Psychodynamic Psychotherapy

2017 ◽  
Author(s):  
Adam Brenner ◽  
Michael Laney
Keyword(s):  
Psychodynamic Psychotherapy ◽  
Free Association ◽  
Symptomatic Improvement ◽  
Evidence Based Treatment ◽  
Developmental Experiences ◽  
Developmental Opportunities ◽  
Key Words Attachment ◽  
Therapeutic Attitude ◽  
Triangular Relationships

Psychodynamic psychotherapy is an evidence-based treatment that historically had its origins in psychoanalysis. It is based on an appreciation that the past continues to interfere with the present through the persisting existence of relationship templates generated during development. These developmental experiences include ideas, wishes, and fears that are too disturbing for the patient to allow awareness but continue to exert their effects outside of conscious awareness. The psychodynamic therapist fosters an experience that allows for unconscious material to become more available, through free association, examination of resistance, and exploration of transference. As therapy progresses, the growth of the patient’s insight and the resumption of stalled developmental opportunities result in symptomatic improvement and an enhanced quality of life. Psychodynamic psychotherapy has both a long history and an expanding literature that will both reward further study and assist in the care and understanding of those sufferers who are seen by clinicians every day. This review contains 5 tables, and 60 references. Key words: attachment, autonomy, free association, identity, resistance, separation, therapeutic attitude, transference, triangular relationships, unconscious motivation

Bleomycin for orbital and peri-orbital veno-lymphatic malformations – A systematic review

2020 ◽  
pp. 159101992097251
Author(s):  
Khunsa Faiz ◽  
Stephanos Finitsis ◽  
Janice Linton ◽  
Jai Jai Shiva Shankar
Keyword(s):  
Systematic Review ◽  
Pulmonary Fibrosis ◽  
Vascular Malformations ◽  
Symptomatic Improvement ◽  
Low Flow ◽  
Cochrane Database ◽  
Objective Reduction ◽  
Retrospective Cohort Studies ◽  
Subjective Reduction

Background Orbital and peri-orbital venolymphatic malformations (VLM) are low flow vascular malformations. Intralesional bleomycin is now commonly being used to treat such malformations. Objective The purpose of this systematic review is to synthesize evidence on the safety and efficacy of bleomycin/pingyangmycin sclerotherapy for the treatment of orbital and peri-orbital VLM. Methods We searched Medline, Embase, Scopus and Cochrane database for studies reporting outcomes of bleomycin/pingyangmycin sclerotherapy for orbital and peri-orbital VLM between 1974 to April 5th, 2019. Nine retrospective cohort studies enrolling 132 patients were included. Two reviewers independently screened and extracted data and assessed the risk of bias. Predefined outcome measures were subjective and objective reduction of the lesion and associated complications. Results Subjective reduction of the lesions was seen in 96.2% of the studies. Objective reduction of the lesion and symptomatic improvement were reported in 91.6 and 95% of the studies respectively. Non responders were 9.0%. Minor adverse events were reported in 18.1% of the studies. Major complications like pulmonary toxicity or pulmonary fibrosis was not encountered in any of the included studies. Quality of evidence was generally low. Conclusion Bleomycin/pingyangmycin sclerotherapy is very effective and relatively safe for the treatment of orbital and periorbital VLM and is not associated with any major side effects including pulmonary fibrosis. Limitations: The systematic review is limited mainly due to low quality of the included studies with retrospective design.

scholarly journals Transarterial Chemoembolization (TACE) with Lipiodol� in HCC PatientsTechnical, clinical and imagistic aspects

2019 ◽  
Vol 56 (1) ◽  
pp. 194-187
Author(s):  
Decebal Fodor ◽  
Bogdan Andrei Suciu ◽  
Ioan Jung ◽  
Simona Gurzu ◽  
Tamas-Csaba Sipos ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Alternative Therapy ◽  
Life Quality ◽  
Case Series ◽  
Hepatic Tumors ◽  
Hepatic Transplantation ◽  
Therapeutic Attitude ◽  
Control Tumor ◽  
Prolongation Of Life

