Day 1 :
Keynote Forum
Gregory P Brown
University of Nevada, USA
Keynote: Hypnosis: The three amazing “Eâ€s of the post-Freud era; Erickson, Estabrooks and Elman
Time : 10:00-10:45
Biography:
Gregory P Brown has completed his BA in Psychology from Oberlin College, followed by Medical School at the University of Arkansas. He has obtained his Postgraduate training in General Psychiatry at Albert Einstein Medical Center in Philadelphia followed by Fellowship training in Forensic Psychiatry at the University of Rochester. He is presently an Associate Professor at the University of Nevada, School of Medicine, where he is also the Program Director for the Psychiatry Residency Training Program in Las Vegas. He is board certified by the American Board of Psychiatry and Neurology in the fields of Psychiatry and Forensic Psychiatry. His other professional focus is on forensic psychiatry. His interests range from models of psychotherapy and the mind to hypnosis, meditation and concepts of creativity.
Abstract:
Freud studied rejected the use of hypnosis with patients due to his desire to slow the development of transference. The science of hypnosis progressed to heights he would never have imagined through the work of three geniuses of the field: Milton Erickson, MD, George Estabrooks and David Elman. With new methods of induction, new concepts as to what hypnosis is, and sophisticated interventions, hypnosis could emerge as a psychotherapeutic science. The approaches of these three gentlemen could not have been more different, but each defined a piece of hypnosis and a specific induction method ideal for particular types of patients. Erickson pioneered a permissive approach to hypnosis using exquisite details of language patterns to lead patients into an inward focused state which he developed into trance. Estabrooks championed a highly authoritative approach still useful with individuals more rigid personality characteristics. Elman fashioned an induction pattern which leads to deep levels of trance reliably in less than three minutes so that the therapeutic time could focus on inner work rather than trance depth. Teaching the client to utilize these techniques on their own through self-hypnosis both gives them the power to control their inner states, but also gives them tools for relaxation, improved sleep, improved habit control and reduction of anxiety related symptoms. As we move into this next century, it is time to reconsider hypnosis as a tool for the psychiatrist, psychologist and psychotherapist.
Keynote Forum
Guy Hugues Fontaine
Université Pierre et Marie Curie, France
Keynote: Is mouth better than nose approach for brain protection in OHCA?
Time : 10:45-11:30
Biography:
Guy Hugues Fontaine has made 17 original contributions in the design and the use of the first cardiac pacemakers in the early 60s. He has serendipitously identified ARVD during his contributions to antiarrhythmic surgery in the early 70s. He has developed the technique of Fulguration to replace surgery in the early 80s. He has 900+ publications including 201 book chapters. He has been the Reviewer of 26 scientific journals both in basic and clinical science. He has served for 5 years as a Member of the Editorial Board of Circulation.
Abstract:
Background & Aim: A new technique of localized brain hypothermia to produce cooling by adiabatic gas expansion. Two approaches can be considered; fossa nasalis up to the nasopharynx and mouth up to the oropharynx. The purpose of this work is to compare the possible respective benefits, risks and limitations of these two methods.
Method: 22 cadavers mean age 77±11.4 SD (56-96) were studied at the School of Surgery in Paris. One case was not valid because of major clots in both fossa nasalis. Slightly curved brass tubes (4 mm Ø) were inserted perpendicular to the head axis in the two nostrils up to block. Depth of penetration in cm was measured on both sides of the nasal septum. Data were processed by Statistica v6.0. A p value≤0.05 was considered as significant.
Results: Depth of penetration was 10.8±1.47 (7-13) for the right nostril and mean 10.7±1.46 SD for the left nostril, this difference is not significant p=0.7. However, the difference in depth was 0.1±1.28 (-3.5-3.5). A difference ≥0.5 cm was observed in 6 cases (27%).
Conclusion: Mouth approach looks less aggressive than nasal approach for cooling the posterior part of the head and more specifically the brain for the treatment of out of hospital cardiac arrest (OHCA). It could be performed by non-CPR trained bystanders with minimal training and therefore started before the intervention of EMS.
Discussion: Nose: fossa nasalis is closer to the brain; however, distortion of the nasal septum may reduce penetration in 27% of patients. This may explain that cases of epistaxis have been reported. In addition, if the angle of introduction is not perpendicular to the head axis as it should be but follows the direction of the nose a blockage occurs before entering the target area. This could reduce the effectiveness of cooling and subsequently the success of the method. Mouth: is easy to access, no block up to the oropharynx, can be used by a lay person with no training with no risk of injury. In addition mouth and tongue offer a large surface exchange area which can be important for general cooling (in addition to localized cooling) for the protection of the heart and other noble organs as the liver, kidney and the lungs. However, oropharynx is more distant from the brain than nasal cooling. Therefore cold produced will take longer to reach the brain area. This limitation can be counterbalanced by faster administration of cooling before EMS arrival in the field.
Keynote Forum
Karin Sernec
University Psychiatric Clinic Ljubljana, Slovenia
Keynote: Assessment & treatment of eating disorders
Time : 12:00-12:45
Biography:
Karin Sernec is an Associate Professor at University of Ljubljana, Slovenia. She has earned her PhD in 2010 with thesis entitled “Anxiety, depression and aggression traits in anorexia and bulimia nervosa patients”. She has been the Head of Slovenia’s Unit for Treatment of Eating Disorders ever since it was founded in 1999. Together with her colleagues she built a multidimensional, mixed-gender inpatient treatment program in addition to group and individual outpatient treatment of persons with eating disorders. She is leading Slovenian Expert Group for Eating Disorders and continues to contribute to this field as an author and co-author of numerous scientific publications.
Abstract:
Until recently, eating disorders were a group of chronic mental disorders known only to a limited circle of professionals. Today, eating disorders are recognized as a significant contemporary medical problem in our society, even a public health issue. The etiological background of eating disorders is comprised of three major segments: Biological/genetic factors, socio-cultural factors and family environment. In most cases, there is a considerable overlap between these three. Eating disorders constitute: Anorexia nervosa, bulimia nervosa, binge eating disorder and recently emerged entities (orthorexia and bigorexia nervosa). Contrary to popular belief, eating disorders affect persons of all ages, genders and economic backgrounds. A key factor in successful outcome of an eating disorder is the patient’s own motivation for treatment. One of the most successful treatment approaches is psychotherapy, especially cognitive-behavioral, developmental-analytic and family psychotherapy. Pharmacotherapy is indicated in cases of comorbidity and is used as needed. The first line of treatment is on an outpatient basis. If that proves insufficient, an inpatient psychotherapeutic treatment is indicated. Recovery is not merely an absence of specific eating disorder symptoms, it means adequate psychosocial functioning.
