional Director in 2004. Much of his work during this term has focused on working with WHO Member States and various partner agencies to avert a potential influenza pandemic of the A(H5N1) avian influenza virus which was detected in the Region. Professor Yueqin Huang, China Yueqin Huang is the Director of the National Center for Mental Health of China CDC and the Deputy Director of Institute of Mental Health, Peking University. She got MD, MPH and PhD from Peking University and started her medical career in the Institute of Mental Health, Peking University since 1987. During 1993 to 1995, she worked for the Department of Psychiatry and Human Behavioral Medicine of University of California, Irvine as a postdoctoral researcher. Since 1995, she has devoted to mental health and becomes a professor of psychiatric epidemiology. She is the principle investigator of a series of national and international research on mental health. She has published over 80 papers and is the Editor-in-Chief of 4 books. Since 2003, Professor Huang is also Honorary Professor of The University of Hong Kong. Professor Diego de Leo, Australia Diego de Leo is Professor of Psychiatry and Director of the Australian Institute for Suicide Research and Prevention at Griffith University, Brisbane; and the WHO Collaborating Centre for Research and Training in Suicide Prevention. He is Principal Adviser, WHO Global Network on Suicide Prevention, Past President of the International Association for Suicide Prevention and Past President of the International Academy for Suicide Research. He has served as a board member of the National Advisory Council for Suicide Prevention and is the Chair of the Advisory Committee to the Queensland Government on Suicide Strategy. He has developed 7 collaborative studies in association with the WHO, including the WHO/SUPRE-MISS (Suicide Prevention and Multisite Intervention Study on Suicide). Professor de Leo is member of the Editorial boards for several internationally renowned refereed journals and has published extensively with 160 refereed journal articles, 120 book chapters, 25 books published and over 100 conference presentations and has 6 international awards. Plenary 1 Professor Lakshmi Vijayakumar, India Lakshmi Vijayakumar is the Head Department of Psychiatry, Voluntary Health Services, Adyar. She is also the founder of SNEHA, an NGO in Chennai for the prevention of suicide. She was Vice President of the International Association for Suicide Prevention (IASP) for four years. She is a member of the WHO’s International Network for Suicide Research and Prevention and a member of the International Academy of Suicide Research. She has various publications and is the Editor of the book titled “Suicide Prevention – Meeting the challenge together” published by Orient Longman. Professor Michael Phillips, China Michael Phillips is the Executive Director of the Beijing Suicide Research and Prevention Center and Director of the WHO Collaborating Center for Research and Training in Suicide Prevention at Beijing Hui Long Guan Hospital. He is also Professor of Clinical Psychiatry and Clinical Epidemiology at Columbia University, advisor on mental health issues in China for the WHO, and the China Representative of the International Association for Suicide Prevention. Dr. Phillips is currently the Principal Investigator on a number of multi-center collaborative projects on suicide, depression and schizophrenia. Dr. Phillips runs a number of research training courses each year, supervises Chinese and foreign graduate students, helps coordinate WHO mental health activities in China, promotes increased awareness of the importance of addressing China’s huge suicide problem and advocates improving the quality, comprehensiveness and access to mental health services around the country. Ven Dr. Jing Yin, Hong Kong SAR Ven Jing Yin, PhD (London) is the Director of the Centre of Buddhist Studies and a Honorary Fellow of The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong. Ven Jing Yin specializes in Vinaya, Chinese Buddhism and applied Buddhism. He has been a monk for over 25 years with much experience in providing spiritual guidance to the dying and counseling to their relatives. Since he took up the current post six years ago, he has published eight books on Buddhist teachings. He is the Chief-Editor of Spiritual Journey to Tunhuangh by Commercial Press. Plenary 2 Professor Eric Chen, Hong Kong SAR Eric Chen is Professor at the Department of Psychiatry and Associate Director of The Hong Kong Jockey Club Center for Suicide Research and Prevention in The University of Hong Kong. His researches focus on neurocognitive functions in schizophrenia and outcome in early psychosis, and suicide studies. He is one of the leading experts in developing the early intervention for psychosis program, EASY and coordinating the development of the Asian Network for Early Psychosis (ANEP). Dr. Chen has published extensively in many international journals. He has been acting as a reviewer for journals such as Biological Psychiatry, British Journal of Psychiatry, and Psychological Medicine etc. Dr. Chen has hold Visiting Professorship and Research Fellowships at Harvard Medical School and is co-leading a Harvard international collaborative study on pathway to care in psychosis. He is currently Vice-President of the International Early Psychosis Association and has been serving on the Editorial Board for Schizophrenia Research. Muhammad Shahid , Pakistan Muhammad Shahid, MBBS, MPH, MSc, MCPS, FCPS, is John F. Finklea Fellow of Johns Hopkins ¡V Aga Khan University International Collaborative Trauma & Injury Research Training Program, and is Consultant Emergency Physician at Aga Khan University Karachi, Pakistan. He is a graduate of Dow Medical College, Karachi, 1996 and is Member and Fellow of College of Physicians and Surgeons Pakistan. He has got Master of Public Health from Johns Hopkins Bloomberg School of Public Health USA in 2007. He is the first resident trained in Emergency Medicine in Pakistan. His research interests include deliberate self harm, mental disorders and intentional injury prevention in low income countries. Dr Shahid is a Secretary of Pakistan Society of Emergency Medicine and a member of IASP. He is the Principal investigator of ¡§Characteristics of deliberate self harm in Emergency Departments ¡V a case control study from Pakistan¡¨ funded by Johns Hopkins ¡V Aga Khan University International Collaborative Trauma & Injury Research Training Program. Dr. Chiyi Hu, China Chiyi Hu, M.D. is the Deputy Head, Professor and Senior Consultant Psychiatrist of the Shenzhen Institute of Mental Health (SIMH, or Shenzhen Kangning Hospital), the teaching hospital of the Jinan University, and the Head of Medical Psychology & Psychotherapy Research Section, SIMH. He is an Associate Editor-in-Chief of the Chinese Journal of Nervous & Mental Diseases. He is also a registered clinical psychologist and supervisor of the Chinese Psychological Society, and the Deputy Head and General Secretary of the Shenzhen Mental Health Association, People’s Republic of China. His research interests include: suicide prevention, migration and mental health, mood disorders and anxiety disorders and family therapy. Plenary 3 Professor Keith Hawton, United Kingdom Keith Hawton is the Director of the Centre for Suicide Research at Oxford University Department of Psychiatry and Consultant Psychiatrist at the Warneford Hospital in Oxford. For thirty years he and his research group have been conducting investigations concerning the epidemiology, causes, treatment, prevention and outcome of suicidal behaviour. He has received the Stengel Research Award from the International Association for Suicide Prevention (1995), the Dublin Career Research Award from the American Association of Suicidology (2000), and the Research Award of the American Foundation for Suicide Prevention (2002). He has published more than 400 papers and chapters, and several books. He is co-editor of The International Handbook of Suicide and Attempted Suicide (2000, Wiley), Editor of Prevention and Treatment of Suicidal Behaviour: From Science to Practice (2005, Oxford University Press), and co-author of By Their Own Young Hand: Deliberate Self Harm and Suicidal Ideas in Adolescents (2006, Jessica Kingsley Publishers). Professor Paul S.F. Yip, Hong Kong SAR Paul Yip is the Director of The Hong Kong Jockey Club Centre for Suicide Research and Prevention of The University of Hong Kong. He is a national representative of the International Association of Suicide Prevention, a board member of Suicide Prevention Services and a consultant for the Beijing Suicide Research and Prevention Center. His research interests are in population health and has published 200 academic papers on topics of suicide prevention, population health and innovative statistical methods with application to Social and Medical Sciences. He is an Associate Editor of the Suicide and Life Threatening Behavior. Mrs. Lakshmi Ratnayeke, Sri Lanka Lakshmi Ratnayeke is the Director of the Rural Programme, Sri Lanka Sumithrayo. She has been a volunteer working in the field of Suicide Prevention for the last 30 years. She initiated a unique suicide prevention programme in some of the most suicide prone remote rural areas in her country and has been working with these economically depressed communities for the last 12 years. She was the recipient of the Ringel Service Award in 2007 for her innovative work among the suicide prone in Sri Lanka. Plenary 4 Professor Brian Mishara, Canada Brian Mishara is Professor of Psychology and Director of the Centre for Research and Intervention on Suicide and Euthanasia (CRISE) at the University of Quebec at Montreal. He is currently the President of the International Association for Suicide Prevention. His publications, including six books in English and five in French in the areas of suicidology and gerontology, include research on the effectiveness of suicide prevention programmes, studies of how children develop an understanding of suicide, theories of the development of suicidality, ethical issues in research, euthanasia and “assisted suicide,” and evaluations of helpline effectiveness. Besides his university activities, Professor Mishara was a founder of Suicide Action Montreal, the Montreal regional suicide prevention centre and the Quebec Association of Suicidology. He was a past President of the Canadian Association for Suicide Prevention. Dr. Morton Silverman, USA Morton M. Silverman, M.D., currently is the Senior Advisor to the National Suicide Prevention Technical Resource Center (SPRC). From 1987-2002, he was an Associate Professor of Psychiatry, Associate Dean of Students in the University, and Director of the Student Counseling and Resource Service, all at the University of Chicago. He currently is a Clinical Associate Professor of Psychiatry at the University of Chicago. He served as the Senior Scientific Editor and Writer for the U.S.National Strategy for Suicide Prevention: Goals and Objectives for Action (2001). Since 1996, he has been the Editor-in-Chief of Suicide and Life-Threatening Behaviour, the scientific journal of the American Association of Suicidology. In 2002 he became a member (elected) of the American Foundation for Suicide Prevention’s (AFSP) Scientific Council. Dr. Silverman is a Distinguished Fellow of the American Psychiatric Association. He is the co-author or author of over 30 peer-reviewed publications, and over 25 book and monograph chapters on the topics of college student mental health, disease prevention, health promotion, alcohol and other drug abuse, suicide, and standards of care. He is the co-editor or co-author of 5 books on topics related to the field of suicidology, including The Comprehensive Textbook of Suicidology (2000), and Adolescent Suicide: Assessment and Intervention (2006). He is the 2005 recipient of the Louis I. Dublin Award from the American Association of Suicidology, for “outstanding service and contributions to the field of suicide prevention as evidenced by leadership, devotion and creativity”. Plenary 5 Professor Andrew Cheng, Taiwan Andrew Cheng is a full-time research psychiatrist with a main interest in epidemiology of mental disorders. He is the immediate past President of the International Federation of Psychiatric Epidemiology. He conducted the first psychological autopsy study of suicides in a non-western society, which has revealed a broadly similar profile of psychiatric and psychosocial antecedents for suicides in Taiwan as compared to previous work in the West. He developed a national suicide prevention strategy for Taiwan in 2004. Recently, he has completed three studies in suicides, suicide attempters and depressive patients respectively to examine the influence of media coverage of a celebrity suicide on subsequent suicidal behavior in Taiwan. Dr. Annette Beautrais, New Zealand Annette Beautrais is the Principal Investigator with the Canterbury Suicide Project at the University of Otago, Christchurch, New Zealand. Her research interests include epidemiology, psychological autopsy, longitudinal studies, developing interventions, means restriction, postvention and translational research. Beautrais has conducted studies and published a number of papers in these areas. She works collaboratively with a number of international suicide research and prevention centres, including those in Hong Kong and China. Dr. Beautrais is a past Vice-President, and the current General Secretary, of the International Association for Suicide Prevention, and Co-Editor-in-Chief of CRISIS, the journal of the International Association for Suicide Prevention. Professor Yoshitomo Takahashi, Japan Dr. Takahashi received his M.D. from Kanazawa University School of Medicine in 1979 and finished psychiatric residency at Department of Neuropsychiatry, Tokyo Medical and Dental University in 1981. He was given an opportunity by Fulbright Commission to study suicide prevention programs under Professor Edwin Shneidman’s guidance at Neuropsychiatric Institute, University of California Los Angeles from 1987 to 1988. His present title is Professor, Division of Behavioral Sciences, National Defense Medical College Research Institute. He has visited the Philippines, Fiji, Micronesia, and Kiribati as the World Health Organization Short-term Consultant in mental health. He has treated suicidal persons, supervised, taught, and served as a consultant to mental health professionals. In addition, he has conducted seminars and workshops on suicide prevention and published 24 monographs, about 300 articles and 140 book chapters on suicide and related psychopathology for mental health professionals and the public in Japan. Plenary 6 Professor Kees van Heeringen, Belgium Kees van Heeringen, MD PhD is Professor of Psychiatry, Head of the University Department of Psychiatry, Director of the Unit for Suicide Research, and Chair of the Division of Psychiatry and Medical Psychology at the Faculty of Medicine and Health Sciences at the University of Ghent. He is Vice-President of the International Association for Suicide Prevention. His main research interests are the epidemiology of suicidal behavior and (the interaction between) trait-dependent biological and psychological risk factors for suicidal behavior, through integrating psychiatric, cognitive psychological, neuropsychological and functional neuro-imaging approaches to the study of the predisposition to suicidal behavior. He has published more than 100 scientific papers and 7 books on suicidal behavior, including The International Handbook of Suicide and Attempted Suicide and Understanding Suicidal Behavior: the Suicidal Process Approach to Research, Treatment and Prevention, both published by Wiley. Dr. Jerry Reed, USA Jerry Reed , PhD, MSW serves as Executive Director of the Suicide Prevention Action Network USA (SPAN USA). Prior to this position, Jerry served as an independent consultant working on health care, mental health, geriatric and suicide prevention issues. He worked on a variety of initiatives in support of the U.S. National Suicide Prevention Strategy and also served as project liaison with the three-year national Hotline Linkage and Evaluation Project (HELP) and the national Suicide Prevention Resource Center (SPRC). S elected as a Congressional Fellow in 1996, he worked in the Office of Senator Harry Reid ( Nevada) serving as senior advisor on health care, mental health, suicide prevention and aging issues. He also worked with the U.S. Senate and completed his assignment in 1999 as Deputy Chief of Staff for Senator Reid. Jerry received his Ph.D. in Health Related Sciences with an emphasis in Gerontology at the Virginia Commonwealth University in 2007. His research interests are crude suicide rate variation and suicide and mental health issues on behalf of older adults. Copyright 2008. All Rights Reserved. Home Photo Album Programme Guide Abstract Book Acknowledgement Scheme for Good Practices of Suicide Prevention in the Asia Pacific Region International Scientific Committee & Organizing Committee Other InformationHong Kong – Arrival Guide
Konrad Talbot
Department of Psychiatry
University of Pennsylvania School of Medicine
Translational Research Laboratories
Room 2210
125 South 31st Street
Philadelphia, PA 19104-3403
Fax: (215) 573-2041
talbotk2@mail.med.upenn.edu
CNB faculty website
A.B. (Psychology)
UCLA, 1972.
M.A. (Psychology)
UCLA, 1976.
PhD (Behavioral Neuroscience)
UCLA, 1989.
Description of Research Expertise
Anatomical and molecular analyses of mammalian neuronal systems, quantitative microscopy, postmortem immunohistochemical and biochemical studies, insulin signaling in Alzheimer disease, dysbindin abnormalities in schizophrenia, and correlative molecular and behavioral studies on animal models of genetic factors in schizophrenia.
Selected Publications
Fairless, A.H., Dow, H.C., Toledo, M.M., Malkus, K.A., Edelmann, M., Talbot, K., Arnold, S.E., and Brodkin, E.S.: Low sociability is associated with reduced size of the corpus callosum in the BALB/cJ inbred mouse strain. Brain Research 1230: 211-217, September 2008.