Hepatocellurar carcinoma (HCC) is the most frequent primary hepatic tumor, the vast majority of patients have less than a 12 month survival rate. The aim of this study was to evaluate the efficacy of TACE in patients with HCC, based on a case series and literature review. The study included 12 consecutive patients with HCC who underwent surgical treatment (resection, liver transplantation � resection) at the Department of Transplantation and Surgery, Semmelweis University, Budapest, during 2009-2015. All the patients received at least one TACE session. Patients with BCLC B-stage who benefit from TACE and another alternative therapy (eg, RFA) may be associated with or exhibit tumor stagnation, or tumor necrosis in most cases. In C BCLC stages, desperate cases - the two patients to whom TACE was the last therapeutic attitude, despite the predicted prognosis, TACE assured the prolongation of life and increased life quality. In the majority of patients in this study, stage A BCLC, chemoembolization was a therapeutic attitude that allowed subsequent liver transplantation (when it was not feasible initially due to tumor size) or liver resection in apparently inoperable cases. The arterial chemotherapy is the unanimously accepted indication in patients with stage B, BCLC. The data presented encourages us to opt for TACE with the intention of destaging BCLC and giving an operability character to the hepatic tumors (resection � hepatic transplantation). In stage C BCLC, TACE can be a last attempt to improve the quality of life and to control tumor progression.

scholarly journals The Third AUTP Conference on ‘Teaching Psychodynamic Psychotherapy’

1986 ◽  
Vol 10 (9) ◽  
pp. 241-242
Author(s):  
John Denford
Keyword(s):  
Small Groups ◽  
Psychodynamic Psychotherapy ◽  
Personal Quality ◽  
The Third ◽  
University College

As is often the case, Oxford was damp and cold, but this did not deter the more athletic of us from trotting round lovely Christchurch meadows, or the more aesthetic from visiting an exhibition of Impressionist drawings in the Bodleian. The unpretentious, even homely, character of University College helped to draw a quite disparate group of psychotherapists together. This in turn was reinforced by the personal quality of all the formal presentations, and by the repeated experiences of small groups whose composition is stable. They allow the development of some degree of relationship both personal and intellectual in the course of two days.

654 PHARYNGEAL POUCH SURGERY IN OCTO- AND NONAGENARIANS IS SAFE AND EFFECTIVE: A MULTICENTER COMPARATIVE COHORT STUDY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
David Liu ◽  
Mohamed Afzal ◽  
Tim Bright ◽  
David Watson ◽  
Peter Devitt ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Revisional Surgery ◽  
Age Groups ◽  
Symptomatic Improvement ◽  
Advanced Age ◽  
Perioperative Outcomes ◽  
Pharyngeal Pouch ◽  
Comparative Cohort Study ◽  
Pouch Surgery

Abstract   Surgery is the only effective treatment strategy for a symptomatic pharyngeal pouch. However, octo- and nonagenarians are often denied referral to a surgeon because of perceived increased risks. Here, we examine the perioperative outcomes of pharyngeal pouch surgery in octo- and nonagenarians in comparison to patients under 80 years-of-age. Methods Analysis of a prospectively maintained database of 113 patients (≥80 years-of-age: 27, <80 years-of-age: 86) who underwent pharyngeal pouch surgery across seven hospitals from 1 January 2006 to 30 September 2020. Results Patients ≥80 years-of-age had comparable operative time, complication profile, intensive care admission, emergency reoperation, and revisional surgery as their younger counterparts. The severity of complications was not significantly different between the two age groups. No surgical mortality was recorded. Multivariate analysis demonstrated that diverticulectomy combined with cricopharyngeal myotomy independently predicted higher rates of complications (OR: 4.53, 95% CI: 1.43-14.33, p = 0.010), but also greater symptomatic improvement (OR: 4.36, 95% CI: 1.50-12.67, p = 0.007). Importantly, a greater proportion of octo- and nonagenarians experienced improved swallowing than patients <80 years-of-age (96.3% vs. 74.4%, p = 0.013). Advanced age was not predictive of complications on multivariate analysis. Conclusion In appropriately selected patients, pharyngeal pouch surgery can be safely offered to patients above 80 years-of-age resulting in significant improvement in their quality-of-life. These patients should not be denied surgery on the basis of advanced age alone.

