Psychiatria Danubina

AN EVALUATION ON ATTITUDES OF POLISH PROFESSIONALS TOWARDS THE RAPID EMERGENCE OF REMOTE PSYCHOTHERAPY ARISING AT THE OUTSET OF THE COVID-19 PANDEMIC, WITHIN A LEGAL CONTEXT
Szostakiewicz Ł, Pyżalski J, Bujacz E, Gozdanek A, Dymerska I, Grochowska K, Pilecki M, Słopień A, Youssef-Khalil M, Lorek-Groniewska A, Borusińska A and Remberk B
The outbreak of the Covid-19 pandemic impacted on everyday life and made necessary to deploy remote medical services. Delivering psychiatric health care remotely for children and adolescents posed a major challenge to healthcare professionals. The study aimed to describe the status and trends in remote psychotherapy used during the pandemic Covid-19 and lockdown in Poland with focus on factors affecting the decisions made by therapists, particularly those specific to child and adolescent therapy. An on-line survey on psychotherapy professionals was conducted in Poland at the beginning of the lockdown. Descriptive statistics and the chi-square test were used. There were 386 completed questionnaires. The higher levels found of accepting remote therapy were linked to working in the private sector, to using audio+video facilities, having previously experienced remote therapy and knowing both the theoretical background to remote therapy along with an appropriate level of internet literacy. There were no associations found between subject categories, gender, age nor theoretical specializations of the respondents. Remote psychotherapy may become permanently introduced into mental healthcare systems, providing safe and effective methods of treatment. Further studies are however required, and medical, organizational and administrative standards need to be developed.
A PSYCHOBIOGRAPHY AND ILLUSTRATION OF SCHAHRIAR SYNDROME MODEL IN VERA RENCZI
Pop AX and Zaimova-Tsaneva EV
The current study's goal was to demonstrate the efficacy of the Schahriar Syndrome Model by using it to create a psychobiography of a female serial killer. The objective was to identify the social and psychological mechanisms included in the Schahriar Syndrome Model (SSM) of serial killing. The case study also aimed to understand better the motivations of such homicides and the attributes and factors that make a female commit them and it offers a fresh perspective on Vera's life. The case study used a qualitative single case design that contains the tracking of experiences and events of an individual in a lifetime. It used both historiographic methodologies and psychological models to identify and analyze the development and specific socio-psychological settings of Vera Renczi, a historical serial murderer from the 20th century (1903-1960). This psychobiography includes secondary data about her development and crimes collected from previous research, archives, and books that contained reliable sources. Vera Renczi demonstrated throughout her life and at several socio-historical junctures, each of the five primal mental processes such as omnipotence, sadistic fantasies, ritualized performance, dehumanization, and symbiotic merger. Vera Renczi's life was impacted by a mixture of socio-historical antecedents including her aristocratic status, the experience of loss and abandonment, and the need for control and devotion. The Schahriar syndrome paradigm is relevant today, and this study invites relevant fields, such as the forensic sector, to reevaluate its applicability, especially on female subjects. The Schahriar syndrome model may be used to identify the psych mechanism of a female serial murderer. This research adds to the knowledge about Vera Renczi and offers information from new angles and fresh perspectives on how she operated.
INVESTIGATION OF THE EFFECT OF THE ONSET OF BRUXISM AS A RESULT OF EARLY ANTIDEPRESSANT USE
Güldiken İ, Elbir B, Nalimov A and Delilbaşı Ç
Among antidepressants, selective serotonin and noradrenaline reuptake inhibitors (SSRIs and SNRIs) have been widely used in the treatment of major depression and may induce sleep disorders and bruxism. In the present study, the effects of SSRIs and SNRIs on awake and sleep bruxism have been evaluated. A total of 125 patients who had been prescribed SSRIs or SNRIs for the treatment of major depression have been evaluated for bruxism. For the purpose of the study, data from the first week (T1) and the fourth week (T2) of antidepressant treatment have been considered. In conclusion, in the early period, the presence of bruxism has not been observed to be significantly influenced by the use of antidepressants. It has been determined that sleep bruxism increased in the fourth week only in males who were using antidepressants (p = 0.015; p < 0.05). An increase in the presence of sleep bruxism due to specific SSRIs and SNRIs has been determined in the fourth week of drug use. Paroxetine in the SSRI group and duloxetine in the SNRI group have been found to cause an increase in sleep bruxism (p = 0.013; p < 0.05). Other active substances have not been found to affect sleep or awake bruxism significantly. The present study has shown that although some antidepressants increase bruxism in the early period of drug use, the effects of similar drugs on sleep or awake bruxism need to be evaluated in detail in long-term studies.