Talbot, K., Cho, D.-S., Ong, W.-Y., Benson, M.A., Han, L.-Y., Kazi, H.A., Hahn, C.-G., Blake, D.J., and Arnold, S.E.: Dysbindin-1 is a synaptic and microtubular protein that binds brain snapin. Human Molecular Genetics 15(20): 3041-3054, October 2006.
Hahn, C.-G., Wang, H.-Y., Cho, D.-S., Talbot, K., Gur, R.E., Berrettini, W.H., Bakshi, K., Kamins, J., Borgmann-Winter, K.E., Siegel, S.J., and Arnold, S.E.: Altered neuregulin 1-erbB4 signaling contributes to NMDA receptor hypofunction in schizophrenia. Nature Medicine 12(7): 824-828, June 2006.
Arnold, S.E., Talbot, K., and Hahn, C.-G: Neurodevelopment, neuroplasticity, and new genes for schizophrenia. Progress in Brain Research 147: 319-345, April 2005.
Talbot, K., Eidem, W., Tinsley, C.L., Benson, M.A., Thompson, E.W., Smith, R.J., Hahn, C.-G., Siegel, S.J., Trojanowski, J.Q., Gur, R.E., Blake, D.J., and Arnold, S.E.: Dysbindin-1 is reduced in intrinsic, glutamatergic terminals of the hippocampal formation in schizophrenia. Journal of Clinical Investigation 113(9): 1353-1363, March 2004.
Uryu, K., Giasson, B.I., Longhi, L., Martinez, D., Murray, I., Conte, V., Nakamura, M., Saatman, K., Talbot, K., Horiguchi, T., McIntosh, T., Lee, V. M.-Y., and Trojanowski, J.Q.: Age dependent synuclein pathology following traumatic brain injury in mice. Experimental Neurology 184(1): 214-224, November 2003.
Talbot, K. and Arnold, S.A.: The parahippocampal region in schizophrenia. The Parahippocampal Region, Organization and Role in Cognitive Function. M. Witter and F. Wouterlood (eds.). Oxford University Press, Page: 297-320, November 2002 Notes: Book chapter.
Talbot, K. Young, R.A., Jolly-Tornetta, C., Lee, V. M.-Y., Trojanowski, J.Q., and Wolf, B.A. : A frontal variant of Alzheimer’s disease exhibits decreased calcium-independent phospholipase A2 activity in the prefrontal cortex. Neurochemistry International 37(1): 17-31, July 2000.
Young, R.A., Talbot, K., Gao, Z.-Y., Trojanowski, J.Q., and Wolf, B.A. : Phospholipase pathway in Alzheimer’s disease brains: decrease in Gαi in dorsolateral prefrontal cortex. Molecular Brain Research 66(1-2): 188-190, March 1999.
Monnica T. Williams
Description of Research Expertise
Dr. Williams’ scholarly publications include scientific articles on racial and ethnic differences in the assessment of obsessive-compulsive anxiety. Her clinical work at CTSA is focused on anxiety disorders in adults, with an emphasis on obsessive-compulsive disorder and post-traumatic stress disorder.
Research Interests:
Obsessive-Compulsive Disorder and Related Disorders
Racial/Ethnic Differences in Anxiety
The Internet as a Research Tool and Intervention
Psychometrics and Survey Research
Women’s Mental Health & Sexual Issues
Description of Clinical Expertise
Monnica T. Williams, Ph.D., joins the University of Pennsylvania School of Medicine as an Assistant Professor of Clinical Psychology in Psychiatry at the Center for the Treatment and Study of Anxiety.
Prior to joining the University of Pennsylvania faculty, Dr. Williams completed her undergraduate studies at MIT and UCLA. She received her Master’s and Doctoral Degrees in clinical psychology from the University of Virginia, where she conducted research in the areas of psychopathology, psychometrics, and ethnic differences. Dr. Williams completed her clinical internship at McGill University Health Centre, Montreal General Hospital Site, where she trained in emergency psychiatric assessment, sexual identity issues, mood disorders, and outpatient care.
Selected Publications
Williams, M., Powers, M., Yun, Y. G., Foa, E. B.: Minority representation in clinical trials for obsessive-compulsive disorder. Journal of Anxiety Disorders 24: 171-177, 2010.
Foa, E., Williams, M.T.: Methodology of a Randomized Double-Blind Clinical Trial for Comorbid Post-Traumatic Stress Disorder and Alcohol Dependence. Mental Health and Substance Abuse: Dual Diagnosis 3(2), June 2010.
Williams, M., Cahill, S., Foa, E.: Psychotherapy for Post-Traumatic Stress Disorder. Textbook of Anxiety Disorders, Second Edition. D. Stein, E. Hollander, B. Rothbaum (eds.). American Psychiatric Publishing, 2010.
M. T. Williams, E. Turkheimer, E. Magee, T. Guterbock: The Effects of Race and Racial Priming on Self-Report of Contamination Anxiety. Personality and Individual Differences 44(3): 744-755, 2008.
M. Williams, E. Turkheimer: The Effects of Interviewer Race on Anxiety in African Americans. Leading-Edge Health Education Issues. L. V. Sebeki (eds.). Nova Publishers, 2008.
M. Williams: Homosexuality Anxiety: A Misunderstood Form of OCD. Leading-Edge Health Education Issues. L. V. Sebeki (eds.). Nova Publishers, 2008.
R. Sposato, N. Jayawickreme, M. Williams, E. B. Foa. : Gender Differences in Depressive Symptomology Among Patients Treated for Comorbid PTSD and Alcohol Dependence. 42nd Convention of the Association of Behavioral & Cognitive Therapies, Orlando, FL November 2008.
M. T. Williams, E. Turkheimer: Identification and Explanation of Racial Differences in Contamination Anxiety. Behavior Research and Therapy 45(12): 3041–3050, Dec 2007.
M. T. Williams, L. Bonner: Sex Education Attitudes and Outcomes Among North American Women. Adolescence 41(161): 1-14, Spring 2006.
M. Williams, G.B. Saathoff, T. Guterbock, A. MacIntosh, R. Bebel: Community Shielding in the National Capital Region: A Survey of Citizen Response to Potential Critical Incidents. Center for Survey Research, University of Virginia. Prepared for the US Department of Homeland Security, June 2005.
M. T. Williams, E. Turkheimer, K. Schmidt, T. Oltmanns: Ethnic Identification Biases Responses to the Padua Inventory for Obsessive-Compulsive Disorder. Assessment 12(2): 174-185, 2005.
Russell Ramsay Adult ADHD
Description of Research Expertise
Adult ADHD, particularly adjunctive psychosocial treatments
Description of Clinical Expertise
Adult ADHD (assessment and treatment), adult asperger’s/autistic spectrum disorders, depression, anxiety, bipolar disorder, borderline personality disorder
Selected Publications
Ramsay, J. R., & Rostain, A. L.: Cognitive behavioral therapy for adult ADHD: An integrative psychosocial and medical approach. New York: Routledge, 2008.
Weiss, M. D., Safren, S. A., Solanto, M., Hechtman, L., Rostain, A. L., Ramsay, J. R., & Murray, C.: Research forum on psychosocial treatment of adults with ADHD. Journal of Attention Disorders 11: 642-651, 2008.
Ramsay, J. R., & Rostain, A. L. : Psychosocial treatments for attention-deficit hyperactivity disorder in adults: Current evidence and future directions. Professional Psychology: Research and Practice 38: 338-346, 2007.
Ramsay, J. R.: Current status of cognitive-behavioral therapy as a psychosocial treatment for adult attention-deficit/hyperactivity disorder. Current Psychiatry Reports 9: 427-433, 2007.
Rostain, A. L., & Ramsay, J. R. : A combined treatment approach for adults with attention-deficit/hyperactivity disorder: Results of an open study of 43 patients. Journal of Attention Disorders 10: 150-159, 2006.
Ramsay, J. R., & Rostain, A. L.: Adapting psychotherapy to meet the needs of adults with attention-deficit/hyperactivity disorder. Psychotherapy: Theory, Research, Practice, Training 42: 72-84, 2005.
Ramsay, J. R., & Rostain, A. L. : A cognitive therapy approach for adult attention-deficit/hyperactivity disorder. Journal of Cognitive Psychotherapy: An International Quarterly 17(4): 319-334, 2003.
Ramsay, J. R., Brodkin, E., Cohen, M. R., Ekman, E., Listerud, J., & Rostain, A. L.: Better strangers: Using the relationship in psychotherapy for adults with asperger syndrome. Psychotherapy: Theory, Research, Practice, Training 42: 483-493, 2005.
Ramsay, J. R., & Rostain, A. L.: Cognitive behavior therapy for college students with attention-deficit/hyperactivity disorder. Journal of College Student Psychotherapy 21(1): 3-20, 2006.
Rostain, A. L., & Ramsay, J. R. : Adult with ADHD? Try medication + psychotherapy. Current Psychiatry 5(2): 13-16, 21-24, 27, 2006.
J. Russell Ramsay
Philadelphia, PA 19104-3309
Fax: 2158981865
ramsay@mail.med.upenn.edu
B.A. (psychology)
University of Miami, 1988.
M.S. (clinical psychology)
Pacific Graduate School of Psychology, 1994.
Ph.D. (clinical psychology)
Pacific Graduate School fo Psychology, 1995.
David W. Oslin
Geriatric and Addiction Psychiatry
Treatment Research Center
3900 Chestnut Street
Philadelphia, PA 19104
Fax: 2158234123
OSLIN@UPENN.EDU
B.S. (Biology major, Mathematics minor)
College of William and Mary, Williamsburg, VA, 1985.
M.D.
University of Virginia, 1989.
University of Richmond, Richmond, VA, 1991.
Description of Research Expertise
Geriatric and Addiction Psychiatry
Description of Clinical Expertise
Geriatric and Addiction Psychiatry, Veterans Behavioral Health
Selected Publications
Lohoff, Falk W. Bloch, Paul J. Hodge, Rachel. Nall, Aleksandra H. Ferraro, Thomas N. Kampman, Kyle M. Dackis, Charles A. O’Brien, Charles P. Pettinati, Helen M. Oslin, David W.: Association analysis between polymorphisms in the dopamine D2 receptor (DRD2) and dopamine transporter (DAT1) genes with cocaine dependence. Neuroscience Letters 473(2): 87-91, Apr 5 2010.
Plebani, Jennifer G. Tirado, Carlos F. Pettinati, Helen M. Kampman, Kyle M. Volpicelli, Joseph R. Oslin, David W.: Combined effects of alcohol and hepatitis C: a secondary analysis of alcohol use biomarkers and high-risk behaviors from two medication trials for alcohol dependence. Addictive Behaviors 35(2): 123-8, Feb 2010.
Ray, Lara A. Oslin, David W.: Naltrexone for the treatment of alcohol dependence among African Americans: results from the COMBINE Study. Drug & Alcohol Dependence 105(3): 256-8, Dec 1 2009.
Bloch, Paul J. Nall, Aleksandra H. Weller, Andrew E. Ferraro, Thomas N. Berrettini, Wade H. Kampman, Kyle M. Pettinati, Helen M. Dackis, Charles A. O’Brien, Charles P. Oslin, David W. Lohoff, Falk W.: Association analysis between polymorphisms in the dopamine D3 receptor (DRD3) gene and cocaine dependence. Psychiatric Genetics 19(5): 275-6, Oct 2009.
Oslin, David W. Cary, Mark. Slaymaker, Valarie. Colleran, Carol. Blow, Frederic C.: Daily ratings measures of alcohol craving during an inpatient stay define subtypes of alcohol addiction that predict subsequent risk for resumption of drinking. Drug & Alcohol Dependence 103(3): 131-6, Aug 1 2009.
Alexopoulos, George S. Reynolds, Charles F 3rd. Bruce, Martha L. Katz, Ira R. Raue, Patrick J. Mulsant, Benoit H. Oslin, David W. Ten Have, Thomas. PROSPECT Group.: Reducing suicidal ideation and depression in older primary care patients: 24-month outcomes of the PROSPECT study.[see comment]. American Journal of Psychiatry 166(8): 882-90, Aug 2009.
Kampman, Kyle M. Pettinati, Helen M. Lynch, Kevin G. Xie, Hu. Dackis, Charles. Oslin, David W. Sparkman, Thorne. Sharkoski, Tiffany. O’Brien, Charles P.: Initiating acamprosate within-detoxification versus post-detoxification in the treatment of alcohol dependence. Addictive Behaviors 34(6-7): 581-6, Jun-Jul 2009.
Mavandadi, Shahrzad. Zanjani, Faika. Ten Have, Thomas R. Oslin, David W.: Psychological well-being among individuals aging with HIV: the value of social relationships. Journal of Acquired Immune Deficiency Syndromes: JAIDS 51(1): 91-8, May 1 2009.
Becker, William C. Fiellin, David A. Gallagher, Rollin M. Barth, Kelly S. Ross, Jennifer T. Oslin, David W.: The association between chronic pain and prescription drug abuse in Veterans. Pain Medicine 10(3): 531-6, Apr 2009.
Lohoff, Falk W. Bloch, Paul J. Ferraro, Thomas N. Berrettini, Wade H. Pettinati, Helen M. Dackis, Charles A. O’Brien, Charles P. Kampman, Kyle M. Oslin, David W.: Association analysis between polymorphisms in the conserved dopamine neurotrophic factor (CDNF) gene and cocaine dependence. Neuroscience Letters 453(3): 199-203, Apr 10 2009.
Wisniewski SR
Professor Department of Epidemiology Co-Director, Epidemiology Data Center Secondary Appointment: Psychiatry Associate Dean for Research Graduate School of Public Health 127 Parran Hall University of Pittsburgh Pittsburgh, PA 15261 Voice: 412-624-5218 Fax: 412-624-3775 E-mail: wisniew@edc.pitt.edu
|
 |
|
Daniel Weintraub
Section of Geriatric Psychiatry
3535 Market Street
Suite 3003
Philadelphia, PA 19104
weintrau@mail.med.upenn.edu
B.A. (History)
University of North Carolina, 1985.
M.D.
University of Maryland, 1991
Description of Research Expertise
Parkinson’s disease;Alzheimer’s disease; late life mental disorders; depression; dementia; mild cognitive impairment; impulse control disorders; psychosis
Selected Publications
Weintraub D., Newberg AB., Cary MS., Siderowf AD., Moberg PJ., Kleiner-Fisman G., Duda JE., Stern MB., Mozley D., Katz IR.: Striatal dopamine transporter imaging correlates with anxiety and depression symptoms in Parkinson’s disease. Journal of Nuclear Medicine 46(2): 227-32, Feb 2005.
Culbertson WC, Moberg PJ, Duda JE, Stern MB, Weintraub D: Assessing the executive function deficits of patients with Parkinson’s disease: utility of the Tower of London-Drexel. Assessment 11: 27-39, 2004.
Weintraub D: Diagnosing and treating depression in patients with Parkinson’s disease Psychiatric Annals 34: 299-304, 2004.
Weintraub D, Moberg PJ, Duda JE, Katz IR, Stern MB: Effect of psychiatric and other nonmotor symptoms on disability in Parkinson’s disease Journal of the American Geriatrics Society 52: 784-788, 2004.
Weintraub D., Moberg PJ., Culbertson WC., Duda JE., Stern MB.: Evidence for impaired encoding and retrieval memory profiles in Parkinson disease. Cognitive & Behavioral Neurology 17(4): 195-200, Dec 2004.
Weintraub D., Moberg PJ., Duda JE., Katz IR., Stern MB.: Effect of psychiatric and other nonmotor symptoms on disability in Parkinson’s disease. Journal of the American Geriatrics Society 52(5): 784-8, May 2004.
