RESUMO
Pregnancy is a major life change for many women. The related biological changes, especially complications in its course and in the course of delivery, carry a risk of developing a variety of psychological problems and mental disorders. However, their treatment is challenging due to the teratogenic effects of most psychoactive drugs and specific requirements for entering different psychotherapeutic programs. Mental disorders during pregnancy are undoubtedly an important issue for both gynecology and psychiatry. There is still a discussion considering the question whether psychotherapy during pregnancy is safe, although no scientifically valid data contradicting the safety of psychotherapy during pregnancy has been published so far. Together with psychotherapy - as a treatment of choice - clinicians approve some other relatively safe treatment methods for psychiatric disorders in pregnant women. Light therapy, limited pharmacotherapy, ECT are included. The goal of this paper is to review current opinions of clinicians and researches concerning possibilities, indications and outcome of psychological treatments as a way to help pregnant women who suffer from different psychiatric conditions, and also because this subject is not yet present in Polish psychiatric journals.
Assuntos
Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/terapia , Gravidez/psicologia , Psicoterapia/métodos , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/terapia , Feminino , Humanos , Transtornos do Humor/epidemiologia , Escalas de Graduação Psiquiátrica , Psicoterapia/organização & administração , Fatores Socioeconômicos , Transtornos Somatoformes/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapiaRESUMO
AIM: The aim of this study was to analyze the effectiveness of intensive (150 - 210 sessions), short-term (10 - 14 weeks) group psychotherapy in the treatment of neurotic disorders, and selected personality disorders. METHODS: The study involved 145 patients treated in day hospital due to neurotic disorders and selected personality disorders. The measurements were performed twice - at the beginning and at the end of hospitalization. The effectiveness of psychotherapy in the reduction of symptoms of neurotic disorders was measured with symptom checklist "0". The change in the severity of personality traits characteristic for neurotic disorders was examined using Neurotic Personality Questionnaire KON-2006. RESULTS: A significant reduction in symptoms of neurotic disorders was found in 84% of patients (85,7% women and 80,8% men). 70,3% of the examined patients obtained in the measurement at the end of treatment results indicating the level of severity of neurotic disorders symptoms below the cutoff point separating population of healthy individuals from patients. A significant reduction in the severity of personality traits characteristically occurring in patients suffering from neurotic disorders was found in 76% of patients (74.5% women and 78.7% men). 42.8% of the examined patients obtained in the measurement at the end of the treatment the value of neurotic personality traits index (X-KON) typical for healthy population. CONCLUSIONS: Intensive, short-term group psychotherapy with elements of individual therapy is an effective treatment for neurotic disorders. The majority of treated persons obtains a significant symptomatic improvement and a reduction in the severity of neurotic personality traits.
Assuntos
Transtornos Neuróticos/terapia , Transtornos da Personalidade/terapia , Terapia Psicanalítica/métodos , Psicoterapia de Grupo/métodos , Autoimagem , Adulto , Feminino , Seguimentos , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Personalidade , Polônia , Resultado do Tratamento , Adulto JovemRESUMO
Pregnancy constitutes not only a challenge for the body of the woman, but also a developmental and psychological task for the mother-to-be, her partner and the entire family. Considerable amount of research has been published on the subject of the puerperal period and treatment options of various disorders emerging after pregnancy. However, data on psychiatric disorders and their treatment during that period, although available, remain insufficient. The paper reviews the literature on mental disorders occurring in pregnancy taking into account the overall emotional situation of the pregnant woman.
