scholarly journals Psychotic Depression: Diagnosis, Differential Diagnosis, and Treatment

2020 ◽  
pp. 1-18
Author(s):  
Steven L. Dubovsky ◽  
Biswarup M. Ghosh ◽  
Jordan C. Serotte ◽  
Victoria Cranwell
Keyword(s):  
Acute Treatment ◽  
Maintenance Treatment ◽  
Unipolar Depression ◽  
Traumatic Experiences ◽  
Psychotic Symptoms ◽  
Psychotic Depression ◽  
Inadequate Information ◽  
Acute And Chronic Treatment ◽  
The Impact ◽  
Psychotic Bipolar Disorder

Psychotic depression was initially considered to be at one end of a continuum of severity of major depression. Subsequent experience demonstrated that psychosis is an independent trait that may accompany mood disorders of varying severity. While much has been learned about the impact of severe mood congruent delusions and hallucinations on the course and treatment response of depression, less is known about fleeting or mild psychosis, mood incongruent features, or psychotic symptoms that reflect traumatic experiences. Acute treatment of psychotic unipolar depression generally involves the combination of an antidepressant and an antipsychotic drug or electroconvulsive therapy. There is inadequate information about maintenance treatment of unipolar psychotic depression and acute and chronic treatment of psychotic bipolar disorder. Decision-making therefore still must rely in part on clinical experience.

scholarly journals S169. THE IMPACT OF PSYCHOSIS IN ADOLESCENT-ONSET BIPOLAR DISORDER: A STRUCTURAL MRI STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S101-S101
Author(s):  
Cristian Llach ◽  
Adriana Fortea ◽  
Isabel Valli ◽  
Iria Mendez ◽  
Sara Lera ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cortical Thickness ◽  
Orbitofrontal Cortex ◽  
Child And Adolescent ◽  
Psychotic Symptoms ◽  
Adolescent Patients ◽  
Bipolar Patients ◽  
Psychotic Features ◽  
The Impact ◽  
Psychotic Bipolar Disorder

Abstract Background Bipolar Disorder (BD) is a major psychiatric illness defined by episodic mood changes, which in approximately 50% of cases is associated with psychotic features. Over the past decades, a large amount of research has identified brain structural and functional alterations in patients with this mental disorder. Some findings have been found to be specific to patients with psychotic symptoms, raising suggestions that this could represent a biological subtype of the disorder. Recent interest has been addressed to Early-Onset Bipolar Disorder (EOBD, onset prior to age 18). Latest reviews in EOBD samples have pointed to abnormalities in the frontal lobe and limbic structures, with some inconsistencies in the reported results possibly caused by differences in the methodology. In addition, no study so far has examined the neural structural correlates of psychotic symptoms in adolescent-onset bipolar disorder (AOBD). The aim of the present study is to examine the impact of psychosis on the neurobiological architecture in a sample of patients with AOBD. To our knowledge, this is the first study comparing gray matter structure between AOBD patients with or without psychotic features. Methods We conducted a cross-sectional study collecting T1-weighted structural magnetic resonance neuroimaging (3T-MRI) data in patients diagnosed with Bipolar Disorder type I or II between 12 and 19 years old (N=46, mean age (SD)=15.89 (1.94), gender=52.2% females). All patients were recruited from child and adolescent mental health services of the Hospital Clinic of Barcelona, Spain. Diagnoses were confirmed with a semi-structured clinical interview (Kiddie-Sads present and lifetime version) by child and adolescent psychiatrists. Images were pre-processed employing FreeSurfer 5.3.0, and data corresponding to Cortical Thickness (CTH) and Subcortical Volumes (SCV) was obtained. Groups were compared according to whether patients had experienced psychotic symptoms at any point during their illness: Non-Psychotic Bipolar Disorder (NPSBD, N=25) and Psychotic Bipolar Disorder (PSBD, N=21). No differences in age (t=0.498, p=0.621) or sex (χ2=0.001, p=0.979). Group effects in relation to both CT and SCV were examined with a general linear model. The main effect of group on CTH and SCV, was performed for the whole brain, performing a correction for multiple comparisons (Montecarlo correction, threshold = 0.05). Results Between-group analyses showed smaller CTH in a cluster in the left medial orbitofrontal cortex (cluster size= 1142.58 mm2) in PSBD relative to NPSBD (x, y, z: 25.63, 89.61, -42.74; p=0.002). In addition, we observed a smaller right hippocampus volume (p=0.025) in PSBD relative to NPSBD. No other statistically significant differences were obtained. Discussion PSBD showed smaller cortical thickness in the left medial orbitofrontal cortex, as well as a volumetric reduction in the right hippocampal volume. Similar results have been reported in a study comparing adolescent patients with psychotic BD and healthy controls. These results add evidence about the role of these two structures in the genesis of psychotic symptoms in a population diagnosed with AOBD. Interestingly, one study has reported a surface area decreased of the orbitofrontal cortex in adolescent patients with a non-bipolar psychotic disorder, which suggests that they may be a common substrate to psychotic symptoms during adolescence regardless of co-occurring affective symptoms. In summary, this study points to the existence of a distinct biological nature between bipolar patients according to psychotic symptoms, underpinned by a different neurobiological architecture. Future research should focus on replication and on examining the clinical value of this finding.

