Group psychotherapy for HIV patients. A different approach

HIV is often related to psychological distress, after the diagnosis and the beginning of HAART. Brief Psychological approaches are important but they give only support, enhancing the relationships of the patients. In many cases these relationships are disfunctional too.Psychotherapies don´t focus on the indidvidual´s autonomy but on the support from the others. A brief-grouppsychotherapy focused on major objectives of each person but with the main common objective to enhance the psychological individual indipendence and to promove a self- maturation; understanding the disfunctional dynamics realized in the past that are enhanced by the HIV-status, to promove individual indipendence with the objective of focusing the good and valid relationships and change the disfunctional ones and to allow the person to be able to open to the world again. A brief group psychotherapy, supportive but mostly expressive. a small group 3 male, 1 female: were choosen for group psychotherapy after 2-3 individual meetings. 16 psychotherapy meetings, weekly, lenghth 1 hour, 40-45 minutes. Results First time patients worked on their disfunctional affective part, that was pre-hiv. In a second time they worked promoting their possibility of indipendence to find their lost self esteem. in the last time they focused to improve their relationships where possible but mostly to think that they can go out alone from the darkness after HIV diagnosis. Quality of life of HIV patients can be focused on changing their disfunctional parts, first enhancing the process of indipendence and individual esteem of the person

Polycyclic Aromatic Hydrocarbons and Polychlorinated Biphenyls in Seawater, Sediment and Biota of Neritic Ecosystems: Occurrence and Partition Study in Southern Ligurian Sea

The Mediterranean Sea is subjected to a high anthropic pressure, which determines direct or indirect discharges of persistent organic pollutants deriving from intensive industrial activities. These compounds could easily enter and contaminate the whole marine compartment, with possible transfers (and contamination) among water, sediment and biota. Based on the above-mentioned assumptions, in this work we studied the presence of 16 polycyclic aromatic hydrocarbons (PAHs) and 14 dioxin and non-dioxin-like polychlorinated biphenyls (PCBs) in the neritic protected marine area of the Southern Ligurian Sea, affected by the impact of human activities. The study was focused on the possible partition of micropollutants within seawater, sediment and zooplankton. Results showed that both seasonal and anthropic causes strongly affect contaminant transfer behaviors, with summertime periods more impacted by PAH and PCB contamination. Regarding the PAH contamination, low molecular weight congeners were mainly detected in the target matrices, revealing concentrations up to 1 µg/L in seawater (anthracene), 250 µg/Kg in sediments (benzo[b]fluoranthene) and 2.3 mg/Kg in carnivorous copepods. Concerning PCBs, only few congeners were detected in the matrices studied. To better understand the occurrence of preferential bioaccumulation pathways in zooplankton, partition studies were also performed in several taxa (hyperbenthic Isopoda, holoplanktonic crustacean copepods and ichthyoplankton) through the calculation of BAF values, observing that both living and feeding habits could influence the bioaccumulation process

Antidepressant therapy and the risk of suicide among patients with major depressive disorders

The world-wide annual suicide rate currently averages approximately 13/100,000 (0.013%/year), with higher average rates for men than women in all but a few countries, very low rates in children, and relatively high rates in elderly men. Suicide rates vary markedly among regions of the world, countries, and locales, in part reflecting differences in case-identification and reporting procedures. Rates of attempted suicide average 20-30 times higher than rates of completed suicide in the general population, but are probably under-reported. A highly controversial question is whether antidepressant treatment modifies the risks of various aspects of "suicidality" among patients with major depressive disorders. Research on the relationship between pharmacotherapy and suicidal behavior was virtually unknown until a decade ago. A minority of ecological studies and most large clinical studies have found that decreases of suicide rates by region or time are correlated with higher rates of prescribing modern antidepressants. However, other studies and data from brief, randomized, controlled trials in patients with acute major depression have found increases for patients of some ages, particularly for the risk of suicide attempts, as well as increases in suicidal ideation in the young. Although other pharmacological treatments, such as clozapine and lithium, appear to have sound evidence for reducing the risk of attempted and completed suicide, in this paper we proposed to analyze the relationship between suicidality in depressed adults and only antidepressants. \ua9 2011 by Nova Science Publishers, Inc

ANTIDEPRESSANT THERAPY AND THE RISK OF SUICIDE AMONG PATIENTS WITH MAJOR DEPRESSIVE DISORDERS

The world-wide annual suicide rate currently averages approximately 13/100,000 (0.013%/year), with higher average rates for men than women in all but a few countries, very low rates in children, and relatively high rates in elderly men Suicide rates vary markedly among regions of the world, countries, and locales, in part reflecting differences in case-identification and reporting procedures. Rates of attempted suicide average 20-30 times higher than rates of completed suicide in the general population, but are probably under-reported A highly controversial question is whether antidepressant treatment modifies the risks of various aspects of "suicidality" among patients with major depressive disorders. Research on the relationship between pharmacotherapy and suicidal behavior was virtually unknown until a decade ago. A minority of ecological studies and most large clinical studies have found that decreases of suicide rates by region or time are correlated with higher rates of prescribing modern antidepressants. However, other studies and data from brief, randomized, controlled trials in patients with acute major depression have found increases for patients of some ages, particularly for the risk of suicide attempts, as well as increases in suicidal ideation in the young. Although other pharmacological treatments, such as clozapine and lithium, appear to have sound evidence for reducing the risk of attempted and completed suicide, in this paper we proposed to analyze the relationship between suicidality in depressed adults and only antidepressants