MULTICOMPONENT EDUCATIONAL-REHABILITATION TREATMENT AND ITS IMPACT ON DEPRESSIVE SYMPTOMS IN STROKE SURVIVORS
Glinac A and Sinanović O
This study aimed to assess the efficacy of a multicomponent educational-rehabilitation intervention in mitigating the occurrence and intensity of depressive symptoms among stroke patients. A prospective, randomized clinical trial was conducted at the Clinic for Physical Medicine and Rehabilitation, University Clinical Center Tuzla. Seventy stroke patients were divided into two groups: the first group (N=40) underwent a multicomponent educational-rehabilitation treatment tailored to individual plans and programs, consisting of 45 minutes daily for five working days a week, totaling 20 sessions. The second group (N=30) did not receive the multicomponent educational-rehabilitation treatment. Both groups received conventional physical therapy methods (electrotherapy and individual kinesiotherapy) and speech therapy. The Beck Depression Inventory Second Edition instrument assessed the presence and severity of depressive symptoms at two time intervals: initially upon admission and finally after one month. The independent samples t-test was employed to identify differences between the initial and final testing across the groups. Patients who underwent the multicomponent educational-rehabilitation treatment exhibited a significant decrease in the presence and severity of depressive symptoms compared to those in the untreated group (t=-2.223, P=0.030). The findings suggest that multicomponent educational-rehabilitation treatment holds promise in reducing the occurrence and intensity of depressive symptoms in stroke patients.
PSYCHIATRIA DANUBINA SUCCESSFULLY SUPPORTS THE ESTABLISHMENT OF TWO NEW JOURNALS
Jakovljević M
EFFICACY OF TRANSCUTANEOUS AURICULAR VAGAL NERVE STIMULATION AND JACOBSON RELAXATION TECHNIQUE ON STRESS MANAGEMENT AMONG HEALTH SCIENCE CRRI POPULATION
Varshani P, Srinivasan V, Suganthirababu P and A K
ANXIETY SYMPTOMS MAY ALARM FOR LIFETHREATENING MEDICAL CONDITION IN FEMALES: A CASE OF THE ANTI-NMDAR ENCEPHALITIS-ASSOCIATED WITH OVARIAN TERATOMA
Kazakova A, Lineva O, Dufinetz I, Kiyashko I, Glukhova M, Pavlenko P, Petyanova V, Vlasov A, Sheyfer M, Paloyko E, Syunyakov T and Smirnova D
CURRENT STATE OF PSILOCYBIN-ASSISTED THERAPY IN MOOD DISORDERS
Kaiserman A, Vanderjist L and Kornreich C
Psychedelics are currently undergoing a scientific renaissance, with modern studies investigating therapeutic efficacy of psychedelic-assisted therapy in a range of psychiatric conditions. In particular, psilocybin-assisted therapy (PAT) has been suggested to have positive effects on patients suffering from depression and psychiatric distress associated with life-threatening disease - contexts with growing needs for alternative treatments - in a therapeutic setting involving fewer doses and less important adverse effect compared to that of classic psychotrope administration. Psychedelics are partial agonists of the serotonin 2A (5-HT2A) G protein-coupled receptors, whose activation likely mediates the acute psychoactive effects. Furthermore, psychedelics seem to induce a hyper-plastic state which allows for adaptation of inflexible pathological thinking patterns. Post-acutely, they are suggested to induce rapid, robust and sustained neuroplasticity. Eight clinical PAT trials have been conducted between January 1st 2001 and March 31st 2023 and are reviewed here. Five of them evaluate the effect on depressive symptomatology in an otherwise general population. The other three evaluate effect on depression and anxiety in patients suffering from somatic life-threatening disease. The studies reviewed here show that PAT is safe and feasible to administer in current clinical models. Preliminary efficacy shows significant improvements in depressive and anxious symptomatology which are immediate and partially sustained. One study comparing PAT to selective serotonergic reuptake inhibitors showed no significant difference of efficacy between the two treatments. Preliminary results regarding efficacy of PAT on mood disorders are promising, but further research is warranted for stronger inferences, with a particular focus on larger, multicentric studies, more diverse populations and a stronger control for expectancy and unblinding.
