[What do Interpreters Cost? - A Retrospective Analysis of the Costs for Interpreters in Treatment of Refugees in a Psychiatric Outpatient Clinic in Berlin]. / Was kosten uns Dolmetscher? ­ Eine retrospektive Analyse der Dolmetscherkosten in der Behandlung von Flüchtlingen in einer Psychiatrischen Institutsambulanz in Berlin.

Clinical diagnostics of mental disorders especially among refugees and asylum seekers come with unique difficulties: language barriers, different forms of expression and concepts of the understanding of mental illness as well as a different cultural background. Therefore professional interpreters are needed but associated with a higher effort related to costs and time. We conducted a retrospective analysis of costs, which incurred by the use of professional interpreters in our outpatient clinic in Berlin, Germany, in the first quarter 2016 for the treatment of refugees and asylum seekers. The sample consisted of 110 refugees and asylum seekers; the highest costs in the use of interpreters incurred among Neurotic, stress-related and somatoform disorders (53.04%), especially Posttraumatic Stress Disorder (39.04%), as well as affective disorders (38.47%), especially major depressive episodes (25.23%). Our data point out the crucial need of a regulation of costs with regard to the service of professional interpreters in Germany.

Basics of the ascetical (christian) psychotherapy.

It is obvious that contemporary man is suffering. His sufferings often seem pointless and causeless. Modern science more and more comes to reveal and acknowledge that human sufferings have a psychosomatic basis. In some of the cases, these sufferings are noogenic neuroses. They do not originate from the psychological dimension but from the noological or spiritual one of human existence. The pointlessness of life is the basic cause for the noogenic neurosis and depression from which the humankind suffers. e. Hence, the many escapes from such experienced reality into various addictions. Possible way towards healing is to retrieve one's meaning of life, to strengthen his will to meaning. Religion has always been - and still remains - a powerful and appealing purpose that fulfills the life and being of the believers. This article demonstrates the systematization of the spiritual development of a person presented in a table of the harmony of the ascetic-hesychastic struggle, according which everyone can find his place on the ladder of spiritual development, become aware, and reconciliate the mode of personal struggle according to his spiritual development. The reconciliation of the primary function of the mind with its secondary function - the intellect, is of an essential importance. Contemporary religious psychology do not regard man merely as a biological or a psychological being. The subject matter of research is the human being as a whole, as a spiritual person that is characterized by autonomy, regarding the biological and psychological processes. The importance of understanding the spiritual level of human existence enables holistic approach and experiencing of the human personality as a whole. Furthermore, it offers new perspectives of psychotherapeutic action not only within the range of the classical psychotherapeutic modalities but also within the range of the applied Christian Psychotherapy.

Implementación de la filosofía hooponopónica modificada en el programa terapéutico para pacientes que funcionan a nivel neurótico / Using the modification of the ho´oponopono philosophy in the therapeutic program for patients with neurotic levels

Se fundamenta la implementación de la filosofía hooponopónica, modificada en el programa terapéutico de los pacientes que funcionan a nivel neurótico en el Hospital de Día de Las Tunas, lo cual responde a una de las líneas de investigación del proyecto institucional FiloArtMed. La filosofía hooponopónica de fundamento idealista, exotérico y negador de la realidad, de orígenes milenarios en Hawái, fue modificada teniendo en cuenta el significado de sus palabras claves: perdóname, gracias, lo siento, te amo, de acuerdo a los preceptos dialécticos materialistas de la Medicina y la Psicología cubanas, insertándola en el programa terapéutico integral del hospital de día para pacientes neuróticos como técnica cognitiva conductual reguladora del comportamiento, rectorizando las terapias a manera de núcleo terapéutico. Se desecharon sus preceptos acientíficos tradicionales y se incluyó, además, el ejercicio de meditación, derivado de esta filosofía, basado en el principio de la neuroplasticidad cerebral, como técnica de relajación y de limpieza mental, fungiendo como la entrada B de la psicoterapia grupal sistémica de regulación emocional (AU)