scholarly journals The impact of poly-traumatization on treatment outcomes in young people with substance use disorders

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sidsel Karsberg ◽  
Morten Hesse ◽  
Michael Mulbjerg Pedersen ◽  
Ruby Charak ◽  
Mads Uffe Pedersen
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Psychological Trauma ◽  
Well Being ◽  
Traumatic Experiences ◽  
Treatment Entry ◽  
Trauma Types ◽  
Using Data ◽  
The Impact ◽  
Drug Use Disorder

Abstract Background It is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders. However, knowledge on the effect of the number of trauma experiences is scarce. Methods Using data from drug use disorder (DUD) treatment in Denmark, we assessed the impact of having experienced multiple potentially traumatic experiences on DUD treatment efficacy. Baseline and follow-up data from 775 young participants (mean age = 20.2 years, standard deviation = 2.6) recruited at nine treatment centers were included in analyses. Results Analyses showed that participants who were exposed multiple trauma experiences also reported a significantly higher intake of cannabis at treatment entry, and a lower well-being score than participants who reported less types or no types of victimization experiences. During treatment, patients with multiple types of trauma experiences showed a slower rate of reduction of cannabis than patients with few or no trauma experiences. The number of trauma types was not associated with number of sessions attended or the development of well-being in treatment. Conclusion Overall, the results show that although traumatized youth in DUD treatment show up for treatment, helping them to reduce substance use during treatment is uniquely challenging. Trial registration ISRCTN88025085, date of registration: 29.08.2016, retrospectively registered.

The Impact of Military Service Exposures and Psychological Resilience on the Mental Health Trajectories of Older Male Veterans

2020 ◽  
pp. 089826432097523
Author(s):  
Stephanie Ureña ◽  
Miles G. Taylor ◽  
Dawn C. Carr
Keyword(s):  
Mental Health ◽  
Depressive Symptom ◽  
Military Service ◽  
Later Life ◽  
Traumatic Experiences ◽  
Psychological Resilience ◽  
Previous Exposure ◽  
Negative Consequences ◽  
Symptom Trajectories ◽  
The Impact

Objectives: We examine the impact of exposure to the dead, dying, and wounded (DDW) during military service on the later-life depressive symptom trajectories of male United States veterans, using psychological resilience as an internal resource that potentially moderates negative consequences. Methods: The Health and Retirement Study (2006–2014) and linked Veteran Mail Survey were used to estimate latent growth curve models of depressive symptom trajectories, beginning at respondents’ first report of resilience. Results: Veterans with higher levels of resilience do not have increased depressive symptoms in later life, despite previous exposure to DDW. Those with lower levels of resilience and previous exposure to DDW experience poorer mental health in later life. Discussion: Psychological resilience is important for later-life mental health, particularly for veterans who endured potentially traumatic experiences. We discuss the importance acknowledging the role individual resources play in shaping adaptation to adverse life events and implications for mental health service needs.