RELIGIOUS COPING OR SPIRITUAL COPING: WHICH ONE IS CORRECT?
Çaksen H
EROTOMANIC DELUSIONS AND TACTILE HALLUCINATIONS IN A LATE ADOLESCENT GIRL WITH SCHIZENCEPHALY
Nur Demirok Z
DATING APPS, FORMS OF ABUSE AND PERSONALITY TYPE
Shantharaju S, Kumar Sharma M and Banik A
CLINICAL AND DYNAMIC CHARACTERISTICS OF SOMATIZED MENTAL DISORDERS IN CHILDREN CAUSED BY ACUTE STRESS DURING THE WAR IN UKRAINE
Kydon P, Svitlana T, Isakov R and Herasymenko L
NEPRILYSIN INHIBITION AS A NEW ANXIOLYTIC TARGET IN MAN - NO MECHANISM VIA CYCLIC GUANOSINE MONOPHOSPHATE?
Kellner M, Yassouridis A, Górski D, Waheed S, Kähler J and Wiedemann K
HOW CAN SCHEMA THERAPY HELP US UNDERSTAND KIERKEGAARD'S BREAKING UP OF HIS ENGAGEMENT
Molnar A
Søren Aabye Kierkegaard (1813-1855) is a great Danish philosopher and the father of existentialism. An essential part of his writings, often under pseudonyms, dealt with his broken engagement, reflecting his doubts and ambivalent feelings. The motives behind the breakup initiated by the philosopher are complex and hard to decipher. This article is an attempt to better understand Kierkegaard´s seemingly controversial psychological motives behind this unhappy love story, by applying the conceptual model of schema therapy. The main subjects of the investigation are two biographies on Kierkegaard written by Georg Brandes and Joakim Garff as well as Garff's book centered on Kierkegaard's fiancée. While it would be scientifically unfounded to establish any diagnosis of mental disorder based on these materials, it may be possible to point out certain psychological patterns, which can help us understand why the philosopher broke off the betrothal and why he was ruminating on it for so long afterwards. The method of choice for the investigation is schema therapy, which is applicable for the analysis of complex psychological problems. The present study can be considered as a form of psychobiographical investigation focused on a specific event in a historical figure's life. The thoroughness and objectiveness of the biography written by Garff, and Kierkegaard' extraordinary inclination to psychological insight and description, made the available material sufficient for a retrospective schema therapy-based conceptualisation. By the help of this systematic approach, one can gain a deeper understanding of how Kierkegaard's seemingly contradictory feelings, thoughts and acts were influenced by his early maladaptive schemas, schema modes and coping styles, and how they interconnected with each other. Schema conceptualisation can be an applicable psychobiographical method, as long as there is quantitatively and qualitatively sufficient study material available.
INTEGRATION OF PSYCHOTHERAPY AND FUNCTIONAL INTERVENTIONS IN THE TREATMENT OF PSYCHOGENIC DYSPHONIA: 5 CASES TREATED ASYNCHRONOUS
Han Almis B
BODY-FOCUSED REPETITIVE BEHAVIORS DURING COVID-19: A MANAGEMENT GUIDE
Rehman S and Bin Tahir S
Body-focused repetitive behaviour refers to nonfunctional, destructive and problematic body directed behaviours that emerge to cope with stressful situations like COVID-19. The damages of body-focused repetitive behaviour are devastating and perilous for the physical and mental health of people. No comprehensive study has been carried out to investigate the global level prevalence rate of BFBRs during COVID-19. However, the incidence of BFBRs is reported to be prevalent in a few countries of the world. Furthermore, the management modalities to reduce or overcome the BFBRs are limited in the literature. The current study aimed at highlighting the prevalence, aetiology and management modalities of BFBRs within pre and post pandemic stage. The findings of the study have been discussed in terms of counseling.