Keynote Forum
Gregory P Brown
University of Nevada, USA
Keynote: The three amazing “Eâ€s of the post-Freud era; Erickson, Estabrooks and Elman
Biography:
Gregory P Brown has completed his BA in Psychology from Oberlin College, followed by Medical School at the University of Arkansas. He has obtained his Postgraduate training in General Psychiatry at Albert Einstein Medical Center in Philadelphia followed by Fellowship training in Forensic Psychiatry at the University of Rochester. He is presently an Associate Professor at the University of Nevada, School of Medicine, where he is also the Program Director for the Psychiatry Residency Training Program in Las Vegas. He is board certified by the American Board of Psychiatry and Neurology in the fields of Psychiatry and Forensic Psychiatry. His other professional focus is on forensic psychiatry. His interests range from models of psychotherapy and the mind to hypnosis, meditation and concepts of creativity.
Abstract:
Freud studied rejected the use of hypnosis with patients due to his desire to slow the development of transference. The science of hypnosis progressed to heights he would never have imagined through the work of three geniuses of the field: Milton Erickson, MD, George Estabrooks and David Elman. With new methods of induction, new concepts as to what hypnosis is, and sophisticated interventions, hypnosis could emerge as a psychotherapeutic science. The approaches of these three gentlemen could not have been more different, but each defined a piece of hypnosis and a specific induction method ideal for particular types of patients. Erickson pioneered a permissive approach to hypnosis using exquisite details of language patterns to lead patients into an inward focused state which he developed into trance. Estabrooks championed a highly authoritative approach still useful with individuals more rigid personality characteristics. Elman fashioned an induction pattern which leads to deep levels of trance reliably in less than three minutes so that the therapeutic time could focus on inner work rather than trance depth. Teaching the client to utilize these techniques on their own through self-hypnosis both gives them the power to control their inner states, but also gives them tools for relaxation, improved sleep, improved habit control and reduction of anxiety related symptoms. As we move into this next century, it is time to reconsider hypnosis as a tool for the psychiatrist, psychologist and psychotherapist.
Keynote Forum
Guy Hugues Fontaine
Université Pierre et Marie Curie, France
Keynote: Is mouth better than nose approach for brain protection in OHCA?
Biography:
Guy Hugues Fontaine has made 17 original contributions in the design and the use of the first cardiac pacemakers in the early 60s. He has serendipitously identified ARVD during his contributions to antiarrhythmic surgery in the early 70s. He has developed the technique of Fulguration to replace surgery in the early 80s. He has 900+ publications including 201 book chapters. He has been the Reviewer of 26 scientific journals both in basic and clinical science. He has served for 5 years as a Member of the Editorial Board of Circulation.
Abstract:
Background & Aim: A new technique of localized brain hypothermia to produce cooling by adiabatic gas expansion. Two approaches can be considered; fossa nasalis up to the nasopharynx and mouth up to the oropharynx. The purpose of this work is to compare the possible respective benefits, risks and limitations of these two methods.
Method: 22 cadavers mean age 77±11.4 SD (56-96) were studied at the School of Surgery in Paris. One case was not valid because of major clots in both fossa nasalis. Slightly curved brass tubes (4 mm Ø) were inserted perpendicular to the head axis in the two nostrils up to block. Depth of penetration in cm was measured on both sides of the nasal septum. Data were processed by Statistica v6.0. A p value≤0.05 was considered as significant.
Results: Depth of penetration was 10.8±1.47 (7-13) for the right nostril and mean 10.7±1.46 SD for the left nostril, this difference is not significant p=0.7. However, the difference in depth was 0.1±1.28 (-3.5-3.5). A difference ≥0.5 cm was observed in 6 cases (27%).
Conclusion: Mouth approach looks less aggressive than nasal approach for cooling the posterior part of the head and more specifically the brain for the treatment of out of hospital cardiac arrest (OHCA). It could be performed by non-CPR trained bystanders with minimal training and therefore started before the intervention of EMS.
Discussion: Nose: fossa nasalis is closer to the brain; however, distortion of the nasal septum may reduce penetration in 27% of patients. This may explain that cases of epistaxis have been reported. In addition, if the angle of introduction is not perpendicular to the head axis as it should be but follows the direction of the nose a blockage occurs before entering the target area. This could reduce the effectiveness of cooling and subsequently the success of the method. Mouth: is easy to access, no block up to the oropharynx, can be used by a lay person with no training with no risk of injury. In addition mouth and tongue offer a large surface exchange area which can be important for general cooling (in addition to localized cooling) for the protection of the heart and other noble organs as the liver, kidney and the lungs. However, oropharynx is more distant from the brain than nasal cooling. Therefore cold produced will take longer to reach the brain area. This limitation can be counterbalanced by faster administration of cooling before EMS arrival in the field.
Keynote Forum
Karin Sernec
University Psychiatric Clinic Ljubljana, Slovenia
Keynote: Assessment & treatment of eating disorders
Biography:
Karin Sernec is an Associate Professor at University of Ljubljana, Slovenia. She has earned her PhD in 2010 with thesis entitled “Anxiety, depression and aggression traits in anorexia and bulimia nervosa patients”. She has been the Head of Slovenia’s Unit for Treatment of Eating Disorders ever since it was founded in 1999. Together with her colleagues she built a multidimensional, mixed-gender inpatient treatment program in addition to group and individual outpatient treatment of persons with eating disorders. She is leading Slovenian Expert Group for Eating Disorders and continues to contribute to this field as an author and co-author of numerous scientific publications.
Abstract:
Until recently, eating disorders were a group of chronic mental disorders known only to a limited circle of professionals. Today, eating disorders are recognized as a significant contemporary medical problem in our society, even a public health issue. The etiological background of eating disorders is comprised of three major segments: Biological/genetic factors, socio-cultural factors and family environment. In most cases, there is a considerable overlap between these three. Eating disorders constitute: Anorexia nervosa, bulimia nervosa, binge eating disorder and recently emerged entities (orthorexia and bigorexia nervosa). Contrary to popular belief, eating disorders affect persons of all ages, genders and economic backgrounds. A key factor in successful outcome of an eating disorder is the patient’s own motivation for treatment. One of the most successful treatment approaches is psychotherapy, especially cognitive-behavioral, developmental-analytic and family psychotherapy. Pharmacotherapy is indicated in cases of comorbidity and is used as needed. The first line of treatment is on an outpatient basis. If that proves insufficient, an inpatient psychotherapeutic treatment is indicated. Recovery is not merely an absence of specific eating disorder symptoms, it means adequate psychosocial functioning.