Post-traumatic Growth: Longitudinal Study on Battered Women in Close Relationships after Both They and Their Partners Undergo Therapy

2021 ◽  
pp. 088626052199793
Author(s):  
Dorota Dyjakon ◽  
Beata Rajba
Keyword(s):  
Battered Women ◽  
Three Dimensions ◽  
Traumatic Experiences ◽  
Important Indicator ◽  
Event Scale ◽  
Post Traumatic Growth ◽  
Polish Version ◽  
Close Relationship ◽  
Post Traumatic ◽  
The Impact

Violence in intimate relationships is a major problem worldwide. Many women, despite having experienced violence from a partner, decide to remain in a relationship with the perpetrator. A special premise for such a decision is that the abusive partner undertakes therapy that serves to build security in the family. An important indicator of dealing with violence is post-traumatic growth (PTG), a concept introduced by Calhoun and Tedeschi (1998) to describe positive changes as a result of traumatic experiences. The purpose of the research was to assess PTG changes in the course of relationships in which the woman had experienced violence from her partner, but both her partner and she had undertaken therapy and changed their behavior ( N = 48). The conducted research used a demographic survey and two questionnaires: The Polish version of the Impact Event Scale-Revised (IES-R, Weiss, Marmara prepared by Juczyński and Ogińska-Bulik [2009]) examining three dimensions of trauma (intrusion, hyperarousal, and avoidance) and the Post-traumatic Growth Inventory ( Tedeschi & Calhoun [2004] ; Polish version prepared by Ogińska-Bulik & Juczyński [2010] ). The studies showed that over a period of one and half years, significant changes in PTG had taken place. Reportedly, changes in self-perception and changes in relating to others have decreased, while appreciation of life increased but spiritual life remained the same. The research also allowed us to distinguish several groups of corelates in changes in individual PTG categories. The studies also indicate that building a close relationship with the person who caused the harm can limit the victim’s PTG.

scholarly journals Childhood adversity and psychosis: generalised or specific effects?

2015 ◽  
Vol 25 (4) ◽  
pp. 349-359 ◽  
Author(s):  
E. Longden ◽  
M. Sampson ◽  
J. Read
Keyword(s):  
Sexual Abuse ◽  
Physical Abuse ◽  
Negative Symptoms ◽  
Childhood Adversity ◽  
Clinical Intervention ◽  
Current Data ◽  
Psychotic Symptoms ◽  
Multiple Exposures ◽  
Specific Effects ◽  
The Impact

Background.This study examines relationships between childhood adversity and the presence of characteristic symptoms of schizophrenia. It was hypothesised that total adversity exposures would be significantly higher in individuals exhibiting these symptoms relative to patients without. Recent proposals that differential associations exist between specific psychotic symptoms and specific adversities was also tested, namely: sexual abuse and hallucinations, physical abuse and delusions, and fostering/adoption and delusions.Method.Data were collected through auditing 251 randomly selected medical records, drawn from adult patients in New Zealand community mental health centres. Information was extracted on presence and subtype of psychotic symptoms and exposure to ten types of childhood adversity, including five types of abuse and neglect.Results.Adversity exposure was significantly higher in patients experiencing hallucinations in general, voice hearing, command hallucinations, visions, delusions in general, paranoid delusions and negative symptoms than in patients without these symptoms. There was no difference in adversity exposure in patients with and without tactile/olfactory hallucinations, grandiose delusions or thought disorder. Indication of a dose–response relationship was detected, in that total number of adversities significantly predicted total number of psychotic symptoms. Although fostering/adoption was associated with paranoid delusions, the hypothesised specificity between sexual abuse and hallucinations, and physical abuse and delusions, was not found. The two adversities showing the largest number of associations with psychotic symptoms were poverty and being fostered/adopted.Conclusions.The current data are consistent with a model of global and cumulative adversity, in which multiple exposures may intensify psychosis risk beyond the impact of single events. Implications for clinical intervention are discussed.

