A Clinical Treatment Intervention for Dysphoria: Externalizing Metaphors Therapy.

A Clinical Treatment Intervention for Dysphoria: Externalizing Metaphors Therapy.

Clin Psychol Psychother. 2013 May 20;
McGuinty E, Armstrong D, Carrière AM

The purpose of this article is to explore a novel, short-term treatment intervention for internalizing behaviours. This intervention is primarily based upon an externalizing process, transforming of metaphoric imagery, and shifting of underlying maladaptive emotional schemas. This article addresses the clinical population of children and youth, specifically through outlining the protocol, externalizing metaphors therapy. A selective review of significant works regarding the efficacy of short-term therapy was conducted, including the process of change within narrative therapy. It is proposed that two specific processes account for the mental health change experienced by clients who receive this new treatment intervention: (1) externalization of problems and (2) purposeful client-generated metaphor manipulation, impacting upon underlying schemas. From these theoretical constructs, the present article outlines a three-session treatment protocol that manualizes these key clinical processes. A case study is presented to illustrate this intervention for anxiety and depression. Further clinical research is underway to address the testable hypotheses resulting from the current theoretical model. Clinical trials in brief psychotherapy are suggested to empirically evaluate the efficacy of this new treatment intervention for dysphoria. Copyright © 2013 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: This article outlines a short-term treatment intervention for anxiety and depression (dysphoira) through a novel 3-session model, where the clinician-practitioner can obtain competency through a one-day workshop. Its relevance for the clinical researcher and the mental health community is in its versatility in addressing internalizing behavior for four clinical populations: (1) children and adolescents; (2) children and adolescents on the autism spectrum; (3) adults in general; and, (4) adults with a dual-diagnosis. The treatment protocol described within is based upon the externalizing and deconstructive properties of Narrative Therapy, and the transformation of metaphoric imagery of Metaphor Therapy; both of which have little empirical support with narrative practices gaining international attention and widespread usage – through brief therapy, long-term therapy, and walk-in clinics in North America. For the first time, the theoretical constructs of the 3-session model are described and a case example illustrates the interlinking concepts. HubMed – depression

 

Psychiatric disorders: Astrocytic ATP in depression.

Nat Rev Neurosci. 2013 Jun; 14(6): 379
Welberg L

HubMed – depression

 

Continuity of Outpatient Treatment After Discharge of Patients With Major Depressive Disorder.

J Nerv Ment Dis. 2013 May 16;
Wang HR, Song HR, Jung YE, Woo YS, Jun TY, Kim KS, Bahk WM

PURPOSE: This study aimed to identify the predictors associated with the continuity of outpatient treatment after discharge for patients with major depression. METHODS: The medical records of patients discharged with diagnosis of major depression were analyzed. The subjects were divided into two groups based on whether they regularly visited the outpatient clinic for more than 4 months after discharge. RESULTS: The 4-month follow-up group was older, had a lower employment rate, and had a lower rate of being divorced or separated. The 4-month follow-up group had a longer duration of illness, a higher rate of recurrent major depressive disorder, older age at onset, and a longer duration of index hospitalization. Longer duration of index hospitalization and combination therapy were significantly related to an increased likelihood of 4-month follow-up visits. CONCLUSIONS: Duration of hospitalization and prescription pattern of psychotropic medication appeared to have an influence on the continuity of outpatient treatment after discharge. HubMed – depression

 

Social Cognition and Clinical Insight in Schizophrenia and Bipolar Disorder.

J Nerv Ment Dis. 2013 May 16;
Vaskinn A, Sundet K, Ueland T, Agartz I, Melle I, Andreassen OA

The association between clinical insight and social cognition assessed with an emotion perception task was investigated in schizophrenia (n = 29) and bipolar I disorder (n = 19). Persons with schizophrenia had reduced auditory emotion perception compared with individuals with bipolar I disorder, but levels of visual emotion perception and clinical insight were comparable. In the schizophrenia group, clinical insight was moderately associated with auditory and visual emotion perception (r = 0.36-0.44) and negative symptoms (r = -0.33). Better insight was associated with better social cognition and fewer negative symptoms. In the bipolar I disorder group, clinical insight showed small associations with social cognition (largest r = -0.28) and moderate to large associations with positive, negative, manic, and depressive symptoms. Poorer insight was associated with higher symptom load. Social cognition seems to be of importance for clinical insight in schizophrenia, whereas symptoms are important in bipolar I disorder. HubMed – depression