- Mental Illness | Psychiatry Nursing
Location: Salon A
Session Introduction
Ellie Wright
EWG Research Institute LLC, USA
Title: Nourish the brain: Omega-3 fatty improve and prevent neurodegenerative disease
Time : 12:45-13:15
Biography:
Ellie Wright has obtained her Bachelor’s degree at Arizona State University in 2008, Master’s degree (ASU) and Graduate Certificate in Geriatric and Gerontology from Arizona University in 2010 and Doctoral degree from Southwest College of Naturopathic Medicine, USA in 2015. She is passionate in the field of natural medicine.
Abstract:
Anti-inflammatory Omega-3 polyunsaturated fatty acids (n-3-PUFAs), mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may improve or prevent some psychiatric and neurodegenerative diseases. In clinical studies, depressed patients manifest higher levels of inflammatory biomarkers. As human brain is mostly made of fat, fatty acids are most crucial molecules that determine the brain's integrity. Beneficial effects of the omega-3 PUFAs has been linked to their involvement in multiple biochemical functions, including synthesis of inflammatory mediators, cell membrane fluidity, intracellular signaling and gene expression. Through these pathways, the omega-3 PUFAs help modulate aspects of inflammation and immunity, cell growth and tissue repair. As important membrane component, n-3-PUFAs benefit brain health by modulating neuroimmune and apoptotic pathways, changing membrane function and competing with n-6 PUFAs strongly suggest omega-3 PUFAs may modulate inflammation and neurogenerative diseases.
Neong Shuet Ching
Penang General Hospital, Malaysia
Title: Quality of life of caregivers of patients with mental illness in Penang
Time : 14:15-14:45
Biography:
Neong Shuet Ching is a Doctor practicing in the Public Health Unit in Penang General Hospital in Malaysia. She has her passion in public health and the wellbeing of the mental health in the general population. She has done Psychiatry in both the hospital and as Locum Doctor to the general population in Penang. She is active in the Public Health and is a Fellow of Royal Society of Public Health from the UK.
Abstract:
Introduction: The prevalence of mental disorders in the developed countries especially in the European Union is at a staggering high of 38.2%. In developing countries, the prevalence of major depressive disorder has been reported as 2.2% in Chinese men from China and 3.5% in Indian men from India. The prevalence of mental health illness among the population in Malaysia has risen from 11% to a staggering 20% in the past 10 years. This is according to the National Health and Morbidity Survey 2011. According to the recent National Health Morbidity Survey 2015, the prevalence of mental disorders in Malaysia was higher at 29.2% for the population 16 years and above.
Objectives: To determine the quality of life of the caregivers of patients with mental illness on follow up in two public hospitals providing outpatient psychiatric services and also to determine the association of demographic factors of caregivers on the quality of life of caregivers of patients with mental illness.
Methodology: 221 patients were chosen using a simple random sampling method using the computer software, R for Randomization. This simple random sampling method is adapted from the computer generated list of random numbers. It is a type of probability sampling technique where there is an equal chance of selecting each patient. A frame was created using the total number of inpatients discharged from Penang Hospital and 300 patients were randomly selected. This number was chosen as it is the total number of outpatients in Penang Hospital for the past two months. Another frame of 214 patients was created using the total number of outpatients for the past two months in Bukit Mertajam Hospital.
Results: There is an association between caregiver’s highest level of education and QOL scores. Caregivers with higher level of education have a better QOL compared to caregivers with lower education levels. Married caregivers fare better while divorced caregivers fare the worst. Malays have a better mean QOL scores compared to Indians and Chinese. Caregivers of Malay patients have better mean QOL scores compared to Indian and Chinese patients. Caregivers of Indian patients and caregivers of Chinese patients have the worst QOL. Patient’s occupation also determines the QOL of caregivers, caregivers of managers having the worst QOL, while caregivers of plant and machine operators and assemblers having the best QOL, followed by caregivers of housewives and caregivers of clerical support workers.
Conclusion: In conclusion, this study has found that there is association between caregiver factors and caregivers QOL and patient factors and caregivers QOL.
Jan Fawcett
The University of New Mexico, USA
Title: When Electro Convulsive Therapy Fails
Time : 14:45-15:15
Biography:
Jan Fawcett has served as the Chair of the Department of Psychiatry at Rush Medical Center in Chicago while maintaining a private practice for 30 years and then has taught residents for 15 years at the University of New Mexico in Albuquerque, New Mexico as a Professor of Psychiatry, where he supervises a TRD clinic and teaches residents. He has won many awards for his research in depression and suicide prevention and has been the Principal Investigator of 9 NUMH funded grants. He has been the Medical Editor of Psychiatric Annals for 25 years and recently served as Chair of the Mood Disorders Workgroup for DSM-5. He currently continues to practice outpatient psychiatry and runs a Treatment Resistant Depression Clinic at the University of New Mexico and has recently published his first novel, Living Forever.
Abstract:
This study will present data showing that psychopharmacotherapy can help patients with treatment resistant depression recover who have not benefitted from electroconvulsive therapy (ECT). Both pramipexole (PPX) and monoamine oxidase inhibitors (MAOI) often augmented with stimulants will lift a patients’ depression that has been considered treatment resistant quite often. ECT has been considered by experts in the field, the most effective treatment for treatment resistant patients. This study show that this often may not be the case and that certain particular psychopharmacologic treatments should be considered. The data presented includes a clinical sample of 42 consecutive patients treated with high dose PPX who failed at least 4 prior antidepressant treatments and followed for an average of 15.9 months as well as a sample of 20 patients who failed to benefit from ECT who benefitted greatly from high dose PPX. This study additionally reviews already published articles with data showing the therapeutic effects of treatment resistant patients treated with MAOI’s augmented by stimulants. The concept and definition of treatment resistant depression and the presenter’s algorithm for approaching this problem will be reviewed. The dose and management of side effects, as well as the relationship with the patient has a great deal to do with the success of these treatments.
Ellie Wright
EWG Research Institute LLC, USA
Title: Anti depressive effects of natural polyphenols: Resveratrol & Curcumin
Time : 15:15-15:45
Biography:
Ellie Wright has obtained her Bachelor’s degree at Arizona State University in 2008, Master’s degree (ASU) and Graduate Certificate in Geriatric and Gerontology from Arizona University in 2010 and Doctoral degree from Southwest College of Naturopathic Medicine, USA in 2015. She is passionate in the field of natural medicine.
