Psychotherapeutic Methods of Coping with Stress in Everyday Life

Stress is an inevitable part of life. Knowing the ways of coping with stress are necessary to preserve our mental and physical health and to maintain good social and/or occupational functioning in daily life activities. Different ways of coping with stress have been developed throughout history. Various type of therapies offer quite effective remedies for coping with stress in everyday life. Among psychotherapeutic treatments cognitive behavioral therapy which involves teaching stressful individuals to develop coping strategies have yielded very promising results. It is helpful to determine first whether stress source can be changed, several therapeutic approaches may then be used. Lazarus and Folkman have identified two major approaches for coping with stress so-called "problem-focused" and "emotion-focused". In "problem-focused" approaches targets are acquiring time management, self-monitoring, problem-solving skills, while in "emotion-focused" approaches, through ways of accepting or rejecting of stress associated negative emotions, or reconciling with these emotions, the target is learning how to keep emotions under control. "Problem-focused" and "emotion-focused" approaches may independently be used effectively in appropriate cases, their simultaneous practice may increase chances of successful treatment. Apart from this methods, psychodynamic therapy may be indicated in some cases. [JCBPR 2015; 4(3.000): 133-140

Increased incidence of autoimmune thyroiditis in patients with anti psychotic-induced hyperprolactinemia

Prolactin (PRL) elevation in patients with protactin-secreting pituitary tumors has been linked to increased prevalence of thyroid autoantibodies. However, the effects of antipsychotic drug-induced hyperprolactinemia (HPRL) on development of thyroid autoimmunity and also of other autoimmune phenomena have not been previously studied. To examine whether serum PRL levels were associated with the prevalence of thyroid autoantibodies in patients with schizophrenia receiving tong-term antipsychotic treatment, we determined serum PRL, thyrotropin, free thyroxine levels, and the presence of antithyroid peroxidase and antithyroglobulin antibodies in 75 consecutive, clinically stable schizophrenic outpatients who had been on stable doses of antipsychotics for at least 3 months, and had no history of overt thyroid disease. We found that the prevalence of hyperprolactinemia was significantly higher in patients positive for thyroid autoantibodies, when compared with patients negative for them (p = 0.045). Serum levels of protactin were also significantly higher in patients with positivity for thyroid autoantibodies (p = 0.039). In separate analyses for genders, a trend-Level relationship was observed in females between increased levels of protactin and the presence of thyroid autoantibodies (p = 0.060). Our findings suggest that through the associated HPRL, long-term antipsychotic treatment can induce thyroid autoimmunity. Future research is required to investigate, whether other autoimmune processes might be triggered by antipsychotic drug-induced HPRL, and to what extent the immune alterations reported in patients with schizophrenia are related with this phenomenon. (C) 2008 Elsevier B.V. and ECNP. All rights reserved

Prolonged anorexia nervosa associated with female-to-male gender dysphoria: A case report

Transsexual (TS) individuals seem to display an increased risk in having eating disorders. Several case reports describe TS individualswith anorexia nervosa (AN). In order to understand better the impact of gender dysphoria (GD) and hormonal/surgical treatments on the occurrence and course of eating disorders in TS patients long term follow-up studies are needed. We present here a 41-year-old female-to-male TS patient suffering from AN. History revealed that pathological eating habits could strongly be associated with her GD. Hormonal and surgical treatments resulted in substantial improvement in the given eating disorder. The impact of GD on the development and treatment of eating disorder is discussed in this report. (C) 2015 Elsevier Ltd. All rights reserved