This study deals with the use of the modification of the ho´oponopono philosophy in the therapeutic program for patients with neurotic levels who were treated at Las Tunas Psychiatric Day Hospital, as a response to the research lines of the FiloArtMed institutional project. The ho´oponopono philosophy of idealistic, exoteric and reality denier basis, which has millenary Hawaiian origins was modified taking into account the meaning of its keywords (forgive me, thanks, I am sorry and I love you) according to the dialectic materialistic precepts of Cuban Medicine and Psychology. Such modification is inserted in the therapeutic program of the day hospital for neurotic patients as a regulatory cognitive- behavioral therapy, ruling the therapies as a therapeutic nucleus. The traditional unscientific precepts were rejected and the meditation exercise derived from this philosophy and based on the brain neuroplasticity principle was included as a relaxation and mental cleaning technique, acting as the B entrance to systemic group psychotherapy of emotional regulation (AU)

Neurofeedback therapy in patients with non pain syndromes of chronic and paroxysmal character-literature review and own experience.

Neurofeedback has been used in treatment of many other than pain clinical syndromes. This group includes chronic as well as paroxysmal syndromes previously treated pharmacologically. However due to non satisfactory results of this treatment introduction of non-pharmacological therapy has been examined. Observations from our 9-year experience of neurofeedback therapy used in children and adult patients with epilepsy, Asperger syndrome, depression, neurosis, personality disorders, drug addiction and other (not pain) syndromes have been presented in this paper. Positive influence of neurofeedback therapy on symptoms intensity, frequency, duration and social relations of treated patients has been confirmed by our own and other authors observations. Neurofeedback therapy has been tried by patients with other difficult life problems and has been effective in some of them. The effectiveness of the therapy has been confirmed by patients, their relatives and also by neurophysiological results. Additionally, preliminary results of neurofeedback therapy used in management of computer addiction in children and adolescents have been presented herein.

[The use of phototherapy and photochromotherapy in the combined treatment of the patients presenting with astheno-depressive syndrome and neurotic disorders].

The objective of the present clinical and psychopathological study was to estimate the influence of high-intensity white and yellow phototherapy on the clinical condition of 41 and 18 patients respectively presenting with astheno-depressive syndrome. The control group was comprised of 42 patients who were treated by standard pharmacotherapy. Clinical observations of the patients were supplemented by the evaluation of their conditions and characteristics using the Symptom Checklist-90 questionnaire, the Bekhterev Depression Inventory, and the Beck Depression Inventory. The patients of the three groups were surveyed before and within 20 days after the initiation of the treatment. It was shown that white light phototherapy considerably reduced the severity of asthenia and depression. Yellow light phototherapy proved more efficacious in the patients with asthenia and somatovegetative dysfunctions.

[Christa Kohler's "communicative psychotherapy" as an integrated psychotherapeutic concept and its biographical, scientific and historical context]. / Christa Kohlers "Kommunikative Psychotherapie"--ein integratives Psychotherapiekonzept im biografischen, wissenschaftlichen und historischen Kontext.

"Communicative psychotherapy" was developed in the 1960s by the East German psychotherapist and psychiatrist Christa Kohler (1928-2004) for the treatment of "neuroses". Similar to established present-day psychotherapeutic methods, such as cognitive behaviour therapy, it combined diverse therapeutic approaches into an integrated treatment programme. This included individual and group therapy, exercise, work and occupational therapy. In contrast to modern psychotherapeutic practice, communicative psychotherapy was based on a firm system of values, namely socialist ideals. According to this system, psychological breakdown was viewed and treated ideologically. In addition, any lack of conformity with the East German system was likewise regarded as a psychopathological deviation, which should be subjected to psychological treatment. The latter concept requires a critical analysis from a current-day perspective. For the first time, this paper concentrates on Kohler's work on neuroses and the theory and practice of her communicative psychotherapy, albeit without neglecting Kohler's other scientific works, her biographical information and her Stasi documents.

Become more optimistic by imagining a best possible self: effects of a two week intervention.