Assuntos
Transtornos Mentais/epidemiologia , Transtornos Mentais/prevenção & controle , Saúde Mental/estatística & dados numéricos , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/prevenção & controle , Feminino , Humanos , Comportamento Materno , Gravidez , Cuidado Pré-Natal/métodos , Transtornos Puerperais/epidemiologia , Transtornos Puerperais/prevenção & controle , Fatores de RiscoRESUMO
AIM: The assessment of links between traumatic events of sexual nature recollected from the past and patients' later functioning in sexual life and relationships. MATERIALS AND METHODS: Comorbidity of memories of traumatic sexual events from childhood and adolescence in patients with the features of their current partner relationships was analysed on the basis of Live Inventory completed by 2,582 women and 1,347 men, undergoing treatment between the years 1980-2002, before they were admitted to a day ward of neurotic disorder department. RESULTS: The existence of numerous significant links was observed e.g. the information regarding incest or incest attempt experience was related with a significant risk ofa sexual life assessment as completely dissatisfying in women (OR = 2.71) and almost completely dissatisfying in men (OR = 2.38). Sexual initiation by rape was related with women's more frequent incidence of getting married as a result of social pressure (OR = 3.77) and a feeling of hatred towards a partner (OR = 5.41). Men and women who considered themselves completely sexually uneducated (before the age of 18) assessed their sexual life as completely dissatisfying (OR = 2.48 and OR = 2.07), which was similar to men who would get punished for masturbation or sexual plays by their guardians (OR=2.68). CONCLUSIONS: Traumatic events and circumstances relating to sexuality, indicated in the questionnaire interview, turned out to be connected with the risk of dysfunctions in a sexual life and relationship. The traumas included, among others, rape during initiation, early initiation, incest, but also unfavourable circumstances of less traumatic nature such as a lack of sexual education, punishment for masturbation, "mostly undesired initiation". Their likely effects were rooted in relationship dysfunctions: reasons for their formation, power division, instability, problems with resolving conflicts and, most of all, sexual life dysfunctions. The results were obtained on the basis of simple questionnaire questions, which allows for the recommendation that they be used in a routine interview.
Assuntos
Abuso Sexual na Infância/psicologia , Abuso Sexual na Infância/estatística & dados numéricos , Relações Interpessoais , Autoimagem , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Disfunções Sexuais Psicogênicas/psicologia , Adulto , Criança , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Fatores de Risco , Autoavaliação (Psicologia) , Disfunções Sexuais Fisiológicas/psicologia , Parceiros Sexuais/psicologia , Adulto JovemRESUMO
AIM: The assessment of links of accumulated traumatic events of a sexual nature, recollected from the past, with the current functioning of the patients in the area of sexual life and relationship. MATERIAL AND METHODS: Comorbidity of memories of traumatic sexual events from childhood and puberty in patients with the features of their current partner relationships and sexual life were analyzed on the basis of Live Inventory completed by 2,582 women and 1,347 men, before treatment in day hospital (years 1980-2002). The accumulation was evaluated for a combination of two or three selected events. RESULTS: The presence of relatively numerous traumatic events in the field of sexuality early initiation or enforced initiation, incest or its attempt, sub-optimal sexual education and punishment for masturbation was indicated. In some patients, these events occurred simultaneously. Especially in women, the presence in the same person of two or three aggravating circumstances of life was associated with a higher risk of among others fleeting, casual sexual contacts, marriage under the influence of environment pressures, reluctance to partner. CONCLUSIONS: Increased accumulation - the presence in the same patient of more than one adverse circumstances associated with sexual development - leads to a higher incidence of interference in relationship with a partner including the elements of sexual dysfunction. The obtained results are generally consistent with clinical observations and literature despite different, simplified methodology of the study based on the analysis of single variables from questionnaire interviews. Finding fewer links in the group of men can be explained by their much lower number in the study group and less frequent burdening with certain traumatic events or different experiencing.
Assuntos
Abuso Sexual na Infância/psicologia , Abuso Sexual na Infância/estatística & dados numéricos , Relações Interpessoais , Rememoração Mental , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Adulto , Criança , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenvolvimento da Personalidade , Polônia/epidemiologia , Autoavaliação (Psicologia) , Distribuição por Sexo , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/psicologia , Parceiros Sexuais/psicologiaRESUMO
OBJECTIVES: Analysis of changes in ego strength in the course of group psychotherapy in patients treated with neurotic and selected personality disorders (F40-F61, ICD-10). METHODS: 82 patients (61 women and 21 men) participated in the study. They underwent intensive short-term group psychotherapy treatment in a day hospital for neurotic and behavioural disorders. The assessment of the patients' personality functioning was carried out at the onset and the end of the psychotherapy. The assessment was reported as a value on the ego strength scale by means of the MMPI-2 questionnaire. RESULTS: The comparative analysis with the use of the t-Student test for related measurements, which was carried out for the measurement of ego strength values at the onset and the end of the therapy, demonstrated a statistically significant positive change both for the entire examined group and the groups which considered the gender and diagnosis distribution. CONCLUSIONS: Short-term intensive comprehensive group psychotherapy with elements of individual psychotherapy results in obtaining the desired changes in the personality functioning manifested through the increase in ego strength.
