[Music therapy and depression]. / Muziektherapie bij depressie.

BACKGROUND: Music therapy is a predominantly non-verbal psychotherapy based on music improvisation, embedded in a therapeutic relationship. This is the reason why music therapy is also used to treat depression. AIM: To examine the efficacy of music therapy and to report on the results of recent research into the value of music therapy as a treatment for depression. METHOD: We reviewed the literature on recent research into music therapy and depression, reporting on the methods used and the results achieved, and we assessed the current position of music therapy for depression in the context of evidence-based scientific research. RESULTS: A wide variety of research methods was used to investigate the effects of using music therapy as a psychotherapy. Most studies focused usually on the added value that music therapy brings to the standard form of psychiatric treatment, when administered with or without psychopharmacological support. Music therapy produced particularly significant and favourable results when used to treat patients with depression. CONCLUSION: Current research into music therapy and depression points to a significant and persistent reduction in patients' symptoms and to improvements in their quality of life. However, further research is needed with regard to the best methods of illustrating the effects of music therapy.

[The relationship between DSM-IV axis II and the anaclitic and introjective personality dimensions]. / Het verband tussen DSM-IV-as II en de anaclitische en introjectieve persoonlijkheidsdimensies.

BACKGROUND: In his psychodynamic theory of personality development, Blatt distinguishes between an anaclitic and an introjective cluster of psychological disorders. Whereas, in the past, research in this area has focused mainly on depression, nowadays more and more attention is being given to the relevance of this distinction for the theoretical conceptualisation and treatment of personality disorders (PD). AIM: To examine the association between dsm-iv pd characteristics and the anaclitic and introjective personality dimensions. METHOD: We conducted a cross-sectional study (n = 48) embedded in a five-year follow-up study after psychodynamic treatment for PD. We used multiple linear-regression analysis to investigate the relationship between pd characteristics (scid-ii Personality Questionnaire) and the anaclitic and introjective personality dimensions (Depressive Experiences Questionnaire), while controlling for the severity of the depression (Beck Depression Inventory) and for the introjective and anaclitic dimension, respectively. RESULTS: There was evidence for a positive relationship between the anaclitic dimension and dependent and borderline pd characteristics on the one hand and between the introjective dimension and avoidant, obsessive-compulsive, passive-aggressive, depressive, paranoid, schizotypal and narcissistic PD characteristics on the other hand. CONCLUSION: Results are consistent with and provide important empirical support for Blatt's assumptions concerning an anaclitic and an introjective cluster of personality pathology.

[A psychodynamic approach to self-harm in patients with a borderline personality disorder]. / Psychodynamische visie op automutilatie bij borderlinepersoonlijkheidsstoornis.

BACKGROUND: Self-harm means deliberate tissue damage inflicted without suicidal intent. It occurs very frequently in patients with personality disorders, particularly in patients with a borderline personality disorder (BPD). Earlier psychodynamic theories were concerned with the symbolic meaning of this type of behaviour, e.g. self-inflicted punishment. More recent theories, however, focus on the role of self-harm in basic psychic functioning, such as affect regulation. AIM: To demonstrate a more recent psychodynamic approach to the concept of self-harm and to outline the clinical implementation of this approach. METHOD: The literature on self-harm was reviewed systematically, particular attention being paid to more recent psychodynamic models. RESULTS: Three dimensions of the psychic change are implemented in hospital-based treatment. Instead of the focus being on the symptoms, it is now on a broader psychotherapeutic process which aims at achieving a structural change in personality. The relation between the basic layer of this process and the therapeutic effect on self-harm in BPD is discussed. CONCLUSION: The described approach to self-harm plays an important role in the psychodynamic treatment of patients with BPD. Current psychodynamic models of the treatment of BPD provide a theoretical background which can be implemented in the actual clinical treatment.

[Analytic inpatient treatment of malignant narcissism. A case study]. / Analytisch-residentiële behandeling van maligne narcisme.

It is extremely doubtful whether a patient diagnosed with malignant narcissism will respond positively to analytic therapy, particularly group therapy. The prospects for recovery are not favourable because a patient with malignant narcissism has a tendency to destroy everything that is good, including the therapeutic relationship, and this destructiveness can seriously undermine the treatment of other patients. Nevertheless, in this article a case is presented that illustrates that long-term analytic in-patient treatment can be successful. The theoretical background to the diagnosis is outlined so that readers will be able to understand the nature of the treatment.

In-patient treatment of borderline personality disorder: convergences and divergences between a psychoanalytical and a cognitive-behavioral approach.

For more than 20 years, patients with borderline personality disorder have been treated as in-patients in the UC St-Jozef in Kortenberg, Belgium. The majority of these patients were treated in a psychoanalytical or a behavior therapy ward. During these years, the treatment programs of these wards were gradually adjusted to the challenges provided by these patients. In this paper, we will describe the process of change that both wards have experienced. We will highlight similarities and differences between the approaches that are the result of an evolution over years. In both approaches, there is a strong emphasis on training and support for staff. While the psychoanalytical ward uses a group approach, the behavior therapy ward evolves towards a more individualized treatment.

Risperidone as add-on therapy in behavioural disturbances in mental retardation: a double-blind placebo-controlled cross-over study.

A double-blind placebo-controlled cross-over trial was carried out to evaluate the efficacy and safety of the combined serotonin-dopamine antagonist risperidone in mentally retarded patients with persistent behavioural disturbances. After an observation period of 1 week, risperidone 4-12 mg or placebo was administered during 3 weeks as add-on treatment to the existing medication, followed by a 1-week single-blind placebo wash-out, and another 3 weeks of double-blind treatment with the cross-over medication. Thirty-seven patients participated in the trials; 30 completed the study. Risperidone was significantly superior to placebo in its effect on the Aberrant Behaviour Checklist and the Clinical Global Impression. The Extrapyramidal Symptom Rating Scale did not show any differences between risperidone and placebo. Two patients experienced hypotension at the start of the risperidone administration. Sedation and drowsiness were the most frequently reported treatment-emergent adverse events. The results of this trial warrant further investigation into the therapeutic assets of risperidone in this indication, as add-on therapy and as monotherapy.

Pain in multiple sclerosis patients. A prospective study using the Mc Gill Pain Questionnaire.

The frequency distribution of pain complaints and its relation with disability are determined in 83 multiple sclerosis (MS) patients. According to their origin, these pain complaints were divided into tendinoskeletal, neurogenic and psychogenic pains. The Mc Gill Pain Questionnaire (MPQ) was administered to these pain patients and appeared to be a good instrument to evaluate their pain. Furthermore, the descriptive value of the MPQ enables us to differentiate three different pain patterns in the neurogenic pain group: persistent pain, painful tonic spasms and paroxysmal pain.