Culbertson WC., Moberg PJ., Duda JE., Stern MB., Weintraub D.: Assessing the executive function deficits of patients with Parkinson’s disease: utility of the Tower of London-Drexel. Assessment 11(1): 27-39, Mar 2004.
Weintraub D, Streim JE, Datto CJ, Katz IR, DiFilippo SD, Oslin DW: Effect of increasing the dose and duration of sertraline trial in the treatment of depressed nursing home residents. Journal of Geriatric Psychiatry and Neurology 16: 109-111, 2003.
Oslin DW, Ten Have TR, Streim JE, Datto CJ, Weintraub D, DiFilippo S, Katz IR: Probing the safety of medications in the frail elderly: evidence from a randomized clinical trial of sertraline and venlafaxine in depressed nursing home residents. Journal of Clinical Psychiatry 64: 875-882, 2003.
Weintraub D, Moberg PJ, Duda JE, Katz IR, Stern MB: Recognition and treatment of depression in Parkinson’s disease. Journal of Geriatric Psychiatry and Neurology 16: 178-183, 2003.
Michael Edward Thase
Selected Publications
Nierenberg AA., Fava M., Trivedi MH., Wisniewski SR., Thase ME., McGrath PJ., Alpert JE., Warden D., Luther JF., Niederehe G., Lebowitz B., Shores-Wilson K., Rush AJ.: A comparison of lithium and T(3) augmentation following two failed medication treatments for depression: a STAR*D report.[see comment] American Journal of Psychiatry 163(9): 1519-30; quiz 1665, Sep 2006.
Brown C., Battista DR., Sereika SM., Bruehlman RD., Dunbar-Jacob J., Thase ME.: How can you improve antidepressant adherence? Journal of Family Practice 56(5): 356-63, May 2007.
Rush AJ., Kraemer HC., Sackeim HA., Fava M., Trivedi MH., Frank E., Ninan PT., Thase ME., Gelenberg AJ., Kupfer DJ., Regier DA., Rosenbaum JF., Ray O., Schatzberg AF., ACNP Task Force.: Report by the ACNP Task Force on response and remission in major depressive disorder. [Review] [138 refs] Neuropsychopharmacology 31(9): 1841-53, Sep 2006.
Najavits LM., Harned MS., Gallop RJ., Butler SF., Barber JP., Thase ME., Crits-Christoph P.: Six-month treatment outcomes of cocaine-dependent patients with and without PTSD in a multisite national trial. Journal of Studies on Alcohol 68(3): 353-61, May 2007.
Thase ME., Friedman ES., Biggs MM., Wisniewski SR., Trivedi MH., Luther JF., Fava M., Nierenberg AA., McGrath PJ., Warden D., Niederehe G., Hollon SD., Rush AJ.: Cognitive therapy versus medication in augmentation and switch strategies as second-step treatments: a STAR*D report. American Journal of Psychiatry 164(5): 739-52, May 2007.
Wisniewski SR., Fava M., Trivedi MH., Thase ME., Warden D., Niederehe G., Friedman ES., Biggs MM., Sackeim HA., Shores-Wilson K., McGrath PJ., Lavori PW., Miyahara S., Rush AJ.: Acceptability of second-step treatments to depressed outpatients: a STAR*D report. American Journal of Psychiatry 164(5): 753-60, May 2007.
Miklowitz DJ., Otto MW., Frank E., Reilly-Harrington NA., Wisniewski SR., Kogan JN., Nierenberg AA., Calabrese JR., Marangell LB., Gyulai L., Araga M., Gonzalez JM., Shirley ER., Thase ME., Sachs GS.: Psychosocial treatments for bipolar depression: a 1-year randomized trial from the Systematic Treatment Enhancement Program. Archives of General Psychiatry 64(4): 419-26, Apr 2007.
Nemeroff CB., Thase ME., EPIC 014 Study Group.: A double-blind, placebo-controlled comparison of venlafaxine and fluoxetine treatment in depressed outpatients. Journal of Psychiatric Research 41(3-4): 351-9, Apr-Jun 2007.
Sachs GS., Nierenberg AA., Calabrese JR., Marangell LB., Wisniewski SR., Gyulai L., Friedman ES., Bowden CL., Fossey MD., Ostacher MJ., Ketter TA., Patel J., Hauser P., Rapport D., Martinez JM., Allen MH., Miklowitz DJ., Otto MW., Dennehy EB., Thase ME.: Effectiveness of adjunctive antidepressant treatment for bipolar depression.[see comment] New England Journal of Medicine 356(17): 1711-22, Apr 26 2007.
Stewart JW., Thase ME.: Treating DSM-IV depression with atypical features. [Review] [16 refs] Journal of Clinical Psychiatry 68(4): e10, Apr 2007.
Grant MM., Friedman ES., Haskett RF., Riso LP., Thase ME.: Urinary free cortisol levels among depressed men and women: differential relationships to age and symptom severity? Archives of Women’s Mental Health 10(2): 73-8, 2007.
Thase ME., Corya SA., Osuntokun O., Case M., Henley DB., Sanger TM., Watson SB., Dube S.: A randomized, double-blind comparison of olanzapine/fluoxetine combination, olanzapine, and fluoxetine in treatment-resistant major depressive disorder. Journal of Clinical Psychiatry 68(2): 224-36, Feb 2007.
Rapaport MH., Thase ME.: Translating the evidence on atypical depression into clinical practice. [Review] [29 refs] Journal of Clinical Psychiatry 68(4): e11, Apr 2007.
Rush AJ., Trivedi MH., Wisniewski SR., Nierenberg AA., Stewart JW., Warden D., Niederehe G., Thase ME., Lavori PW., Lebowitz BD., McGrath PJ., Rosenbaum JF., Sackeim HA., Kupfer DJ., Luther J., Fava M.: Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. American Journal of Psychiatry 163(11): 1905-17, Nov 2006.
Thase ME.: Bipolar depression: diagnostic and treatment considerations. [Review] [108 refs] Development & Psychopathology 18(4): 1213-30, 2006.
Siegle GJ., Thompson W., Carter CS., Steinhauer SR., Thase ME.: Increased amygdala and decreased dorsolateral prefrontal BOLD responses in unipolar depression: related and independent features. Biological Psychiatry 61(2): 198-209, Jan 15 2007.
Mood and Anxiety Disorders Treatment and Research Program
3535 Market Street
Suite 670
Philadelphia, PA 19104-3309
Fax: 215-573-0759
thase@mail.med.upenn.edu
B.A. (Psychology)
Wright State University, Dayton, OH, 1975.
M.D. (Medicine)
Ohio State University College of Medicine, Columbus, OH, 1979
Psychotherapy1bjp
Abstract 1 of 64
Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial
Stephan Doering, MD
Department of Prosthodontics and Material Sciences, Department of Psychosomatics and Psychotherapy, University of Muenster, Germany, and Department of Medical Psychology and Psychotherapy, Medical University Innsbruck, Austria
Susanne Hörz, PhD
Department of Psychiatry and Psychotherapy, Technical University Munich and Department of Psychology, University of Munich, Germany
Michael Rentrop, MD
Department of Psychiatry and Psychotherapy, Technical University Munich, Germany
Melitta Fischer-Kern, MD and Peter Schuster, MD
Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Austria
Cord Benecke, PhD and Anna Buchheim, PhD
Department of Clinical Psychology, University of Innsbruck, Austria
Philipp Martius, MD
Department of Psychiatry and Psychotherapy, Technical University Munich, and Klinik Höhenried gGmbH, Bernried, Germany
Peter Buchheim, MD
Department of Psychiatry and Psychotherapy, Technical University Munich, Germany
Correspondence: Correspondence: Stephan Doering, MD, Psychosomatics in Dentistry, Department of Prosthodontics and Material Sciences, University of Muenster, Waldeyerstrasse 30 48149 Muenster, Germany. Email: Stephan.doering{at}ukmuenster.de
Declaration of interest
None.
Background
Transference-focused psychotherapy is a manualised treatment for borderline personality disorder.
Aims
To compare transference-focused psychotherapy with treatment by experienced community psychotherapists.
Method
In a randomised controlled trial (NCT00714311) 104 female out-patients were treated for 1 year with either transference-focused psychotherapy or by an experienced community psychotherapist.
Results
Significantly fewer participants dropped out of the transference-focused psychotherapy group (38.5% v. 67.3%) and also significantly fewer attempted suicide (d = 0.8, P = 0.009). Transference-focused psychotherapy was significantly superior in the domains of borderline symptomatology (d = 1.6, P = 0.001), psychosocial functioning (d = 1.0, P = 0.002), personality organisation (d = 1.0, P = 0.001) and psychiatric in-patient admissions (d = 0.5, P = 0.001). Both groups improved significantly in the domains of depression and anxiety and the transference-focused psychotherapy group in general psychopathology, all without significant group differences (d = 0.3–0.5). Self-harming behaviour did not change in either group.
Conclusions
Transference-focused psychotherapy is more efficacious than treatment by experienced community psychotherapists in the domains of borderline symptomatology, psychosocial functioning, and personality organisation. Moreover, there is preliminary evidence for a superiority in the reduction of suicidality and need for psychiatric in-patient treatment.
[ Full Text of Doering et al.] [Reprint (PDF) Version of Doering et al.]
——————————————————————————–
Abstract 2 of 64
Cost-effectiveness of psychotherapy for cluster B personality disorders
Djøra I. Soeteman, MSc
Department of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, and Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands
Roel Verheul, PhD
Department of Clinical Psychology, University of Amsterdam, and VISPD, Halsteren, The Netherlands
Jos Delimon, MA
VISPD, Halsteren, The Netherlands
Anke M. M. A. Meerman, MA
Center of Psychotherapy De Gelderse Roos, Lunteren, The Netherlands
Ellen van den Eijnden, MA
Center of Psychotherapy Arkin, Amsterdam, The Netherlands
Bert V. Rossum, MA
Altrecht, Utrecht, The Netherlands
Uli Ziegler, MD
Medical Center Zaandam, Zaandam, The Netherlands
Moniek Thunnissen, PhD
GGZWNB, Bergen op Zoom, The Netherlands
Jan J.V. Busschbach, PhD
Department of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, and VISPD, Halsteren, The Netherlands
Jane J. Kim, PhD
Center for Health Decision Science, Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, USA
Correspondence: Correspondence: Djøra Soeteman, Viersprong Institute for Studies on Personality Disorders, P.O. Box 7, 4660 AA Halsteren, The Netherlands. Email: Djora.Soeteman{at}deviersprong.nl
Declaration of interest
None.
Background
Recommendations on current clinical guidelines are informed by limited economic evidence.
Aims
A formal economic evaluation of three modalities of psychotherapy for patients with cluster B personality disorders.
Method
A probabilistic decision-analytic model to assess the cost-effectiveness of out-patient, day hospital and in-patient psychotherapy over 5 years in terms of cost per recovered patient-year and cost per quality-adjusted life-year (QALY). Analyses were conducted from both societal and payer perspectives.
Results
From the societal perspective, the most cost-effective choice switched from out-patient to day hospital psychotherapy at a threshold of 12 274 per recovered patient-year; and from day hospital to in-patient psychotherapy at 113 298. In terms of cost per QALY, the optimal strategy changed at 56 325 and 286 493 per QALY respectively. From the payer perspective, the switch points were at 9895 and 155 797 per recovered patient-year, and 43 427 and 561 188 per QALY.
Conclusions
Out-patient psychotherapy and day hospital psychotherapy are the optimal treatments for patients with cluster B personality disorders in terms of cost per recovered patient-year and cost per QALY.
[ Full Text of Soeteman et al.] [Reprint (PDF) Version of Soeteman et al.]
——————————————————————————–
Abstract 3 of 64
Supervised case experience in supportive psychotherapy: suggestions for trainers
Navjot Bedi and Helena Vassiliadis
Navjot Bedi is a consultant psychiatrist in the Nottinghamshire Eating Disorders Service. She has previously worked as a consultant in general adult psychiatry and in undergraduate medical education. She is trained in cognitive–behavioural psychotherapy. Helena Vassiliadis is a consultant psychiatrist in psychodynamic psychotherapy in Nottinghamshire Healthcare NHS Trust. She has a role in psychotherapy training within the North Trent School of Psychiatry. The authors developed an interest in supportive psychotherapy while working together on a local project to implement the Royal College of Psychiatrists’ guidelines for psychotherapy training.
Correspondence: Correspondence Dr Navjot Bedi, Nottinghamshire Eating Disorders Service, Mandala Centre, Gregory Boulevard, Nottingham NG7 6LB, UK. Email: navjot.bedi{at}nottshc.nhs.uk
The Royal College of Psychiatrists’ guidelines for the psychotherapy training of trainee psychiatrists include a supervised case experience in supportive psychotherapy. There is, however, a lack of clarity over the concept of supportive psychotherapy and how this might be taught and supervised, and this may discourage trainers from offering formal clinical supervision in this modality. In this article we briefly describe the history of supportive psychotherapy, the various ways in which it has been conceptualised, and some of the research in the area. We discuss the case for training and make practical suggestions for how this experience might be offered by consultant psychiatrists in an everyday psychiatric setting.
[ Full Text of Bedi and Vassiliadis] [Reprint (PDF) Version of Bedi and Vassiliadis]
——————————————————————————–
Abstract 4 of 64
Life after therapy: post-termination boundary violations in psychiatry and psychotherapy
Sameer P. Sarkar
Sameer P. Sarkar is a Forensic and General Psychiatrist in full-time private practice. His practice is limited to medico-legal work and general adult psychiatry. He has trained in psychiatry in the UK and USA, and has read law at Harvard Law School, Massachusetts, USA, and at Northumbria University, UK. His main research interest is in mental health law, human rights and their applications.
Correspondence: Correspondence Sameer P. Sarkar, PO Box 3544, Wokingham, Berkshire RG40 9FA, UK. Email: spsarkar{at}onetel.com
Although recent cases of egregious boundary violations in professional relationships in the UK have led to a concerted and robust government response, the issue of doctors having relationships with former patients is relatively sparsely talked about. Publications by the General Medical Council and the Department of Health deal with this tricky and often contentious matter in some depth. This article discusses the abuse of professional relationships and examines the ethics, law and advances in understanding in the area of doctors’ relationships with former patients.
[ Full Text of Sarkar] [Reprint (PDF) Version of Sarkar]
——————————————————————————–
Abstract 5 of 64
Out-patient psychotherapy for borderline personality disorder: cost-effectiveness of schema-focused therapy v. transference-focused psychotherapy
Antoinette D. I. van Asselt and Carmen D. Dirksen
Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht
Arnoud Arntz
Department of Medical, Clinical and Experimental Psychology, Maastricht University
Josephine H. Giesen-Bloo
Department of Medical, Clinical and Experimental Psychology, Maastricht University, and Department of Medical Psychology, University Hospital Maastricht, Maastricht
Richard van Dyck
Department of Psychiatry, VU Medical Center/GGZ BuitenAmstel, Amsterdam
Philip Spinhoven
Department of Clinical and Health Psychology and Department of Psychiatry, Leiden University, Leiden
Willem van Tilburg
Department of Psychiatry, VU Medical Center/GGZ BuitenAmstel, Amsterdam
Ismay P. Kremers
Department of Clinical and Health Psychology and Department of Psychiatry, Leiden University, Leiden
Marjon Nadort
Department of Psychiatry, VU Medical Center/GGZ BuitenAmstel, Amsterdam
Johan L. Severens
Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, and Department of Health Organisation, Policy and Economics, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
Correspondence: Thea van Asselt, University Hospital Maastricht, Department KEMTA, PO Box 5800, 6202 AZ Maastricht, The Netherlands. Email: avas{at}kemta.azm.nl
Declaration of interest
None. Funding detailed in Acknowledgements.