Trauma Focused Psychodynamic Psychotherapy

2021 ◽  
Author(s):  
Frederic Busch ◽  
Barbara Milrod ◽  
Cory Chen ◽  
Meriamne Singer
Keyword(s):  
Traumatic Stress ◽  
Psychodynamic Psychotherapy ◽  
Symptomatic Relief ◽  
Traumatic Experiences ◽  
Veterans Administration ◽  
Post Traumatic Stress ◽  
Interpersonal Engagement ◽  
Post Traumatic ◽  
The Impact ◽  
Insight Into

This book, which operationalizes and articulates in detail a unique, brief, tested psychodynamic psychotherapy for Post-Traumatic Stress Disorder, Trauma Focused Psychodynamic Psychotherapy [TFPP], describes how to perform this helpful treatment. The book provides tailored psychodynamic background that underpins these approaches, and explains the different phases of treatment. Additionally, it articulates common underlying dynamics of PTSD that the treatment commonly addresses in patients to bring about symptomatic relief. TFPP is being tested in two diverse populations: military Veterans with PTSD who are receiving care at three Veterans Administration Hospitals, and also among LGBTQ patients with PTSD. The book is focused on the authors’ experiences treating Veterans and many clinical examples are provided demonstrating how to work with these principles and approaches. In general, patients and therapists have found the treatment to be an extremely useful tool. Veterans have gained insight into the impact of traumatic experiences on various aspects of their lives and had improvements in dissociation, interpersonal engagement, anxiety, and anger/hostility. TFPP appears to be particularly effective for patients with prominent avoidance symptoms and those who are unwilling or unable to recount the details of their trauma directly. Patients have been found to be more affectively engaged and better connected to others (including the therapist) following treatment.

scholarly journals Inner strategies of coping with operational work amongst SAPS officers

2013 ◽  
Vol 39 (2) ◽  
Author(s):  
Masefako A. Gumani ◽  
Mattheus E. Fourie ◽  
Martin J. Terre Blanche
Keyword(s):  
Coping Strategies ◽  
Critical Incident ◽  
The Body ◽  
Traumatic Experiences ◽  
Critical Incident Stress Debriefing ◽  
Critical Incident Stress ◽  
South African Police Service ◽  
Managerial Implications ◽  
Value Add ◽  
The Impact

Orientation: Identification of the inner coping strategies used by South African Police Service (SAPS) officers who do operational work is something the SAPS should consider to ensure the officers’ management of trauma and efficiency at work.Research purpose: The objective of this study was to describe inner coping strategies used by officers in the Vhembe district (South Africa) to reconstruct stressful and traumatic experiences at work.Motivation for the study: Most studies on coping amongst SAPS officers focus on organisational stress and not on the impact of the officers’ operational work.Research design, approach and method: An exploratory design was used and 20 SAPS officers were selected through purposive sampling. In-depth face-to-face and telephone interviews, as well as diaries were used to collect data, which were analysed using content thematic data analysis.Main findings: The results showed that the main categories of coping strategies that led to management of the impact of operational work amongst the selected sample were centred around problem-focused and emotion-focused strategies, with some use of reappraisal and minimal use of avoidance. Considering the context of the officers’ work, the list of dimensions of inner coping strategies amongst SAPS officers should be extended.Practical/managerial implications: Intervention programmes designed for the SAPS, including critical incident stress debriefing, should take the operational officers’ inner strategies into account to improve the management of the impact of their work.Contribution/value-add: This study contributes to the body of knowledge on the inner coping strategies amongst SAPS officers, with special reference to operational work in a specific setting.

