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Emotional therapy for patients with dementia.

Geriatr Gerontol Int. 2008 Dec;8(4):303-6

Authors: Hirazakura A, Hatakeyama R, Fukuoka Y, Satoh A, Kobayashi K, Fujii M, Sasaki H

PMID: 19149844 [PubMed - indexed for MEDLINE]

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Real-time monitoring of spontaneous resonance in heart rate variability.

Conf Proc IEEE Eng Med Biol Soc. 2008;2008:2789-92

Authors: Jovanov E

The resonant characteristic of heart rate variability is usually generated using biofeedback and the external pacing of breathing, which is typically around 6 breaths/min (0.1 Hz), although the exact frequency varies between individuals. It was hypothesized that the actual resonant characteristic of heart rate actually depends on the current psychophysiological state of the subject; therefore, the real-team evaluation of this form of resonance is important for a variety of biofeedback applications. This paper presents an analysis of the spontaneous resonance of heart rate variability generated during singing and non-paced slow breathing after breathing exercises. Two methods for automatic analysis and characterization of heart rate variability resonance in real-time have been presented. The first method uses FFT-based spectral analysis, while the second method calculates the period and amplitude of the RR interval variation during each resonant cycle. The proposed methods were tested on a 45-min record from a chanting session and compared with manually annotated and measured periods.

PMID: 19163284 [PubMed - indexed for MEDLINE]

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Current considerations in the treatment of generalized anxiety disorder.

CNS Drugs. 2009;23(2):103-20

Authors: Katzman MA

Generalized anxiety disorder (GAD) is a chronic disorder that frequently co-occurs with a variety of co-morbidities in patients with somatic conditions and other mental disorders. GAD is highly prevalent and is one of the most common anxiety disorders seen by primary care physicians. The individual and societal cost associated with GAD is high and the marked level of impairment experienced by patients with this disorder is equivalent in magnitude to that reported in patients with major depressive disorder. Furthermore, patients with GAD are at risk of suicide or suicide attempts, and are frequent users of healthcare services. Thus, GAD is a serious and chronic condition that requires appropriate long-term treatment. The focus of acute treatment for patients with GAD is the improvement of symptoms, while the primary goal of long-term clinical management is remission, i.e. the complete resolution of both symptoms and functional impairment. The consensus across current treatment guidelines is that first-line treatment for patients with GAD should consist of an antidepressant, either a selective serotonin reuptake inhibitor (SSRI) such as sertraline, paroxetine or escitalopram, or a selective serotonin noradrenaline (norepinephrine) reuptake inhibitor (SNRI) such as venlafaxine or duloxetine. However, the SSRIs and SNRIs have efficacy limitations, such as lack of response in many patients, a 2- to 4-week delay before the onset of symptom relief, lack of full remission, and risk of relapse. In addition, there are troublesome adverse effects associated with both the SSRIs and SNRIs. Evidence from early clinical studies of the atypical antipsychotics in the treatment of anxiety and GAD indicate that they may have a potential role in the treatment of GAD, either as monotherapy or as augmentation to standard treatment.

PMID: 19173371 [PubMed - indexed for MEDLINE]

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Are women better mindreaders? Sex differences in neural correlates of mentalizing detected with functional MRI.

BMC Neurosci. 2009;10:9

Authors: Krach S, Blümel I, Marjoram D, Lataster T, Krabbendam L, Weber J, van Os J, Kircher T

BACKGROUND: The ability to mentalize, i.e. develop a Theory of Mind (ToM), enables us to anticipate and build a model of the thoughts, emotions and intentions of others. It has long been hypothesised that women differ from men in their mentalizing abilities. In the present fMRI study we examined the impact of (1) gender (women vs. men) and (2) game partner (human vs. computer) on ToM associated neural activity in the medial prefrontal cortex. Groups of men (n = 12) and women (n = 12) interacted in an iterated classical prisoner’s dilemma forced choice situation with alleged human and computer partners who were outside the scanner. RESULTS: Both the conditions of playing against putative human as well as computer partners led to activity increases in mPFC, ACC and rTPJ, constituting the classic ToM network. However, mPFC/ACC activity was more pronounced when participants believed they were playing against the alleged human partner. Differences in the medial frontal lobe activation related to the sex of the participants could be demonstrated for the human partner > computer partner contrast. CONCLUSION: Our data demonstrate differences in medial prefrontal brain activation during a ToM task depending on both the gender of participants and the game partner.

PMID: 19193204 [PubMed - indexed for MEDLINE]

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Obsessive-compulsive disorder in school-age children.