Background
Schema-focused therapy (SFT) and transference-focused psychotherapy (TFP) for borderline personality disorder were recently compared in a randomised multicentre trial.
Aims
To assess the societal cost-effectiveness of SFT v. TFP in treating borderline personality disorder.
Method
Costs were assessed by interview. Health-related quality of life was measured using EQ–5D. Outcomes were costs per recovered patient (recovery assessed with the Borderline Personality Disorder Severity Index) and costs per quality-adjusted life-year (QALY).
Results
Mean 4-year bootstrapped costs were 37 826 for SFT and 46 795 for TFP (95% uncertainty interval for difference –21 775 to 3546); QALYs were 2.15 for SFT and 2.27 for TFP (95% UI –0.51 to 0.28). The percentages of patients who recovered were 52% and 29% respectively. The SFT intervention was less costly and more effective than TFP (dominant), for recovery; it saved 90 457 for one QALY loss.
Conclusions
Despite the initial slight disadvantage in QALYs, there is a high probability that compared with TFP, SFT is a cost-effective treatment for borderline personality disorder.
[ Full Text of van Asselt et al.] [Reprint (PDF) Version of van Asselt et al.]
——————————————————————————–
Abstract 6 of 64
Mentalisation and metaphor in poetry and psychotherapy
Jeremy Holmes
Jeremy Holmes is a retired consultant psychiatrist in North Devon and Visiting Professor of Psychotherapy at the University of Exeter (Department of Clinical Psychology, University of Exeter, Exeter EX4 4QG, UK. Email: j.a.holmes{at}btinternet.com ). He works part-time as a psychoanalytic psychotherapist. His current professional interests include the psychotherapeutic implication of attachment theory, and common factors in psychotherapy. He occasionally writes a poem, never for publication.
People turn to poetry and to psychotherapy when in states of heightened emotion – love, elation, despair, death and loss. Through the analysis of a particular poem this article suggests that there are formal similarities between poetry and psychotherapy that can illuminate the workings of the latter. Perhaps the most overarching of these is mentalisation: the capacity to ‘think about feelings’ or to be ‘mind-minded’. Finding the ‘right words in the right order’ is a task for therapists and their patients as well as for poets, since the appropriate image or metaphor can mirror or evoke feelings in the listener in a way that facilitates empathic attunement. If feelings can be objectified, their power to distress or overwhelm is mitigated. Thus, poetry and psychotherapy are similarly concerned with processes of repair of the human experiential and communicative fabric.
[ Full Text of Holmes] [Reprint (PDF) Version of Holmes]
——————————————————————————–
Abstract 7 of 64
When the going gets tougher: the importance of long-term supportive psychotherapy in psychosis
Alan Meaden and Susie Van Marle
Alan Meaden is a consultant clinical psychologist and psychology lead specialising in psychiatric rehabilitation with Birmingham and Solihull Mental Health NHS Trust (Psychology Services, 208 Monyhull Hall Road, Kings Norton, Birmingham B30 3QJ, UK. Email: alan.meaden{at}bsmht.nhs.uk ). He is also lead for the trust’s Psychological Interventions Research Programme and project manager for reviewing residential rehabilitation services. Other clinical and research interests include engagement, working with staff groups, and challenging behaviour and risk. Susanna Van Marle retired from her post as part-time consultant psychiatrist in psychotherapy in 2006. She was involved in applying psychotherapeutic thinking to help patients with severe mental health difficulties and the staff involved in their care. Her clinical and research interests include assessment, consultation, long-term supportive psychotherapy and staff support.
There has been considerable progress in recent years in developing psychosocial interventions for people who experience persistent psychotic symptoms. However, it is sometimes difficult to generalise these findings into routine clinical practice. Long-term, psychodynamically informed, supportive psychotherapy is a valuable approach for working with individuals for whom current psychosocial interventions are ineffective or where unhelpful team reactions are obstacles to care. Its principles are used to inform a multiaxial formulation, which is shared with the treatment team and guides treatment, promoting good-quality comprehensive routine care. The benefits of this approach can best be seen at the individual case level using a subsequent multiaxial reformulation.
[ Full Text of Meaden and Van Marle] [Reprint (PDF) Version of Meaden and Van Marle]
——————————————————————————–
Abstract 8 of 64
——————————————————————————–
EDITORIAL
Computer-aided psychotherapy: revolution or bubble?
I. M. Marks, MD, FRCPsych
Institute of Psychiatry, King’s College London, and Vrije Universiteit, Amsterdam
K. Cavanagh, DPhil, DClinPsych
University of Newcastle
L. Gega, BA(Hons), BN(Hons), RMN
ENB650, University of East Anglia, Norwich, UK
Correspondence: I. M. Marks, 43 Dulwich Common, London SE21 7EU. Email: i.marks{at}iop.kcl.ac.uk
Declaration of interest I.M.M. shares intellectual property rights in FearFighter and OCFighter. K.C. is an occasional consultant to CCBT Ltd and Ultrasis plc.
Research into computer-aided psychotherapy is thriving around the world. Most of it concerns computer-aided cognitive–behavioural therapy (CCBT). A recent narrative review found 97 computer-aided psychotherapy systems from nine countries reported in 175 studies, of which 103 were randomised controlled trials. The rapid spread of the mass delivery of psychotherapy through CCBT, catalysed in the UK by the National Institute for Health and Clinical Excellence’s recommendation of two CCBT programmes and the Department of Health’s CCBT implementation guidance, seems unprecedented. This editorial is a synopsis of the current status of CCBT and its future directions.
[ Full Text of Marks et al.] [Reprint (PDF) Version of Marks et al.]
——————————————————————————–
Abstract 9 of 64
The cognitive behavioural analysis system of psychotherapy: a new psychotherapy for chronic depression
John S. Swan and Alastair M. Hull
John Swan is a clinical lecturer and cognitive–behavioural psychotherapist in Dundee (Section of Psychiatry and Behavioural Neurosciences, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, Tayside, UK. Email: johnswan{at}nhs.net ). He is currently the Course Director of the Postgraduate Diploma and MSc in Cognitive–Behavioural Psychotherapy at the University of Dundee. His research interests focus on the effectiveness of psychological therapies for chronic affective disorder and obsessive–compulsive disorder. Alastair Hull is a consultant psychiatrist in psychotherapy in Tayside. His clinical work is predominantly with individuals with chronic depression and/or a history of traumatic experience. His research interests include the follow-up of intensive care patients, legal aspects after trauma, long-term sequelae of trauma, including the role of trauma in chronic depression, and the effectiveness of psychological treatments. John Swan was the first accredited CBASP trainer in the UK and both authors are accredited CBASP therapists.
The cognitive behavioural analysis system of psychotherapy (CBASP) is a new therapy specifically designed to treat chronic depression. Conceptually, the bio-psychosocial signs and symptoms of chronic depression are viewed as the result of either arrested maturational development at a Piagetian preoperational stage (in early-onset patients) or heightened emotionality and general functional regression (in late-onset patients). In this therapy, patients learn how their cognitive and behavioural patterns produce and perpetuate interpersonal problems and how to alter maladaptive patterns of interpersonal behaviour. The focus is primarily on interpersonal interactions, including with the therapist, through the latter’s disciplined personal involvement. In this article we outline the therapy process and key mechanisms of change using examples to illustrate specific techniques. We also outline the theoretical model underpinning CBASP and summarise the evidence from a large clinical trial.
[ Full Text of Swan and Hull] [Reprint (PDF) Version of Swan and Hull]
——————————————————————————–
Abstract 10 of 64
Next year in Jerusalem: psychotherapy training for tomorrow’s consultants
Sally Mitchison
Sally Mitchison is a group analyst and a consultant psychiatrist in psychotherapy (Upper Poplars, Cherry Knowle Hospital, Ryhope, Sunderland SR2 0NB, UK. Email: sally.mitchison{at}stw.nhs.uk ). She is responsible for the psychotherapy service in Sunderland. She previously worked in the same locality in a special responsibility consultant post, split between psychotherapy and general adult psychiatry.
The Royal College of Psychiatrists’ requirements for psychotherapy training and the role of the local psychotherapy tutor are summarised. Practical issues concerning the provision of this training are discussed, taking into account the anxieties that trainees experience. Suggestions are made about conducting case discussion groups, providing case supervision in small groups, locating short cases and arranging group and systemic therapy experience.
[ Full Text of Mitchison] [Reprint (PDF) Version of Mitchison]
——————————————————————————–
Abstract 11 of 64
Randomised controlled trial of interpersonal psychotherapy and cognitive–behavioural therapy for depression
SUZANNE E. LUTY, BM BS, PhD, FRANZCP, JANET D. CARTER, DipClinPsych, PhD, JANICE M. McKENZIE, MB ChB, FRCP(Canada), FRANZCP, ALMA M. RAE, MB ChB, FRANZCP, CHRISTOPHER M. A. FRAMPTON, PhD, ROGER T. MULDER, MB ChB, PhD, FRANZCP and PETER R. JOYCE, MD, PhD, DSc, FRANZCP, FRSNZ
Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand
Correspondence: Professor Sue Luty, Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences, PO Box 4345, Christchurch, New Zealand. Tel: +64 3 3720 400; fax: +64 3 3720 407; email: sue.luty{at}chmeds.ac.nz
Declaration of interest None.
See pp. 503–508, this issue.
Background Interpersonal psychotherapy and cognitive–behavioural therapy (CBT) are established as effective treatments for major depression. Controversy remains regarding their effectiveness for severe and melancholic depression.
Aims To compare the efficacy of interpersonal psychotherapy and CBT in people receiving out-patient treatment for depression and to explore response in severe depression (Montgomery–Åsberg Depression Rating Scale (MADRS) score above 30), and in melancholic depression.
Method Randomised clinical trial of 177 patients with a principal Axis I diagnosis of major depressive disorder receiving 16 weeks of therapy comprising 8–19 sessions. Primary outcome was improvement in MADRS score from baseline to end of treatment.
Results There was no difference between the two psychotherapies in the sample as a whole, but CBT was more effective than interpersonal psychotherapy in severe depression, and the response was comparable withthatfor mild and moder-ate depression. Melancholia did not predictpoor response to either psychotherapy.
Conclusions Both therapies are equally effective for depression but CBT may be preferred in severe depression.
[ Full Text of LUTY et al.] [Reprint (PDF) Version of LUTY et al.]
——————————————————————————–
Abstract 12 of 64
Temperament, character and personality disorders as predictors of response to interpersonal psychotherapy and cognitive–behavioural therapy for depression
PETER R. JOYCE, MD, PhD, DSc, FRANZCP, FRSNZ, JANICE M. McKENZIE, MB ChB, FRCP(Canada), FRANZCP, JANET D. CARTER, DipClinPsych, PhD, ALMA M. RAE, MB ChB, FRANZCP, SUZANNE E. LUTY, BM BS, PhD, FRANZCP, CHRISTOPHER M. A. FRAMPTON, PhD and ROGER T. MULDER, MB ChB, PhD, FRANZCP
Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand
Correspondence: Professor Peter Joyce, Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand. Tel: +64 3 3720 400; fax: +64 3 3720 407; e-mail: peter.joyce{at}chmeds.ac.nz
Declaration of interest None.
See pp. 496–502, this issue.
Background Interpersonal psychotherapy and cognitive–behavioural therapy are widely accepted as effective treatments for major depression. There is little evidence on how personality disorder or personality traits affect treatment response.
Aims To determine whether personality disorder or traits have an adverse impact on treatment response to interpersonal psychotherapy or cognitive–behavioural therapy in people receiving out-patient treatment for depression.
Method The study was a randomised trial in a university-based clinical research unit for out-patients with depression.
Results Personality disorder did not adversely affect treatment response for patients with depression randomised to cognitive–behavioural therapy. Conversely, personality disorder did adversely affect treatment response for patients randomised to interpersonal psychotherapy.
Conclusions Despite the two therapies having comparable efficacy in patients with depression, response to interpersonal psychotherapy (but not cognitive–behavioural therapy) is affected by personality traits. This could suggest the two therapies are indicated for different patients or that they work by different mechanisms.
[ Full Text of JOYCE et al.] [Reprint (PDF) Version of JOYCE et al.]
——————————————————————————–
Abstract 13 of 64
Effective psychotherapy in a racially and culturally diverse society
Kamaldeep Bhui and Neil Morgan
Kamaldeep Bhui is Professor of Cultural Psychiatry and Epidemiology and Director of the MSc course in transcultural mental healthcare at Barts and the London School of Medicine (Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1A 6BQ, UK. Email: k.s.bhui{at}qmul.ac.uk ) and an honorary consultant psychiatrist in psychotherapy at Mile End Hospital, which is part of the East London and City Mental Health Trust. His interests include racism, cultural identity and religious factors in healing. Neil Morgan is a consultant psychiatrist and Head of Psychotherapy at the Department of Psychotherapy at Mile End Hospital. The Department receives referrals for people from diverse racial and cultural backgrounds in East London. The authors are developing models of improved practice and psychotherapy training processes that produce culturally capable practitioners.
This article is aimed at psychotherapists and health practitioners who have not reflected on the role of race, culture and ethnicity in the provision of psychological treatments. We highlight the key issues of importance in engagement, assessment and ongoing therapy, supporting practitioners to reach a stage of pre-competency. Competency will be achieved with additional training, supervision and innovation.
[ Full Text of Bhui and Morgan] [Reprint (PDF) Version of Bhui and Morgan]
——————————————————————————–
Abstract 14 of 64
Mindfulness in psychotherapy: an introduction
Chris Mace
Chris Mace is consultant psychotherapist to Coventry and Warwickshire Partnership Trust (The Pines, St Michael’s Hospital, Warwick CV34 5QW, UK. Email: C.Mace{at}Warwick.ac.uk ), honorary senior lecturer in psychotherapy at the University of Warwick and chair of the Royal College of Psychiatrists’ Faculty of Psychotherapy. He has introduced mindfulness into his own clinical work and is researching its use to reduce stress among patients and professionals.
‘Mindfulness’ has become a popular topic among psychological therapists. This introductory article explains what mindfulness is and how it can be developed, before exploring how it has been incorporated within psychoanalytic and cognitive–behavioural psychotherapies. These reflect general as well as specific presumed therapeutic actions. At present, variations in the way mindfulness is understood, taught and applied mean that it is too early to fully assess its potential. They demonstrate how the use of attention and awareness in therapy cuts across traditional divisions and where mindfulness in therapy is most in need of further investigation.
[ Full Text of Mace] [Reprint (PDF) Version of Mace]
——————————————————————————–
Abstract 15 of 64
Supportive psychotherapy in dementia
Ola Junaid and Soumya Hegde
Ola Junaid is a consultant in old age psychiatry in Nottingham (St Francis Unit, Nottingham City Hospital, Nottingham NG5 1PB, UK. Email ola.junaid{at}nottshc.nhs.uk ) and an associate postgraduate dean in the Trent Multiprofessional Deanery. His interests include all aspects of dementia care, service provision and postgraduate medical education. Soumya Hegde is a specialist registrar in old age psychiatry at Derby City General Hospital. Her research interests are alcohol misuse in elderly people and the non-pharmacological management of dementia.