Impact of protracted venous infusion fluorouracil with or without interferon alfa-2b on tumor response, survival, and quality of life in advanced colorectal cancer.

1995 ◽  
Vol 13 (9) ◽  
pp. 2317-2323 ◽  
Author(s):  
M Hill ◽  
A Norman ◽  
D Cunningham ◽  
M Findlay ◽  
M Watson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Advanced Colorectal Cancer ◽  
Symptomatic Improvement ◽  
Interferon Alfa ◽  
Life Questionnaire ◽  
European Organization ◽  
Significant Difference ◽  
Venous Infusion

PURPOSE The aim of this study was to investigate the effects of adding interferon alfa-2b (IFN) to protracted venous infusion fluorouracil (PVI 5-FU) from the start of treatment in patients with advanced colorectal cancer. PATIENTS AND METHODS Patients who attended our unit with histologically confirmed advanced colorectal cancer were randomized to receive either PVI 5-FU 300 mg/m2/d via Hickman line, and IFN 5 MU subcutaneously three times weekly, or PVI 5-FU alone. Treatment was given for a maximum of two 10-week blocks, with a 2-week gap for reassessment of all parameters. Quality of life (QL) was measured by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) pretreatment and every 6 weeks thereafter. RESULTS A total of 160 patients were randomized, with 155 eligible for assessment. Radiologic response was observed in 43 patients (28%): 17 of 77 (22%) in the 5-FU-plus-IFN arm (all partial responses [PRs]) and 26 of 78 (33%) in the 5-FU-alone group (complete responses [CRs] and 22 PRs) (difference not significant). Symptomatic improvement occurred in the majority of patients, and equally in both arms: 61% to 80% depending on the symptom. There was no significant difference between the two groups in failure-free survival (median, 161 v 193 days) or overall survival (median, 328 v 357 days). However, patients who received IFN did experience significantly more toxicity in the form of leukopenia (P = .001), neutropenia (P = .04), mucositis (P = .008), and alopecia (P = .0002). There were no toxic deaths and few notable differences in QL between the two arms. CONCLUSION This study confirms that PVI 5-FU is effective in treating the symptoms associated with metastatic colorectal carcinoma, with only mild to moderate toxicity and maintenance of QL. IFN 5 MU three times weekly does not enhance these palliative benefits.

scholarly journals Integrating Cognitive Restructuring Within Psychodynamic Therapy for Erectile Dysfunction

2019 ◽  
Vol 1 (3-4) ◽  
pp. 277-279
Author(s):  
T. S. Sathyanarayana Rao ◽  
Sona Kakar
Keyword(s):  
Erectile Dysfunction ◽  
Psychodynamic Psychotherapy ◽  
Cognitive Restructuring ◽  
Psychodynamic Therapy ◽  
Sexual Inhibition ◽  
Developmental Experiences ◽  
Body Attitude ◽  
Sexual Dissatisfaction ◽  
Distorted Cognitions ◽  
Early Developmental

The behavior of a human being in sexual matters is often a prototype for the whole of his other modes of reaction in life. 1 Erectile dysfunction due to psychogenic cause has been a highly researched area. Psychoanalytically, it has been seen as a symptom of an underlying conflict due to early developmental experiences. The attitude of parents especially at the time of a child’s emerging sexuality is considered important in perpetuating sexual inhibition and symptom. Sexual dysfunction has been found to be closely linked to anxiety and guilt and fears of punishment. This pattern of disturbance permeates into other areas of a person’s life and may continue to perpetuate his symptoms. Negative body attitude and shame have been found closely linked to sexual dissatisfaction. In this paper, a case is discussed where a patient is undergoing psychodynamic psychotherapy for depression reported along with erectile dysfunction. Distorted cognitions related to his and the partner’s body were addressed along with both current and past conflicts related to his current symptomatology.

