Bioenergetic exercises in inpatient treatment of Turkish immigrants with chronic somatoform disorders: a randomized, controlled study.

OBJECTIVE: The aim of this study was to examine whether bioenergetic exercises (BE) significantly influence the inpatient psychotherapeutic treatment results for Turkish immigrants with chronic somatoform disorders. METHOD: In a 6-week randomized, prospective, controlled trial, we treated a sample of 128 Turkish patients: 64 were randomly assigned to BE and 64 participated in gymnastic exercises in lieu of BE. The Symptom Checklist (SCL-90-R) and State-Trait Anger Expression Inventory (STAXI) were employed. RESULTS: According to the intent-to-treat principle, the bioenergetic analysis group achieved significantly better treatment results on most of the SCL-90-R and STAXI scales. CONCLUSIONS: BE appears to improve symptoms of somatization, social insecurity, depressiveness, anxiety, and hostility in the inpatient therapy of subjects with chronic somatoform disorders. Reduction of the anger level and reduction in directing anger inwards, with a simultaneous increase of spontaneous outward emotional expression, could be expected.

Suicide attempts versus suicidal ideation in bulimic female adolescents.

BACKGROUND: Suicide attempts by adolescents continue to be a major public health problem. The purpose of this study was to examine the difference in the family functioning and sociopsychopathological risk factor relationship between female bulimic adolescents with suicidal ideation only, and those who attempted suicide. METHODS: A group of 211 patients were observed for 12 months. Data from 63 subjects (SUG [suicide group], age 17.2 +/- 1.3 years) who had attempted suicide were then compared with 148 (control group, age 18.1 +/- 1.5 years) who had expressed suicidal ideation but did not follow through. RESULTS: Those in the suicide attempt group had been exposed more frequently to physical/sexual violence in childhood. As adults they either lived alone or were dissatisfied with their partnership. The frequency of borderline personality disorders and depressive disorders in this group was significant. Psychosomatic symptoms, disturbed coenesthesia, substance abuse, social impairment and interference with their perception of their own life circumstances, as well as their job performance, often preceded the suicide attempt. Nine genuine risk factors that occurred significantly more often in the SUG were calculated out of all the stress factors using stepwise logistic regression: 'as a child I was even hit with a stick or whip', 'I had no set orientation in life', 'I had a feeling of loneliness despite family and friends', 'I could not relax', 'incapable of dealing with the public', 'I do not like to be touched', 'parents have psychiatric disorders', 'misuse of stimulants', and 'as a child I felt lonely' (odds ratio, 10.56-1.90). CONCLUSION: Adverse family experiences and multiple sociopsychopathological factors may increase the risk of suicide in female bulimic adolescents.

Influence of family therapy on bullying behaviour, cortisol secretion, anger, and quality of life in bullying male adolescents: A randomized, prospective, controlled study.

OBJECTIVE: To determine the influence of brief strategic family therapy (BSFT) on salivary cortisol, anger, and health-related quality of life (QoL) in adolescent boys with bullying behaviour. METHOD: We selected a sample of 72 boys demonstrating bullying behaviour from the general population and treated 36 with BSFT for 12 weeks. The other 36 boys formed the control group. Primary outcome measures were salivary cortisol concentration 15 to 30 minutes after awakening and changes on the subscales of the State-Trait Anger Expression Inventory (STAXI) and the Health Survey (SF-36). RESULTS: After 12 weeks' treatment, we observed a significant reduction in bullying behaviour in the BSFT group (P = 0.017) and in the mean values (according to the intent-to-treat principle) for salivary cortisol concentration (P < 0.001). The BSFT group also showed significantly greater change on the STAXI subscales State-Anger (P < 0.001), Trait-Anger (P < 0.001), Anger-Out (P < 0.001), and Anger-Control (P < 0.001). Treatment with BSFT also resulted in significant improvement on the SF-36 subscales for Vitality (P < 0.001), Social Functioning (P < 0.001), Role-Emotional (P < 0.001), and Mental Health (P < 0.001). CONCLUSIONS: BSFT effectively influenced bullying behaviour, salivary cortisol concentration, anger, and health-related QoL in adolescent bullying boys.

Pregnant women with bronchial asthma benefit from progressive muscle relaxation: a randomized, prospective, controlled trial.

BACKGROUND: Asthma is a serious medical problem in pregnancy and is often associated with stress, anger and poor quality of life. The aim of this study was to determine the efficacy of progressive muscle relaxation (PMR) on change in blood pressure, lung parameters, heart rate, anger and health-related quality of life in pregnant women with bronchial asthma. METHODS: We treated a sample of 64 pregnant women with bronchial asthma from the local population in an 8-week randomized, prospective, controlled trial. Thirty-two were selected for PMR, and 32 received a placebo intervention. The systolic blood pressure, forced expiratory volume in the first second, peak expiratory flow and heart rate were tested, and the State-Trait Anger Expression Inventory and Health Survey (SF-36) were employed. RESULTS: According to the intend-to-treat principle, a significant reduction in systolic blood pressure and a significant increase in both forced expiratory volume in the first second and peak expiratory flow were observed after PMR. The heart rate showed a significant increase in the coefficient of variation, root mean square of successive differences and high frequency ranges, in addition to a significant reduction in low and middle frequency ranges. A significant reduction on three of five State-Trait Anger Expression Inventory scales, and a significant increase on seven of eight SF-36 scales were observed. CONCLUSIONS: PMR appears to be an effective method to improve blood pressure, lung parameters and heart rate, and to decrease anger levels, thus enhancing health-related quality of life in pregnant women with bronchial asthma.