The role of psychotherapy for elderly people is the subject of much debate. Yet this has not resulted in a shift of resources towards increasing its availability within the UK’s National Health Service. Over the past decade the pessimistic view of psychotherapy for elderly people has diminished owing to the growing evidence base and the commitment of champions in old age psychiatry and psychotherapy. However, there is still very little structured research into psychotherapy in dementia. Supportive psychotherapy is a poorly understood but very practical means of helping people with dementia to adjust to the effects of their illness. Its inherent flexibility enables individual sessions to be tailored to the patient’s needs and deficits. An understanding of supportive psychotherapy and its benefits could enable clinicians to improve the quality of life of people with dementia and their carers within the ever-present constraints of limited time and resources. This article explores the use of supportive psychotherapy as a treatment option in dementia.
[ Full Text of Junaid and Hegde] [Reprint (PDF) Version of Junaid and Hegde]
——————————————————————————–
Abstract 16 of 64
Group interpersonal psychotherapy for depression in rural Uganda: 6-month outcomes
Randomised controlled trial
JUDITH BASS, PhD, MPH
Applied Mental Health Research Group (AMHR), Center for International Health and Development, Boston University School of Public Health, Boston, Massachusetts
RICHARD NEUGEBAUER
Epidemiology of Developmental Brain Disorders Department, New York State Psychiatric Institute, G. H. Sergievsky Center, Faculty of Medicine, College of Physicians and Surgeons, Columbia University, New York, and Department of International Health, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
KATHLEEN F. CLOUGHERTY, HELEN VERDELI and PRIYA WICKRAMARATNE
Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute and Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York
LINCOLN NDOGONI
World Vision International, Washington, DC, USA
LIESBETH SPEELMAN
War Child Netherlands, Amsterdam, The Netherlands
MYRNA WEISSMAN
Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute and Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York
PAUL BOLTON
AMHR, Center for International Health and Development, Boston University School of Public Health, Boston, Massachusetts, USA
Correspondence: Dr Judith Bass, Center for International Health and Development, Boston University School of Public Health, 85 East Concord Street, 5th Floor, Boston, MA 02118, USA. Tel: +1 617 414 1264; fax: +1 617 414 1261; e-mail: jbass{at}bu.edu
Declaration of interest None.
Background A randomised controlled trial comparing group interpersonal psychotherapy with treatment as usual among rural Ugandans meeting symptom and functional impairment criteria for DSM–IV major depressive disorder or sub-threshold disorder showed evidence of effectiveness immediately following the intervention.
Aims To assess the long-term effectiveness of this therapy over a subsequent 6-month period.
Method A follow-up study of trial participants was conducted in which the primary outcomes were depression diagnosis, depressive symptoms and functional impairment.
Results At 6 months, participants receiving the group interpersonal psychotherapy had mean depression symptom and functional impairment scores respectively 14.0 points (95% CI 12.2–15.8; P<0.0001) and 5.0 points (95% CI 3.6–6.4; P<0.0001) lower than the control group. Similarly, the rate of major depression among those in the treatment arm (11.7%) was significantly lower than that in the control arm (54.9%) (P<0.0001).
Conclusions Participation in a 16-week group interpersonal psychotherapy intervention continued to confer a substantial mental health benefit 6 months after conclusion of the formal intervention.
[ Full Text of BASS et al.] [Reprint (PDF) Version of BASS et al.]
——————————————————————————–
Abstract 17 of 64
——————————————————————————–
REVIEW ARTICLE
Psychotherapy plus antidepressant for panic disorder with or without agoraphobia
Systematic review
TOSHI A. FURUKAWA, MD, PhD and NORIO WATANABE, MD
Department of Psychiatry and Cognitive–Behavioural Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
RACHEL CHURCHILL, MSc, PhD
Cochrane Collaboration Depression, Anxiety and Neurosis Review Group, Health Services Research Department, Institute of Psychiatry, London, UK
Correspondence: Professor Toshi A. Furukawa, Department of Psychiatry and Cognitive–Behavioural Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City University Medical School, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. Tel: +81 52 853 8271; fax: +81 52 852 0837; e-mail: furukawa{at}med.nagoya-cu.ac.jp
Declaration of interest T.A.F. has received research grants and fees for speaking from several pharmaceutical companies. These companies did not provide funding for the current study (see Acknowledgements).
Background Panic disorder can be treated with psychotherapy, pharmacotherapy or a combination of both.
Aims To summarise the evidence concerning the short- and long-term benefits and adverse effects of a combination of psychotherapy and antidepressanttreatment.
Method Meta-analyses and meta-regressions were undertaken using data from all relevant randomised controlled trials identified by a comprehensive literature search. The primary outcome was relative risk (RR) of response.
Results We identified 23 randomised comparisons (21 trials involving a total of 1709 patients). In the acute-phase treatment, the combined therapy was superior to antidepressant pharmacotherapy (RR=1.24,95% CI1.02–1.52) or psychotherapy (RR=1.16,95% CI1.03–1.30). After termination of the acute-phase treatment, the combined therapy was more effective than pharmacotherapy alone (RR=1.61,95% CI1.23–2.11) and was as effective as psychotherapy (RR=0.96, 95% CI 0.79–1.16).
Conclusions Either combined therapy or psychotherapy alone may be chosen as first-line treatment for panic disorder with or without agoraphobia, depending on the patient’s preferences.
[ Full Text of FURUKAWA et al.] [Reprint (PDF) Version of FURUKAWA et al.]
——————————————————————————–
Abstract 18 of 64
What can we conclude from studies on psychotherapy in bipolar disorder?
Invited commentary on.. .Cognitive–behavioural therapy for severe and recurrent bipolar disorders,
DOMINIC LAM, PhD
Professor of Clinical Psychology, University of Hull, Hertford Building, University of Hull, Hull HU6 7RX, UK.
Correspondence: E-mail: d.lam{at}hull.ac.uk
Declaration of interest None.
See pp. 313–320, this issue.
A letter by Scott et alin reply to this commentary will appear in the May issue of the Journal.
The study by Scott et al in this issue of the Journal is at odds with other published studies.Their design of a mixed group of relatively well or acutely ill bipolar patients who may or may not be on medication leads to difficulties in interpreting the results.Important clinical decisions should not be based on a post hoc analysis with a retrospective variable.
[ Full Text of LAM] [Reprint (PDF) Version of LAM]
——————————————————————————–
Abstract 19 of 64 The British Journal of Psychiatry (2005) 187: 143-147
© 2005 The Royal College of Psychiatrists
Brief psychotherapy in Alzheimer’s disease
Randomised controlled trial
ALISTAIR BURNS, MD, FRCP, FRCPsych
Department of Psychiatry, Wythenshawe Hospital, Manchester
ELSE GUTHRIE, MD, FRCPsych
Department of Psychiatry, Manchester Royal Infirmary, Manchester
FEDERICA MARINO-FRANCIS and CHARLOTTE BUSBY, MRCPsych
Department of Psychiatry, Wythenshawe Hospital, Manchester
JULIE MORRIS, MSc
Department of Medical Statistics, Wythenshawe Hospital, Manchester
EVE RUSSELL, MD, MRCPsych, FRANK MARGISON, FRCPsych, SEAN LENNON, FRCPsych and JANE BYRNE, FRCPsych
Department of Psychiatry, Wythenshawe Hospital, Manchester, UK
Correspondence: Professor Alistair Burns, Department of Psychiatry, 2nd Floor, Education and Research Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK. Tel: +44 (0)161 291 5887; fax: +44 (0)161 291 5882; e-mail: Alistair.Burns{at}manchester.ac.uk
Declaration of interest None.
Background Although there is good evidence that interventions for carers of people with Alzheimer’s disease can reduce stress, no systematic studies have investigated psychotherapeutic intervention for patients themselves. This may be important in the earlier stages of Alzheimer’s disease, where insight is often preserved.
Aims The aim was to assess, in a randomised controlled trial, whether psychotherapeutic intervention could benefit cognitive function, affective symptoms and global well-being.
Method Individuals were randomised to receive six sessions of psychodynamic interpersonal therapy or treatment as usual; cognitive function, activities of daily living, a global measure of change, and carer stress and coping were assessed prior to and after the intervention.
Results No improvement was found on the majority of outcome measures. There was a suggestion that therapy had improved the carers’ reactions to some of the symptoms.
Conclusions There is no evidence to support the widespread introduction of brief psychotherapeutic approaches for those with Alzheimer’s disease. However, the technique was acceptable and helpful individually.
[ Full Text of BURNS et al.] [Reprint (PDF) Version of BURNS et al.]
——————————————————————————–
Abstract 20 of 64 The British Journal of Psychiatry (2005) 186: 342-349
© 2005 The Royal College of Psychiatrists
Transference patterns in the psychotherapy of personality disorders: empirical investigation
REBEKAH BRADLEY, PhD, AMY KEGLEY HEIM, PhD and DREW WESTEN, PhD
Departments of Psychology and Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
Correspondence: Professor Drew Westen, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30322, USA. E-mail: dwesten{at}emory.edu
Declaration of interest None. Funding detailed in Acknowledgements.
Background The concept of transference has broadened to a recognition that patients often express enduring relational patterns in the therapeutic relationship.
Aims To examine the structure of patient relational patterns in psychotherapy and their relation with DSM–IV personality disorder symptoms.
Method A random sample of psychologists and psychiatrists (n=181) completed a battery of instruments on a randomly selected patient in their care.
Results Exploratory factor analysis identified five transference dimensions: angry/entitled, anxious/preoccupied, avoidant/counterdependent, secure/engaged and sexualised. These were associated in predictable ways with Axis II pathology; four mapped on to adult attachment styles. An aggregated portrait of transference patterns in narcissistic patients provided a clinically rich, empirically based description of transference processes that strongly resembled clinical theories.
Conclusions The ways patients interact with their therapists can provide important data about their personality, attachment patterns and interpersonal functioning. These processes can be measured in clinically sophisticated and psychometrically sound ways. Such processes are relatively independent of clinicians’theoretical orientation.
[ Full Text of BRADLEY et al.] [Reprint (PDF) Version of BRADLEY et al.]
——————————————————————————–
Abstract 21 of 64 The British Journal of Psychiatry (2004) 185: 416-421
© 2004 The Royal College of Psychiatrists
Minimal-contact psychotherapy for sub-threshold depression in primary care
Randomised trial
Godelief R. W. M. Willemse, PhD and Filip Smit, MSc
Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht
Pim Cuijpers, PhD
Department of Clinical Psychology, Vrije Universiteit Amsterdam, and Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht
Bea G. Tiemens, PhD
Gelderse Roos Institute for Professionalizing, Renkum, The Netherlands
Correspondence: Godelief Willemse, Trimbos Institute, PO Box 725, 3500 AS Utrecht, The Netherlands. E-mail: gwillemse{at}trimbos.nl
Declaration of interest None. Funding detailed in Acknowledgements.
Background Sub-threshold depression is a prognostic variable for major depression. Interventions in sub-threshold depression may prevent the onset of new cases of major depression.
Aims To examine the effects of minimal-contact psychotherapy in primary care patients with sub-threshold depression on the onset of major depression, on the reduction in depressive symptoms and on health-related quality of life.
Method We conducted a randomised trial in primary care, in which patients screened for sub-threshold depression were randomly assigned to minimal-contact psychotherapy (n=107) or to usual care (n=109).
Results One year after baseline, the incidence of major depressive disorder was found to be significantly lower in the psychotherapy group (12%) than in those receiving usual care (18%). Small but significant effects were also found on depressive symptoms and on aspects of health-related quality of life.
Conclusions Primary care patients with sub-threshold depression can benefit from minimal-contact psychotherapy.
[ Full Text of Willemse et al.] [Reprint (PDF) Version of Willemse et al.]
——————————————————————————–
Abstract 22 of 64 Advances in Psychiatric Treatment (2004) 10: 371-377
© 2004 The Royal College of Psychiatrists
Psychotherapies with older people: an overview
Jason Hepple
Jason Hepple is a consultant psychiatrist and Medical Director of Somerset Partnership NHS and Social Care Trust (Magnolia House, 56 Preston Road, Yeovil, Somerset BA20 2BN, UK. E-mail: jason.hepple{at}sompar.nhs.uk ). He is a clinical research fellow of the Peninsula Medical School and is a cognitive analytic therapy practitioner and supervisor.
Psychotherapies with older people have been slow to develop, both theoretically and operationally, in the UK. This is due to ageism and the predominance of models of psychological development relevant to children and younger adults. Despite this, many have applied their practice and skills to psychological work in old age psychiatry, countering the dominance of the ‘organic’ model. An evidence and practice base exists to suggest that cognitive–behavioural therapy, interpersonal therapy, cognitive analytic therapy, psychodynamic and systemic approaches can help in a range of psychiatric problems in older people, including affective disorders, personality disorders and dementia. The inclusion of older people in existing psychotherapy services and the development of networks of practitioners whose support and supervision are encouraged are likely to be positive ways forward.
[ Full Text of Hepple] [Reprint (PDF) Version of Hepple]
——————————————————————————–
Abstract 23 of 64 The British Journal of Psychiatry (2004) 185: 37-45
© 2004 The Royal College of Psychiatrists
Psychotherapy alone and combined with pharmacotherapy in the treatment of depression
Frans de Jonghe, PhD
Department of Psychiatry, University of Amsterdam, and Depression Research Group, Mentrum Institute for Mental Health, Amsterdam
Mariëlle Hendricksen, MA, Gerda van Aalst, MD, Simone Kool, MD, Vjaap Peen, MA, Rien Van, MD and Ellen van den Eijnden, MA
Depression Research Group, Mentrum Institute for Mental Health, Amsterdam
Jack Dekker, PhD
Department of Clinical Psychology, Free University of Amsterdam, and Depression Research Group, Mentrum Institute for Mental Health, Amsterdam, The Netherlands
Correspondence: Dr J. Dekker, Mentrum GGZ Amsterdam, dep. Onderzoek en Ontwikkeling, PO Box 75848, 1070 AV Amsterdam, The Netherlands. Tel: +31 20 6352833; fax: +31 20 6352840; e-mail: jack.dekker{at}mentrum.nl
Declaration of interest Supported by an unrestricted educational grant from Wyeth Nederland.
Background The relative efficacy of psychotherapy and combined therapy in the treatment of depression is still a matter of debate.
Aims To investigate whether combined therapy has advantages over psychotherapy alone.
Method A 6-month randomised clinical trial compared Short Psychodynamic Supportive Psychotherapy (n=106) with combined therapy (n=85) in ambulatory patients with mild or moderate major depressive disorder diagnosed using DSM–IV criteria. Antidepressants were prescribed according to a protocol providing four successive steps in case of intolerance or inefficacy: venlafaxine, selective serotonin reuptake inhibitor, nortriptyline and nortriptyline plus lithium. Efficacy was assessed using the 17-item Hamilton Rating Scale for Depression, the Clinical Global Impression of Severity and of Improvement, and the depression sub-scale of the Symptom Checklist.
Results The advantages of combining antidepressants with psychotherapy were equivocal. Neither the treating clinicians nor the independent observers were able to ascertain them, but the patients experienced them clearly.
Conclusions The advantages of combining antidepressants with psychotherapy are equivocal.
[ Full Text of de Jonghe et al.] [Reprint (PDF) Version of de Jonghe et al.]
——————————————————————————–
Abstract 24 of 64 Advances in Psychiatric Treatment (2004) 10: 312-320
© 2004 The Royal College of Psychiatrists
Boundary violation and sexual exploitation in psychiatry and psychotherapy: a review
Sameer P. Sarkar
Sameer P. Sarkar is a consultant in forensic psychiatry at Broadmoor Hospital (Crowthorne, Berkshire RG45 7EG, UK. E-mail: Sameer.Sarkar{at}wlmht.nhs.uk ) and an associate in the hospital’s psychotherapy department. He has studied law at the University of Northumbria at Newcastle and at Harvard Law School and has written on the law and ethics in forensic psychiatry. He teaches ethics of forensic psychiatry to psychiatrists and mental health professionals at two London medical schools. The opinions expressed are those of the author and do not reflect the opinions of West London Mental Health Trust, of Broadmoor Hospital or of the Ethics and the Law sub-committees of the Royal College of Psychiatrists, of both of which the author is a member.
