Body, Mind & Spirit Articles and Latest News

Racism in the consulting room: myth or reality?

Psychoanal Rev. 2011 Aug;98(4):451-92

Authors: Msebele N, Brown H

Abstract
This paper explores ways in which issues of race might impact on, and/or be ignored within, the practice of psychotherapy. Racial difference, that is being white as well as being black, taps into ingrained patterns of binary thinking that create hierarchies of “otherness.” This generates anxiety which leads some therapists to avoid seeing race or naming its resonance in the therapeutic alliance. The origins of this splitting may lie in the unconscious, from whence it can be subtly nudged into more conscious awareness, as a seminal paper by Andrew Curry, published in this journal, suggested some forty-five years ago. Other modalities bring these dynamics more directly into the therapeutic space by exploring the patient’s familial history or their daily lived experiences of racial (dis) advantage from an explicitly empowering standpoint. But whatever route is taken, racism is not an animal that can, or should, be left sleeping in the corner of the consulting room.

PMID: 21864143 [PubMed - in process]

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Psychobiological aspects of somatization syndromes: Contributions of inflammatory cytokines and neopterin.

Psychiatry Res. 2011 Aug 23;

Authors: Euteneuer F, Schwarz MJ, Hennings A, Riemer S, Stapf T, Selberdinger V, Rief W

Abstract
Previous research suggests a dysregulation of immune-to-brain communication in the pathophysiology of somatization syndromes (multiple somatoform symptoms). We compared blood levels of the inflammatory markers tumor necrosis factor-alpha (TNF-α), interleukin-1 receptor antagonist (IL-1ra), interleukin-6 (IL-6) and neopterin between 23 patients with somatization syndromes (Somatoform Symptom Index-8, SSI-8), 23 age- and sex-matched healthy controls and 23 patients with major depression. No group differences were found for IL-1ra and IL-6. While TNF-α was increased in both clinical groups, neopterin was only increased in somatization syndromes. Correlational analyses revealed that neopterin tended to be related to somatoform pain complaints in patients with somatization syndromes. This study is the first to demonstrate increased levels of TNF-α and neopterin in patients with somatization syndromes without a diagnosis of depression, which may support a role of immune alterations in somatization syndromes. Neopterin is a reliable indicator for interferon-γ (IFN-γ) which was identified as the only cytokine that induces significant production of neopterin. Considering recent research indicating that IFN-γ can lead to increased neuronal responsiveness and body perceptions by reducing inhibitory tone in the dorsal horn, the observed association between somatization syndromes and neopterin might support the idea of central sensitization in the pathogenesis of somatoform symptoms.

PMID: 21864915 [PubMed - as supplied by publisher]

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Somatization disorder treated with electroconvulsive therapy.

J ECT. 2011 Sep;27(3):266-7

Authors: Gahr M, Schönfeldt-Lecuona C, Connemann BJ

PMID: 21865963 [PubMed - in process]

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Schizophrenia as a disorder of disconnectivity.

Eur Arch Psychiatry Clin Neurosci. 2011 Aug 25;

Authors: Schmitt A, Hasan A, Gruber O, Falkai P

Abstract
Schizophrenia is considered as a neurodevelopmental disorder with genetic and environmental factors playing a role. Animal models show that developmental hippocampal lesions are causing disconnectivity of the prefrontal cortex. Magnetic resonance imaging and postmortem investigations revealed deficits in the temporoprefrontal neuronal circuit. Decreased oligodendrocyte numbers and expression of oligodendrocyte genes and synaptic proteins may contribute to disturbances of micro- and macro-circuitry in the pathophysiology of the disease. Functional connectivity between cortical areas can be investigated with high temporal resolution using transcranial magnetic stimulation (TMS), electroencephalography (EEG), and magnetoencephalography (MEG). In this review, disconnectivity between different cortical areas in schizophrenia patients is described. The specificity and the neurobiological origin of these connectivity deficits and the relation to the symptom complex of schizophrenia and the glutamatergic and GABAergic system are discussed.