BACKGROUND AND OBJECTIVES: Optimism is a personality trait which has repeatedly been shown to correlate with, and predict psychological and physical well-being. The present study investigated whether optimism can be increased by imagining a best possible self (BPS). Effects were compared to a control group in which participants imagined their daily activities (DA). METHODS: In order to minimize inter-individual differences in content of imagery, participants constructed their BPS according to 3 domains, namely a personal, relational, and professional domain. All participants were instructed to practice their imagery exercise for 5 min per day over a period of two weeks. Effects on optimism and mood were measured after one session, after one week and after two weeks. RESULTS: Results indicated that BPS imagery led to significantly larger increases in optimism as compared to DA imagery, after one session and over a two week period. Effects on optimism remained after controlling for possible mediation by the change in positive mood. LIMITATIONS: In order to test the effectiveness of our BPS imagery intervention we relied exclusively on self-report measures. CONCLUSION: The present study confirmed that imagining a BPS enhances levels of optimism, independent of the mood effect.

[Peculiarities of therapy of neurotic disorders in patients with rheumatoid arthritis].

Evaluation of neurotic disorders (ND) in 168 patients with rheumatoid arthritis revealed them in 65.6% of the cases including 22.6% weak, 31.7% moderate and 14.9% severe ones. Asthenovegetative disorders were most frequently detected (61.3%). They associated with emotional, hypochondriac, hysterical, and obsessional disorders in 24.4, 14.3, 9.5, and 4.8% of the patients respectively. ND were treated depending on their type and severity. Mild ND were managed by combined therapy including general tonics, physiotherapeutic procedures, and remedial gymnastics. Patients with moderate ND were given sedative medicines (novopassit, sedavit, glycine, peony tincture). Severe ND were managed using antidepressants and tranquilizers. Duration of therapy was 10-21 days depending on its form. The treatment eliminated all symptoms of ND in 66 (54.1%) and reduced them in 44 (36.1%) of the patients. The outcome of psychotherapy was regarded as unsatisfactory in 11.5%, satisfactory in 26.2%, and positive in 62.3% of the patients. These values in a control group of 46 patients without HD were 10.8, 37.0, and 52.2% respectively.

[Results of experimental study of psychophysiological state and hematological characteristics in servicemen presenting with hyperuricemia].

Laboratory, clinical, and pathophysiological methods were used to examine servicemen presenting with hyperuricemia. Pronounced hypersympaticotony was accompanied by stabilization of cardiac rhythm. Neurotic personality profile was identified in 48% of the subjects, psychotic in 17.3%, and undefined in 34.6%. The elevated plasma uric acid level was shown to be a factor associated with the neurotic psychotype. There was no correlation between other hematological characteristics and personality psychotype. The examined subjects exhibited high working capacity and level of ambition. Inability to take mind off the pressure of work creates psychosomatic predisposition for and risk of cardiovascular pathology strengthened by permanent hypersympaticotony. It is proposed to teach the subjects like those included in the study to reach neuromuscular relaxation in combination with cognitive-behavioural training as a means of preventing the development of cardiovascular pathology.

Psychological aspects and psychotherapy of inflammatory bowel diseases and irritable bowel syndrome in children.

BACKGROUND: Despite holistic approach to psychosomatic medicine, gastroenterological disorders (GI) tend to be categorized broadly into "functional" and "organic". Major GI illnesses are Inflammatory bowel diseases (IBD) include ulcerative colitis and Crohn's disease. Both are chronic, with remissions and relapses over the years while irritable bowel syndrome (IBS) is a common, often disabling functional gastrointestinal disorder. METHODS: A literature review was performed using the National Library of Medicine PubMed database, including all resources within the period 1991-2008, additional references were found through bibliography reviews of relevant articles. RESULTS: Psychological problems: Higher scores of neuroticism, depression, inhibition, and emotional instability, are typical for many patients with chronic diseases and nonspecific for chronic gastroenterological disorders. Patients with chronic gastrointestinal disorders have impaired health-related quality. Psychological treatments: There have been few adequate psychological treatment trials in IBD. These achieved lower demands for health care rather than a reduction of anxiety or depression. Psychotherapy with chronic gastrointestinal disorders could lead to improve the course of the disease, changing psychological factors such as depression and dysfunctional coping and improving the patient's quality of life. CONCLUSIONS: There seem to be "risk patients" in whom psychosocial components have a bigger influence on the course of disease than in other patients; and those would probably benefit from psychotherapeutic treatment. Psychological treatments help patients manage the psychological distress which worsens bowel symptoms and quality of life.

