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OCD with comorbid OCPD: a subtype of OCD?

J Psychiatr Res. 2008 Mar;42(4):289-96

Authors: Coles ME, Pinto A, Mancebo MC, Rasmussen SA, Eisen JL

OBJECTIVE: The current study examined the validity of using comorbid obsessive-compulsive personality disorder (OCPD) to identify a subtype of individuals with obsessive-compulsive disorder (OCD). METHOD: Data for the current study were drawn from an ongoing, longitudinal study of the course of OCD and include intake assessments for 238 subjects with primary and current DSM-IV OCD who were treatment seeking. RESULTS: More than one fourth of the subjects (N=65, 27%) met criteria for comorbid OCPD. As compared to OCD-OCPD subjects, the OCD+OCPD subjects had a significantly younger age at onset of first OC symptoms (p=0.013), and a higher rate of symmetry and hoarding obsessions, and cleaning, ordering, repeating, and hoarding compulsions (all p’s<0.01). Individuals with OCD+OCPD had higher rates of comorbid anxiety disorders (p=0.007) and avoidant personality disorder (p=0.006). The OCD+OCPD subjects also had significantly lower ratings of global functioning (p=0.001) and more impaired social functioning (p=0.004), despite a lack of significant differences on overall severity of OCD symptoms. CONCLUSIONS: Our findings indicate that individuals with both OCD and OCPD have distinct clinical characteristics in terms of age at onset of initial OC symptoms, the types of obsessions and compulsions they experience, and psychiatric comorbidity. Our findings, coupled with data from family studies showing a higher than expected frequency of OCPD in first degree relatives of OCD probands, suggest that OCD associated with OCPD may represent a specific subtype of OCD. Additional research is warranted to further establish the validity of this subtype.

PMID: 17382961 [PubMed - indexed for MEDLINE]

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Collaborative action learning: a professional development model for educational innovation in nursing.

Nurse Educ Pract. 2008 May;8(3):184-9

Authors: Marlow A, Spratt C, Reilly A

The paper describes the processes and outcomes of a major curriculum innovation which was conducted by a collaborative multi-disciplinary team (nurse academics, educational developers and software developers). The paper argues that collaborative professional development in pedagogical innovation in nursing can be successfully supported by action learning as a framework for practice. In presenting this argument the paper draws on the experience of the School of Nursing and Midwifery (SNM) at the University of Tasmania in integrating high-fidelity simulation-based learning into an existing undergraduate case-based learning curriculum in the three year Bachelor of Nursing (BN).

PMID: 17716945 [PubMed - indexed for MEDLINE]

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Low-intensity family therapy intervention is useful in a clinical setting to treat obese and extremely obese children.

Int J Pediatr Obes. 2007;2(4):211-7

Authors: Nowicka P, Pietrobelli A, Flodmark CE

AIMS: To study the influence of low-intensity solution-focused family therapy with obese and extremely obese pediatric subjects on body mass index (BMI) z-scores and self-esteem. MATERIALS AND METHODS: Fifty-four obese children, aged 6-17 years, were referred to an outpatient obesity clinic. The families received solution-focused family therapy provided by a multidisciplinary team. Height and weight were recorded; BMI and BMI z-scores were derived. Self-esteem was assessed with a validated questionnaire, “I Think I Am.” Parents completed “The Family Climate Scale” assessing family dynamics. RESULTS: Eighty-one percent of the children (n =44, mean age 11.9 years, mean BMI z-score 3.67, range 2.46-5.48) and their parents participated in the follow-up. Eleven children were treated for 6-12 months, and 33 for more than 12 months. On average, the families received 3.8 family therapy sessions. Intervention resulted in a mean decrease in BMI z-score of 0.12 (p =0.0001). Self-esteem on the global scale improved after intervention (p =0.002), and also on sub-scales, depicting physical characteristics (p <0.001), psychological well-being (p =0.026), and relations with others (p =0.046). The Family Climate Scale showed improvement in the sub-scales for Expressiveness (p = 0.002) and Chaos (p =0.002). CONCLUSIONS: Solution-focused family therapy provided by a multidisciplinary team to obese and extremely obese children may prove useful in the clinical setting, with a positive impact on obesity and self-esteem.

PMID: 17852553 [PubMed - indexed for MEDLINE]

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Psychosocial interventions for self-harm.

Br J Psychiatry. 2007 Oct;191:359-60; author reply 360

Authors: Rudd MD

PMID: 17906253 [PubMed - indexed for MEDLINE]

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Conscious control of electrodermal activity: the potential of mental exercises.

Conf Proc IEEE Eng Med Biol Soc. 2006;Suppl:6561-4

Authors: Blain S, Mihailidis A, Chau T

Few practical methods of communicating with people who are locked-in currently exit. This study investigates conscious control of physiological signals, specifically electrodermal activity, to generate two distinguishable and reproducible states. These states can be translated into a binary signal to control a communication device for people who are locked in. Breathing rates, mental arithmetic and mental music were investigated as means of controlling electrodermal activity. Features extracted from the signals included mean, range and number of electrodermal reactions. For these of four subjects, at least one mental technique caused a reproducible, statistically significant the potential of using mental exercises to develop volitional control of electrodermal activity.