PMID: 21866371 [PubMed - as supplied by publisher]

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Aetiology of anorexia nervosa: from a “psychosomatic family model” to a neuropsychiatric disorder?

Eur Arch Psychiatry Clin Neurosci. 2011 Aug 25;

Authors: Herpertz-Dahlmann B, Seitz J, Konrad K

Abstract
Eating disorders and, in particular, anorexia nervosa (AN) have morbidity and mortality rates that are among the highest of any mental disorders and are associated with significant functional impairment. More than 25 years ago, several researchers hypothesised that the prerequisite for the development of AN was a family process characterised by an overprotective and conflict-avoiding parent-child interaction. Family studies, however, suggest that AN is a complex genetic disorder that is likely expressed primarily by temperament and specific traits during childhood, including inhibition, perfectionism and harm avoidance. Recent studies have described an impaired flexibility and deficits in social cognition that are independent of body weight and the current state of the eating disorder, providing further evidence for a genetic component of AN. The physiological and psychological alterations and the increasing societal demands that occur during puberty may trigger onset. The starvation process itself is associated with severe alterations of central and peripheral metabolism, especially neuroendocrine and neurotransmitter changes, which are thought to affect the adolescent brain during the vulnerable period of neural restructuring. Long-standing malnutrition during adolescence and young adulthood associated with hormonal and neuropeptide dysfunctions may produce “biological scars” that maintain and accelerate the disorder and likely result in chronic mental disorders in adulthood as well as poor social functioning.

PMID: 21866370 [PubMed - as supplied by publisher]

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Efficacy of Antidepressant Medications in Children and Adolescents With Obsessive-Compulsive Disorder: A Systematic Appraisal.

J Clin Psychopharmacol. 2011 Aug 24;

Authors: Gentile S

Abstract
The aim of this article was to analyze systematically literature information published in English (between 1966 and January 2011) on the efficacy of antidepressants in pediatric obsessive-compulsive disorder. Data were identified through different databases by using variously combined patterns of search terms. Searches provided 85 articles, excluding duplicates, but only articles reporting primary data on use of antidepressants in this specific disorder were reviewed. Fifty-nine articles were excluded because they did not report primary efficacy data or investigated patients with different psychiatric diagnosis. Twenty-five electronically recognized articles met the inclusion criteria. Two additional studies, available as congress communication, were identified by manually checking the references’ list of electronically identified articles. Reviewed studies show several methodological biases (the lack/limited number of long-term trials and head-to-head comparisons and the inclusion of patients who continued different forms of psychotherapy), which make it difficult to individuate the best pharmacological strategy. Despite these limitations, evidence-based information suggests that clomipramine and sertraline, especially for long-term treatments, should be considered as first-choice agents for treating obsessive-compulsive disorder at onset during childhood or adolescence.

PMID: 21869690 [PubMed - as supplied by publisher]

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A joint approach to treating dental phobia: a re-evaluation of a collaboration between community dental services and specialist psychotherapy services ten years on.

Br Dent J. 2011;211(4):159-162

Authors: Davies JG, Wilson KI, Clements AL

Abstract
Objective To audit the records of a group of patients who had previously benefited from cognitive behavioural therapy (CBT) for dental phobia.Aim To ascertain if they had returned to the use of intravenous (IV) sedation to facilitate dental treatment. Ten years ago these patients were routinely requiring IV sedation to facilitate dental treatment due to severe dental phobia.Method Sixty patients entered the original pilot project. Of those, 30 were offered CBT and 21 attended. Twenty of those patients (95.2%) were subsequently able to have dental treatment without IV sedation. In this follow-up study the electronic records of 19 of the 20 patients who had originally been successful with CBT were re-audited. Our purpose was to see if there was any record of subsequent IV sedation administration in the intervening ten years.Results Of the 19 successful CBT patients available to follow-up, 100% had not received IV sedation since the study ten years ago. This may suggest the initial benefit of CBT has endured over the ten-year period.Conclusion This study indicates that the use of CBT for patients with dental phobia proves beneficial not only in the initial treatment but that the benefits may endure over time. This results in a significant reduction in health risks to the patient from repeated IV sedation. It may also translate into significant financial savings for dental care providers. Our evidence for CBT as treatment for dental phobia suggests dental services should be implementing this approach now rather than pursuing further research.