A model for self-treatment of four sub-types of symptomatic 'depression' using non-prescription agents: neuroticism (anxiety and emotional instability); malaise (fatigue and painful symptoms); demotivation (anhedonia) and seasonal affective disorder 'SAD'.

This article will present a model for how 'depression' (i.e. depressive symptoms) can be divided into four self-diagnosed sub-types or causes which might then be self-treated using agents available without prescription. (Another, much rarer, cause of depressed symptoms is the classical illness of 'melancholia', which when severe cannot be self-treated and typically requires hospitalization.) A self-management option and alternative is now needed due to the an inappropriate emphasis of modern psychiatry on treatment of imprecise syndromal 'disorders' which may entail treating 'depression' at the cost of making the patient feel and function worse. By contrast, the basic theoretical stance of self-management is that depressed mood should be seen as a result of unpleasant symptoms - and it is the symptoms that require treatment, not the mood itself. Furthermore, drugs (or other interventions) need to be classified in terms of their potential therapeutic effects on these symptoms that may cause depressed mood. The four common causes of depressed mood considered here are the personality trait of Neuroticism; the state of malaise (fatigue, aching etc) which accompanies an illness with an activated immune system; demotivation due to lack of positive emotions (anhedonia); and the syndrome of seasonal affective disorder (SAD). Each of the four sub-types is then 'matched' with a first-line non-prescription agent. The 'stabilizing' agents such as St John's Wort and the antihistamines chlorpheniramine and diphenhydramine are used for treatment of Neuroticism; analgesics/pain killers such as aspirin, ibuprofen, paracetamol/acetaminophen and the opiates are used to treat malaise; energizing agents such as caffeine and nicotine are used for the treatment of demotivation; and bright light used in the early morning to treat SAD. Self-treatments are intended to be used after research and experimentally, on a trial-and-error basis; with self-monitoring of beneficial and harmful effects, and a willingness to stop and switch treatments. The model of S-DTM (self-diagnosis, self-treatment and self-monitoring) is suggested as potentially applicable more widely within psychiatry and medicine.

Non-traditional psychiatric treatments in Asia.

Non-traditional (Eastern/non-conventional) treatments have gained increased interest and recognition recently. The utilization of these treatments in psychiatry challenges mental health professionals to examine the impact of cultural factors and the bi-directional effects of body on mind and mind on body when treating psychiatric illnesses. Professionals in the psychiatric field need to be aware of commonly practised treatments used by people in Asia, the most populous region in the world. There is a wide variety of non-traditional (Eastern) psychiatric treatments in Asia. This article selects only a few commonly practised treatments and describes the clinical application of each treatment.

Efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia.

BACKGROUND: Music therapy (MT) has been proposed as valid approach for behavioral and psychologic symptoms (BPSD) of dementia. However, studies demonstrating the effectiveness of this approach are lacking. OBJECTIVE: To assess MT effectiveness in reducing BPSD in subjects with dementia. METHOD: Fifty-nine persons with dementia were enrolled in this study. All of them underwent a multidimensional assessment including Mini Mental State Examination, Barthel Index and Neuropsychiatry Inventory at enrollment and after 8, 16, and 20 weeks. Subjects were randomly assigned to experimental (n=30) or control (n=29) group. The MT sessions were evaluated with standardized criteria. The experimental group received 30 MT sessions (16 wk of treatment), whereas the control group received educational support or entertainment activities. RESULTS: NPI total score significantly decreased in the experimental group at 8th, 16th, and 20th weeks (interaction time x group: F3,165=5.06, P=0.002). Specific BPSD (ie, delusions, agitation, anxiety, apathy, irritability, aberrant motor activity, and night-time disturbances) significantly improved. The empathetic relationship and the patients' active participation in the MT approach, also improved in the experimental group. CONCLUSIONS: The study shows that MT is effective to reduce BPSD in patients with moderate-severe dementia.

Forty cases of gastrointestinal neurosis treated by acupunture.

