Psychopathology of schizophrenia in Ljubljana (Slovenia) from 1881 to 2000: changes in the content of delusions in schizophrenia patients related to various sociopolitical, technical and scientific changes.

BACKGROUND: Clinical observations and research have found the content of delusions in schizophrenia to be sensitive to sociopolitical and cultural factors. AIMS: The aim of this retrospective case-note study was to determine changes in the frequencies of various contents of delusions in schizophrenia patients over time. METHODS: A total of 120 records of first-time admission schizophrenia patient at Ljubljana's psychiatric hospital in the period from 1881 to 2000 were randomly selected. Information was taken from each record to fill out a form specially created for this study. The frequencies of delusions with regard to their content in various time spans were compared. RESULTS: A marked increase in two delusional themes--persecution and self-reference--was found after the change of political regime (1941-2000) in Slovenia. After the spread of radio in the 1920s and television in the 1950s in Slovenia, there was an obvious increase in delusions of outside influence and control as well as delusions with technical themes. A striking increase in the percentage of Schneiderian first-rank symptoms was found after the spread of Schneider's ideas in the 1950s. CONCLUSIONS: Sociopolitical changes and scientific and technical developments have a marked influence on the delusional content in schizophrenia.

Psychiatry in selected countries of Central and Eastern Europe: an overview of the current situation.

OBJECTIVE: To review the current status of psychiatry in selected countries of Central and Eastern Europe: Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, Russia, Slovakia, and Slovenia. METHOD: A group of psychiatrists from the region evaluated the status of psychiatry at the end of 2004 based on data from their countries and information available on WHO homepages. RESULTS: There is a shift from traditional in-patient facilities towards out-patient and community services as evidenced by a decreasing number of hospital beds. Economic pressures affect the financing of psychiatric services, and reimbursement for novel psychotropics. Political changes were followed by updated legislation. Psychiatric training, pre-, postgraduate and continuous medical education, are gradually being transformed. Scientific output as measured by publications in peer-reviewed journals has been significantly lower than in the West. CONCLUSION: The major changes in the period of transition documented in the review pose new challenges for psychiatry.

Regulación respecto a síntomas psicológicos y conductuales de la demencia en Eslovenia: guías de actuación / No disponible

Los síntomas psicológicos y conductuales de la demencia (SPCD) son muy frecuentes entre los pacientes con demencia. A menudo se asocian con la prescripción indiscriminada de medicación psicotrópica, especialmente benzodiacepinas y antipsicóticos. Así, en la última década ha surgido la conciencia en todo el mundo de que es necesario aplicar directivas más rigurosas a la prescripción y monitorización de la medicación. La práctica clínica del uso de medicamentos psicotrópicos para el tratamiento de la agitación en la demencia en Eslovenia no siempre es la mejor. Por eso se sugirió que eran necesarias unas guías de actuación. Presentamos aquí las guías de actuación redactadas en diciembre de 2001

Evaluation of brain perfusion with technetium-99m bicisate single-photon emission tomography in patients with depressive disorder before and after drug treatment.

Depression is one of the most common psychiatric illnesses. Its influence on brain perfusion has been demonstrated, but conflicting data exist on follow-up after drug treatment. The aim of our study was to evaluate the effects of antidepressant drugs on regional cerebral blood flow (rCBF) in patients with depression after 3 weeks and 6 months of drug therapy. Clinical criteria for depression without psychosis were met according to psychiatric evaluation. Severity of depression was evaluated with the Hamilton Depression Rating Scale (HAMD) before every scintigraphic study. rCBF was assessed using technetium-99m bicisate (Neurolite) brain single-photon emission tomography in nine patients with severe depression before the beginning of antidepressant drug therapy and 3 weeks and six months after initiation of therapy. Only patients with no change in antidepressant medication during the study were included. No antipsychotic drugs were used. Cerebellum was used as the reference region. rCBF was evaluated for eight regions in each study in three consecutive transversal slices. Follow-up studies were compared with the baseline study. The mean HAMD score was 25.5 points initially, 16 at the second examination and 8.8 after 6 months. Global CBF was decreased compared with the reference region in drug-free patients. Perfusion of left frontal and temporal regions was significantly lower (P < 0.005) in comparison with the contralateral side. After therapy, a moderate decrease in perfusion was seen in the right frontal region (P < 0.05). Perfusion decreased further after 6 months in the right frontal (P < 0.005) and temporal regions (P < 0.01). The highly significant asymmetry in perfusion between the left and right frontal and temporal lobes almost disappeared during treatment. Our findings implicate dysfunction of the frontal and temporal cortex in clinically depressed patients before specific drug treatment. Clinical improvement and decreases in HAMD score after 3 weeks and after 6 months reflect the treatment effect on mood-related rCBF changes.

Problems with borderline patients in a crisis intervention unit: a case history.

This article describes some characteristics, advantages, and disadvantages of crisis intervention in patients with borderline personality disorder. The theoretical issues are illustrated by a case study of a patient with the disorder. Therapeutic proceedings are analyzed, with special focus on the treatment plan, goal-setting, and termination of therapy. The positive effects of the treatment and the patient's unexpected loss of compliance are discussed. Some suggestions are made about dealing with such patients in the light of mistakes made by the crisis therapist, which produced feelings of inadequacy and incompetence in her, stemming from unresolved transference-countertransference problems.

Patients' experience of the therapeutic process in a crisis intervention unit.

To all patients hospitalized in 1986 in the Crisis Intervention Unit in Ljubljana, Yugoslavia, an inventory was sent. In this way, we tried to find out how the patients experience the treatment and stay on the Unit, what is most helpful in solving their problems and what are, in their opinion, the direct gains of hospitalization. On the basis of the results, we determined what should be changed or improved to make the treatment in our Unit more effective.