Abstract:
The present research aimed to investigate the mechanisms underlying the antidepressant-like effects of curcumin and resveratrol. Depression is a neuropsychiatric disease associated with wide disruptions in neuronal plasticity and increased basal ganglia glutamate. Curcumin, a natural polyphenolic compound of curcuma longa is anti-inflammatory, antioxidant, neuroprotective and antimicrobial. Curcumin decreases inflammatory cytokines interleukin 1 beta and tumor necrosis factor alpha. Curcumin has a neuroprotective effect against oxidative glutamate toxicity by inhibiting MAP kinase signaling and influencing cell-cycle regulation. The potent antidepressant property of curcumin might be attributed to its improvement of AC-cAMP pathway as well as CREB via suppressing central 5-HT(1A/1B/7). Resveratrol is anti-inflammatory, antioxidant and protector of astrocytes and modulate glial functions including glutamate uptake and glutathione. Resveratrol play a significant role between the signals pathways of NFκB, HO-1 and MAPK, p38, ERK. Some research suggests curcumin and resveratrol have neuroprotective attributes against glutamate excitotoxicity because increases the expression of sirtuin 1 (SIRT1) mediated deacetylation of PGC alpha, in addition, resveratrol down-regulated the levels of p65 and phospho-p38 MAPK.
Joyceline Ntoh Yuh
University of Oldenburg, Germany
Title: Psychological consequences of HIV-related stigma among African migrant women in Lower Saxony, Germany: What can we learn from their stories?
Time : 15:45-16:15
Biography:
Joyceline Ntoh Yuh is a Feminist and Ph.D candidate in the University of Oldenburg,Germany. She holds an MA in Women & Gender Studies from the ISS Erasmus University Netherlands. Her research interest includes HIV/AIDS related stigma, gender issues, Sexual and Reproductive health. Since 2006 she took keen interest in the field of HIV/AIDS were she researched on the impact of HIV on Agriculture affecting mostly women with the UN FAO Gender unit,mainstreaming HIV policies in UNFFE Uganda,HIV stigma & child bearing in Cameroon and currently facilitates workshops with MA students in the area of Gender, Migration & HIV/AIDS(Health).She is also a Reviewer in the journal of AIDS Clinical Research & STD and works as a volunteer in the AIDS Help NGO (AIDSHilfe) in Oldenburg, Germany.
Abstract:
Epidemiological studies from Western EU countries shows that migration has an impact on HIV epidemiology.Meanwhile 2012/13 reports in Germany points a 70% increase in heterosexual transmission from immigrants with about 40-50% from Sub saharan Africa marking new diagnosis especially in women.
Moreover, HIV-related stigma among African women is rather complex especially when using the intersectionality framework for analysis which distinguishes the subjective experiences and realities of women's lives,not just as a single category stemming from a gender-based research critique. Meanwhile,HIV-stigma denotes the link between sero status and negative behavior toward people who are seropositive. Thus, such stigma will reflect guilt, shame, denial, prejudice, discrediting, discrimination, sterotypes, denial, rejection and self-blame associated with one’s serostatus. African-migrant women are particulary vulnerable to HIV-related stigma due to various factors which are often undermined or neglected. It is imperative to mention that women are generally supceptible to getting infected due to biological and other socio-cultural reasons compared to men,which eventually positions them into a high risk category. Moreover,women tend to be negatively perceived when infected and labeled promiscous for transimitting the virus to their partners, without knowing the transmission dynamic. Stigma futher constrains relationships within the family and in the community.This in the long term results into secrecy, affects HIV infection status disclosure and seeking of the much needed preventive services. Stigma affects seeking of health services since labelled people fear to seek health services and this affects their health in future.
This therefore highlights the link between HIV and mental health, paying attention to the fact that, people living with HIV among other vulnerable groups are prone to have mental problems compared to the general population. In so doing, their emotional, psychological and social well being becomes essential just as their physical health. Dealing with stigma attached to HIV further complicates the overall well being in realizing ones potentials in life, which tends to hamper their productivity and sense of purpose. The study shows the dilemmas and challenges faced by seropositive women in the face of HIV, dealing with problems such as anxiety about disclosure, depression, social isolation,stress, fear, rejection especially from partners.The pychological impact continues to affect sero-positive women in negative ways in living fulfilled lives, imapacting their well being with unfulfilled sexual satisfactions due to continuous use of condoms as expressed by most respondents. Thus, such insecurities becomes overwhelming at times pushing them to neglect their self esteem as women.Its is therefore prudent to design intereventions that highlight importance of cultural variables,migration, issues of gender and sexuality, access quality health care services if we are to achieve effective prevention strategies especially among migrant women.
Ellie Wright
EWG Research Institute LLC, USA
Title: Nourish the brain: Omega-3 fatty improve and prevent neurodegenerative disease
Biography:
Ellie Wright has obtained her Bachelor’s degree at Arizona State University in 2008, Master’s degree (ASU) and Graduate Certificate in Geriatric and Gerontology from Arizona University in 2010 and Doctoral degree from Southwest College of Naturopathic Medicine, USA in 2015. She is passionate in the field of natural medicine.
Abstract:
Anti-inflammatory Omega-3 polyunsaturated fatty acids (n-3-PUFAs), mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may improve or prevent some psychiatric and neurodegenerative diseases. In clinical studies, depressed patients manifest higher levels of inflammatory biomarkers. As human brain is mostly made of fat, fatty acids are most crucial molecules that determine the brain's integrity. Beneficial effects of the omega-3 PUFAs has been linked to their involvement in multiple biochemical functions, including synthesis of inflammatory mediators, cell membrane fluidity, intracellular signaling and gene expression. Through these pathways, the omega-3 PUFAs help modulate aspects of inflammation and immunity, cell growth and tissue repair. As important membrane component, n-3-PUFAs benefit brain health by modulating neuroimmune and apoptotic pathways, changing membrane function and competing with n-6 PUFAs strongly suggest omega-3 PUFAs may modulate inflammation and neurogenerative diseases.
Neong Shuet Ching
Penang General Hospital, Malaysia
Title: Quality of life of caregivers of patients with mental illness in Penang
Biography:
Neong Shuet Ching is a Doctor practicing in the Public Health Unit in Penang General Hospital in Malaysia. She has her passion in public health and the wellbeing of the mental health in the general population. She has done Psychiatry in both the hospital and as Locum Doctor to the general population in Penang. She is active in the Public Health and is a Fellow of Royal Society of Public Health from the UK.
Abstract:
Introduction: The prevalence of mental disorders in the developed countries especially in the European Union is at a staggering high of 38.2%. In developing countries, the prevalence of major depressive disorder has been reported as 2.2% in Chinese men from China and 3.5% in Indian men from India. The prevalence of mental health illness among the population in Malaysia has risen from 11% to a staggering 20% in the past 10 years. This is according to the National Health and Morbidity Survey 2011. According to the recent National Health Morbidity Survey 2015, the prevalence of mental disorders in Malaysia was higher at 29.2% for the population 16 years and above.
Objectives: To determine the quality of life of the caregivers of patients with mental illness on follow up in two public hospitals providing outpatient psychiatric services and also to determine the association of demographic factors of caregivers on the quality of life of caregivers of patients with mental illness.