J Sch Nurs. 2009 Feb;25(1):15-26

Authors: Helbing ML, Ficca M

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by disturbing thoughts, impulses, or images (obsessions); repetitive or ritualistic behaviors (compulsions); or the presence of both. Although some may believe this disorder is isolated to the adult population, it affects anywhere from 1% to 4% of children in the United States. However, symptom presentation of this psychiatric condition may be different in the pediatric population. School-age children who are affected by the condition or their parents may attempt to hide these behaviors due to embarrassment or fear of peer victimization. If left untreated, OCD can interfere with the ability to play, socialize, attend school, and function as a part of a family, ultimately affecting success not only in school but in life. It is imperative school nurses are aware of this condition, its symptoms, and treatments and techniques to help students with OCD cope effectively.

PMID: 19197014 [PubMed - indexed for MEDLINE]

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Longitudinal assessment of psychotherapeutic day hospital treatment for neuropsychiatric symptoms in dementia.

Aging Ment Health. 2009 Jan;13(1):92-8

Authors: Weber K, Meiler-Mititelu C, Herrmann FR, Delaloye C, Giannakopoulos P, Canuto A

OBJECTIVE: Behavioral and psychological symptoms (BPSD) of dementia are associated with more rapid cognitive deterioration as well as increased caregiver stress. The effectiveness of psychiatric day hospital care for this condition remains disputed. We report here the assessment of a psychotherapeutic day hospital program in a series of elderly people with dementia and concomitant BPSD. METHODS: Treatment setting: The day hospital program combined music, movement, psychodynamic group therapies, sociotherapy as well as individual interviews and family interventions. Participants: 76 individuals with mild to moderate dementia. Outcome measures: The Neuropsychiatric Inventory (NPI), Therapeutic Community Assessment scale including staff (SAS) and client assessments (CAS) and a Group Evaluation Scale (GES) were administrated at admission, 3, 6 and 12 months and discharge. RESULTS: Linear regression analysis showed that SAS (but not CAS) and GES scores significantly increased while the NPI total scores decreased across the different time points. NPI item score modifications were significant for anxiety and apathy. These changes remained significant when demographic variables, drug treatment changes and occurrence of life events were also considered. CONCLUSION: A psychotherapeutic day hospital program designed for older people with dementia and neuropsychiatric symptoms allows for a significant reduction of anxiety and apathy, better adhesion to therapeutic community treatment and clinical progress in group therapy. Controlled interventional studies are needed to further confirm these data.

PMID: 19197694 [PubMed - indexed for MEDLINE]

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Pharmacotherapy guidelines for the aged by family doctors for the use of family doctors.

Int J Clin Pharmacol Ther. 2009 Jan;47(1):11-22

Authors: , Bergert FW, Conrad D, Ehrenthal K, Fessler J, Gross J, Gundermann K, Kluthe B, Lang Heinrich W, Liesenfeld A, Loew PG, Luther E, Pchalek R, Seffrin J, Sterzing A, Wolfring HJ, Zimmermann U

Part C of the guideline is preceded by Part B General Pharmacology IJCPT. 2008; 46: 600 - 617. Included in Part C are practical guidelines for improving the therapy of some age-specific diseases and problems commonly encountered in general practice. The article in this issue is dedicated to the therapy of Dementia and M. Parkinson. Further guidelines for the other age specific diseases and problems named above will be published in the following issues of IJCPT. An important feature of these guidelines are the inclusion of Levels of Evidence and of the Strength of Recommendations for the therapy which are shown when reliable studies are available. (For both see levels of evidence at the end of this article.).

PMID: 19203528 [PubMed - indexed for MEDLINE]

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Putting a new face on depression treatment.

Provider. 2009 Feb;35(2):28-35

Authors: Kaldy J

PMID: 19275000 [PubMed - indexed for MEDLINE]

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Adult behavioral weight loss treatment.

Med Health R I. 2009 Feb;92(2):50-2

Authors: Gokee-LaRose J

PMID: 19288685 [PubMed - indexed for MEDLINE]

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[Telephone counseling for tobacco cessation]

Rev Gaucha Enferm. 2008 Dec;29(4):513-9

Authors: Chaves EC, Oyama SM

Interventions with the objective of guiding and facilitating smoking cessation are important strategies, as well as necessary for planning health promotion programs. This article proposes a new approach for smoking cessation: a telephone approach. This study was conducted at the Health Promotion Center of the Hospital de Clínicas, School of Medicine of the University of São Paulo (HCFMUSP), Brazil. Eighteen patients were called five times receiving counseling and interventions based on the Cognitive Behavioral Theory McNemar and Kappa tests were used for the statistical analysis. According to the results, patients who received five phone calls reduced their cigarette intake and 16.7% of them quit smoking, suggesting that this method can become an alternative in the treatment to quit smoking.

PMID: 19320336 [PubMed - indexed for MEDLINE]

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