scholarly journals CINP 2005 Regional Meeting, 20-22 April 2005

2005 ◽  
Vol 11 (1) ◽  
pp. 10
Author(s):  
Anissa Abi-Dargham ◽  
Christer Allgulander ◽  
O Gureje ◽  
Rachel Jenkins ◽  
R N Kalaria ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Mental Health Policy ◽  
Traumatic Experiences ◽  
Focus Group Study ◽  
African Context ◽  
The Impact

List of abstract titles and authors:1. Antipsychotics across the spectrum: An overview of their mechanisms of actionAnissa Abi-Dargham2. Recent advances in the treatment of common anxiety disordersChrister Allgulander3. Psychiatry in Africa: The myths, the realities and the exoticO Gureje4. Mental Health policy developmet in Kenya and Tanznia - A DFID funded projectRachel Jenkins, David Kima, Joseph Mbatia, Frank Njenga5. Vascular factors in Alzheimer's diseaseR N Kalaria6. Depression as an immunologically based Neurodegenerative disorderBrian Leonard7. Eight years of progress in Arican PsychiatryF Njenga8. Treatment of Depression: Present and futureDr R.M. Pinder9. Imaging the Serotinergic system in impulsive aggressive personality disorder patientsLarry J Siever, Antonia S. New, Mari Goodman, Monte Buchsbaum, Erin Hazlett, Karen O'Flynn, Anissa Abi-argham, Marc Lauelle10. Mode of action of Atypical antipsychotic rugs: Focus on A2 AdrnoceptorsT.H. SvenssonNeuroscience: Selected Abstracts11. Chemical odulato of Fronto-execuitive functions: Neropsychiatric implicationsTrevor W Robbins12. Neural mechanisms of recognition memory and of social atacntProf. G Horn13. Estrogen signling after estrogen receptor ß (ERß)Jan-Ake Gustafsson14. Getting Lost: Hippocampal contributions to agerelated memory dysfunctionCarol BarnesMetals and the brain: Selected abstracts15. Modeling the contributin of iron mismanagement to Neurological disordersProf. J R C Connor16. Aluminium-triggered fibrillogenesis of B-AmyloidsProf. PZ Zatta, Dr D Drago, Mr G Tognon, Dr F RicchelliPsychiatry in Africa:17. Psychosocal aspects of Khat use among the youth of NairobiMs T M Khamis18. PTSD among motor vehicle accident survivors, KenyaDr F A Ongecha19. Psychiatric relities within African context - The Kenyan case StudyProf. D M  N Ndetei20. Adolescent-parenta interactions from infancy, Nairobi KenyaDr L K Ksakhala, Prof. D M N Ndetei21. Alcohol use ong young persons: A focus group study in Southwest NigeriaO A Obeijide22. Personality disorders and personality traits among tyoe 2 Diabetic patientsProf. O El Rufaie, Dr M Sabosy, Dr M S Abuzeid23. Association of traumatic experiences with depression among Nigerian adolescentsDr O Omigbodun, Dr K BakareMs O B Yusuf, Dr O Esan24. Prevalence of depression among women attending outpatient clinics in MalawiDr  M Tugumisirize, Prof. Agn, Dr Musisi25. Non-fatal suicidalbehaviour at the Johannesburg General HospitalDr  M Y H Moosa, Prof. F Y Jeenah, Dr A Pillay, Pof. M Vorstere, Dr R Liebenberg26. Integrating mental health into general primary health care - Uganda's experienceDr N Kigozi27. Depression among Nigerian survivors of stroke:Prevalance and associated factorsDr F.O Fatoye Dr M A Komolafe, Dr A. O Adewuya, Dr B.A. Eegunranti Prof. M.A. Lawal28. NGO Involvement mental health care -The way forwardDr  Basangwa29. Prevalen of Attenton Deficit Hyperactivity sorder among African school childrenDr E KashalaProf. T Tylleskar, Dr I Elgen, Dr K Sommerfelt30. Barriers to effective mental health care in NigeriaMs L. Kola31. Quay of life evaluation in patients with HIV-I infection with respect to the impact of Phyttherapy (Traditional Herb in Zimbabwe)M B Sebit, S K Chandiwaa, A S Latif, E Gomo, S W Acuda, F Makoni, J Vushe

scholarly journals A Scoping Review of Trauma-Informed Curricula for Primary Care Providers

