Contemporary Supportive Therapy: A Review of History, Theory, and Evidence

2021 ◽  
Vol 49 (4) ◽  
pp. 562-590
Author(s):  
Holly M. Van Den Beldt ◽  
Anne E. Ruble ◽  
Randon S. Welton ◽  
Erin M. Crocker
Keyword(s):  
Body Dysmorphic Disorder ◽  
Supportive Therapy ◽  
Collaborative Problem Solving ◽  
Supportive Psychotherapy ◽  
Psychiatric Illnesses ◽  
Reality Testing ◽  
Flexible Form ◽  
Wide Range ◽  
Artery Disease ◽  
Default Form

Supportive psychotherapy interventions were developed as a part of psychodynamic psychotherapy work, and supportive psychotherapy was historically considered to be the default form of therapy only for lower-functioning patients. These roots unfortunately have resulted in supportive psychotherapy being viewed as an inferior form of treatment. In reality, supportive psychotherapy is a practical and flexible form of psychotherapy that helps patients with a wide range of psychiatric illnesses, including mood disorders, anxiety disorders, posttraumatic stress disorder, schizophrenia, personality disorders, eating disorders, body dysmorphic disorder, and substance use disorders. In addition, supportive psychotherapy can be well-suited to higher-functioning patients, as well as to patients who are chronically lower-functioning. There is also evidence to support the use of supportive psychotherapy in patients with certain medical illnesses, including coronary artery disease, some gastrointestinal illnesses, HIV infection, and certain types of cancer. The goals of supportive psychotherapy include helping patients to understand emotional experiences, improving affective regulation and reality-testing, making use of their most effective coping strategies, and engaging in collaborative problem solving to reduce stressors and increase effective engagement with support systems.

scholarly journals Fat Embolism and Nonconvulsive Status Epilepticus

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Yanetsy Olivera Arencibia ◽  
Mai Vo ◽  
Jennifer Kinaga ◽  
Jorge Uribe ◽  
Gloria Velasquez ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Mental Status ◽  
Supportive Therapy ◽  
Altered Mental Status ◽  
Fat Embolism ◽  
Nonconvulsive Status Epilepticus ◽  
Altered Level ◽  
Fat Embolism Syndrome ◽  
Embolism Syndrome ◽  
Wide Range

Fat embolism syndrome (FES) typically occurs following orthopedic trauma and may present with altered mental status and even coma. Nonconvulsive status epilepticus is an electroclinical state associated with an altered level of consciousness but lacking convulsive motor activity and has been reported in fat embolism. The diagnosis is clinical and is treated with supportive care, antiepileptic therapy, and sedation. A 56-year-old male presented with altered mental status following internal fixation for an acute right femur fracture due to a motor vehicle accident 24 hours earlier. Continued neuromonitoring revealed nonconvulsive status epilepticus. Magnetic resonance imaging of the brain showed multiple bilateral acute cerebral infarcts with a specific pattern favoring the diagnosis of fat embolism syndrome. He was found to have a significant right to left intracardiac shunt on a transesophageal echocardiogram. He improved substantially over time with supportive therapy, was successfully extubated on day 6, and discharged to inpatient rehabilitation on postoperative day 15. Fat embolisms can result in a wide range of neurologic manifestations. Nonrefractory nonconvulsive status epilepticus that responds to antiepileptic drugs, sedation, and supportive therapy can have a favorable outcome. A high index of suspicion and early recognition reduces the chances of unnecessary interventions and may improve survival.

scholarly journals The Diagnosis and Treatment of Borderline Schizophrenia in Adolescence

1967 ◽  
Vol 12 (3) ◽  
pp. 247-251 ◽  
Author(s):  
Philip Katz
Keyword(s):  
Treatment Program ◽  
Thought Disorder ◽  
The Other ◽  
Strengthening Effect ◽  
Supportive Psychotherapy ◽  
Environmental Manipulation ◽  
Reality Testing ◽  
Schizophrenic Reaction ◽  
Real Person ◽  
The Relationship