Fatigue and HIV

2017 ◽  
Author(s):  
William Breitbart ◽  
Anna L. Dickerman
Keyword(s):  
Quality Of Life ◽  
Treatment Adherence ◽  
Symptom Management ◽  
Treatment Strategies ◽  
Hiv And Aids ◽  
Evidence Based ◽  
Important Condition ◽  
Evidence Based Treatment ◽  
The Past

Fatigue is commonly reported by persons with HIV and AIDS and is associated with impaired physical function, reduced quality of life, and suboptimal treatment adherence. Patients regard fatigue as an important condition to be addressed because it is disabling and distressing. In the past, fatigue was overlooked and undertreated by physicians, but clinicians caring for persons with HIV and AIDS have been giving more attention to symptom management and patients’ quality of life. Increased attention to symptom management in HIV and AIDS warrants familiarity with major issues in evaluation and treatment of fatigue. This chapter reviews the definition and assessment of fatigue, prevalence of fatigue in HIV/AIDS and its impact on patients, medical and psychological causes of fatigue, and evidence-based treatment strategies.

scholarly journals Study on the combination of brief psychodynamic psychotherapy with Viagra in the treatment of non-organic ED

2020 ◽  
Vol 33 (5) ◽  
pp. e100184
Author(s):  
Zhihang Zhang ◽  
Xiang Gao ◽  
Ying Zhou ◽  
Chao Yu ◽  
Jittikorn Pimolsettapun ◽  
...  
Keyword(s):  
Treatment Group ◽  
Clinical Efficacy ◽  
Psychodynamic Psychotherapy ◽  
Control Group ◽  
Chinese Men ◽  
Oral Medications ◽  
Psychotherapeutic Interventions ◽  
Optimal Efficiency ◽  
Positive Effect

BackgroundErectile dysfunction (ED) has gradually become an important issue that seriously affects the quality of life of Chinese men. In addition to classic oral medications, psychotherapeutic interventions are increasingly being used in the treatment of ED.AimThis study aims to investigate the clinical efficacy of brief psychodynamic psychotherapy (BPP) plus Viagra in the treatment of non-organic ED.MethodsWe initiated this study via a controlled, prospective experimental design with initial optimal efficiency standard greater than 10%. On the standard, 63 patients were enrolled who were assigned to control or treatment group. The control group (including 33 cases) received Viagra treatment for 2 months, and the treatment group (including 30 cases) was cured with BPP plus Viagra. After the treatments, the clinical efficacy was assessed using the International Erectile Function Index (IIEF-5) score, the Self-rating Anxiety Scale (SAS), Sexual Satisfaction (SS) score and Erection Hardness Score (EHS).ResultsIn the comparison of efficacy, pretreatment and post-treatment within each group, the two groups showed improvements in IIEF, SAS scores, SS, and EHS (treatment group: PIIEF<0.001, PSAS<0.001, PSS<0.001, PEHS<0.001; control group: PIIEF<0.001, PSAS<0.001, PSS<0.001, PEHS<0.001). Furthermore, the treatment group presented better performances in IIEF (p=0.040), SAS (p=0.006), SS scores (p=0.045) and EHS (p=0.041) than the control group.ConclusionThe combination of BPP with Viagra has positive effect on the treatment of non-organic ED.

scholarly journals Quality of Life in Children with Disorders of Sex Development

2017 ◽  
Vol 88 (5) ◽  
pp. 324-330 ◽  
Author(s):  
Nalini M Selveindran ◽  
Syed Zulkifli Syed Zakaria ◽  
Muhammad Yazid Jalaludin ◽  
Rahmah Rasat
Keyword(s):  
Quality Of Life ◽  
Family Income ◽  
Disorders Of Sex Development ◽  
School Functioning ◽  
Control Group ◽  
Evidence Based Treatment ◽  
Sex Development ◽  
Longitudinal Outcome ◽  
And Gender

