Body, Mind & Spirit Articles and Latest News

Neurobiological and clinical relationship between psychiatric disorders and chronic pain.

Psychiatr Danub. 2010 Jun;22(2):221-6

Authors: Bras M, Dordević V, Gregurek R, Bulajić M

Pain is one of the most ubiquitous problems of today’s world, its impact being far-reaching. Current conceptualizations of pain medicine adopt a bio-psycho-social perspective. In this model, pain is best described as an interactive, psycho-physiological behavioral pattern that cannot be divided into independent psycho-social and physical components. Neurophysiologic substrates of the pain experience can be broken down into the pain transmission elements emanating from peripheral, spinal, and supra-spinal processes. There are many complex mechanisms involved in pain processing within the central nervous system, being influenced by genetics, interaction of neurotransmitters and their receptors, and pain- augmenting and pain-inhibiting neural circuits. The patient’s emotional experiences, beliefs and expectations may determine the outcome of treatment, and are fully emphasized in the focus of treatment interventions. There are several common psychiatric disorders accompanying and complicating the experience of pain that warrant clinical attention and that can be the focus of psychiatric treatment. These include depression, anxiety, sleep disorders, somatoform disorders, substance-related disorders and personality disorders. Complex and disabling pain conditions often require comprehensive pain treatment programs, involving interdisciplinary and multimodal treatment approaches. There are many roles that the psychiatrist can perform in the assessment and treatment of the patients with pain, individually tailored to meet the specific needs of the patient. Rational poly-pharmacy is of a high importance in the treatment of patients with chronic pain, with antidepressants and anticonvulsants contributing as the important adjuvant analgesic agents.

PMID: 20562750 [PubMed - indexed for MEDLINE]

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Psychological problems of patients with cancer.

Psychiatr Danub. 2010 Jun;22(2):227-30

Authors: Gregurek R, Bras M, Dordević V, Ratković AS, Brajković L

Psycho-oncology is a broad approach to cancer therapy which treats the emotional, social, and spiritual distress which often accompanies cancer patients. The development of psycho-oncology began in the second part of the 20th century reflecting the increased interest in the study of cancer patients’ psychological reactions to their illness at all stages of its course, and the analysis of the emotional, spiritual, social, and behavioral factors which influence the risk of developing cancer and long-term aftercare treatment. Today the psycho-oncology has become an accepted part of cancer treatment, with departments of psycho-oncology established in most major cancer centers in Canada, the United States and many Western European countries. A key clinical challenge for the oncologist is differentiating the expected and transient distress associated with cancer from the excessive, disabling distress requiring psychiatric interventions. One third of patients with cancer will experience distress which requires evaluation and treatment, and the most common psychiatric disorders are depression, anxiety disorders and adjustment disorders. Psychiatrists should be involved in the multidisciplinary treatment team who work with the cancer patients. Further research is needed to determine the effectiveness of different psychological and psychopharmacological interventions in psycho-oncology and palliative medicine. Mental health issues should be included in the training of health care professionals in all areas of medicine, psychology and social work to meet the demands of cancer patients.

PMID: 20562751 [PubMed - indexed for MEDLINE]

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Comorbidity of kidney stones and psychiatric disease.

Psychiatr Danub. 2010 Jun;22(2):249-52

Authors: Bilić V, Marcinko D

This paper describes a patient who is suffering from PTSD with elements of hypochondria, panic attacks and episodes of depression in comorbidity with kidney stones. Kidney stones provoked egzacerbation of psychiatric symptoms. Kidney stones and frustration about them have taken part of provoking factor, the last drop, which led to regression of otherwise precarious, but compensated patient’s mental functioning which resulted in development of psychiatric symptoms.

PMID: 20562755 [PubMed - indexed for MEDLINE]

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Premorbid combat related ptsd in Huntington’s disease - Case report.

Psychiatr Danub. 2010 Jun;22(2):286-8

Authors: Skocić M, Dujmović J, Jevtović S, Jakovljević M

Huntington’s disease (HD) is a neurodegenerative, autosomal dominant disease that manifests with a triad of symptom clusters including movement disorder, cognitive impairment and psychiatric symptoms. We present a patient with HD who, prior to developing neurological signs and symptoms, had been exposed to war trauma and had developed posttraumatic stress disorder. Fifteen years later he manifested with dysarthria, difficulties with swallowing and involuntary movement. What brought him to psychiatrist was a heteroanamnestically noticed change in personality with irritable mood, impulsivity, aggressive outbursts in behavior and delusional ideation. Therapy was stared with haloperidol, but patient developed severe extrapiramidal side effects. Subsequent treatment with olanzapine, diazepam and omega 3 fatty acids lead to mood stabilization and better impulse control with even some improvement in motoric symptoms. To our knowledge, this is the first case report on combat related PTSD as psychiatric disorder manifested prior to HD. We discuss a possible influence of psychological stress disorder on severity of psychiatric symptoms in the HD. The importance of personalized approach in both psychopharmacological and psychotherapeutical treatment of patients with HD is emphasized. If the influence of environmental stress on the psychiatric phenotype of the disease should be confirmed by clinical trials and further studies, both screening methods and interventions aimed to reduce psychological stress in carriers of Huntington gene could be considered.

PMID: 20562764 [PubMed - indexed for MEDLINE]

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Psychogenic dystonia - Case report.