Assuntos
Ego , Transtornos Neuróticos/terapia , Transtornos da Personalidade/terapia , Psicoterapia Breve/métodos , Psicoterapia de Grupo/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Neuróticos/psicologia , Personalidade , Transtornos da Personalidade/psicologia , Autoimagem , Inquéritos e Questionários , Resultado do TratamentoRESUMO
OBJECTIVES: Analysis of associations between changes in the intensity of neurotic symptoms and reduction of suicidal ideation (SI) or lack of SI reduction, in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach in a day hospital. METHODS: Symptom Checklist KO"O" and Life Inventory completed by 461 women and 219 men treated in the psychotherapeutic day hospital due to neurotic, behavioral or personality disorders between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. RESULTS: The reduction of neurotic symptoms intensity was greater in patients of both genders who improved in terms of SI than in those who did not. This referred to global intensity of neurotic symptoms (OWK coefficient) in both genders (p<0.001), as well as to the majority of the neurotic symptoms subtypes in both genders (p<0.05): Phobic disorders, Other anxiety disorders, Obsessive-compulsive disorders, Conversions and dissociations, Autonomic disorders, Somatization disorders, Neurasthenia, Avoidance and dependence, Sexual dysfunctions, Dysthymia; and in case of women (p<0.05): Hypochondriasis, Depersonalization and derealization, Impulsiveness and histrionism and Non-organic sleep disorders. CONCLUSIONS: The results show effectiveness and comprehensiveness of intensive psychotherapy as a treatment method that leads to improvement in terms of both SI and neurotic symptoms. This suggests that the applied therapy may be effective in preventing suicidality in this group of patients. The observed associations also point in favor of hypothesis on similarities in etiopathogenesis of and partly identical personality-related factors predisposing to SI and neurotic disorders.
Assuntos
Transtornos Neuróticos/terapia , Transtornos da Personalidade/terapia , Psicoterapia Psicodinâmica/métodos , Ideação Suicida , Tentativa de Suicídio/prevenção & controle , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Neuróticos/complicações , Personalidade , Transtornos da Personalidade/complicações , Resultado do Tratamento , Adulto JovemRESUMO
INTRODUCTION: The symptoms of dissociation, depersonalization and derealization are often associated with exposure of patients to mental and physical injuries, usually occurring in childhood. Most of these observations were carried out in populations of patients with various disorders (posttraumatic, conversion-dissociation, personality disorders - especially borderline), who reported their exposure to adverse life circumstances through questionnaire interviews. AIM: Assessment of the risk associated with various traumatic events in childhood and adolescence concerning the symptoms of pain and tactile dissociation, depersonalization and derealization. MATERIAL AND METHOD: The coexistence of the earlier life circumstances and the currently existing symptoms was examined on the basis of KO "0" Symptom Checklist and Life Inventory, completed prior to treatment in a day hospital for neurotic disorders. RESULTS: In the group of 2582 women, patients of a day hospital for neurotic and personality disorders, the symptoms of pain and tactile dissociation, depersonalization and derealization were present in 24-36 % of patients, while the maximum severity of these symptoms reported approximately 4-8 % of patients. The studied patients reported the exposure during childhood and adolescence (before 18yo) to numerous traumatic events of varying severity and frequency, including hostility of one parent (approximately 5% of respondents), the sexual initiation before 13yo (1%), worse than peers material conditions (23%), harassment of the family of origin (2%), reluctance of their peers (9%). Conducted regression analysis showed illustrated by the coefficients OR (odds ratios) a statistically significant relationship between the majority of