OBJECTIVE: To compare the therapeutic effect of acupuncture for gastrointestinal neurosis with that of oral remedy. METHODS: Eighty cases were randomly divided into the following 2 groups. In the treatment group, acupuncture was given for one month at the main points of Zhongwan (CV 12), Zusanli (ST 36), Taichong (LR 3) and Shenmen (HT 7), with the auxiliary points selected according to TCM differentiation. In the control group, Domperidone was orally administered for one month. RESULTS: The total effective rate was 92.5% in the treatment group and 75.0% in the control group, with a significant difference between the 2 groups (chi2 = 4.423, P < 0.05). Acupuncture was superior to the oral remedy in therapeutic effects. CONCLUSIONS: Acupuncture may show better results for gastrointestinal neurosis and with less toxic side effects.

[Target dimensions of psychosomatic-psychotherapeutic care]. / Zieldimensionen der psychosomatisch-psychotherapeutischen Versorgung.

In 1965, the effectiveness of psychoanalytic therapy was demonstrated, which was then included in the reimbursement schemes of the statutory health insurance. In 1987, epidemiologic evidence was provided for the high prevalence of psychosomatic diseases, often associated with a high risk load. Later a phase model described the effects of psychotherapy by the successive levels of remoralisation, symptom and functional improvement. On the basis of health insurance data Felliti (2002) provided plausible evidence for the psychosocial aetiology of most chronic somatic diseases. These data correspond to a dramatically reduced life expectancy. Thus, a causal bio-psycho-social chain exists between adverse childhood events (ACE), unspecific bodily tensions, dysfunctional health-related coping behavioural strategies (risk load), serious chronic diseases and premature death. In summary, psychosomatic medicine and psychotherapy is a field of health care with a variety of target dimensions which can be brought together in an appropriate model.

[Comparative efficacy of non-medicamentous methods for the treatment of patients with neurotic anxiety disorders].

The objective of this work was to compare effectiveness of non-medicamentous methods for the treatment of patients with neurotic anxiety disorders. The study included 193 patients at the age from 18 to 40 years. They were offered the following methods of non-medicamentous therapy: psychotherapy, phytotherapy, and reflexotherapy (acupuncture). Psychotherapy was the first-line treatment while phytotherapy and reflexotherapy were used as adjuvant modalities. Patients of the control group received psychotherapy alone. The study has demonstrated relatively high efficiency of non-medicamentous therapies in the patients with neurotic anxiety disorders. It was shown that psychotherapy not only provides a solid basis for application of the second treatment modality but can also be used as a self-contained method. The best results were obtained by combined treatment based on cognitive and behavioural psychotherapy, hypnosis, and autogenic training as its major components. Their most important outcomes were modification of basic skills, habit patterns, and mode of thinking as well as self-care education of the patients.

Utilidad de la homeopatía en trastornos neuróticos

Se realiza un estudio descriptivo en el servicio de Medicina Tradicional y Natural del Hospital Psiquiátrico Provincial Docente Luis Ramírez López de Guantánamo, con el objetivo de evaluar la utilidad de la homeopatía en trastornos psiquiátricos del nivel neurótico, en el período comprendido desde diciembre de 2002 hasta diciembre de 2003. El universo de estudio está constituido por 30 pacientes. El dato primario se obtuvo a través de la entrevista directa al paciente y los datos recogidos en las historias clínicas homeopáticas. Se estudian las siguientes variables: sexo, motivos de consulta, medicamentos y evolución. Se obtuvieron los siguientes resultados: Predominio del grupo etario comprendido entre 26 y 45 años y sexo femenino. El motivo de consulta más frecuente resultó ser la ansiedad seguida de tristeza, insomnio y cefalea. El remedio más utilizado fue el Sulphur, seguida de Pulsatilla, Ignatia, Arsenicun album y Lachesis. La mayoría de los pacientes (60.7 por ciento) obtuvo mejoría con el tratamiento homeopático sin el tratamiento psicofarmacológico habitual en estos casos, evitando el riesgo adictivo, los desagradables efectos secundarios y el mayor costo de los mismos(AU)

[Psychoneurological disorders in acute intoxications by psychotropic drugs and their correction using hyperbaric oxygenation].

The paper presents the results of a study of the clinical features of psychoneurological disorders in 178 patients with acute intoxications by various psychotropic drugs. Hyperbaric oxygenation showed positive changes in psychopathological syndromic kinesis. A sanogenetic rationale is provided for the method of choice in treating this category of patients.