It is necessary to establish the presence or absence of a borderline schizophrenic reaction early, for it is of great importance in deciding on the treatment program for the patient. Its presence is suspected if there are symptoms that indicate that the patient is developing a thought disorder, and/or a disturbance of affect of schizophrenic type, and/or is beginning to detach from reality. It is also suspected if there is a persistence of such symptoms as disturbances of judgment, poor empathy and understanding of others, an absence of enjoyment, periods of seclusiveness, or sexual and philosophical preoccupations. Mixtures of the neuroses, with free-floating anxiety often indicates an underlying schizophrenic process. In the treatment of a patient with a borderline schizophrenic reaction, the prime focus should be on the prevention of a psychosis. The child should be protected against severe stresses, which may involve some environmental manipulation. Anxiety has a deteriorating effect and tranquillizers may have to be used. Supportive psychotherapy is of great value. It is essential that the relationship with the therapist be a positive one. The therapist should be a real person who offers the adolescent patient someone with whom to identify. One strengthens useful defences and lessens the need for the other defences by reducing the ego's needs for those defences, e.g. by reality testing the fantasied threats, by offering a less punitive and less rigid superego, and by manipulating the environment to reduce stress. It is often helpful to orient the patient towards pleasurable experiences which have an ego-strengthening effect. Here then, in the handling of the defences and in the management of anxiety, can be seen a major difference in the treatment of patients with a borderline schizophrenic reaction, from the treatment of patients with psycho-neuroses or personality disorders. Failure to recognize the presence of an underlying schizophrenic process may lead to the choice of the wrong treatment program for the patient, with a resultant worsening of his condition and the onset of a psychosis.

scholarly journals Cost-effectiveness of internet-delivered cognitive behaviour therapy for body dysmorphic disorder: results from a randomised controlled trial

2021 ◽  
Author(s):  
Oskar Flygare ◽  
Erik Andersson ◽  
Gjermund Glimsdal ◽  
David Mataix-Cols ◽  
Diana Djurfeldt ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Outcome Measures ◽  
Cognitive Behaviour Therapy ◽  
Body Dysmorphic Disorder ◽  
Controlled Trial ◽  
Cost Utility ◽  
Secondary Outcome ◽  
Behaviour Therapy ◽  
Supportive Psychotherapy ◽  
Cognitive Behaviour

Objectives: To evaluate the cost-effectiveness of internet-delivered cognitive behaviour therapy for body dysmorphic disorder (BDD-NET). Design: Secondary cost-effectiveness analysis from a randomised controlled trial on BDD-NET versus online supportive psychotherapy. Setting: Academic medical centre. Participants: Self-referred adult patients with a primary diagnosis of body dysmorphic disorder and a score of 20 or higher on the modified Yale-Brown obsessive compulsive scale (n = 94). Patients receiving concurrent psychotropic drug treatment were included if the dose had been stable for at least two months and remained unchanged during the trial. Interventions: Participants received either BDD-NET (n = 47) or online supportive psychotherapy (n = 47) for 12 weeks. Primary and secondary outcome measures: The primary outcome measures were cost-effectiveness and cost-utility from a societal perspective, using remission status from a diagnostic interview and quality-adjusted life years from EQ-5D, respectively. Secondary outcome measures were cost-effectiveness and cost-utility from a health care perspective and the clinics perspective. Results: Compared to supportive psychotherapy, BDD-NET produced one additional remission for an average societal cost of $4132. The cost-utility analysis showed that BDD-NET generated one additional QALY to an average cost of $14319 from a societal perspective. Conclusions: BDD-NET is a cost-effective treatment for body dysmorphic disorder, compared to online supportive psychotherapy. The efficacy and cost-effectiveness of BDD-NET should be directly compared to face-to-face cognitive behaviour therapy.

An Overview of FGF19 and FGF21: The Therapeutic Role in the Treatment of the Metabolic Disorders and Obesity

2018 ◽  
Vol 50 (06) ◽  
pp. 441-452 ◽  
Author(s):  
Nasim Babaknejad ◽  
Hashem Nayeri ◽  
Roohullah Hemmati ◽  
Somaye Bahrami ◽  
Ahmad Esmaillzadeh
Keyword(s):  
Cellular Proliferation ◽  
Metabolic Diseases ◽  
Glucose And Lipid Metabolism ◽  
Timely Review ◽  
Wide Range ◽  
Probable Role ◽  
Artery Disease ◽  
Treatment Of Obesity ◽  
The Relationship

AbstractFibroblast growth factors (FGFs) are responsible for the regulation of a wide range of biological functions, among which cellular proliferation, survival, migration, and differentiation could be pointed out. FGF19 controls the enterohepatic bile acid/cholesterol system, and FGF21 modulates fatty acid/glucose metabolism. Obesity, type 2 diabetes, coronary artery disease, and cancer, all can alter FGF21 circulating concentrations. In contrast to FGF21, metabolic diseases exhibit reduced serum FGF19 levels. Accordingly, FGF19 and FGF21 play important roles in regulating glucose and lipid metabolism. Hence, we present here a timely review on the relationship between FGF19/21 and metabolic diseases, especially obesity, and their probable role in development and treatment of obesity seems necessary.

