Dialectical Behaviour Therapy For A Woman With Borderline Personality Disorder: A Case Report

Objective: Borderline personality disorder (BPD) is often manifested by maladaptive behaviours such as self-injury. The interpersonal style characteristic of BPD makes it difficult to maintain stable therapeutic relationships, with the patient often discontinuing treatment. Although dialectical behavior therapy (DBT) has been reported to benefit patients with BPD, reports in Asian countries have been few. We herein describe a 22-year-old female with BPD and a history of attempted suicide and self-injury who underwent DBT at our hospital. Methods: Our 6-month DBT consists of 4 parts: weekly psychotherapy by a psychiatrist, weekly skills training by a clinical psychologist and nurse, emergency consultations, and supervision/consultation meetings. Individual psychotherapy and skills training sessions, respectively, were conducted for this patient 24 times. Results: After completing DBT, the number of self-injuries and frequency of suicidal ideation in our patient decreased. Conclusion: Although more costly than standard treatment for BPD, a trial of DBT might be worthwhile in Japanese patients. ASEAN Journal of Psychiatry, Vol. 14 (1): January – June 2013: XX XX

Protocol for highly selective transgene expression through the flip-excision switch system by using a unilateral spacer sequence in rodents

Summary: We present a protocol to induce Cre-dependent transgene expression in specific cell types in the rat brain, suppressing a leak expression in off-target cells, by using a flip-excision switch system with a unilateral spacer sequence. We describe steps for construction of transfer plasmids, preparation of adeno-associated viral vectors, intracranial injection, and detection of transgene expression. Our protocol provides a useful strategy for a better understanding of the structure and function of specific cell types in the complex neural circuit.For complete details on the use and execution of this protocol, please refer to Matsushita et al.1 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics

Are saving appearance responses typical communication patterns in Alzheimer's disease?

INTRODUCTION:To keep up appearances, people with dementia sometimes pretend to know the correct answer, as seen during administration of neuropsychological tests such as the Mini-Mental State Examination (MMSE). These saving appearance responses (SARs) of people with dementia often lead to caregivers and/or medical staff underestimating the severity of dementia and impede proper early initiation of treatment. However, most descriptions of SARs are based on empirical knowledge of clinicians. In this study, we investigated whether SARs are typical communication patterns in people with Alzheimer's disease (AD), compared with mild cognitive impairment (MCI) or dementia with Lewy bodies (DLB). METHODS:The participants were 107 outpatients with AD, 16 with mixed AD with cerebrovascular dementia, 55 with MCI, and 30 with DLB. We assessed the occurrence of SARs during the MMSE. The relationships between the SARs and AD were examined by the χ2 test and logistic regression analysis. RESULTS:People with AD who showed SARs were 57.9%, whereas those with MCI were 18.2% and DLB were 20.0% (P with Bonferroni correction < 0.05). Although there were significant differences in some variables in each group of diagnosis, logistic regression analysis showed that people with AD were more likely to show SARs than those with MCI (Odds ratio = 3.48, 95% Confidential Interval = 1.18-10.28) and DLB (Odds ratio = 4.24, 95% Confidential Interval = 1.50-12.01), even after controlling for sex, estimated disease duration, MMSE, and frontal assessment battery scores. CONCLUSION:The occurrence of SARs could be found most frequently in people with AD. Clinicians should develop a respectful attitude toward dementia patients with SARs because SARs imply conflicted feelings about questions that patients cannot answer correctly

Caregiver Burden in Semantic Dementia with Right- and Left-Sided Predominant Cerebral Atrophy and in Behavioral-Variant Frontotemporal Dementia

Background: Caregiver burden is a serious concern for family caregivers of dementia patients, but its nature is unclear in patients with semantic dementia (SD). This study aimed to clarify caregiver burden for right- (R &#x3e; L) and left-sided (L &#x3e; R) predominant SD versus behavioral-variant frontotemporal dementia (bvFTD) patients. Methods: Using the Japanese version of the Zarit Burden Interview (ZBI) and the Neuropsychiatric Inventory, we examined caregiver burden and behavioral and psychological symptoms of dementia (BPSD) in 43 first-visit outpatient/family caregiver dyads (bvFTD, 20 dyads; SD [L &#x3e; R], 13 dyads; SD [R &#x3e; L], 10 dyads). Results: We found a significant difference in ZBI score between the 3 diagnostic groups. Post hoc tests revealed a significantly higher ZBI score in the bvFTD than in the SD (L &#x3e; R) group. The ZBI scores in the SD (L &#x3e; R) and SD (R &#x3e; L) groups were not significantly different, although the effect size was large. Caregiver burden was significantly correlated with BPSD scores in all groups and was correlated with activities of daily living and instrumental activities of daily living decline in the bvFTD and SD (R &#x3e; L) groups. Conclusion: Caregiver burden was highest in the bvFTD group, comparatively high in the SD (R &#x3e; L) group, and lowest in the SD (L &#x3e; R) group. Adequate support and intervention for caregivers should be tailored to differences in caregiver burden between these patient groups

Malnutrition in Alzheimer's Disease, Dementia with Lewy Bodies, and Frontotemporal Lobar Degeneration: Comparison Using Serum Albumin, Total Protein, and Hemoglobin Level.

Malnutrition among dementia patients is an important issue. However, the biochemical markers of malnutrition have not been well studied in this population. The purpose of this study was to compare biochemical blood markers among patients with Alzheimer's disease (AD), dementia with Lewy bodies (DLB), and frontotemporal lobar degeneration (FTLD). A total of 339 dementia outpatients and their family caregivers participated in this study. Low serum albumin was 7.2 times more prevalent among patients with DLB and 10.1 times more prevalent among those with FTLD than among those with AD, with adjustment for age. Low hemoglobin was 9.1 times more common in female DLB patients than in female AD patients, with adjustment for age. The levels of biochemical markers were not significantly correlated with cognitive function. Family caregivers of patients with low total protein, low albumin, or low hemoglobin were asked if the patients had loss of weight or appetite; 96.4% reported no loss of weight or appetite. In conclusion, nutritional status was worse in patients with DLB and FTLD than in those with AD. A multidimensional approach, including blood testing, is needed to assess malnutrition in patients with dementia

Results of logistic regression analysis for the relationship between saving appearance responses and AD in people with AD and DLB.

<p>Results of logistic regression analysis for the relationship between saving appearance responses and AD in people with AD and DLB.</p

Demographics of participants.

<p>Demographics of participants.</p