Methodology: 221 patients were chosen using a simple random sampling method using the computer software, R for Randomization. This simple random sampling method is adapted from the computer generated list of random numbers. It is a type of probability sampling technique where there is an equal chance of selecting each patient. A frame was created using the total number of inpatients discharged from Penang Hospital and 300 patients were randomly selected. This number was chosen as it is the total number of outpatients in Penang Hospital for the past two months. Another frame of 214 patients was created using the total number of outpatients for the past two months in Bukit Mertajam Hospital.
Results: There is an association between caregiver’s highest level of education and QOL scores. Caregivers with higher level of education have a better QOL compared to caregivers with lower education levels. Married caregivers fare better while divorced caregivers fare the worst. Malays have a better mean QOL scores compared to Indians and Chinese. Caregivers of Malay patients have better mean QOL scores compared to Indian and Chinese patients. Caregivers of Indian patients and caregivers of Chinese patients have the worst QOL. Patient’s occupation also determines the QOL of caregivers, caregivers of managers having the worst QOL, while caregivers of plant and machine operators and assemblers having the best QOL, followed by caregivers of housewives and caregivers of clerical support workers.
Conclusion: In conclusion, this study has found that there is association between caregiver factors and caregivers QOL and patient factors and caregivers QOL.
Biography:
Jan Fawcett has served as the Chair of the Department of Psychiatry at Rush Medical Center in Chicago while maintaining a private practice for 30 years and then has taught residents for 15 years at the University of New Mexico in Albuquerque, New Mexico as a Professor of Psychiatry, where he supervises a TRD clinic and teaches residents. He has won many awards for his research in depression and suicide prevention and has been the Principal Investigator of 9 NUMH funded grants. He has been the Medical Editor of Psychiatric Annals for 25 years and recently served as Chair of the Mood Disorders Workgroup for DSM-5. He currently continues to practice outpatient psychiatry and runs a Treatment Resistant Depression Clinic at the University of New Mexico and has recently published his first novel, Living Forever.
Abstract:
This study will present data showing that psychopharmacotherapy can help patients with treatment resistant depression recover who have not benefitted from electroconvulsive therapy (ECT). Both pramipexole (PPX) and monoamine oxidase inhibitors (MAOI) often augmented with stimulants will lift a patients’ depression that has been considered treatment resistant quite often. ECT has been considered by experts in the field, the most effective treatment for treatment resistant patients. This study show that this often may not be the case and that certain particular psychopharmacologic treatments should be considered. The data presented includes a clinical sample of 42 consecutive patients treated with high dose PPX who failed at least 4 prior antidepressant treatments and followed for an average of 15.9 months as well as a sample of 20 patients who failed to benefit from ECT who benefitted greatly from high dose PPX. This study additionally reviews already published articles with data showing the therapeutic effects of treatment resistant patients treated with MAOI’s augmented by stimulants. The concept and definition of treatment resistant depression and the presenter’s algorithm for approaching this problem will be reviewed. The dose and management of side effects, as well as the relationship with the patient has a great deal to do with the success of these treatments.
- Psychiatry | Psychological disorders | Adult and Geriatric Psychiatry
Location: Salon A
Session Introduction
Sophia Achab
University Hospitals of Geneva, Switzerland
Title: Features of Gambling disorder and Internet gaming disorder in the spectrum of Addictive disorders
Biography:
Sophia Achab is a Psychiatrist and Psychotherapist In-Charge of specialized program in Behavioral Addictions at University Hospitals of Geneva, where she has the position of Medical Deputy to the Addiction Division Head in Department of Mental Health and Psychiatry. She combines clinical activity with research and training in the field of behavioral addictions (Internet use disorders, pathological gambling, sexual addiction and compulsive buying). She has a PhD in Neurosciences of Human Behavior and she is a Senior Lecturer (Privatdocent) at University of Geneva, In-Charge of courses, mainly on Psychiatry and Primary Care with a specific focus on addictive disorders including behavioral addictions. She is also a Coordinator for Addictive Disorders at WHO Collaborating Center for training and research in Mental Health at Geneva University and part of several work groups at a Swiss and Global level in the field of behavioral addictions.
Abstract:
Emergent behavioral addictions (BAs) such as gambling disorder (GD) and internet use disorders (e.g., Internet Gaming Disorder (IGD) have become common treatment-seeking motives and a flourishing field for research. Their similarities to substance use disorders (SUDs) have raised debate in the scientific community and among clinicians and resulted in the enlargement of the addictive spectrum to include addictions that do not require the intake of a psychoactive substance. This inclusion has sparked debate on addiction determinism and whether neurobiological processes could be involved in repetitive exposure to a substance, as well as in cognitions and behaviors. A core clinical addiction syndrome can be extracted by comparing recent diagnostic criteria for SUDs in the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5; American Psychiatric Association, 2013) with those for the two considered BAs: GD and IGD. Clinical, psychological and neurobiological differences and similarities between BAs and SUDs are reviewed and discussed in the present work. Critical links are made between these scientific findings and recent DSM-5 criteria.
Lama Muhammad
University of New Mexico, USA
Title: Revolution in psychiatry: Butterfly effect; beyond psychiatry and against stigma
Biography:
Lama Muhammad is board certified in Dermatology and Venereal Diseases. She has completed preliminary Internal Medicine training and is a professional Arabic Writer. Currently she is a Chief Resident in the Psychiatric Department of University of New Mexico, USA. She is interested in psychosomatic medicine and nonverbal communications. Her current research focuses are on psychosomatic medicine, nonverbal communications and psychotherapy.
Abstract:
It was surprising to me while teaching medical students and residents that many of them did not know the meaning of psychiatry! All around the world we are still fighting the stigma in one way or another! It is the time of revolution in psychiatry. The term "psychiatry" was first coined by the German physician "Johann Reil" in 1808 and literally means the 'medical treatment of the soul’, (psych- "soul" or butterfly from Ancient Greek), (iatry "medical treatment" from Greek). Why butterfly? To answer this question maybe we should answer this one: Why we can't put a butterfly in a cage? Psychiatry is different by the fact that we need the whole story and we all know that telling the whole truth is the most difficult of all arts. Science cannot know the whole story, for which we need to supplement it with philosophical reason and personal experience, this is the butterfly (soul) of psychiatry and will speak about that more. It is good to think of mental illness in terms of: Target condition versus current condition, the illness is the gap between the two; to do so, (1) We need to learn about psychiatry as field in medicine, (2) Fight stigma!, (3) Emotional hygiene strategies and, (4) First aid in psychiatry. And will cover all above during the oral presentation.