PMID: 21869789 [PubMed - as supplied by publisher]

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Marked Mydriasis and Neuritis Nervi Optici Associated with Galactorrhea Following Citalopram Treatment: A Case Report and Discussion.

Case Report Med. 2011;2011:191735

Authors: Koch HJ, Zellmer H

Abstract
We report the case of a 25-year-old women suffering from major depression who was treated with citalopram for several weeks with doses between 20 mg and 60 mg. She gradually developed marked mydriasis within 2 months after treatment and subsequently neuritis nervi optici. Moreover, abrupt galactorrhea occurred after 2 months of treatment. All neuro-ophthalmological, neurophysiological, clinical laboratory, and neuroradiological diagnostic efforts did not reveal an underlying organic pathophysiology. The ocular symptoms disappeared rapidly after the discontinuation of citalopram and pulse therapy with methyl-prednisolone. However, galactorrhea persisted for a few weeks necessitating treatment with bromocriptine.

PMID: 21869891 [PubMed - as supplied by publisher]

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Chess & Schizophrenia: Murphy v Mr Endon, Beckett v Bion.

J Med Humanit. 2011 Aug 26;

Authors: Winship G

Abstract
This paper reconvenes Samuel Beckett’s psychotherapy with Wilfred Bion during 1934-1936 during which time Beckett’s conceived and began writing this second novel, Murphy. Based on Beckett’s visits to the Bethlem & Maudsley Hospital and his observation of the male nurses, the climax of Murphy is a chess match between Mr Endon (a male schizophrenic patient) and Murphy (a male psychiatric nurse). The precise notation of the Endon v Murphy chess match tells us that the Beckett intended it to be an exemplar of an anti-match, perhaps a metaphor for the tragedy of being locked into madness. It is also argued that the match offers us insight into Beckett’s experience of the process of psychotherapy with Bion. Based on new information from Beckett’s nephew and Bion’s widow, hypotheses about the long term impact of the Bion-Beckett analysis are advanced as a mutual experience which shaped the lives and later literary output of both men, producing conjoined career writings which continue to offer us stark and sublime condensations of depression, psychosis, and the challenges of therapy and recovery.

PMID: 21870181 [PubMed - as supplied by publisher]

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Biopsychosocial predictors of preterm delivery.

J Perinat Med. 2011 Aug 26;

Authors: Rauchfuss M, Maier B

Abstract
Abstract Aim: The aim of this study is to integrate a psychosomatic approach in the investigation of causes for preterm deliveries. Methods: A prospective study including 589 pregnant women between the 13(th) and the 24(th) gestation week (GW) was performed. In addition to medical and sociodemographic risk factors for preterm birth, factors such as biographical information, coping strategies and personality factors, pregnancy-related attitudes and anxieties as well as the pregnant women’s social environment were examined. A factor analysis was performed using a principal component method with subsequent varimax rotation. Results: Psychosocial variables were found to have a significant influence on the course of pregnancy and delivery. A total of 29 pregnant women (5.8%) delivered prematurely before they completed the 37(th) GW. Lack of support, poor emotional understanding by the partner, and additional stress subsequent to gynecological disorders were significantly associated with prematurity delivery. Pregnancy-related fears and general anxiety were additional significant predictors for preterm delivery. Conclusions: Partner relationships, women’s support groups, psychosomatic reactions due to problems with reproductive functions, and anxiety deserve special attention for the prevention of preterm birth.

PMID: 21867452 [PubMed - as supplied by publisher]

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