the analyzed symptoms and many of the listed events, such as being regarded as worse than siblings, mother's anger in the situation of the patient's disease in childhood, lack of support, indifference of parent, poverty and worseness of the family of origin, inferior position in the classroom and the school grades, total sexual unawareness, incest or its attempt. CONCLUSIONS: The symptoms of dissociation, depersonalization and derealization occurred in significantly more patients reporting burdening life events - difficult situations in childhood and adolescence. Therefore, in clinical practice in patients presenting such symptoms, regardless of diagnosis (e. g. a specific neurotic disorder), we can expect revealing information about such events.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Despersonalização/psicologia , Transtornos Dissociativos/psicologia , Transtornos Neuróticos/epidemiologia , Dor/psicologia , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Despersonalização/epidemiologia , Transtornos Dissociativos/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos Neuróticos/psicologia , Dor/epidemiologia , Saúde da MulherRESUMO
AIM: The study of group psychotherapy influence on the personality functioning of patients on treatment for neurotic disorders and selected personality disorders (F4-F6 under ICD-10). METHODS: The study concerned 82 patients (61 women and 21 men) who underwent intensive short-term group psychotherapy in a day ward. A comprehensive assessment of the patients' personality functioning was carried out at the outset and the end of the psychotherapy utilising the MMPI-2 questionnaire. RESULTS: At the treatment outset the majority of the study patients demonstrated a considerable level of disorders in five MMPI-2 clinical scales (Depression, Hysteria, Psychopathic Deviate, Psychastenia, Schizophrenia) and moderate pathology in Hypochondria. In the Mania scale most patients obtained results comparable to the healthy population when the treatment commenced. Having undergone the psychotherapy treatment, the majority of the examined were observed to demonstrate positive changes in those areas of personality functioning which were classified as severe or moderate pathology. CONCLUSIONS: Short-term intensive comprehensive group psychotherapy with elements of individual psychotherapy leads to desirable changes in personality functioning.
Assuntos
Transtornos Neuróticos/terapia , Transtornos da Personalidade/terapia , Terapia Psicanalítica/métodos , Psicoterapia de Grupo/métodos , Autoimagem , Adulto , Feminino , Seguimentos , Humanos , Relações Interpessoais , Masculino , Transtornos Neuróticos/psicologia , Transtornos da Personalidade/psicologia , Polônia , Resultado do Tratamento , Adulto JovemRESUMO
UNLABELLED: AIM : The aim of this study was to determine the effectiveness of intensive psychotherapy in the day hospital for neurotic and behavioral disorders as well as the assessment of the usefulness of the Neurotic Personality Inventory KON-2006 for routine evaluation of psychotherapy effectiveness. METHODS: The results of the questionnaires KON-2006 completed by 690 patients (women - 69%, men - 31%, mean age 29 years, SD 8 years) were analyzed. All persons have received comprehensive, mainly psychodynamic psychotherapy (group with elements of individual therapy), in the years 2004-2009 in the Day Hospital for Neurotic and Behavioral Disorders in Krakow. RESULTS: The vast majority of patients achieved after the end of psychotherapy beneficial changes in personality corresponding to various degrees of improvements in terms of the questionnaire KON-2006. Only a few patients deteriorated, somewhat more numerous group did not achieve significant changes or the effects are not possible for unambiguous interpretation. These results are highly correlated with those obtained in the personality questionnaire NEO-PI-R. CONCLUSIONS: The Neurotic Personality Inventory KON-2006 appears to be an adequate tool to assess the results of intensive, comprehensive psychotherapy, conducted in the day hospital for neurotic and behavioral disorders.