Background/Aims: Disorders of sex development (DSD) are a heterogeneous group of rare conditions. Evidence-based treatment is challenged by a lack of clinical longitudinal outcome studies. We sought to investigate the quality of life of children with DSD other than congenital adrenal hyperplasia. Methods: The participants (aged 6–18 years) were 23 patients raised as males and 7 patients raised as females. Control data were obtained from representatives of the patients’ siblings matched for age and gender. The Pediatric Quality of Life InventoryTM Version 4.0 (PedsQL) Generic Core Scales were used as the study tool. Results: In comparison with the reference data, the patient group had significantly lower overall PedsQL (p < 0.01) and school functioning (p < 0.01) scores. Also, the total PedsQL score was significantly lower in patients with DSD who were of female social sex as compared to the controls who were females. Family income, surgical procedures, degree of virilization, and mode of puberty did not influence the PedsQL scores. Conclusion: This study revealed a poorer quality of life for patients with DSD as compared to the age-matched control group. This highlights the need for a skilled multidisciplinary team to manage this group of patients.

Colesevelam Hydrochloride for the Treatment of Lenalidomide Induced Diarrhea

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5779-5779 ◽  
Author(s):  
Melanie Watson ◽  
Ajay K. Nooka ◽  
Charise Gleason ◽  
Kelly Valla ◽  
Jonathan L. Kaufman ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Median Time ◽  
Research Funding ◽  
Chronic Diarrhea ◽  
Single Agent ◽  
Symptomatic Improvement ◽  
Lipid Lowering ◽  
Patient Response ◽  
Immunomodulatory Drug

Abstract INTRODUCTION: Lenalidomide is an immunomodulatory drug used for both induction and maintenance in Multiple Myeloma patients. In the pooled multiple myeloma studies, 29.2% of patients reported diarrhea with lenalidomide and dexamethasone. Colesevelam hydrochloride, a drug used primarily for lipid-lowering, has shown efficacy when used for diarrhea in patients receiving lenalidomide in European studies. METHOD: In our retrospective analysis, we have evaluated the response of twenty patients receiving lenalidomide and experiencing chronic diarrhea between October 29, 2013, and August 5, 2014. Patients were prescribed colesevelam hydrochloride, 1875mg orally twice daily. Patients were instructed to dose their lenalidomide and colesevelam separated by at least two hours. The objective is symptomatic improvement in lenalidomide induced diarrhea. RESULTS: Twelve males and eight females on lenalidomide based therapy experiencing chronic diarrhea were prescribed colsevelam. Seventeen patients were receiving single agent lenalidomide and three patients were receiving combination therapies (elotuzumab/lenalidomide/dexamethasone:1 pt, lenalidomide/bortezomib/dexamethasone: 1 pt, and lenalidomide/cyclophosphamide/dexamethasone: 1 pt). Median age of the patients was 60 year (range: 44-77 yrs). Median prior lines of therapy were 1 (range: 1-6). Median time from initiation of lenalidomide to Colesevelam hydrochloride is 44 months (0-64 months). Eighty-five percent of patients have noted improvement and 30% experienced total resolution of symptoms. Median time from initiation of Colesevelam hydrochloride to symptomatic response is 4 weeks (range, 0-17). In one patient response was seen in less than a week. CONCLUSION: Multiple Myeloma patients on lenalidomide therapy with chronic diarrhea noted improvement or total resolution of symptoms with the addition of colesevelam, thus allowing patients to stay on therapy, improving survival as well as quality of life. Disclosures Gleason: Celgene: Consultancy; Novartis: Consultancy. Lonial:Millennium: The Takeda Oncology Company: Consultancy, Research Funding; Celgene: Consultancy, Research Funding; Novartis: Consultancy, Research Funding; Bristol-Myers Squibb: Consultancy, Research Funding; Onyx Pharmaceuticals: Consultancy, Research Funding.

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