Disa Kneck-Moller
Abo Akademi University, Finland
Title: Functional music therapy and learning challenges in school
Biography:
Disa Kneck-Moller is a Functional Music Therapist from Musikterapi-institutet i Uppsala (The Institute for musical therapy in Uppsala) in Sweden. She also holds a Master’s degree in Music Science, Psychology and Pedagogy at Åbo Akademi University and a Bachelor’s degree in Classical Guitar from Turku Conservatory of Music. Since 20 years, she is working as a Functional Music Therapist with children, youths and adults. She is also working on a Doctoral thesis as a Post-graduate student at Åbo Akademi University.
Abstract:
Functional music therapy, or shortly FMT, is a form of therapy used in medical rehabilitation. It is a neuro-muscular motion therapy aiming to develop the brain by stimuli from muscles and nerves. FMT is used in a large spectrum of disabilities and brain damages but also as a support method for children with learning challenges in reading, writing and mathematics and concentration problems. The music consists of custom composed melodies, a.k.a. musical codes, guiding the client in his/her playing. The therapist plays an acoustic piano and the client is offered a flexible array of percussion instruments, mainly drums and cymbals and some wind instruments. Functional music therapy addresses human primary functions based on perception, breathing and body control. It is a non-verbal treatment where the musical codes facilitate, activate and substantiate the person's actions and enhance desirable motion patterns. The individual spontaneous movements give direct access to sensomotorical areas in the brain, circumventing any verbal or intellectual processing. The goal with FMT is to raise a person's level of functionality by creating possibilities for his/her own reaction, action, thought and planning. A child's development is intimately connected to movements and motion. I also wish to establish which basic functions and motion patterns are important to have obtained in order to achieve school maturity.
Fu Jing Hui
Perdana University-Royal College of Surgeons, Ireland
Title: Body image disturbance: How happy are young adults with their bodies
Biography:
Fu Jing Hui is currently studying Bachelor of Medicine, Bachelor of Surgery and Bachelor of The Arts of Obstetrics in Perdana University-Royal College of Surgeons in Ireland.
Abstract:
Body image is a multidimensional psychological experience involving the mental representations which we create for ourselves yet unnecessarily resemble how others view us. It is subjective, may trigger positive or negative emotions, potentially leading to avoidant behavior. Many factors, mainly social media, cultural expectation and gender differences influence one’s body image. In this research, body image is assessed using validated rating scales to identify one’s body esteem in terms of body size and its correlations with his feelings and resultant behaviors among young adults in Malaysia. The rating scales used in this research are Body Esteem Scale for Adolescents and Adults (BESAA) and Body Image Acceptance and Action Questionnaire (BIAAQ). Participants were presented with the images of 2 models to assess their wish to conform to the social standard of beauty. Data analysis was done using SPSS. Results showed predictably that, BMI is inversely and age is positively related with BESAA and BIAAQ scores. However, contrary to traditional beliefs, males score a lower mean score than females for both BESAA and BIAAQ. Men also express more desire to achieve an ideal body shape. Coincidentally, the images used showed that women expressed more resistance for heavily advertised skinny. Although shocking, this study is not the first to show such correlation. By analyzing these scores, there is an evident cultural and gender shift in the attitudes towards male bodies. Body esteem has either increased among females or decreased among males.
Rut Thakkar
Vanderbilt University, USA
Title: Thinking correlates with insight, metacognition and social cognition in the early and prolonged phases of Schizophrenia
Biography:
Rut Thakkar is currently an undergraduate student at Vanderbilt University pursuing a degree in Neuroscience. While working under Dr. Jennifer Vohs, on an Integrated Metacognitive Therapy (IMT) study, he started to pursue this study as he intrigued by the peculiar relationship between abstract thinking and insight.
Abstract:
Schizophrenia, the infamous debilitating mental illness, is caused by a multitude of environmental and genetic factors. Behaviors corresponding to abnormal perceptual experiences, social withdrawal and cognitive impairments are symptomatic of the disease with the underlying mechanisms still being obscure. Current psychiatric interventions revolve around cognitive behavioral therapy (CBT), which focuses on encouraging the patient to develop rational thought and interpretations of evidence. Despite its widespread use, this approach along with many others tends to exhibit poor clinical efficacy over the long term. However, the key to a psychiatric intervention could lie in “Abstract thinking”, a core deficit in schizophrenia, characterized by adaptability, flexibility and the use of concepts and generalizations. Although known to be severely diminished, its changes along with the different phases of the illness are still unclear. The limited data available suggests that patients in the earlier phases of schizophrenia tend to have a higher capacity for abstraction than those in the prolonged phases. Supplemental studies further suggest that abstract thinking could be related to clinical insight or the awareness of one’s illness. In this study, we focused on these questions and examined the differences in abstract thinking between two groups; patients with chronic schizophrenia and patients with early onset schizophrenia. Furthermore, we conducted exploratory analyses of abstraction with clinical insight, metacognition and social cognition, hypothesizing that patients with better abstract thinking would possess better insight and cognition. After analyzing the data collected from 70 patients, the results indicate that while abstract thinking did not differ across the phases of the illness, it was significantly correlated with insight, metacognition and social cognition. To explain the relationship between abstract thinking and insight and cognition, a theory could be put forward which asserts that more fluid and liberal thought patterns or higher abstraction would allow patients to contemplate their own illness and its symptoms, providing them with better clinical insight. This relationship could be crucial in developing novel therapeutic approaches for treating psychosis by targeting abstraction to improve insight, leading to better outcomes.
- Psychology | Anxiety & Depression Disorders | Regulation & Case reports
Location: Salon A
Session Introduction
Guy Hugues Fontaine
Université Pierre et Marie Curie, France
Title: First case of brain protection in out of hospital cardiac arrest
Time : 09:00-0930
Biography:
Guy Hugues Fontaine has made 17 original contributions in the design and the use of the first cardiac pacemakers in the early 60s. He has serendipitously identified ARVD during his contributions to antiarrhythmic surgery in the early 70s. He has developed the technique of Fulguration to replace surgery in the early 80s. He has 900+ publications including 201 book chapters. He has been the Reviewer of 26 scientific journals both in basic and clinical science. He has served for 5 years as a Member of the Editorial Board of Circulation.