PMID: 17959453 [PubMed - indexed for MEDLINE]

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Efficacy of electrotactile vestibular substitution in patients with bilateral vestibular and central balance loss.

Conf Proc IEEE Eng Med Biol Soc. 2006;Suppl:6605-9

Authors: Danilov YP, Tyler ME, Skinner KL, Bach-y-Rita P

Patients with bilateral vestibular loss (BVL) of both central and peripheral origin experience multiple problems with balance and posture control, movement, and abnormal gait.Wicab, Inc. has developed the BrainPort balance device to transmit head position/orientation information normally provided by the vestibular system to the brain through a substitute sensory channel: electrotactile stimulation of the tongue. Head-orientation data (artificially sensed) serves as the input signal for the BrainPort balance device to control the movement of a small pattern of stimulation on the tongue that relates to head position in real-time. With training, the brain learns to appropriately interpret the information from the device and utilize it to function as it would with data from a normal-functioning natural sense. Ina total of 40 subjects trained with the BrainPort, 18 have been tested using standardized quantitative measurements of the treatment effects. A specialized set of exercises, testing, and training procedures has been developed that may serve as the course of intensive physical therapy with the BrainPort balance device. Our results demonstrate consistent positive and statistically significant balance rehabilitation effects independent of aging and etiology of balance deficit.

PMID: 17959464 [PubMed - indexed for MEDLINE]

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Underwater photosynthesis and respiration in leaves of submerged wetland plants: gas films improve CO2 and O2 exchange.

New Phytol. 2008;177(4):918-26

Authors: Colmer TD, Pedersen O

Many wetland plants have gas films on submerged leaf surfaces. We tested the hypotheses that leaf gas films enhance CO(2) uptake for net photosynthesis (P(N)) during light periods, and enhance O(2) uptake for respiration during dark periods. Leaves of four wetland species that form gas films, and two species that do not, were used. Gas films were also experimentally removed by brushing with 0.05% (v/v) Triton X. Net O(2) production in light, or O(2) consumption in darkness, was measured at various CO(2) and O(2) concentrations. When gas films were removed, O(2) uptake in darkness was already diffusion-limited at 20.6 kPa (critical O(2) pressure for respiration, COP(R)>/= 284 mmol O(2) m(-3)), whereas for some leaves with gas films, O(2) uptake declined only at approx. 4 kPa (COP(R) 54 mmol O(2) m(-3)). Gas films also improved CO(2) uptake so that, during light periods, underwater P(N) was enhanced up to sixfold. Gas films on submerged leaves enable continued gas exchange via stomata and thus bypassing of cuticle resistance, enhancing exchange of O(2) and CO(2) with the surrounding water, and therefore underwater P(N) and respiration.

PMID: 18086222 [PubMed - indexed for MEDLINE]

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Multi-modal weight control intervention for people with persistent mental disorders.

Psychiatr Rehabil J. 2008;31(3):194-200

Authors: Melamed Y, Stein-Reisner O, Gelkopf M, Levi G, Sivan T, Ilievici G, Rosenberg R, Weizman A, Bleich A

Obesity, a major problem worldwide, is more prevalent among people with schizophrenia. This study examined the effect of behavior intervention, nutritional information and physical exercise on the body mass index (BMI) and weight of people who were hospitalized with persistent DSM-IV schizophrenia and schizoaffective disorders. Fifty nine inpatients with a BMI greater than 25 participated, (28 intervention group; 31 control group). Significant reductions in BMI and weight were observed in the intervention group after 3 months and were maintained 1-year post study [F(1,52) = 6.1, p = .017) and F(1,52) = 3.7, P = .006, respectively]. If provided with adequate information and an appropriate framework, people with persistent schizophrenia can significantly reduce BMI and weight and maintain the loss.

PMID: 18194946 [PubMed - indexed for MEDLINE]

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Through the eyes of another: improving the skills of forensic providers using a consumer-informed role-play procedure.

Psychiatr Rehabil J. 2008;31(3):239-42

Authors: Hillbrand M, Hawkins D, Howe DM, Stayner D

OBJECTIVE: We describe an intervention aimed at improving the quality of care delivered by forensic clinicians and at exposing them to the principles of client-centered care. METHOD: Thirty-five forensic clinicians belonging to various professional disciplines participated in a day-long, multi-modal training developed with the help of former residents of a maximum-security forensic hospital. The main components of the training included a 1.5-hour simulation during which participants role-played being hospital residents, a video on discrimination, and a panel discussion with several of the former hospital residents. RESULTS: Participants rated the training as very relevant to their work, very worthy of being recommended to their peers, and as a profoundly positive and enriching experience. The benefits derived from the training included greater connectedness among the staff and better understanding of the patients’ experiences. CONCLUSION: Factors that appear to have contributed to the success of the training sessions include administrative support, use of a multi-modal approach, and use of small groups.

PMID: 18194952 [PubMed - indexed for MEDLINE]

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Being bipolar and dealing with obesity: personal lessons.

Psychiatr Rehabil J. 2008;31(3):247-8

Authors: Hensley MA

PMID: 18194954 [PubMed - indexed for MEDLINE]

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