Postoperative complications associated with coronary artery bypass graft surgery and their therapeutic interventions

2020 ◽  
Vol 16 (5) ◽  
pp. 481-496 ◽  
Author(s):  
Ali Pooria ◽  
Afsoun Pourya ◽  
Alireza Gheini
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Adverse Events ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Wide Range ◽  
Artery Disease

Coronary artery disease is one of the commonest surgery demanding cardiovascular diseases. Coronary artery bypass graft surgery is practiced all over the world for the treatment of coronary artery disease. Systemic trauma during the surgery is associated with a wide range of complications, some of which are fatal. Preoperative risk factors such as age, previous illness and obesity are common predictors of these adverse events. Advances in therapeutic medicine have allowed timely treatment of these adverse events and co-morbidities. This review summarizes some of the most occurring complications associated with coronary artery bypass graft and corresponding treatment options.

Simultaneous use of bilateral subthalamic nucleus stimulators and an implantable cardiac defibrillator

2003 ◽  
Vol 99 (1) ◽  
pp. 167-169 ◽  
Author(s):  
Joshua M. Rosenow ◽  
Howard Tarkin ◽  
Elias Zias ◽  
Carmine Sorbera ◽  
Alon Mogilner
Keyword(s):  
Subthalamic Nucleus ◽  
Implantable Defibrillator ◽  
Content Type ◽  
Ventricular Lead ◽  
Wide Range ◽  
Risk Patients ◽  
Neurological Effects ◽  
Artery Disease ◽  
Deep Brain ◽  
Implantable Cardiac Defibrillators

✓ Bilateral electrical stimulation of the subthalamic nucleus is being used with increasing frequency as a treatment for severe Parkinson disease (PD). Implantable cardiac defibrillators improve survival in certain high-risk patients with coronary artery disease and ventricular arrhythmias. Because of concern about possible interaction between these devices, deep brain stimulation (DBS) systems are routinely disconnected before defibrillators are implanted in patients with PD and arrhythmia. The authors report on a patient with bilateral subthalamic stimulators who underwent successful placement of an implantable defibrillator. Testing of the devices over a wide range of settings revealed no interaction. The patient subsequently underwent multiple episodes of cardioversion when the ventricular lead became dislodged. There was no evidence of adverse neurological effects, and interrogation of the DBS devices after cardioversion revealed no changes in stimulus parameters. The outcome in this case indicates that DBS systems may be safely retained in selected patients who require implantable cardiac defibrillators.

scholarly journals Fixed-dose combinations in the treatment of hypertension to increase adherence

2020 ◽  
Vol 25 (11) ◽  
pp. 4184
Author(s):  
T. E. Morozova ◽  
E. O. Samokhina
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Fixed Dose ◽  
Optimal Solutions ◽  
Comorbid Conditions ◽  
Treatment Regimens ◽  
Wide Range ◽  
Treatment Of Hypertension ◽  
Artery Disease ◽  
Initiation Of Therapy

Despite a wide range of antihypertensive drugs, blood pressure (BP) control often remains unsatisfactory, and every year the number of people with uncontrolled high BP increases. One of the strategies aimed at improving medical adherence is the use of fixed-dose combinations of 2 antihypertensive drugs for starting therapy, and, if necessary, 3 drugs. Initiation of therapy with 2 drugs in one tablet is recommended for most patients. A review of algorithms for choosing combinations of antihypertensive drugs in different clinical situations, including in patients with various comorbid conditions, is presented. Simplification of treatment regimens makes it possible to choose the most optimal solutions in various clinical situations, in particular, with stage I-II hypertension, with a combination of hypertension with chronic kidney disease, as well as with a combination of hypertension with coronary artery disease and a number of other diseases.

scholarly journals Associations of rs4244285 in the CYP2C19 gene with multifactorial diseases

2022 ◽  
Vol 36 (4) ◽  
pp. 125-131
Author(s):  
N. P. Babushkina ◽  
A. E. Postrigan ◽  
A. N. Kucher ◽  
V. M. Shipulin
Keyword(s):  
Population Control ◽  
Population Sample ◽  
Xenobiotic Metabolism ◽  
Comorbid Conditions ◽  
Multifactorial Diseases ◽  
Organ Systems ◽  
Wide Range ◽  
Cyp2c19 Gene ◽  
Endogenous Substrates ◽  
Artery Disease