Assuntos
Transtornos Neuróticos/terapia , Transtornos da Personalidade/terapia , Terapia Psicanalítica/métodos , Psicoterapia Breve/métodos , Adulto , Feminino , Humanos , Masculino , Transtornos Neuróticos/psicologia , Personalidade , Transtornos da Personalidade/psicologia , Avaliação de Programas e Projetos de Saúde , Psicologia Clínica/métodos , Autoimagem , Inquéritos e Questionários/normas , Resultado do Tratamento , Adulto JovemRESUMO
AIM: Analysis of associations between initial neurotic personality traits and subsequent reduction of suicidal ideation (SI) - or lack of such reduction - obtained until the end of hospitalization in patients who underwent the course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach. METHODS: Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006 and Life Inventory completed by 461 women and 219 men hospitalized in the day-hospital due to neurotic, behavioral and personality disorders between 2005-2013. At the stage of qualification 134 women and 80 men reported SI, of whom subsequently 84.3% and 77.5% respectively improved. RESULTS: Women with prominent Tendency to risk-taking (p=0.002) and Impulsiveness (p=0.038) constituted subgroups with decreased chances of improvement in terms of SI, while men with prominently elevated level of Envy (p=0.041) and women who seemed to have difficulties in expressing anger adequately (p<0.05) had increased chances of SI reduction. CONCLUSIONS: Initially prominent Tendency to risk-taking and Impulsiveness may coexist with SI of increased resistance to psychotherapy. Thus, those subgroups require special attention and diligent selection of therapeutic methods. Also, it is probable that focusing therapy at the above-mentioned personality components may increase effectiveness of SI treatment. Reducing SI during psychotherapy appears to be highly effective especially in women with difficulties in expressing anger adequately and in men with prominently elevated level of Envy, which suggests adequacy of this treatment choice and of targeting those difficulties during psychotherapy.
Assuntos
Transtornos Neuróticos/terapia , Psicoterapia Psicodinâmica/métodos , Ideação Suicida , Tentativa de Suicídio/prevenção & controle , Adulto , Comorbidade , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/terapia , Resultado do TratamentoRESUMO
AIM: Analysis of associations between changes in neurotic personality profile and reductionof suicidal ideation (SI) - or lack of such reduction - defined as its elimination or reduction of its intensity in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach. METHODS: Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006 and Life Inventory completed by 461 women and 219 men treated due to neurotic, behavioral or personality disorders in a day hospital between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. RESULTS: Patients who improved in terms of SI obtained significantly greater reduction of global neurotic personality disintegration (neuroticism) than others (p<0.0005 in women and p=0.015 in men). Associations were found between improvement in terms of SI and greater reduction of many neurotic personality traits (p<0.05) in both genders: Negative self-esteem, Impulsiveness, Sense of alienation, Demobilization, Difficulties in emotional relations, Lack of vitality, Sense of lack of control, Sense of guilt, Difficulties in interpersonal relations, Sense of being in danger, Exaltation, Ponderings; and only in women: Feeling of being dependent on the Environment, Asthenia, Difficulties with decision making, Conviction of own resourcelessness in life, Deficit in internal locus of control and Imagination. indulging in fiction. CONCLUSIONS: The results confirm effectiveness of intensive psychotherapy as a treatment method that leads to comprehensive improvement encompassing reduction of neurotic personality disorders (neuroticism) and of majority of neurotic personality traits, as well as SI reduction. The revealed associations weigh in favor of hypothesis on neuroticism as SI predisposing factor in patients with neurotic, behavioral and personality disorders.
Assuntos
Transtornos Neuróticos/terapia , Psicoterapia Psicodinâmica/métodos , Ideação Suicida , Tentativa de Suicídio/prevenção & controle , Adulto , Comorbidade , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Neuróticos/psicologia , Transtornos da Personalidade/terapia , Resultado do TratamentoRESUMO
AIM: Analysis of prevalence and intensity of suicidal thoughts and their associations with neurotic personality traits as well as neurotic symptoms intensity in patients participating in qualification for hospitalization in a day hospital for treatment of neurotic and behavioral disorders. METHODS: The results of Symptom Checklist KO"0", Neurotic Personality Questionnaire KON-2006 and Life Inventory of 1063 patients (739 women and 324 men), admitted to psychotherapy in a day hospital because of neurotic, behavioral and personality disorders. RESULTS: In the population of patients coming for treatment in the day hospital, the presence of suicidal ideations (SI) was common (reaching one-third of the respondents) and was regardless of the respondents'gender associated with significantly higher global symptom level (OWK) and significantly greater global neurotic personality disintegration (XKON) as well as significantly higher values of most of the neurotic personality inventory scales. None of the neurotic personality traits reduced the risk of suicidal ideation nor was associated with low SI arduousness. CONCLUSIONS: Day hospital patients reporting SI are a subgroup burdened with more severe neurotic disorders and comorbid personality disorders. Thus, the persons reporting in symptom questionnaires willingness to take one's own life, although relatively frequently encountered, deserve special attention due to the greater severity of their symptoms.