Psychiatr Danub. 2010 Jun;22(2):289-92

Authors: Radonja AP, Ruzić K, Grahovac T

The concept of psychogenic dystonia refers to an unusual but well-known concept of movement disorders caused by mental disorders. It’s self manifested as a permanent muscular contractions that cause twisting, repetitive movements or abnormal posture of the body. It is characterized by high psychiatric comorbidity. 50-year-old patient who has diagnosed segmental dystonia will be presented. He was treated twice at psychiatry department because of comorbid psychiatric disorders. Diagnostic and therapeutic procedures that have confirmed comorbidity and association with clinical signs of neurological disorders were performed.

PMID: 20562765 [PubMed - indexed for MEDLINE]

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Depressive disorder and alopecia.

Psychiatr Danub. 2010 Jun;22(2):293-5

Authors: Grahovac T, Ruzić K, Sepić-Grahovac D, Dadić-Hero E, Radonja AP

Psychophysical dermatitis is frequently manifested in patients that suffer from psychiatric illnesses and disorders as well as in patients that suffer from depressive disorders. These diseases occur or worsen after acute stress that may trigger them. Difficulties in expressing feelings or impossibility to verbalise them are connected to somatic diseases. In order to emphasize their importance, we will present a case of a 58 years old woman who has been suffering from alopecia areata that developed after her husband’s death. The patient doesn’t function well since then - she is socially isolated, she has lost self confidence and self esteem. As she has realised it was impossible to live like that, she decided to seek psychiatric help. The patient should be examined through the prism of the interdisciplinary treatment and as an integral structure of the mind and body.

PMID: 20562766 [PubMed - indexed for MEDLINE]

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Effects of meaning or psychodynamic psycopharmacotherapy.

Psychiatr Danub. 2010 Jun;22(2):313-6

Authors: Vlastelica M

Despite advances in psychiatry, treatment outcomes are still a big problem, and are not always substantially better than it was in the past time. Treatment resistance remains a serious psychiatric problem. One of the reasons for that is that the pendulum has swung from a psychodynamic framework to a biological one, and the impact of meaning (i.e. the role of psychodynamic and psychosocial factors in treatment-refractory illness) has been relatively neglected. Dynamic factors in psychopharmacology play a pivotal role in pharmacological treatment responsiveness. There is a small but impressive evidence base that shows that psychological and interpersonal factors play that role. Psychodynamic psycho pharmacotherapy combines rational prescribing with tools to identify irrational interferences with effective use of medications, i.e. to resolve the problems of the pharmacological-treatment resistance. Psychodynamic psychopharmacology represents an integration of biological psychiatry and psychodynamic insights and techniques.

PMID: 20562772 [PubMed - indexed for MEDLINE]

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Personalised approach in treatment of a prepsychotic adolescent.

Psychiatr Danub. 2010 Jun;22(2):377-80

Authors: Graovac M, Rebić J, Ruzić K, Dadić-Hero E, Francisković T

In clinical practice with adolescents we often come across with prepsychotic and psychotic disorders. When an adolescent patient has a positive hereditary burden for psychiatric illnesses in both parents, then the qualification of adolescent’s mental disorder seems closer to psychotic. We must have in mind that hereditary burden is only one of many etiological factors that contribute to mental decompensations in adolescent age, that can, but don’t have to be the prodrome of psychosis in the future. Whether is characterised as psychotic or not, the treatment of an adolescent in critical situation must be personalised, considering biological, social and individual factors of a patient. We believe that clinician’s experience in treating psychotic adolescent patients and personalised and integrative approach to a patient is of great importance. In this article we will present the therapeutical process of a 19-year old female adolescent, with psychotic symptoms, whose both parents are psychiatric patients. A personalised and integrative approach in treatment of this patient made possible the overcome of crisis, termination of high school education and an employment. These achievements, no matter what the future can bring to this patient, create better conditions for her functioning in life.

PMID: 20562788 [PubMed - indexed for MEDLINE]

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The roles of behavioral and implementation intentions in changing physical activity in young children with low socioeconomic status.

J Sport Exerc Psychol. 2010 Jun;32(3):359-76

Authors: Armitage CJ, Sprigg CA

There is a dearth of research examining physical activity in children aged 6-10 years with low socioeconomic status, despite the fact there is good reason to suspect this is a critical period when physical activity habits are created. Physical activity and theory of planned behavior variables were measured at three time points, and children (N = 77) randomized to the experimental condition were additionally asked to form an implementation intention. Intention was a potent mediator of the past behavior-future behavior relationship and the implementation intention intervention significantly increased physical activity compared with the control condition. The findings suggest that physical activity can be increased in children aged 6-10 years with low socioeconomic status and that implementation intentions might enhance the effectiveness of children’s physical activity programs.

PMID: 20587823 [PubMed - indexed for MEDLINE]

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Computer- and video-based instruction of food-preparation skills: acquisition, generalization, and maintenance.

Intellect Dev Disabil. 2010 Jun;48(3):195-208

Authors: Ayres K, Cihak D

The purpose of this study was to evaluate the effects of a computer-based video instruction (CBVI) program to teach life skills. Three middle school-aged students with intellectual disabilities were taught how to make a sandwich, use a microwave, and set the table with a CBVI software package. A multiple probe across behaviors design was used to evaluate for a functional relation between the software and skill acquisition. All students increased the percentage of steps completed in the correct order after receiving CBVI. During maintenance probes, the performance of all students deteriorated; after a single review session with CBVI, all students regained previous levels of performance, tentatively indicating a role of CBVI as a tool for reviewing previously mastered material. Results are discussed in terms of the use of CBVI for providing students sufficient learning trials on tasks that require the use of consumable products (e.g., food).

PMID: 20597730 [PubMed - indexed for MEDLINE]

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