DIAGNOSTIC APPROACH TO BEHAVIORAL OR "NON-SUBSTANCE" ADDICTIONS

Until recently, non-substance related behavioral addictions were not categorized in diagnostic manuals of mental disorders. Addictive states are characterized by changed reinforcement contingencies, anhedonia, diminished capacity to experience pleasures due to reduced sensitivity to endogenous brain dopamine, and increased sensitivity to internal and external triggering factors. An underlying biological mechanism for urge-driven disorders may involve the pre-frontal cortex, nucleus accumbens, the ventral tegmental area, amygdala and hippocampus, which are considered to play a critical role in the characteristic behavioral impairments of addictive disorders. Recent literature implicates serotonergic, dopaminergic, noradrenergic, and opioidergic neurotransmitter systems in the pathophysiology of behavioral addictions. A reduction in the sensitivity of the brain reward system and hyperactivity towards addiction-associated stimuli was demonstrated in addiction disorders. Due to the lack of a diagnostic guide, different psychometric instruments were used to assess behavioral addictions, including pathological gambling, compulsive buying, internet addiction, video/computer game addiction, sexual addiction, and excessive tanning. Psychosocial interventions encourage the abstinence by lifestyle changes, and reinforce healthy behaviors via motivational enhancement and cognitive behavioral therapies. Pharmacologically, there are no medications currently approved for the treatment of behavioral addictions, but naltrexone, topiramate, and N-acerylcysteine have some promising effects

Minor physical anomalies and neurological soft signs in patients with schizophrenia and their siblings

Neurological soft soft signs (NSSs) and minor physical anomalies (MPAs) are consistently found at higher rates in individuals with schizophrenia compared to healthy controls. However, limited research has been conducted on these traits among the biological relatives of these patients. We aimed to identify the possible origins of these traits in schizophrenia by exploring them in patients with schizophrenia, their healthy siblings and normal controls. Ninety-six patients with schizophrenia, their 66 non-psychotic siblings and 52 healthy subjects were studied. Measures included the Neurological Evaluation Scale, a structured examination for detection of minor physical anomalies, stroop and verbal fluency tests for cognitive assessment, and scales for assessment of disease severity in patients; the Scale for the Assesment of Negative Symptoms and the Scale for the Assesment of Positive Symptoms. Increased rates of NSSs and high MPA scores were found in both the patients and their siblings as compared to normal controls. MPAs in several body regions were similar (eyes, ears, hands and feet) or correlated (innercanthal width and head circumference) between patients and their respective siblings. However, there was little similarity in palate and tongue anomalies between these subjects. These results suggest that NSSs and MPAs might represent two distinct markers of risk for schizophrenia. MPAs at different locations may also represent distinct pathological processes, such that palate and tongue abnormalities are more likely to represent non-familial rather than familial factors compared to other abnormalities. (C) 2011 Elsevier Ireland Ltd. All rights reserved

A Multi-Dimensional Psychiatric Perspective on the Impact of the COVID-19 Pandemic

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) arose in Wuhan, China in December 2019 and spread worldwide rapidly, and was declared a global pandemic by the World Health Organization as of March 2020. As the SARS-CoV-2 pandemic has spread worldwide, its impact is increasingly being recognized among vulnerable groups and also by the public in general. Recent findings indicate that patients with mental health disorders are among the groups most vulnerable to psychological stress and social hardships related to the current pandemic. Studies also indicate an increased risk of infection by SARS-CoV-2 in subjects with psychiatric disorders. Patients affected by SARS-CoV-2 may present to the psychiatrist with delirium, psychotic symptoms, depression, anxiety, post-traumatic stress disorder, and insomnia. Some patients will develop persistent somatic symptoms such as fatigue after the acute infection. In this article, we summarize the preliminary findings related to the effects of the SARS-CoV-2 pandemic on patients with mental health disorders, as well as recent research on psychiatric presentations in patients affected by SARS-CoV-2

Reducing Mental Illness Stigma in Mental Health Professionals Using a Web-based Approach

Objective: This study was designed to investigate the efficacy of a web-based mental disorder stigma education program for mental health professionals. Methods: The sample consisted of 205 individuals who were either residents or specialists in psychiatry. Participants were contacted through a national web-based e-mail group that consisted of professionals in psychiatry, who were randomly assigned to experimental and control groups. The experimental group received an informative e-mail which contained a general account of "stigma" before they were asked to respond to an Internet-based questionnaire which was designed to predict their stigmatizing attitudes towards individuals with mental disorders. Control subjects, on the other hand, were asked to respond to the same Internet-based questionnaire without having been given the aforementioned informative e-mail. Results: The experimental group, compared to the control group, demonstrated a lesser stigmatizing attitude towards individuals with mental illness, as measured by the Internet-based survey which utilized the "social distance" concepts of stigma. Conclusions: These data suggest that such "anti-stigma" campaigns using the potential of the Internet might be an effective tool in the fight against the stigmatization of persons with mental illness