ASSESMENT OF EMOTIONAL FUNCTIONING AND SELF-PERCEPTION IN POST MASTECTOMY WOMEN
Pačarić S, Kristek J, Turk T, Farčić N, Biljan M and Nemčić A
Breast cancer is the most common cancer in women which affects them emotionally and psychologically. The aim of this research was to examine emotional functioning and self-perception in post mastectomy women. This cross-sectional single-center study included 101 women with breast cancer one month and one year after mastectomy. It was conducted using anonymous questionnaires developed by the European Organization for Research and Treatment of Cancer (EORTC): EORTC Quality of Life questionnaire (QLO) - C 30 (version 3), questionnaire with breast cancer module EORTC QLQ BR-23 and a sociodemographic questionnaire. Compared to results one month after mastectomy, in women one year after mastectomy there was significantly less tension (Mann-Whitney U test, p=0.011) and emotional irritability (Mann- Whitney U test, p=0.013), also the memory problems declined (Mann-Whitney U test, p=0.008). Discomfort with hair loss affected all parameters except concentration problems. The participants felt less physical attractive (p=0.647), were worried (p=0.645) and less feminine due to illness (p=0.638). A year after surgery there was no connection between anxiety and observed parameters. Breast cancer affects emotional functioning and self-perception of women especially in early postoperative period and during cancer treatment. A year after surgery there was no more connection between anxiety and hair loss discomfort. Patients need medical, social and psychological support during and after breast cancer treatment.
OUTLINING THE ABSENCE: FROM INFLAMMATION TO A DISTINCT ENDOPHENOTYPE FOR THE NEGATIVE SYMPTOMS OF SCHIZOPHRENIA
Moga CI, Pavăl D and Micluția IV
The concept of schizophrenia as a mental condition is subject to deconstruction for a broader approach toward a systemic disorder by encompassing the links with inflammation. Beyond the salient psychotic symptoms of schizophrenia, the negative symptoms remain the silent cause of deterioration and the hallmark of a worse prognosis. Either as part of a unitary disorder or as a distinct subtype of schizophrenia, the negative symptoms seem to be associated with specific biological features. They might suggest a more transparent phenotype of the underlying pathological process. Therefore, recent lines of research indicate that peripheral immune alterations may be predictive early-phase biomarkers for targeting a specific subgroup of schizophrenia patients at risk of later developing enduring negative symptoms. In this paper, we review 1. The most influential theories of inflammation in schizophrenia, in conjunction with 2. The hitherto data linking immune alterations to negative symptoms. Thus, we propose a theoretical framework to delineate a model of inflammatory endophenotype for the negative symptoms of schizophrenia.
DO CHILDHOOD MEMORIES INFLUENCE THE THERAPEUTIC RELATIONSHIP? AN EMPIRICAL BAYESIAN SEM APPROACH
Fuchshuber J, Schwigon D, Masic N and Löffler-Stastka H
This study aims to explore the interplay of these concepts in a sample patients diagnosed with schizophrenia and related psychotic disorders. Hence, the potentially mediating role of countertransference in the relationship between recalled parenting styles, childhood trauma and therapeutic working alliance was examined. A total sample of 30 patients (Age: 38.60; SD = 16.37; 50% female) treated for psychotic disorders in an inpatient setting were assessed. Pathways between the variables Recalled Parental Styles, Childhood Trauma, Countertransference and Working Alliance were estimated via frequentist and empirical Bayesian Structural Equation Modeling (EBSEM). Both maximum likelihood and EBSEM derived results suggested direct effects of remembered parental style on childhood trauma, as well as of childhood trauma on negative countertransference. Positive and negative countertransference were associated with working alliance. Furthermore, the findings suggested indirect effects of remembered parental style on negative countertransference via childhood trauma, as well as remembered parental style with working alliance mediated via childhood trauma and negative countertransference. Childhood trauma showed a significant indirect effect on working alliance via negative countertransference. The results provide preliminary support for the idea that traumatic memories from the past influence the therapeutic relationship in the present. In correspondence to this, the clinical significance of concepts like reverie and containment are discussed.
PROLOGUE: HERO'S JOURNEY OF NORMAN SARTORIUS
Jakovljević M
LARGE-SCALE BRAIN NETWORKS IN CHRONIC AND SMOLDERING SEROTONIN SYNDROME
Nagamine T