[Dialectical behaviour therapy for adolescents; a literature review]. / Dialectische gedragstherapie bij adolescenten;een literatuuronderzoek.

BACKGROUND: According to several randomised controlled trials (rct's) dialectical behaviour therapy (dbt) is effective in treating adults diagnosed with borderline personality disorder (bpd) who present with self-injurious and suicidal behaviour. In recent years there have been several studies about dbt in adolescents with varying problems and disorders. AIM: To review the literature for evidence of the effectiveness of dbt in adolescents aged 12 to 18. METHOD: With the help of PubMed and Medline and using the search-terms 'dialectical', 'adolescent', 'suicide attempt' and 'deliberate self harm', we searched the literature for references to dbt in adolescents. RESULTS: There were no rct's involving dbt in adolescents, but we did find one quasi-experimental design and several other studies with a pre-post treatment design. However, the studies were difficult to compare. In some cases it was doubtful whether the treatment could still be called dbt. The results suggested that dbt may be just as effective with adolescents as it is with adults in reducing bpd symptoms, suicidal ideation, and comorbid depressive disorder symptoms, and in reducing the need for hospitalisation. The results also indicated that dbt might be effective in treating eating disorders, bipolar disorder, oppositionality, aggression and nonsuicidal self-injurious behaviour (nsib) in a variety of treatment settings. CONCLUSION: dbt is possibly effective for treating adolescents with nsib and/or bpd symptoms. It may also be an effective treatment for various other affective and behavioural disorders. rct's are needed.

[Clinical implications of Capgras syndrome. Case report and literature review of "doubles" delusion in the elderly]. / Heeft het syndroom van Capgras bestaansrecht? Een casus en literatuuroverzicht van een dubbelgangerswaan bij ouderen.

A case of an 84-year-old woman with Capgras' syndrome is presented, and questions on diagnostic consequences and treatment are answered after reviewing the literature. There appears to no syndrome, but a symptom, that is associated with many psychiatric diagnoses, for instance psychosis, acute confusional state, affective psychosis and dementia with delusions. The mainly casuistic literature furthermore reveals that treating the 'syndrome of Capgras' consists of a symptomatic treatment of the underlying psychiatric disturbance. These case descriptions mention a variety of somatic illnesses that occur amongst elderly with the symptom of Capgras. Therefore many authors advocate exhaustive diagnostic procedures to find these illnesses. However, from our review it is clear that almost all these diagnoses have already been made before the symptom of Capgras appears. Moreover, these diagnoses vary so much that in the individual case a specific diagnostic procedure is impossible. We therefore conclude that diagnostic procedures and treatment of elderly persons with the symptom of Capgras do not differ from that of other elderly persons with psychiatric symptoms.