Assuntos
Transtornos Neuróticos/terapia , Personalidade , Psicoterapia Psicodinâmica/métodos , Autoimagem , Ideação Suicida , Tentativa de Suicídio/psicologia , Adulto , Comorbidade , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Neuróticos/psicologia , Transtornos da Personalidade/terapia , Tentativa de Suicídio/prevenção & controle , Resultado do TratamentoRESUMO
BACKGROUND: Patients in various areas of medicine report symptoms that are unexplained by other medical reasons than psychological/psychiatric. Some of them urgently seek treatment due to cardiovascular complaints, mostly rapid heart rate, palpitations and chest pain. Typical cardiac investigations, usually showing no organic reasons for these conditions, bring little information about stressful life events and psychological predispositions of these patients. Identification of coexistence of "cardiac" symptoms with other symptoms typical for neurotic disorders and difficult life circumstances may facilitate not only psychiatric diagnosis but also evaluation by cardiologists, primary care physicians, and other specialists. AIM: To determine the psychosocial context of psychogenic "pseudocardiac" symptoms and their coexistence with other symptoms in patients with neurotic disorders. METHODS: Medical records of patients from the years 1980-2002 that included self-administered questionnaires transformed into an anonymised database were examined. An analysis of the relationship between symptoms reported in the Symptom Checklist and biographical circumstances described in the Life Inventory before admission to a psychotherapy day clinic for patients with neurotic disorders was performed using simple logistic regression with estimation of odds ratios and their 95% confidence intervals. RESULTS: The symptoms of tachycardia/palpitations and chest pain were very common, present in most subjects, and were significantly associated with such circumstances as suboptimal conflict solving by passive aggression or quarrels, uncertainty in the relationship, a sense of being inferior to the partner, and poor financial situation. In addition, these "pseudocardiac" symptoms were also associated with such childhood reminiscences as origin from a large low income family, feeling that the family of origin was inferior to others, and experience of parental hostility or lack of support. CONCLUSIONS: Physicians of all specialties who deal with patients experiencing pseudocardiac symptoms should expect their psychological background and perform a simple interview to identify the presence of adverse biographical circumstances described above. Identification and discussing these difficult experiences with the patients may help to convince them to seek psychological support or psychotherapy.
Assuntos
Dor no Peito/psicologia , Transtornos Neuróticos , Transtornos Psicofisiológicos , Taquicardia/psicologia , Adolescente , Pré-Escolar , Feminino , Humanos , Relações Interpessoais , Masculino , Polônia , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVES: Analysis of changes in prevalence and intensity of suicidal ideation (SI) in patients who underwent an intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach in the Day Hospital for Neurotic and Behavioral Disorders. METHODS: Symptom checklist KO"O" and Life Inventory completed by 461 women and 219 men who were treated in the day hospital due to neurotic, behavioral and personality disorders in 2005-2013. RESULTS: Patients initially reporting SI showed greater than others global intensity of the neurotic symptoms (p < 0.001 for both sexes) and greater intensity in almost all the neurotic symptoms scales. Improvement (elimination or reduction of intensity) in terms of SI was observed in 84.3% of women and 77.5% of men. The prevalence of SI-reporting patients decreased substantially from 29.1% to 10.2% in women and from 36.5% to 13.7% in men. CONCLUSIONS: The patients reporting SI before the commencement of psychotherapy constituted a large part of the studied population - approximately 1/3. They showed greater intensity of neurotic symptoms than those who were not reporting SI. Intensive psychotherapy in the day hospital was characterized by high effectiveness in terms of reduction and elimination of SI. Prevalence of SI in both women and men until the end of therapy decreased almost three times. Cases of improvement in terms of SI were several times more frequent than cases of deterioration in terms of SI (increase in its intensity or its occurrence at the end of therapy). Etiopathogenesis of SI and its methods of treatment require further research.