Abstract:
The case of my wife, a 73 year-old psychiatrist, experienced OHCA on June 2011 in the living room where she was watching the BBC world channel on TV. I immediately laid her down on the floor. There was no femoral pulse. I initiated standard CPR including chest compression (90 compressions per minute) for about 30 seconds followed by mouth to mouth breathing. I then resumed cardiac massage since she did not regain consciousness and there was no femoral pulse. I had a defibrillator in the basement of my house because of my interest in the Fulguration procedure. Since I had no gel to apply between the electrodes and the skin to decrease the impedance, I applied saliva to the electrodes and then gave a third shock. This last shock was successful, and the femoral pulse returned strong and regular. The femoral pulse remained stable, regular and strong. I estimated that about 6 minutes elapsed between her loss of consciousness and the return to a stable circulation. I then addressed the issue of possible brain protection. Fortunately, I had a smaller portable bottle now called the “Fontaine bottle” that was designed with a gas regulator to be used with a nasal cannula inserted into the nose to provide protection of the brain by nasal cooling. When the injector was in position I opened the valve of the cylinder and induced nasal cooling by expansion of the CO2. Her hospital course was notable for repeated episodes of ventricular fibrillation with the same ECG pattern of Torsade de Pointes-like tachycardia degenerating in Ventricular Fibrillation in a few seconds. The absence of Troponin release demonstrated that she had no acute myocardial infarction which was my main concern. When sedation was stopped, she was fully awake and the tracheal tube was removed. Psychological test showed that she had absolutely no neurologic deficit. In particular, she could remember 9 telephone numbers. During the follow-up, she experienced three more episodes of sudden death with drop (one with injury of the face) immediately converted by the defibrillator leading to an increase of Bisoprolol. No more episode of arrhythmia up to now almost 7 years since the SD episode.
Arif Pendi
University of California Irvine, USA
Title: Depression severity and stigmatized beliefs in Emirati university students: Preliminary findings of a crosssectional study
Biography:
Arif Pendi has recently completed his Master of Science degree in Global Medicine after which he continued his research in the fields of psychiatry and orthopedic surgery. His current research interests include studying common mental disorders in college-aged men and women, the mental health consequences of intimate partner violence and the role of anxiety in predicting surgical outcomes after spine surgery. He also directs the operations of Free Minds United, a grassroots non-profit organization dedicated to mental health advocacy in the community.
Abstract:
Introduction: Depressive disorders constitute a serious mental health issue in university students across the world. However, the social stigma surrounding mental illness and depression in particular, must be accounted due to emerging evidence indicating that stigmatized beliefs mediate treatment-seeking behavior. Depression specific stigma can be divided into two components: Personal and perceived beliefs. The former refers to one’s own beliefs surrounding depression while the latter refers to one’s beliefs about others’ perceptions of depression. It was hypothesized that greater depression severity would be associated with more stigmatized beliefs.
Methodology: A cross-sectional study was conducted at a university in Dubai, United Arab Emirates. The survey contained a socio-demographic questionnaire, Patient Health Questionnaire-9 (PHQ-9) and Depression Stigma Scale (DSS) and was disseminated online to university students. Depression severity in the sample was determined by applying the PHQ-9 summed-item scoring method and the relationship to personal and perceived stigmatized beliefs (DSS) was explored with t-test. A series of linear regressions were used to identify predictors of personal and perceived stigma.
Findings: In the sample, 39.5% of respondents reported moderate to severe depression severity. This more depressed group exhibited less perceived stigmatized beliefs compared to their counterparts (p=0.048). In addition, heterosexuality and non-Indian ethnicity constituted predictors of perceived stigma (p=0.004 and p=0.007, respectively).
Conclusions: Depression severity was not associated with greater personal of perceived stigma; in fact, moderate to severe depression was associated with less perceived stigma. Nevertheless, heterosexual and ethnic Indian students may benefit from efforts to reduce perceived stigma.
Arif Pendi
University of California Irvine, USA
Title: The association between intimate partner violence and anxiety and depression: Preliminary findings of a survey of University students
Biography:
Arif Pendi has recently completed his Master of Science degree in Global Medicine after which he continued his research in the fields of psychiatry and orthopedic surgery. His current research interests include studying common mental disorders in college-aged men and women, the mental health consequences of intimate partner violence and the role of anxiety in predicting surgical outcomes after spine surgery. He also directs the operations of Free Minds United, a grassroots non-profit organization dedicated to mental health advocacy in the community.
Abstract:
Introduction: Intimate partner violence (IPV) has been linked to the development of mental disorders such as anxiety and depression. However, the link between IPV and mental illnesses such as anxiety and depression has not been well-studied in university students. Given the large burden of anxiety and depressive disorders among university students and the high prevalence of dating violence, investigating the association between IPV and anxiety or depression has serious implications for on-campus screening efforts as well as the practice of psychiatry.
Methodology: An anonymous survey was disseminated via email to invite undergraduate and graduate students to complete an online survey form regarding their beliefs surrounding IPV, anxiety and depression. The survey included socio-demographic questions, HITS Domestic Violence Screening Tool, Generalized Anxiety Scale (GAS-7) and Patient Health Questionnaire-9 (PHQ-9). Respondents that were considered positive for IPV according to HITS were compared to the remaining respondents in terms of continuous scores on GAS-7 and PHQ-9 for anxiety and depression, respectively. Comparisons were made using t-test, two-tailed and assuming unequal variances.
Findings: Of 396 respondents, 18 students showed signs of IPV according to the HITS tool. This group exhibited greater intensity of anxiety (10.83±5.711 versus 6.23±5.355; p=0.003) and depression (12.06±6.384 versus 7.34±6.266; p=0.007) compared to the remaining respondents.
Conclusions: These preliminary findings indicate IPV was significantly associated with both anxiety and depression in a large sample of university students. Psychiatrists treating students that have experienced IPV may need to be aware of symptoms of anxiety as well as depression. Universities may need to screen for anxiety and depression in students that report IPV on-campus.
Hadis Yousefi
University of Mohaghegh Ardabilli, Iran
Title: The effect of self-control training on alexithymia and tempting ideas in drug-dependent patients
Biography:
Hadis Yousefi has completed her Master’s degree in Psychology from the University of Mohaghegh Ardabilli and Bachelor’s degree in Clinical Psychology from Allameh Tabatabaii University in Iran. She has submitted 7 papers in the field of addiction and has 8 years of work experience and research in the field of psychoanalysis and also new treatments for addiction.
Abstract:
Aim: The aim of the present paper is to study the effectiveness of self-control training on alexithymia and tempting ideas in drug-dependent patients.
Method: This research is performed using pre-testing and post-testing plan with control group. The statistical society in this research constitutes all addicted male individuals who voluntarily visited a detoxification centers in Tehran in 2013. The research sample includes 50 addicted men who were chosen by clinical randomly assigned into the two test and control groups. The test group received self-control training for 10 sessions of 45 minutes. To collect the data, we used the Emotion Regulation Questionnaire (short version), Toronto Alexithymia Scale, scale tempting ideas and morphine test.
Results: The results of the monotype variance analysis (MANOVA) showed that self-control training has been effective on emotional well-being of individuals who are dependent on drugs.
Conclusion & Discussion: Emotional problems are among the most significant factors involved in drug-addiction; drug abusers have considerable problems in regulating and managing their emotions. Self-control skills and the ability to manage one’s emotions can help people, in situations with high risk of substance abuse, to acquire coping strategies, to better withstand the unwanted pressure from their friends and to control their own emotions more effectively, all resulting in demonstrating a higher resistance to drug consumption.
