Integrated Psychological Therapy and Treatment-Resistant Schizophrenia: Initial Findings

Objective: The aim of this Randomized Controlled Trial (RCT) is to present the initial findings of a larger RCT study conducted internationally for the first time, regarding the hypothesis, when the Integrated Psychological Therapy (IPT) for individuals with schizophrenia is more and when it is less effective, regarding Treatment-Resistant Schizophrenia (TRS) and nontreatment resistant schizophrenia (NTRS). Methods: Forty-eight outpatients with schizophrenia of an adult psychiatric department participated in this RCT study. Eleven outpatients of IPT and 11 of the Treatment as Usual (TAU) belong to TRS. Thirteen patients of IPT and 13 of TAU belong to NTRS. A test battery was given at baseline after therapy (10 weeks) and at 3 months’ follow-up. Neurocognition, social cognition, psychopathology, and functional outcome were assessed. The General Linear Model (GLM) for repeated measurements was used. Effect sizes, z-scores, and the sign test were calculated. Results: There was a statistical significance for verbal memory; positive, negative symptoms and general psychopathology; Global Assessment and Functioning scale (GAF) and quality of life favoring NTRS. Effect sizes showed superiority of NTRS in comparison to TRS. The sign test showed a significant improvement in Integrated Psychological Therapy treatment-resistant schizophrenia (IPTTRS) that was maintained in the follow-up, in Integrated Psychological Therapy nontreatment resistant schizophrenia (IPTNTRS) and in Treatment as Usual nontreatment resistant schizophrenia (TAUNTRS). Conclusion: The IPT is more effective in NTRS in comparison to TRS, although IPTTRS showed some improvements, maintained at follow-up. Further RCT studies with larger samples are needed. © 2019, © 2019 Washington School of Psychiatry

A Rare Manifestation of Secondary Hyperparathyroidism Due to Brown Tumors: A Case Report

Maria Boudina,1 Eleana Zisimopoulou,1 Pantelitsa Rakitzi,1 Sotirios Barbanis,2 Eleni Syndouka,3 Chrysanthi Zouli,1 Aimilia Fotiadou,1 Mariana Stamati Stamati,1 Chrysanthi Balodimou,1 George Christantoniou,1 Alexandra Chrisoulidou1 1Department of Endocrinology, Theagenio Cancer Hospital, Thessaloniki, Greece; 2Department of Pathology, Theagenio Cancer Hospital, Thessaloniki, Greece; 3Department of Radiology, Theagenio Cancer Hospital, Thessaloniki, GreeceCorrespondence: Maria Boudina, Department of Endocrinology, Theagenio Cancer Hospital, Thessaloniki, Greece, Email [email protected]: Brown tumors, also known as cystic fibrosa, are rare, benign, osteolytic, fibrotic lesions of the bones that occur secondary to hyperparathyroidism. They are caused by increased osteoclastic activity leading to an abnormal bone metabolism.Case Description: Here, we present the case of a 58-year-old male, who presented with painful bony lesions, initially attributed to metastatic disease. After biochemical workout, imaging and biopsy, the nature of the lesions was revealed. We discuss the differential diagnosis and clinical management of the disease.Conclusion: Patients with brown tumors should be assessed in the differential diagnosis of bony lesions and should always be tested for hyperparathyroidism. An early diagnosis is crucial for the successful treatment of such patients.Keywords: brown tumor, hyperparathyroidism, chronic kidney disease, case repor