Aripiprazole in the treatment of patients with borderline personality disorder: a double-blind, placebo-controlled study.

OBJECTIVE: Aripiprazole is a relatively new atypical antipsychotic agent that has been successfully employed in therapy for schizophrenia and schizoaffective disorders. A few neuroleptics have been used in therapy for patients with borderline personality disorder, which is associated with severe psychopathological symptoms. Aripiprazole, however, has not yet been tested for this disorder, and the goal of this study was to determine whether aripiprazole is effective in the treatment of several domains of symptoms of borderline personality disorder. METHOD: Subjects meeting criteria for the Structured Clinical Interview for DSM-III-R Personality Disorders for borderline personality disorder (43 women and 9 men) were randomly assigned in a 1:1 ratio to 15 mg/day of aripiprazole (N=26) or placebo (N=26) for 8 weeks. Primary outcome measures were changes in scores on the symptom checklist (SCL-90-R), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), and the State-Trait Anger Expression Inventory and were assessed weekly. Side effects and self-injury were assessed with a nonvalidated questionnaire. RESULTS: According to the intent-to-treat principle, significant changes in scores on most scales of the SCL-90-R, the HAM-D, the HAM-A, and all scales of the State-Trait Anger Expression Inventory were observed in the subjects treated with aripiprazole after 8 weeks. Self-injury occurred in the groups. The reported side effects were headache, insomnia, nausea, numbness, constipation, and anxiety. CONCLUSIONS: Aripiprazole appears to be a safe and effective agent in the treatment of patients with borderline personality disorder.

Familial and sociopsychopathological risk factors for suicide attempt in bulimic and in depressed women: prospective study.

OBJECTIVE: This study was carried out to examine sociopsychopathological predictors of prospective observed suicide attempts in bulimic women purging type without comorbid major depression (BNG) at the time of study entry and in woman with major depression without comorbid eating disorder at the time of study entry (MDG). METHODS: Data from 28 BNG (age 23.5 +/- 3.6) and 126 MDG women (age 33.4 +/- 5.1) who had attempted suicide during 12 months' monitoring were compared. RESULTS: A univariate comparison of the two groups revealed various differences. Analysis of risk factors for suicide attempts using stepwise logistic regression was conducted separately for each group. The derived logistic models showed that patients from the BNG group had a history of higher incidence of sexual abuse in childhood, as well as abuse of laxatives and illicit drugs; they also lacked orientation in life, felt lonely despite family and friends, tended to direct their anger outward, and were unable to relax. CONCLUSIONS: Sociopsychopathological risk factors for suicide attempts in the BNG and MDG appear to vary.

Topiramate treatment for women with borderline personality disorder: a double-blind, placebo-controlled study.

Borderline personality disorder is a common and severe psychiatric illness. The goal of this study was to determine whether topiramate can influence patients' borderline psychopathology, health-related quality of life, and interpersonal problems. Women meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Structured Clinical Interview II criteria for borderline personality disorder were randomly assigned in a 1:1 ratio to topiramate titrated from 25 to 200 mg/d (n = 28) or placebo (n = 28) for 10 weeks. Primary outcome measures were changes on the Symptom-Checklist, on the SF-36 Health Survey, and on the Inventory of Interpersonal Problems. Body weight and additional side effects were assessed weekly. According to the intent-to-treat principle, significant changes (all P < 0.001) on the somatization, interpersonal sensitivity, anxiety, hostility, phobic anxiety, and Global Severity Index scales of the Symptom Checklist were observed in the topiramate-treated subjects after 10 weeks (no significant changes on the obsessive-compulsive, depression, paranoid ideation, and psychoticism scales). In the SF-36 Health Survey, significant differences were observed on all 8 scales (all P < 0.01 or P < 0.001). In the Inventory of Interpersonal Problems, significant differences (all P < 0.001) were found in the scales for overly autocratic, overly competitive, overly introverted, and overly expressive (no significant differences in the scales for overly cold, overly subassertive/subservient, overly exploitable/compliant, and overly nurturant/friendly). Weight loss was additionally observed (p < 0.001). Topiramate appears to be a safe and effective agent in the treatment in women with borderline personality disorder. Additional weight loss can be expected.

Change in instrumental activities of daily living disability in female senior patients with musculosceletal pain: a prospective, randomized, controlled trial.

Previous studies found that depressive symptoms and low functional self-efficacy are associated with the occurrence of disabling musculoskeletal pain, and diminished quality of life in elderly people. The target of this study was to consider the change in instrumental activities of daily living (IADL) disability and health related quality of life after integrative psychotherapeutic treatment program of depressive symptoms in senior female patients with musculoskeletal pain. In an 8-week outpatient-based, random, prospective, controlled trial, 36 female patients between 70 and 79 with a history of clinically evident musculoskeletal pain and afflicted with depressive symptoms, but who were able to bathe, walk, dress, and transferring inside the house were evaluated. The study was performed using the Center for Epidemiological Studies Depression Scale (CES-D), IADL, and the Health Survey (SF-36). In comparison with the untreated group, according to the intent-to-treat principle, significant changes on the CES-D (P < 0.01), IADL (P < 0.01), and all scales of SF-36 were observed after eight weeks in the treated subjects. The treatment of moderate depression with integrative psychotherapy may be efficacious in improving of IADL disability and health related quality of life in affected senior female patients with musculoskeletal pain.