Assuntos
Transtornos Mentais/terapia , Psicoterapia Psicodinâmica/métodos , Ideação Suicida , Tentativa de Suicídio/prevenção & controle , Adulto , Comorbidade , Escolaridade , Emprego/classificação , Emprego/estatística & dados numéricos , Feminino , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Transtornos Mentais/classificação , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Neuróticos/epidemiologia , Transtornos Neuróticos/terapia , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/terapia , Inventário de Personalidade , Prevalência , Autoimagem , Transtornos do Sono-Vigília/epidemiologia , Tentativa de Suicídio/estatística & dados numéricos , Inquéritos e Questionários , Resultado do TratamentoRESUMO
OBJECTIVES: Analysis of associations between symptoms reported before the beginning of the hospitalization and reduction of suicidal ideation - or its lack - obtained until the end of the hospitalization in patients of the day hospital for the treatment of neurotic and behavioral disorders. METHODS: Symptoms Checklist KO"O" and Life Inventory completed by 461 women and 219 men treated with intensive integrative psychotherapy with predominance of psychodynamic approach in the day hospital due to neurotic, behavioral and personality disorders between 2005-2013. Percentages of patients reporting SI initially and at the end of the treatment were 29.1% and 10.2% respectively in women and 36.5% and 13.7% in men. The improvement in terms of initially reported SI was obtained by 84.3% of women and 77.5% of men. Among patients, those initially reporting SI were characterized by greater intensity of neurotic symptoms (p<0.001) and greater intensity of nearly all of 14 subtypes of neurotic symptoms(p<0.05). RESULTS: Among those reporting SI, subgroups of women with greater intensity of Obsessive-compulsive symptoms (p=0.003), Neurasthenia (p=0.005), Autonomic disorders (p=0.044) and women reporting episodes of uncontrollable hunger (p<0.01) had significantly lower chances of improvement in terms of SI than others. CONCLUSIONS: Patients initially reporting SI constituted approximately 1/3 in both genders and were characterized by greater intensity of neurotic disorders. Among those, women with particularly higher intensity of Obsessive-compulsive symptoms, Neurasthenia and Autonomic disorders and women reporting episodes of uncontrollable hunger seemed to suffer from SI that were more resistant to the psychotherapy. As such, those subgroups of women require special attention and diligent selection of the therapeutic methods.
Assuntos
Transtornos Mentais/terapia , Transtornos Neuróticos/terapia , Psicoterapia Psicodinâmica/métodos , Ideação Suicida , Tentativa de Suicídio/prevenção & controle , Adulto , Idoso , Comorbidade , Feminino , Hospitalização , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Transtornos Neuróticos/epidemiologia , Transtornos da Personalidade/terapia , Tentativa de Suicídio/estatística & dados numéricos , Resultado do TratamentoRESUMO
INTRODUCTION: Gastrointestinal symptoms are very common in the general population. Many of them coincide with mental disorders (especially with neuroses, stress-related disorders, somatisation disorders, autonomic dysfunction, and anxiety) that are associated with psychological trauma, conflicts, and difficulties with interpersonal relationships. AIM: Assessment of the association between gastrointestinal complaints and stressful situations in relationships, among patients admitted to day hospital for neurotic and behavioural disorders. MATERIAL AND METHODS: Analysis of the likelihood of co-occurrence of abdominal symptoms and stressful situations, reported by patients before admission, in a large group of subjects treated with psychotherapy. RESULTS: Gastrointestinal symptoms were highly prevalent in the studied group (they were reported by 40-50% of patients). The most common complaints in women were: loss of appetite (52%), nausea (49%), and constipation and flatulence (45%). In men the most prevalent symptoms were: loss of appetite (47%), heartburn (44%), and flatulence (43%). Functional gastrointestinal symptoms (especially vomiting in cases of nervousness in females or heartburn in males) were significantly associated with greater likelihood of current difficulties in interpersonal relationships, such as conflicts with partner/spouse or parent. CONCLUSIONS: The results suggest that in many cases symptoms of anxiety disorders or somatisation disorders coexisted with irritable bowel syndrome and functional dyspepsia.