Xenobiotic metabolism system in the current populations is involved in the biotransformation of a wide range of endogenous substrates and various xenobiotics, which can contribute to developing the diseases of various organ systems, and, in some cases, comorbid conditions where increased biotransformation system activity is observed. In this regard, it is of great interest to study the involvement of polymorphism in xenobiotic metabolism genes in the development of both isolated pathology and various comorbid conditions.Aim. The goal of study was to investigate the involvement of rs4244285 in the CYP2C19 gene in the development of isolated pathology and comorbidities.Material and Methods. The frequencies of alleles and genotypes were studied in groups of patients with comorbid conditions including groups of coronary artery disease (CAD) with hypertension (HTN) (CAD_HTN, n = 133) and bronchial asthma (BA) with HTN (BA_HTN, n = 178), in group of isolated BA (n = 135), and in the population sample of the city of Tomsk (n = 377). Association analysis covered three initial groups of patients (CAD, BA, and BA_HTN) and subgroups assigned based on the presence of absence of HTN diagnosis taking into account comorbid conditions both in patient samples and in population control.Results and Discussion. The study demonstrated the predisposing eff ect of GA genotype on the development of comorbid BA and HTN (OR = 1.94, p = 0.038) and comorbid CAD and HTN (OR = 2.26, p = 0.009) compared to isolated BA. The AA genotype was observed 3.98 times less often in HTN patients than in normotensive individuals. However, the diff erences did not reach the level of statistical signifi cance due to the low occurrence of this genotype.Conclusion. The obtained results may be explained by the involvement of CYP2C19-metabolites of arachidonic acid in the regulation of vascular tone, which requires further study.

scholarly journals The Oxford Service for the Young Adult Chronically Mentally Ill

1987 ◽  
Vol 11 (11) ◽  
pp. 377-379
Author(s):  
G. P. Pullen
Keyword(s):  
Hospital Care ◽  
Psychiatric Hospitals ◽  
Group Homes ◽  
Psychiatric Illnesses ◽  
Realistic Option ◽  
Wide Range ◽  
Active Rehabilitation ◽  
High Level ◽  
Oxford Group ◽  
The University

Oxfordshire is a pleasant, prosperous county dominated by the City where about one third of its 480,000 population lives. Oxford itself has nearly 15,000 students attending the University or Polytechnic. The active rehabilitation of long-stay patients was started in Oxford over 25 years ago, with the result that by 1986 there were only 40 non-dementing psychiatric-in-patients with a current admission of five or more years. This successful programme of rehabilitation, now virtually completed, was achieved by creating a wide range of sheltered work and other activities, and by the provision since 1963 of over 40 group homes and hostels by the Oxford Group Homes Organisation. However, many psychiatric illnesses still have a chronic and relapsing course; 65% of all admissions, aged 18 to 65 to the Oxford District mental illness units in 1982 and 1983, were readmissions. For those diagnosed as suffering from schizophrenia the figure rises to 80%. In 1972 and 1973 Mann & Cree surveyed 400 ‘new’ long-stay patients (current admission one to five years, aged 18 to 65) in 15 hospitals in England and Wales. They found a rate of 25 per 100,000 population and concluded that for about one third continuing hospital care was the only realistic option. If the remainder were to leave hospital, hostels providing a high level of support would be needed. The recent 1982 survey of ‘new chronic’ in-patients in 14 Scottish psychiatric hospitals still showed a rate of 17.2 per 100,000 population, of whom only 38% were not thought to be in need of continuing hospital care.

Introduction to nuclear cardiology

2017 ◽  
Author(s):  
Nikant Sabharwal ◽  
Parthiban Arumugam ◽  
Andrew Kelion
Keyword(s):  
Nuclear Cardiology ◽  
Left Ventricular ◽  
Imaging Modalities ◽  
Non Invasive ◽  
Early Twenty ◽  
Cardiac Imaging Technique ◽  
Wide Range ◽  
History Of ◽  
X Ray Computed ◽  
Artery Disease

The cardiologist of the early twenty-first century takes for granted the wide range of imaging modalities at his/her disposal, but it was not always so. At the beginning of the 1970s, invasive cardiac catheterization was the only reliable cardiac imaging technique. Subsequently, nuclear cardiology investigations led the way in the non-invasive assessment of cardiac disease. This chapter covers the history of nuclear cardiology, including important milestones in the development of nuclear medicine. It details the relation of nuclear cardiology to other imaging modalities, covering the common imaging modalities used to evaluate left ventricular function and coronary artery disease, and the challenges of multislice X-ray computed tomography.

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