2021 ◽  
Vol 53 (10) ◽  
pp. 843-856
Author(s):  
Constance Gundacker ◽  
Tyler W. Barreto ◽  
Julie P. Phillips
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Health Outcomes ◽  
Primary Care Providers ◽  
The United States ◽  
Traumatic Experiences ◽  
Search Term ◽  
Care Providers ◽  
Trauma Informed ◽  
The Impact

Background and Objectives: Traumatic experiences such as abuse, neglect, and household dysfunction have a lifetime prevalence of 62%-75% and can negatively impact health outcomes. However, many primary care providers (PCPs) are inadequately prepared to treat patients with trauma due to a lack of training. Our objective was to identify trauma-informed approach curricula for PCPs, review their effectiveness, and identify gaps. Methods: We systematically identified articles from Medline, Scopus, Web of Science, Academic Search Premier, Cochrane, PsycINFO, MedEd Portal, and the STFM Resource Library. Search term headings “trauma-informed care (TIC),” “resilience,” “patient-centered care,” “primary care,” and “education.” Inclusion criteria were PCP, pediatric and adult patients, and training evaluation. Exclusion criteria were outside the United States, non-English articles, non-PCPs, and inpatient settings. We used the TIC pyramid to extract topics. We analyzed evaluation methods using the Kirkpatrick Model. Results: Researchers reviewed 6,825 articles and identified 17 different curricula. Understanding health effects of trauma was the most common topic (94%). Evaluation data revealed overall positive reactions and improved knowledge, attitudes, and confidence. Half (53%) reported Kirkpatrick level 3 behavior change evaluation outcomes with increased trauma screening and communication, but no change in referrals. Only 12% (2/17) evaluated Kirkpatrick level 4 patient satisfaction (significant results) and health outcomes (not significant). Conclusions: Pilot findings from studies in our review show trauma-informed curricula for PCPs reveal positive reactions, an increase in knowledge, screening, communication, and patient satisfaction, but no change in referrals or health outcomes. Further research is needed to examine the impact of trainings on quality of care and health outcomes.

scholarly journals IS HAVING A HELICOPTER MOTHER A TRAUMATIC EXPERIENCE? THE RELATIONSHIP BETWEEN HELICOPTER MOTHER ATTITUDE AND TRAUMATIC EXPERIENCES AND LEARNED HELPLESSNESS

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Hasan Yılmaz ◽  
Coşkun Arslan ◽  
Emel Arslan
Keyword(s):  
Young Children ◽  
Learned Helplessness ◽  
Scientific Explanation ◽  
Traumatic Experience ◽  
Traumatic Experiences ◽  
Scientific Fact ◽  
Scientific Facts ◽  
The Impact ◽  
The Relationship

The purpose of this study is to examine the impact of mothers’ and teachers’ testimonies that conflict with scientific facts and scientific explanations on kindergartners’ judgments. The participants consisted of 104 young children in Şanlıurfa province in Turkey. Their ages ranged from 48 to 79 months, with a mean age of 61.48 months (SD = 5.58). The participants were randomly assigned to the following four groups: 1) Scientific explanation followed by teacher’s testimony, 2) teacher’s testimony; 3) scientific explanation followed by mother’s testimony, 4) mother’s testimony. The children responded to a question about a scientific fact. After the response, they watched their mothers’ or teachers’ testimonies which contradict the scientific fact. Findings revealed that when a scientific explanation was not provided, the children tended to show deference to their teachers’ and especially mothers’ testimony. A week later, a follow-up measurement revealed that this impact did not last a week.

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