In psychiatric and psychotherapeutic practice, ‘boundaries’ delineate the personal and the professional roles and the differences that should characterise the interpersonal encounters between the patient/client and the professional. Boundaries are essential to keep both parties safe. The author outlines the various types of boundary violation that can arise in clinical practice, their consequences (both clinical and legal), how professionals can avoid them and how health care institutions might respond, should they occur. He concentrates on sexual boundary violations, because these have been the subject of most empirical study.
[ Full Text of Sarkar] [Reprint (PDF) Version of Sarkar]
——————————————————————————–
Abstract 25 of 64 Advances in Psychiatric Treatment (2003) 9: 117-124
© 2003 The Royal College of Psychiatrists
Contribution of forensic psychotherapy to the care of forensic patients
Gill McGauley and Martin Humphrey
Gill McGauley is a consultant forensic psychotherapist with the West London Mental Health NHS Trust and a senior lecturer in forensic psychotherapy at St George’s Hospital Medical School (Department of Psychiatry, St George’s Hospital Medical School, Cranmer Terrace, London SW17 ORE, UK; e-mail: gmcgaule{at}sghms.ac.uk ). She is also the forensic psychotherapy representative on the Psychotherapy and Forensic Psychiatry Specialist Advisory Committees of the Royal College of Psychiatrists. Martin Humphrey is a specialist registrar in forensic psychotherapy with South West London and St George’s Mental Health NHS Trust, London. He is a dual-accreditation trainee in psychotherapy and forensic psychiatry and has a particular interest in medical education.
This article outlines the current provision and describes the role of forensic psychotherapy in the management of forensic patients. The authors maintain that the contribution of forensic psychotherapy is not limited solely to treatment provision. The forensic psychotherapist has a supervisory role, which can help staff and institutions to understand the dynamic processes that arise from the effects of managing forensic patients. The article outlines how forensic psychotherapy can contribute towards risk assessment and highlights some particular areas of concern for the forensic psychotherapist.
[ Full Text of McGauley and Humphrey] [Reprint (PDF) Version of McGauley and Humphrey]
——————————————————————————–
Abstract 26 of 64 The British Journal of Psychiatry (2002) 180: 416-422
© 2002 The Royal College of Psychiatrists
Effectiveness of time-limited psychotherapy for minor psychiatric disorders
Randomised controlled trial evaluating immediate v. long-term effects
SERGIO LUÍS BLAY, PhD, JAIR S. VEL FUCKS, MD, MÁRCIA BARRUZI, MÔNICA CRISTINA DI PIETRO, MD, FÁBIO LEITE GASTAL, PhD, ALFREDO MALUF NETO, MD, MATEUS P DE SOUZA, MD and LADISLAU R. U. GLAUSIUSZ, MD
Department of Psychiatry of the Federal University of São Paulo (UNIFESP), Brazil
MICHAEL DEWEY, PhD
University of Nottingham, UK
Correspondence: Dr Sergio Luís Blay, Department of Psychiatry, UNIVESP, R. Botucatu 740, CEP 04023-900, São Paulo, Brazil. Tel: 55-11-3816-1030; Fax: 55-11-3816-1030; E-mail: blaysl{at}psiquiatria.epm.br
Declaration of interest None.
Background Psychotherapy research rarely has studied outcome in the longer term.
Aims To evaluate the effectiveness of brief group dynamic psychotherapy (BGDP) intervention in patients with minor psychiatric disorders compared with the usual clinical management shortly after treatment termination and to investigate whether intervention would show a differential effect at 2-year follow-up.
Method Patients were allocated randomly to an experimental or control group. The General Health Questionnaire (GHQ) was used as a primary outcome measure.
Results Based on improvement in the GHQ, at termination of treatment the BGDP group showed a significant improvement in 23 out of 42 (54.8%) compared with 11 out of 41 (26.8%) in the clinical management group. The difference in the total improvement rate is 28% (95% C18-48) (2=6.7; d.f.=1; P=0.009). In contrast, no differential follow-up effects were found between the BGDP and clinical management groups.
Conclusions Psychotherapy appears to have beneficial effects at termination of treatment but the changes attained were not stable.
[ Full Text of BLAY et al.] [Reprint (PDF) Version of BLAY et al.]
——————————————————————————–
Abstract 27 of 64 The British Journal of Psychiatry (2002) 180: 234-247
© 2002 The Royal College of Psychiatrists
Psychotherapy for sexually abused girls: psychopathological outcome findings and patterns of change
J. TROWELL, FRCPsych
I. KOLVIN, FRCPsych
The Tavistock and Portman NHS Trust
T. WEERAMANTHRI, MRCPsych
South London and Maudsley NHS Trust
H. SADOWSKI (deceased), MRCPsych
Royal Free Hospital and Tavistock and Portman NHS Trust
M. BERELOWITZ, FRCPsych
Royal Free Hospital
D. GLASSER, FRCPsych
Great Ormond Street Hospital for Sick Children
I. LEITCH, MBCS, Consultant Statistician
London
Correspondence: Dr. J. Trowell, The Tavistock and Portmand NHS Trust, Child & Family Department, 120 Belsize Lane, London NW3 5BA, UK
Declaration of interest None. Funding described in Acknowledgements.
Background Controversy exists about the efficacy of psychotherapy for the mental health problems of sexually abused children.
Aims To compare the relative efficacy of focused individual or group therapy in symptomatic sexually abused girls, and to monitor psychiatric symptoms for persistence or change.
Method A multi-centre psychotherapy outcome study recruited 71 sexually abused girls aged 6-14 years who were randomly assigned to focused individual psychotherapy (up to 30 sessions) or psychoeducational group therapy (up to 18 sessions). Changes over the course of the study were monitored.
Results Both treatment groups showed a substantial reduction in psychopathological symptoms and an improvement in functioning, but with no evident difference between individual and group therapy. However, individual therapy led to a greater improvement in manifestations of post-traumatic stress disorder (PTSD).
Conclusions The beneficial effects on PTSD support the use of individual therapy. However, the small sample size and lack of a control group limit conclusions about changes attributable to treatment.
[ Full Text of TROWELL et al.] [Reprint (PDF) Version of TROWELL et al.]
——————————————————————————–
Abstract 28 of 64 The British Journal of Psychiatry (2002) 180: 200-204
© 2002 The Royal College of Psychiatrists
——————————————————————————–
REVIEW ARTICLE
The maturing of therapy*
Some brief psychotherapies help anxiety/depressive disorders but mechanisms of action are unclear
ISAAC M. MARKS, FRCPsych
Institute of Psychiatry, London SE5 8AF, UK
Correspondence: E-mail: I.Marks{at}iop.kcl.ac.uk
Declaration of interest I.M.M. shares intellectual property rights in Fear Fighter, BTSteps and Cope.
* Based on the 16th Aubrey Lewis Lecture given at the Institute of Psychiatry, London, 14 December 2000.
Background Psychiatric therapy needs assessment regarding its maturation as a therapeutic science.
Aims Judgement of whether such a science is emerging.
Method Four criteria are used: efficacy; identification of responsible treatment components; knowledge of their mechanisms of action; and elucidation of why they act only in some sufferers.
Results Brief behavioural, interpersonal, cognitive, problem-solving and other psychotherapies have a mature ability to improve anxiety and depressive disorders reliably and enduringly, often only with instruction from a manual or a computer. Therapy’s cost-effectiveness and acceptability deserve more attention. We know little about which treatment components produce improvement, how they do so and why they do not help all sufferers.
Conclusions Therapy is coming of age regarding efficacy for anxiety and depression, but is only a toddler regarding the scientific principles to explain its effects.
[ Full Text of MARKS] [Reprint (PDF) Version of MARKS]
——————————————————————————–
Abstract 29 of 64 The British Journal of Psychiatry (2000) 177: 131-137
© 2000 The Royal College of Psychiatrists
——————————————————————————–
PSYCHOTHERAPY PAPERS
Psychotherapy for patients with complex disorders and chronic symptoms
The need for a new research paradigm
E. GUTHRIE, MRCPsych
School of Psychiatry and Behavioural Sciences, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
Declaration of interest None.
See editorial, pp. 93-94, this issue.
Background A clear distinction has been made between efficacy and effectiveness in relation to the methods of evaluation of new psychological treatments in psychiatry. Efficacy trials target patients with relatively pure conditions, who may not be representative of the patients who are usually referred for psychological treatment in a clinical setting. Few studies have explored the benefits of psychotherapy in patients with complex disorders and enduring symptoms.
Aims To explore the rationale for the distinction between efficacy and effectiveness, particularly in relation to outcome studies of patients with complex and enduring disorders.
Method A narrative review with examples drawn from the literature, and an illustration of a recent naturalistic outcome study which combines features of both efficacy and effectiveness.
Results Studies of patients with complex and mixed disorders can be designed so that they retain internal validity, but also have external validity and are relevant to clinical practice.
Conclusion Studies which evaluate psychological interventions should be carried out in populations of patients clinically representative of those who are likely to receive the intervention, should it be shown to be of benefit.
[ Full Text of GUTHRIE] [Reprint (PDF) Version of GUTHRIE]
——————————————————————————–
Abstract 30 of 64 The British Journal of Psychiatry (2000) 177: 117-122
© 2000 The Royal College of Psychiatrists
——————————————————————————–
PSYCHOTHERAPY PAPERS
A neurobiologically informed perspective on psychotherapy
GLEN O. GABBARD, MD
Bessie Walker Callaway Distinguished Professor of Psychoanalysis and Education, Karl Menninger School of Psychiatry; Clinical Professor of Psychiatry, University of Kansas School of Medicine, Wichita: and Director and Training and Supervising Analyst, Topeka Institute for Psychoanalysis
Correspondence: Professor Glen O. Gabbard, The Menninger Clinic, PO Box 829, Topeka, KS 66601-0829, USA. E-mail: gabbargo{at}menninger.edu
Declaration of interest This work was funded by the Callaway Professorship of the Menninger Clinic.
See editorial, pp. 93-94, this issue.
Background Polarisation of biological and psychosocial aspects of psychiatry has promoted a form of Cartesian dualism. Current knowledge of the interaction between biology and psychology makes it possible to consider a truly integrative approach to treatment.
Aims The aim of this overview is to consider conceptual models of how psychotherapy may affect the brain.
Method The literature discussing the mutual influence of genes and environment is surveyed. Relevant data involving the influence of psychotherapy on the brain are also reviewed.
Results Research findings suggest that the brain responds to environmental influence through the alteration of gene expression; that psychotherapy has specific measurable effects on the brain; and that implicit memory may be modified by psychotherapeutic interventions.
Conclusions Advances in neuroscience research have led to a more sophisticated understanding of how psychotherapy may affect brain functioning. These developments point the way towards a new era of psychotherapy research and practice in which specific modes of psychotherapy can be designed to target specific sites of brain functioning.
[ Full Text of GABBARD] [Reprint (PDF) Version of GABBARD]
——————————————————————————–
Abstract 31 of 64 The British Journal of Psychiatry (2000) 177: 112-116
© 2000 The Royal College of Psychiatrists
——————————————————————————–
PSYCHOTHERAPY PAPERS
Psychotherapies in psycho-oncology
An exciting new challenge
SIDNEY BLOCH, FRCPsych
Department of Psychiatry
DAVID KISSANE, FRANZCP
Centre for Palliative Care, University of Melbourne
Correspondence: Professor Sidney Bloch, Department of Psychiatry, University of Melbourne, St Vincent’s Hospital, Fitzroy, Melbourne 3065, Australia. Fax: +613 9819 0635; e-mail: s.bloch{at}medicine.unimelb.edu.au
Declaration of interest This research has been supported by the Australian Rotary Health Fund, Bethlehem Griffiths Research Foundation and the Australian National Health and Medical Research Council.
See editorial, pp. 93-94, this issue.
Background There is ample scope to devise forms of psychotherapy in consultation—liaison psychiatry, including the newly evolving area of psychooncology.
Aims To highlight the development of psychotherapy in psycho-oncology, providing two illustrations.
Method We report on conceptual and clinical research in the context of oncology and palliative care, focusing on (a) an approach for families at risk of maladaptive bereavement; and (b) a group programme for women newly diagnosed with early-stage breast cancer.
Results We were able to introduce new forms of psychological treatment for specific clinical groups, and anecdotal evidence points to useful benefits for participants.
Conclusions Psychotherapists should grasp the opportunity to bring their skills to the medical arena, but need to subject newly devised interventions to well-designed and methodologically rigorous research.
[ Full Text of BLOCH and KISSANE] [Reprint (PDF) Version of BLOCH and KISSANE]
——————————————————————————–
Abstract 32 of 64 The British Journal of Psychiatry (2000) 177: 107-111
© 2000 The Royal College of Psychiatrists
——————————————————————————–
PSYCHOTHERAPY PAPERS
Early termination of treatment in personality disorder treated in a psychotherapy hospital
Quantitative and qualitative study
MARCO CHIESA, MRCPsych, CARLA DRAHORAD, DPsychol (Padua) and SILVIA LONGO, DPsychol (Padua)
Research Unit, The Cassel Hospital, Richmond, Surrey
Correspondence: Dr M. Chiesa, Research Unit, The Cassel Hospital, I Ham Common, Richmond, Surrey TW107JF. e-mail: marco{at}cassel.ftech.co.uk
Declaration of interest This study was funded by a grant from the Sir Jules Thorn Charitable Trust.
See editorial, pp. 93-94, this issue.
Background Factors underlying premature discontinuation of psychosocial in-patient treatment are still unclear.
Aims Investigation of early discontinuation of specialised in-patient psychosocial treatment in a sample of people with personality disorder.
Method Out of 134 consecutive admissions to the Cassel Hospital, 42 early drop-outs and 92 patients who remained were compared on demographic and clinical variables. Early drop-outs were invited for in-depth interviews, to explore their hospital experiences.
Results The early drop-out group and the group which remained showed significant differences in occupational status, borderline personality disorder (BPD) and the treatment programme to which they were allocated. All three independent variables predicted early discontinuation of treatment. The qualitative analysis of interview transcripts identified significant problems in institutional dimensions.
Conclusions Important subjects and process variables contributing to early drop-out in people with personality disorder were identified, with potential implications for clinical practice.
[ Full Text of CHIESA et al.] [Reprint (PDF) Version of CHIESA et al.]
——————————————————————————–
Abstract 33 of 64 The British Journal of Psychiatry (2000) 176: 32-36
© 2000 The Royal College of Psychiatrists
Psychotherapy, learning disabilities and trauma: new perspectives
SHEILA HOLLINS, FRCPsych and VALERIE SINASON, BPAS
Department of Psychiatry of Disability, St George’s Hospital Medical School, London
Correspondence: Professor Sheila Hollins, St George’s Hospital Medical School, Department of Psychiatry of Disability, Jenner Wing, Cranmer Terrace, London SW17 ORE. Tel: 020 8725 5501; Fax: 020 86721070; e-mail: s.hollins{at}sghms.ac.uk
Declaration of interest None.
See editorial pp. 10—11, this issue.
Background Psychological therapies are rarely used in people with learning disabilities. Learning disability is often given as an exclusion criterion. There is insufficient published research to conduct a systematic review. Few outcome studies of psychoanalytic or cognitive psychotherapy have been reported.