Temperament, insecure attachment, impulsivity, and sexuality in women in jail

Background: Women constitute only a small proportion of inmates, but several studies have shown that they have higher rates of psychiatric disturbance than incarcerated men and community samples. Mental health treatment is necessary to prevent severe illness and suicide in these women. Methods: The convenience sample consisted of 40 female detainees and 40 controls who were administered self-report questionnaires to assess temperament (TEMPS-A), insecure attachment (ECR), impulsivity (BIS-11), and sexual behavior (SESAMO). Results: The incarcerated women had higher levels of affective temperament (except for hyperthymia), avoidance, anxiety, impulsivity, and psychosexual issues than the female community sample. Conclusions: Many interrelated emotional and affective disturbances affect the physical and psychological well-being of women in jail, and it is possible that these problems may lead to suicide. Health professionals need to develop gender-specific therapeutic interventions for women in jail. © 2012 International Association of Forensic Nurses

Temperaments in completed suicides: Are they different from those in suicide attempters and controls?

BACKGROUND: Temperaments in completed suicides have never been assessed whereas there is substantial research on temperaments in attempted suicides and psychiatric patients. METHODS: The significant others of 18 completed suicides participated in this study in order to provide an assessment of temperaments, hopelessness, depression and the suicide risk of their loved ones. The data were compared with data from 244 psychiatric patients of whom 83 had attempted suicide in the previous month. The following instruments were used: the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire (TEMPS-A), the Beck Hopelessness Scale (BHS), the Gotland Scale for Male Depression (GSMD), and the Mini International Neuropsychiatric Interview (MINI) module for assessing suicide risk. RESULTS: Individuals who died by suicide more frequently had scores of 9 or higher on the BHS and higher MINI suicide risk scores compared with patients with mood disorders who had not attempted suicide in the previous month. Completed suicides also had lower scores on the TEMPS-A Cyclothymia and Anxiety scales and on the MINI suicide risk scale than mood disorder patients with a recent suicide attempt. LIMITATIONS: Proxy assessment of variables through survivors can result in underestimation of psychiatric morbidity and other parameters investigated, and limits the generalization of our results CONCLUSIONS: Our study adds information about temperamental subtypes and other variables in completed suicides and points to their difference from attempted suicides and non-suicidal psychiatric patients

Unmet treatment needs in schizophrenia patients: is asenapine a potential therapeutic option?

Adverse metabolic events, such as increased adiposity, hyperglycemia, diabetes mellitus and dyslipidemia, have been associated with treatment using atypical antipsychotic medications. However, the complexity of some of the reports on this problem and marketing efforts in this area may make it difficult for psychiatrists to remain fully and accurately informed about the metabolic complications of atypical antipsychotic therapy. Little is currently known about how psychiatrists view what they have read or heard, how they perceive the available information and how this affects their management of patients with schizophrenia. A number of studies have demonstrated that nonadherence to the medication regimen in schizophrenia is associated with poor symptomatic outcome, increased risk of relapse, more frequent use of compulsory treatment and increased risk of suicide and severe self-harm. Suicide is a major cause of death among schizophrenic patients, and their attitude toward medication can make the difference between a proper therapeutic regimen that protects patients from suicide risk versus discontinuation of treatments that are associated with disabling symptoms, some of which are risk factors for suicide. We review the characteristics of a new drug, asenapine, that may improve adherence in patients as a result of a distinctive receptor profile that may be associated with fewer side effects than other second-generation antipsychotic drugs

Depression and affective temperaments are associated with poor health-related quality of life in patients with HIV infection

Introduction. Human immunodeficiency virus (HIV) represents one of the most chronic and debilitating infections worldwide. Hopelessness and affective temperaments (mood that is characteristic of an individual's habitual functioning) may play important roles in the health-related quality of life (HRQoL) of patients with HIV. The purpose of this study was to examine affective temperaments in a sample of patients with HIV, the impact of hopelessness on HRQoL, and associations among HRQoL, hopelessness, and affective temperaments. Methods. The study involved 88 participants who were administered the Short-Form Health Survey (SF-36), the Beck Hopelessness Scale (BHS), the Suicidal History Self-Rating Screening scale (SHSS), the Gotland Male Depression Scale (GMDS), and the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A). Results. Patients with a poorer HRQoL reported more severe depression and hopelessness than patients with a higher HRQoL. Patients with a poorer HRQoL also had higher scores on all dimensions of the TEMPS-A with a depressive component compared to patients with a higher HRQoL. The small sample size in this study limits the generalizability of the findings. Conclusion. Patients with a poorer HRQoL were more depressed and also at an increased risk of suicide as indicated by the more severe hopelessness they reported compared to patients with higher HRQoL. These patients were also more likely to have depressive affective temperaments than those with a higher HRQoL. Copyright © 2013, Lippincott Williams & Wilkins