- Mental Illness | Psychiatry Nursing
- Video Presentation
Location: Salon A
Session Introduction
Jorge Tomas Balseiro Estevez
Georgetown Public Hospital, Guyana
Title: Profile and Psychosocial factors associated with suicidal behavior in Guyana
Biography:
Jorge Tomas Balseiro Estevez is currently working as a Psychiatrist at Georgetown Public Hospital and Professor of University of Guyana. His expertise is in different areas of mental health, especially in psychosocial intervention, programs and plans to improve the mental health and wellbeing. His well-structured diagnosis based in a holistic approach to address individual, community and social psychosocial factors involved in suicide behavior offer new opportunity to develop similar interventions in low income countries.
Abstract:
Statement of the Problem: The WHO report, published in 2014, gives Guyana in the top worldwide with an age-standardized suicide rate of 44.2 per 100,000 inhabitants.
Methodology & Theoretical Orientation: A nationally represented sample of 899 cases involved in suicidal behavior, 555 who committed suicide and another 344 attempted suicides from 2010-2012, were surveyed using an epidemiologic study to identify the psychosocial factors associated.
Findings: As results founded most affected in suicide deaths is 20 to 49 years (50%). Males commit suicide more frequently with a ratio of almost 4:1. Most commonly used methods are poisoning (pesticide/herbicide) more than 65% of cases, followed by hanging (>20%). East Indians account for >80%; geographically concentrated in regions 6, 5, 4, 3 and 2. In suicide attempt were collected more detailed information, where age groups more affected are 12-18 (30%) and 19-25 (>20%). Females attempt suicide more frequently (>75%) with a proportion of 3:1. East Indians account for >50% and Afro Guyanese provide 25.9% of cases. Similar geographical area is affected in suicidal attempts and isolated cases are reported from rest of regions. More cases of suicidal attempt were single (60%), without children (68%), living with family (>50%), belong to Hindu (>30%) and Pentecostal (>30%) religions, less common frequent are other factors as low income and unemployed. Persons involved in suicide behavior are related with hopelessness, depression and uncontrollable anger in more than 60% of cases of this study, usually associated to family discord (31%), couple problems (25%), domestic violence (11%) and interpersonal conflict (16%). Other risk factors identified were, acute emotional distress and depression (36.6%), the accessibility of lethal substances (herbicides, pesticides and others) in the 63.7% of cases, alcohol and drug use (32%), family dysfunction (34.5%).
Conclusion & Significance: Profile and psychosocial factors associated to suicidal behavior were identified. Implementation of the national suicide prevention plan designed as imperative of the problem.
- Poster Presentation
Location: Salon A
Session Introduction
Heela Azizi and Alexa Kahn
American University of Antigua, USA
Title: Body dysmorphic disorder: A systematic review of treatment and management
Biography:
Heela Azizi is currently a Medical student at the American University of Antigua. She has received her Master’s degree in Business Administration from Urbana University and her Masters in Health Administration from Franklin University.
Alexa Blair Kahn is currently a Medical student at American University of Antigua. She has received her Bachelor’s degree of Science in Biology and minor in Global Health, Culture and Society from Emory University.
Abstract:
Objective: Body dysmorphic disorder (BDD) is a severe psychiatric disorder that affects many around the world. Patients with BDD exhibit a preoccupation with one or more perceived defects in their physical appearance which is exacerbated by poor insight and delusions regarding the perceived bodily flaw. BDD is more prevalent in an all clinical setting than in the general community population, but goes undiagnosed due to lack of screening for the disorder. Therefore, this literature review is aimed to determine most effective treatment for BDD.
Method: A systematic literature review was piloted using PubMed, ScienceDirect, Embase and the American Psychological Association PsycINFO to determine the most effective treatment for BDD.
Results: We found that serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT) are efficacious in treating body dysmorphic disorder. Randomized control studies found both SSRIs and CBT (especially with imagery restructuring) to be successful in treating BDD if used for longer than six months. Recent case studies suggest electroconvulsive therapy (ECT) and adjunctive antipsychotic use are viable treatment modalities for treatment resistant BDD.
Conclusions: SSRIs are the recommended pharmacologic agent for treatment, primarily fluoxetine. It should be continued for 12-16 weeks although increasing the medication to maximum dose for additional 24 weeks duration is more appropriate. Furthermore, newer research has shown imagery restructuring as an efficacious treatment for mild to moderate BDD as it is faster than CBT and can give patients more insight on the disorder.
Karin Sernec and Gorazd V Mrevlje
University Psychiatric Clinic Ljubljana, Slovenia
Title: Inpatient treatment and family involvement of patients with eating disorders: Experience from Slovenia
Biography:
Karin Sernec is an Associate Professor at University of Ljubljana. She has earned her PhD in 2010. She has been the Head of Slovenia’s Unit for Treatment of Eating Disorders ever since it was founded in 1999. She built a multidimensional, mixed-gender inpatient treatment program in addition to group and individual outpatient treatment of persons with eating disorders. She is leading Slovenian Expert Group for Eating Disorders and continues to contribute to this field as an author and co-author of numerous scientific publications.
Abstract:
Problem & Aim: Eating disorders (ED) are chronic mental disorders that commonly involve not only patients but their entire families. The involvement of family members in the treatment of ED has been known to have beneficial effects on patient motivation which is partly reflected by the patients’ adherence to the treatment program. The purpose of this study is to assess whether participation of family members in educational support group contributes to the outcome of inpatient treatment. Educational support group for family members is held weekly at the Unit for Treatment of Eating Disorders (UED) in Ljubljana, Slovenia, in addition to the multidimensional inpatient program consisting of group psychotherapy (cognitive, behavioral and psychodynamic), psychodrama, educational groups and music, art and dance/movement therapy.
Methodology: Our retrospective cohort study included patients with ED hospitalized at the UED between January 1st 2010 and December 31st 2015 and their family members. Of the 135 admissions to our inpatient program in this time period, 55 (40.7%) terminated prematurely. Most of these (58.2%) were due to dropout by patients who were insufficiently motivated. We were able to retrieve information about family members' participation during 105 inpatient admissions. In 72 cases, family members participated actively. In 33 cases, family members did not attend the educational support group consistently (two visits or less, mostly none).
Findings: There was a statistically significant, if small, association between whether or not the patient completed our program and whether or not their family members actively participated in the treatment (χ2=6.243, p<0.05, p=0.017, Cramer's V test=0.244).
Conclusions: Those patients whose family members did attend our educational support group were more likely to complete the treatment program. This encourages us to continue to provide education and support to family members of our ED inpatients.