Aims To describe recent advances in understanding and practice within the learning disability field which have not received wider recognition within mainstream psychotherapy and psychiatry.
Method The availability of different psychotherapeutic approaches is discussed. We explore developmental issues including the contribution of attachment theory to our understanding, and the effects of trauma on the lives of people with learning disabilities.
Results Theoretical and clinical perspectives suggest that many therapeutic opportunities exist.
Conclusions Practitioners are encouraged to extend their therapeutic repertoire, and to report measurable outcomes.
[ Full Text of HOLLINS and SINASON] [Reprint (PDF) Version of HOLLINS and SINASON]
——————————————————————————–
Abstract 34 of 64
The British Journal of Psychiatry 168: 723-731 (1996)
© 1996 The Royal College of Psychiatrists
Severe personality disorders. Treatment issues and selection for in- patient psychotherapy
K Norton and RD Hinshelwood
Henderson Hospital, Sutton, Surrey.
BACKGROUND: Severe personality disorder (SPD) is an imprecise but useful term referring to some notoriously difficult to treat psychiatric patients. Their long-term psychiatric treatment is often unsuccessful, in spite of hospitalisation. The specialist expertise of in-patient psychotherapy units (IPUs) can successfully meet some of SPD patients’ needs. METHOD: Relevant literature on the subject is summarised and integrated with the authors’ specialist clinical experience. RESULTS: Many clinical problems with SPD patients are interpersonal and prevent any effective therapeutic alliance, which is necessary for successful treatment. With in-patients, inconsistencies in treatment delivery and issues surrounding compulsory treatment reinforce patients’ mistrust of professionals, compromising accurate diagnosis and an assessment of the need for specialist IPU referral. CONCLUSIONS: General psychiatric teams are well-placed to plan long- term treatment for SPD patients which may include IPU treatment. Timely referral of selected SPD patients to an IPU maximises a successful outcome, especially if there is appropriate post-discharge collaboration with general psychiatric teams to consolidate gains made.
[Reprint (PDF) Version of Norton and Hinshelwood]
——————————————————————————–
Abstract 35 of 64
The British Journal of Psychiatry 168: 10-15 (1996)
© 1996 The Royal College of Psychiatrists
Psychotherapy assessment and treatment selection
R Tillett
Wonford House Hospital, Exeter.
BACKGROUND: Current acceptance of the need for a wide range of treatments and growing pressure for cost-effectiveness suggest the need for a more discriminating approach to assessment of psychotherapy. METHOD: Medline and manual literature searches, and personal experience of over 1000 assessments in a district psychotherapy service. RESULTS: There is substantial evidence for the general efficacy of psychotherapy; differential benefits are beginning to be identified. Short-term treatments are appropriate in a wide variety of situations and can be surprisingly effective. Chronic/complex psychopathology is likely to need longer term therapy. CONCLUSIONS: Effective use of scarce psychotherapy resources requires knowledge of the research evidence of treatment effectiveness, careful assessment of the patient and a logical and collaborative approach to treatment planning.
[Reprint (PDF) Version of Tillett]
——————————————————————————–
Abstract 36 of 64
The British Journal of Psychiatry 168: 87-93 (1996)
© 1996 The Royal College of Psychiatrists
Perceptions of the significant other of the effects of psychodynamic psychotherapy. Implications for thinking about psychodynamic and systemic approaches
J Roberts
Camden and Islington Community Health Services NHS Trust, London.
BACKGROUND: Clinical suggests that partners of psychotherapy patients often have powerful feelings about the therapy and therapist. The repercussions of psychotherapy on those close to the patient are rarely considered. A small exploratory study was therefore conducted. METHOD: All patients who had completed at least two months of weekly psychodynamic psychotherapy in 1990 at an out-patient unit of a psychiatric hospital (n = 35) and had a partner with whom they were living at the time of starting therapy (n = 23) were contacted. Eight gave permission for their partner to be contacted directly. All eight partners agreed to participate in a semi-structured interview exploring their perceptions of the effects of the therapy on a number of family relationships. The impact of the process of the study was also investigated by means of a questionnaire sent to all partners some weeks after the interview. RESULTS: Considerable changes were perceived to have taken place in association with therapy affecting not only the relationship between the couple but also their parenting relationship, the children, and at time members of the extended family. Partner’s views about the direction of such changes seemed to influence other perceptions about the therapy. CONCLUSION: The repercussions of individual psychotherapy may well spread extensively within a family. This further blurs the boundary between individual and family therapy, both theoretically and clinically. Research procedures are themselves a major intervention and may have a considerable emotional impact on participants.
[Reprint (PDF) Version of Roberts]
——————————————————————————–
Abstract 37 of 64
The British Journal of Psychiatry 167: 581-588 (1995)
© 1995 The Royal College of Psychiatrists
Psychotherapy for bipolar disorder
J Scott
University Department of Psychiatry, Royal Victoria Infirmary, Newcastle upon Tyne.
BACKGROUND. Psychosocial factors may contribute 25-30% to the outcome variance in bipolar disorders. Sufferers have identified benefits from psychotherapy, but biological models and treatments dominate the research agenda. The author reviews research on psychosocial issues and interventions in this disorder. METHOD. Research on adjustment to the disorder, interpersonal stressors and obstacles to treatment compliance were located by computerised searches and the author’s knowledge of the literature. All published outcome studies of psychosocial interventions in bipolar disorder are reviewed. RESULTS. There is an inadequate database on psychosocial factors associated with onset and maintenance of bipolar disorder. While the outcome studies available are methodologically inadequate, the accumulated evidence suggests that psychosocial interventions may have significant benefits for bipolar sufferers and their families. CONCLUSIONS. Given the significant associated morbidity and mortality, there is a clear need for more systematic clinical management that addresses psychosocial as well as biological aspects of bipolar disorder. The author identifies appropriate research strategies to improve knowledge of effective psychosocial interventions.
[Reprint (PDF) Version of Scott]
——————————————————————————–
Abstract 38 of 64
The British Journal of Psychiatry 167: 439-445 (1995)
© 1995 The Royal College of Psychiatrists
Supportive psychotherapy. The search for positive meanings
J Holmes
North Devon Healthcare Trust, Barnstaple.
BACKGROUND: The attempt to define psychotherapeutic skills appropriate for psychiatrists has aroused an interest in supportive psychotherapy, a previously undervalued and underdeveloped member of the psychotherapeutic family. This has been coupled with an increasing recognition of the importance of support within formal psychotherapies, especially when working with highly disturbed patients. METHOD: A review of supportive psychotherapy (ST) was performed, based on a Medline literature search. RESULTS: It is argued that, from the perspective of attachment theory, support is an integral part of al psychotherapies. ST is also a specific mode of treatment suitable for some patients suffering from psychotic illnesses and borderline personality disorder. ST is an eclectic treatment drawing on many theoretical approaches. A common theme based on a narrative co- constructionist perspective, the search for positive meaning, is identified. CONCLUSIONS: Supportive psychotherapy is an essential component of good psychiatric practice. Further research is needed to define its benefits and limitations.
[Reprint (PDF) Version of Holmes]
——————————————————————————–
Abstract 39 of 64
The British Journal of Psychiatry 167: 495-502 (1995)
© 1995 The Royal College of Psychiatrists
Incorporating psychological debriefing techniques within a brief group psychotherapy programme for the treatment of post-traumatic stress disorder
W Busuttil, GJ Turnbull, LA Neal, J Rollins, AG West, N Blanch and R Herepath
Psychiatric Centre, Princess Alexandra Hospital, Royal Air Force Wroughton, Wiltshire.
BACKGROUND: The Royal Air Force Wroughton Post-Traumatic Stress Disorder (PTSD) Rehabilitation Programme is described. It comprised a 12-day structured in-patient ‘course’ of group psychotherapy and day- case group follow-up sessions over a one-year period. Psychological debriefing was the main therapeutic technique employed. METHOD: This is a ‘before and after’ open outcome study. A comprehensive assessment protocol confirmed the presence and severity of PTSD and measured co- morbid psychopathological status, occupational and social function longitudinally. RESULTS: A highly significant global response to treatment is demonstrated in the 34 subjects included in the study, with 85.3% not fulfilling the DSM-III-R criteria for PTSD at one year after treatment. CONCLUSIONS: Further controlled studies assessing the value of psychological debriefing techniques in the treatment of established PTSD are required.
[Reprint (PDF) Version of Busuttil et al.]
——————————————————————————–
Abstract 40 of 64
The British Journal of Psychiatry 165: 315-323 (1994)
© 1994 The Royal College of Psychiatrists
Cognitive therapy, analytic psychotherapy and anxiety management training for generalised anxiety disorder
RC Durham, T Murphy, T Allan, K Richard, LR Treliving and GW Fenton
Tayside Area Clinical Psychology Department, Royal Dundee Liff Hospital.
BACKGROUND. We test the hypotheses that (a) cognitive therapy is of comparable efficacy to psychodynamic psychotherapy, (b) 8-10 sessions of therapy is as effective as 16-20 sessions, and (c) brief therapist training is as effective as intensive training. METHOD. Of 178 out- patients referred to a clinical trial of psychological treatment for generalised anxiety, 110 patients met DSM-III-R criteria for generalised anxiety disorder and were randomly assigned to three different forms of psychotherapy. The main comparison was between cognitive therapy and analytic psychotherapy, delivered by experienced therapists at weekly or fortnightly intervals over six months. A third treatment, anxiety management training, was delivered at fortnightly intervals by registrars in psychiatry after a brief period of training. Eighty patients completed treatment and were assessed before treatment, after treatment, and at six-month follow-up. RESULTS. Cognitive therapy was significantly more effective than analytic psychotherapy, with about 50% of patients considerably better at follow-up. Analytic psychotherapy gave significant improvement but to a lesser degree than cognitive therapy. There was no significant effect for level of contact. Patients receiving anxiety management training showed similar improvements to cognitive therapy after treatment, with rather lower proportions showing clinically significant change. CONCLUSIONS. Cognitive therapy is likely to be more effective than psychodynamic psychotherapy with chronically anxious patients. Significant improvements in symptoms can be achieved by trainee psychiatrists after only brief instruction in behaviourally based anxiety management. However, the superiority of cognitive therapy at follow-up suggests that the greater investment of resources required for this approach is likely to pay off in terms of more sustained improvement. There is no evidence that 16-20 sessions of treatment is more effective, on average, than 8-10 sessions.
[Reprint (PDF) Version of Durham et al.]
——————————————————————————–
Abstract 41 of 64
The British Journal of Psychiatry 165: 131-135 (1994)
© 1994 The Royal College of Psychiatrists
Reason and emotion in psychotherapy: Albert Ellis
W Dryden and FW Bond
Department of Psychology, Goldsmith’s College, University of London, New Cross.
To summarise then, in 1962 RET displayed important features still current. These include the interrelatedness of cognitive, emotive and behavioural processes, the important role that cognition plays in psychological problems, its humanistic view of the self, and the futility and dangers of self-rating. The emphasis on perpetuation rather than acquisition processes of emotional disturbance holds good now as it did then, and the core view of therapeutic change is essentially the same now as it was in 1962, despite further, more recent elaborations. Significant change has occurred in RET since 1962 that updates several of Ellis’ original ideas. These include the distinction between interpretations (or inferences) and evaluations, the primary of musts in accounting for psychological disturbance, the clear distinction between healthy and unhealthy negative emotions and the greater role according to force and energy in the change process. In addition, a greater emphasis is placed on biological aspects of emotional disturbance now than 30 years ago. Finally, a greater range of cognitive, imaginal, emotive and behavioural methods are found in current RET literature than in Reason and Emotion in Psychotherapy, where Ellis restricts himself to illustrating a few cognitive and behavioural techniques. RET, then, has grown and developed over the past 30 years. In large part, this reflects the theory’s flexibility and the competent people who have worked to make RET one of the most viable and widely used cognitive-behaviour therapies.
[Reprint (PDF) Version of Dryden and Bond]
——————————————————————————–
Abstract 42 of 64
The British Journal of Psychiatry 163: 430-438 (1993)
© 1993 The Royal College of Psychiatrists
Attachment theory: a biological basis for psychotherapy?
J Holmes
North Devon District Hospital, Barnstaple.
John Bowlby bemoaned the separation between the biological and psychological approaches in psychiatry, and hoped that attachment theory, which brings together psychoanalysis and the science of ethology, would help bridge the rift between them. Recent findings in developmental psychology have delineated features of parent-infant interaction, especially responsiveness, attunement, and modulation of affect, which lead to either secure or insecure attachment. Similar principles can be applied to the relationship between psychotherapist and patient–the provision of a secure base, the emergence of a shared narrative (‘autobiographical competence’), the processing of affect, coping with loss–these are common to most effective psychotherapies and provide the basis for a new interpersonal paradigm within psychotherapy. Attachment theory suggests they rest on a sound ethological and hence biological foundation.
[Reprint (PDF) Version of Holmes]
——————————————————————————–
Abstract 43 of 64
The British Journal of Psychiatry 163: 315-321 (1993)
© 1993 The Royal College of Psychiatrists
A randomised controlled trial of psychotherapy in patients with refractory irritable bowel syndrome
E Guthrie, F Creed, D Dawson and B Tomenson
North West Regional Health Authority, Manchester.
Patients with chronic, refractory irritable bowel syndrome (n = 102) were entered into a randomised controlled trial of psychotherapy versus supportive listening. Independent physical and psychological assessments were carried out at the beginning and end of the 12-week trial. For women, psychotherapy was found to be superior to supportive listening, in terms of an improvement in both physical and psychological symptoms. There was a similar trend for men, but this did not reach significance. Following completion of the trial, patients in the control group were offered psychotherapy; 33 accepted and following treatment experienced a marked improvement in their symptoms; ten declined. At follow-up one year later, those patients who had received psychotherapy remained well, patients who had dropped out of the trial were unwell with severe symptoms, and most of the controls who declined psychotherapy had relapsed. This study shows that psychotherapy is feasible and effective in the majority of irritable bowel syndrome patients with chronic symptoms unresponsive to medical treatment.
[Reprint (PDF) Version of Guthrie et al.]
——————————————————————————–
Abstract 44 of 64
The British Journal of Psychiatry 163: 223-229 (1993)
© 1993 The Royal College of Psychiatrists
The treatment of severe, chronic, resistant obsessive-compulsive disorder. An evaluation of an in-patient programme using behavioural psychotherapy in combination with other treatments
LM Drummond
Department of Mental Health Sciences, St George’s Hospital Medical School, London.
This study examined 49 in-patients with obsessive-compulsive disorder who were treated over three years. The patients had failed to respond to previous treatment. Treatment consisted of in-patient exposure, occasionally combined with other interventions individually tailored to the patient’s specific difficulties. This resulted in significant clinical improvements and an average 40% reduction in rituals in 31 (63.3%) of these chronic patients. These gains were maintained at an average 19-month follow-up. Checking rituals were more likely to be associated with good outcome. Women had a later onset of the disorder and a slight tendency to better prognosis. No other predictors of outcome were found.
[Reprint (PDF) Version of Drummond]
——————————————————————————–
Abstract 45 of 64
The British Journal of Psychiatry 161: 23-43 (1992)
© 1992 The Royal College of Psychiatrists
Psychotherapy in borderline and narcissistic personality disorder
A Higgitt and P Fonagy
St Charles Hospital, London.
Psychodynamic concepts about borderline personality disorder are reviewed and the literature concerning psychotherapeutic treatment of this group is examined. The treatment contexts considered include: psychoanalysis and intensive (expressive) psychoanalytic psychotherapy, supportive psychotherapy, group psychotherapy, family therapy, in- patient treatment, the therapeutic community, cognitive-behavioural approaches, and combinations of drugs and psychotherapy. The practical implications of recent follow-up studies for intervention strategies are considered.
[Reprint (PDF) Version of Higgitt and Fonagy]
——————————————————————————–
Abstract 46 of 64
The British Journal of Psychiatry 160: 41-50 (1992)
© 1992 The Royal College of Psychiatrists
Psychodynamics and psychotherapy on an acute psychiatric ward. The story of an experimental unit
M Jackson and R Cawley
King’s College Hospital, Bethlem Royal Hospital.
The treatment of severely disturbed patients is strengthened in an important way by listening closely to them and by attempting to understand their experience in the depth that is made possible by the use of psychoanalytic concepts. It follows that the practice of clinical psychiatry in the UK would be greatly improved by the introduction of a psychoanalytic and psychotherapeutic perspective into the acute ward. This paper reviews the work done on a ward at the Maudsley Hospital in which this approach was the practice.
[Reprint (PDF) Version of Jackson and Cawley]
——————————————————————————–
Abstract 47 of 64
The British Journal of Psychiatry 158: 362-367 (1991)
© 1991 The Royal College of Psychiatrists
An in-patient behavioural psychotherapy unit. Description and audit
G Thornicroft, L Colson and I Marks
Social and Community Psychiatry Unit, Institute of Psychiatry, London.
An in-patient behavioural psychotherapy unit is described that emphasises self-treatment, teaching relatives to become cotherapists while resident in the unit, routine collection of outcome data, minimising use of medication, and absence of night nurses. Patients are referred from all over the UK, mostly with chronic disabling OCD. Treatment includes self-exposure and self-imposed response prevention. A year’s cohort (52 patients) showed substantial improvement that consolidated during six-month follow-up (83% decrease in total ritual time per day, 58% fall in target ritual scores, better social adjustment), and families noted relief of burden; eight patients dropped out. Further such units are needed in the UK, perhaps on a regional basis; they could be run as specialist hostels.
[Reprint (PDF) Version of Thornicroft et al.]
——————————————————————————–
Abstract 48 of 64
The British Journal of Psychiatry 157: 389-391 (1990)
© 1990 The Royal College of Psychiatrists
Two-year follow-up of the Sheffield Psychotherapy Project
DA Shapiro and J Firth-Cozens
Social and Applied Psychology Unit, University of Sheffield.
Of 40 depressed and anxious patients who received treatment during the Sheffield Psychotherapy Project, 31 completed the BDI and SCL-90 at two- year follow-up. At both group and individual levels, outcomes were very similar to those obtained at the completion of treatment. Substantial minorities of patients reported major life events and seeking further help for psychological problems during the two years, but these reports were not reliably associated with symptoms at follow-up. Patients recalled very different elements in prescriptive and exploratory therapies as helpful, with a notable emphasis upon prescriptive therapy’s relaxation and anxiety management as a source of problem solution.
[Reprint (PDF) Version of Shapiro and Firth-Cozens]
——————————————————————————–
Abstract 49 of 64
The British Journal of Psychiatry 157: 384-388 (1990)
© 1990 The Royal College of Psychiatrists
The value of the Claybury Selection Battery in predicting benefit from group psychotherapy
MJ Pearson and AJ Girling
Uffculme Clinic, Moseley, Birmingham.
Before receiving psychodynamic group psychotherapy at the Uffculme Clinic four groups of out-patients were assessed on the Claybury Selection Battery and the SCL 90, and therapists were asked to predict their progress. Outcome was assessed at about three months and one year by patients’ self-reports of symptom change on the SCL 90 and therapists’ ratings of progress. Only one of the three Claybury questionnaires, the TEQ, which measures attitudes to treatment, was significantly correlated with outcome, along with therapists’ predictions. This result is different to that of a previous study which also found that outcome correlated with direction of interest (DIQ) and conservatism (C). The C and DIQ scales may provide useful predictive information only in a small proportion of cases.
[Reprint (PDF) Version of Pearson and Girling]
——————————————————————————–
Abstract 50 of 64
The British Journal of Psychiatry 157: 34-40 (1990)
© 1990 The Royal College of Psychiatrists
Combining pharmacological antagonists and behavioural psychotherapy in treating addictions. Why it is effective but unpopular
C Brewer
Stapleford Centre, Belgravia, London.
Supervised administration of disulfiram is one of the very few treatments that can significantly reduce alcohol consumption, yet it is rarely used, despite being simple and cheap. Disulfiram is not ‘aversion therapy’, but a technique for facilitating exposure and response prevention, and it fits comfortably into a behavioural, social- learning model of addiction (or dependence) and its treatment. The availability of other effective antagonists, notably to opiates, suggests that an approach that is demonstrably effective in alcohol dependence may be helpful in treating other addictions. The reasons for the unpopularity of this approach appear to be largely ideological.
[Reprint (PDF) Version of Brewer]
——————————————————————————–
Abstract 51 of 64
The British Journal of Psychiatry 155: 842-845 (1989)
© 1989 The Royal College of Psychiatrists
Studying the ‘Grammar of Psychotherapy’ Course using a student and control population. Some results, trends and disappointments
S Lieberman, J Cobb and CH Jackson
Department of Psychiatry, St. George’s Hospital Medical School, Tooting, London.
In a study of the effects of the teaching of the ‘Grammar of Psychotherapy’ Course, 26 subjects were matched with 27 controls. The students were found to have significantly better interviews than the controls as rated by their patients and by independent blind assessment of their audiotapes six months later. There are some trends which were of interest, although not statistically significant.
[Reprint (PDF) Version of Lieberman et al.]
——————————————————————————–
Abstract 52 of 64
The British Journal of Psychiatry 155: 239-245 (1989)
© 1989 The Royal College of Psychiatrists
Signal and noise in psychotherapy. The role and control of non-specific factors
H Omer and P London
Harvard University Graduate School of Education, Program in Counselling and Consulting Psychology, Cambridge, Massachusetts 02138.
Four major categories of non-specific or common factors are systematically analysed: relationship, expectancy, reorganising, and impact factors. The placebo control method should be discarded in psychotherapy research for two reasons: (a) sham treatment controls are unworkable because common factors in treatment are manifest only when real treatment is administered; and (b) the very events which were once thought of as ‘non-specific’ noise are now recognised as active therapeutic factors common to many schools.
[Reprint (PDF) Version of Omer and London]
——————————————————————————–
Abstract 53 of 64
The British Journal of Psychiatry 154: 445-453 (1989)
© 1989 The Royal College of Psychiatrists
Psychotherapy and general practice
L Gask and G McGrath
Department of Psychiatry, University Hospital of South Manchester.
The authors review the development of liaison psychotherapy in general practice, and argue that a ‘skill-sharing’ approach, where the general practitioner retains the treatment role, is a more efficient model than a ‘consultation’ approach. Skill-sharing models are reviewed, and the need for psychiatrists and psychotherapists to be more directly involved in teaching basic psychotherapeutic skills to general practitioners is emphasised.
[Reprint (PDF) Version of Gask and McGrath]
——————————————————————————–
Abstract 54 of 64
The British Journal of Psychiatry 154: 383-385 (1989)
© 1989 The Royal College of Psychiatrists
The question of therapists’ differential effectiveness. A Sheffield Psychotherapy Project addendum
DA Shapiro, J Firth-Cozens and WB Stiles
Department of Psychology, University of Sheffield.
Further analysis of outcome data from the Sheffield Psychotherapy Project suggested that one of the principal therapists was responsible for most of the reported advantage of Prescriptive over Exploratory treatment.
[Reprint (PDF) Version of Shapiro et al.]
——————————————————————————–
Abstract 55 of 64
The British Journal of Psychiatry 152: 824-829 (1988)
© 1988 The Royal College of Psychiatrists
Supportive analytical psychotherapy. An account of two cases
J Holmes
North Devon Hospital, Barnstaple.
Supportive psychotherapy is much practiced, but little described. An account is given of an approach that combines supportive and dynamic elements, is suitable for ‘difficult’ patients, and may be cost- effective. Two illustrative causes are presented.
[Reprint (PDF) Version of Holmes]
——————————————————————————–
Abstract 56 of 64
[Reprint (PDF) Version of Whalan and Mushet]
——————————————————————————–
Abstract 57 of 64
The British Journal of Psychiatry 152: 408-409 (1988)
© 1988 The Royal College of Psychiatrists
Psychotherapy–a last resort
R Whyte
A patient in whom a series of treatments of all sorts had failed was given two trials of psychotherapy over a prolonged period. Although the patient judged the trials of psychotherapy to be a failure, and therapy was terminated, he does seem to have matured, and his disturbed behaviour has ceased. The possible reasons for this are discussed.
[Reprint (PDF) Version of Whyte]
——————————————————————————–
Abstract 58 of 64
The British Journal of Psychiatry 152: 271-274 (1988)
© 1988 The Royal College of Psychiatrists
Psychotherapy and dysmorphophobia: a case report
S Bloch and P Glue
University of Oxford.
The treatment of patients with dysmorphophobia remains a confused matter, probably because of clinical heterogeneity. Our experience with the case reported in this paper suggests that psychodynamic psychotherapy is indicated for certain carefully selected patients.
[Reprint (PDF) Version of Bloch and Glue]
——————————————————————————–
Abstract 59 of 64
The British Journal of Psychiatry 152: 229-233 (1988)
© 1988 The Royal College of Psychiatrists
Therapeutic factors within in-patient and out-patient psychotherapy groups. Implications for therapeutic techniques
R Kapur, K Miller and G Mitchell
Department of Clinical Psychology, Shenley Hospital, Radlett, Herts.
Therapeutic factors operative in in-patient and out-patient therapy groups were compared. These settings differ greatly, both in terms of the patient population they serve and the overall systems within which they operate. The study revealed significant differences between the therapeutic factors operative in these two settings, and suggested that clinicians should modify their techniques for running psychotherapy groups across settings, to take account of these findings.
[Reprint (PDF) Version of Kapur et al.]
——————————————————————————–
Abstract 60 of 64
The British Journal of Psychiatry 152: 107-111 (1988)
© 1988 The Royal College of Psychiatrists
Childhood sexual abuse in adult female psychotherapy referrals. Incidence and implications for treatment
H Sheldon
McCartney Day Department, North Manchester General Hospital, Crumpsall.
Among 115 women referred to a regional psychotherapy unit, childhood sexual abuse was reported at the referral or assessment stage by 19, and referred to covertly by 5. A significant number of cases must remain undetected. For the purpose of this study, sexual abuse includes any form of sexual activity between a female child and a familiar adult or young person older than her, which was perceived by the subject to be of a sexual nature and distressing to her. The symptoms in adulthood have been described as similar to those of Borderline Personality Disorder. Development, treatment and implications are discussed.
[Reprint (PDF) Version of Sheldon]
——————————————————————————–
Abstract 61 of 64
The British Journal of Psychiatry 151: 790-799 (1987)
© 1987 The Royal College of Psychiatrists
Prescriptive v. exploratory psychotherapy. Outcomes of the Sheffield Psychotherapy Project
DA Shapiro and J Firth
Department of Psychology, University of Sheffield.
Prior research suggests that psychotherapeutic techniques which differ in their contents are quite similar in their outcomes. Outcome data are reported from a study designed to maximise sensitivity to technique effects on outcome in a clinically realistic setting, and to permit detailed analysis of the relations between content, immediate impact, and outcome of therapy. Forty professional and managerial workers with depression or anxiety received eight sessions of Prescriptive (cognitive/behavioural) and eight sessions of Exploratory (relationship- oriented) therapy in a crossover design, with each client seeing the same therapist throughout. Outcome was assessed by standard interview and questionnaire methods. The results favoured Prescriptive therapy, although this difference was of moderate extent. The outcome was largely unaffected by the order in which the two methods were offered.
[Reprint (PDF) Version of Shapiro and Firth]
——————————————————————————–
Abstract 62 of 64
The British Journal of Psychiatry 151: 594-601 (1987)
© 1987 The Royal College of Psychiatrists
The Grammar of Psychotherapy. Interactograms: three self-monitoring instruments for audiotape feedback
S Lieberman and JP Cobb
St. George’s Hospital Medical School, Department of Psychiatry, London.
This paper describes the development of three self-monitoring forms to enable students to make constructive use of audiotapes of their interviews with patients. Each interactogram is described in detail, with examples where necessary.
——————————————————————————–
Abstract 63 of 64
The British Journal of Psychiatry 151: 589-594 (1987)
© 1987 The Royal College of Psychiatrists
The Grammar of Psychotherapy. A descriptive account
JP Cobb and S Lieberman
Priory Hospital, London.
The Grammar of Psychotherapy is a method of teaching both communication skills and the elements of psychotherapy. Supervised training is supplemented by self-monitored tasks. The course is economical in terms of tutors’ time, and is particularly suitable for trainees in general psychiatry.
——————————————————————————–
Abstract 64 of 64
The British Journal of Psychiatry 151: 283-287 (1987)
© 1987 The Royal College of Psychiatrists
Psychotherapy today. Further consideration of the essence of psychotherapy
SE Greben
University of Toronto, Ontario, Canada.
Despite swings between over-valuation and rejection of psychotherapy on the part of some psychiatrists, there remains a valid and necessary place for psychotherapy in psychiatry. The essential elements of that place are described.
[Reprint (PDF) Version of Greben]
© 2010 The Royal College of Psychiatrists.
Online ISSN: 1472-1465
Print ISSN: 0007-1250
pervasive developmental disorders
- Selected Abstracts
- Returned: 2 citations and abstracts. Click on down arrow or scroll to see abstracts.
DJ Clarke, CS LittleJohns, JA Corbett, and S Joseph - Pervasive developmental disorders and psychoses in adult life
The British Journal of Psychiatry 155: 692-699. - C Gillberg, and L Svennerholm
- CSF monoamines in autistic syndromes and other pervasive developmental disorders of early childhood
The British Journal of Psychiatry 151: 89-94.
- Institution: Pakistan:RCP Sponsored | Sign In via User Name/Password
 Download ALL Selected Citations to Citation Manager |
Abstract 1 of 2
The British Journal of Psychiatry 155: 692-699 (1989)© 1989 The Royal College of Psychiatrists
Pervasive developmental disorders and psychoses in adult life
DJ Clarke, CS LittleJohns, JA Corbett and S Joseph
University of Birmingham, Department of Psychiatry, Queen Elizabeth Hospital.
Of five patients with pervasive developmental disorders (PDDs), four developed psychotic illnesses in adult life. The other was treated with antipsychotic medication for many years following a mistaken diagnosis of schizophrenia.
[Reprint (PDF) Version of Clarke et al.]
Abstract 2 of 2
The British Journal of Psychiatry 151: 89-94 (1987)© 1987 The Royal College of Psychiatrists
CSF monoamines in autistic syndromes and other pervasive developmental disorders of early childhood
C Gillberg and L Svennerholm
Department of Child and Adolescent Psychiatry, East Hospital University.
Spinal fluid concentrations of the three major monoamine metabolites were examined in 25 infantile autistic children and 12 children with other childhood psychoses, and were contrasted with results obtained in normal children and in groups of children with neurological and neurodevelopmental disorders. Autistic children showed absolute and relative increases of the dopamine metabolite homovanillic acid. The group with other childhood psychoses also showed an increase in HVA level; in this group there were also indications of high levels of serotonin and norepinephrine metabolites. The results are discussed in the context of a pathogenetic model for autism involving hyperfunction of dopaminergic nerve fibres in the brain stem-mesolimbic system.
[Reprint (PDF) Version of Gillberg and Svennerholm]
Kraeplinpsychiatry's Blog 