Abstract
OBJECTIVE: To report a case and to discuss the use of psychodynamic psychotherapy (PD-P) to treat individuals at ultra-high risk (UHR) of psychosis. METHODS: An individual at UHR was followed up for 24 months. The baseline evaluation included a psychiatric interview, the Structured Interview for Prodromal Symptoms (SIPS), the Scale of Prodromal Symptoms (SOPS), and neuropsychological assessment. He underwent weekly sessions of PD-P for 12 months and was followed up for 12 months after the end of PD-P. The evaluations were at baseline, after 6-, 12-, and 24-month follow-up. No medication was prescribed during the 24-month follow-up. RESULTS: The prodromal symptoms remitted. The initial total score on the SIPS/SOPS was 37 points. After the first 12 months of PD-P, there was a reduction to 12 points on the SIPS/SOPS score, which stabilized in the 24-month follow-up. There was also a slight improvement in his performance on the neuropsychological evaluations. CONCLUSION: This case report suggests that PD-P can reduce prodromal symptoms; nevertheless, a better understanding of the specificity and efficacy of PD-P as an option of treatment for UHR individuals is needed.
Highlights
One of the most significant current discussions in psychiatry is the potential beneficial aspects of early intervention in psychosis
One of the most used instruments to evaluate and diagnose ultra-high risk (UHR) subjects is the Structured Interview for Prodromal Syndromes (SIPS). It consists of a structured interview, and includes the Scale of Prodromal Symptoms (SOPS) that measures the severity of prodromal symptoms, a family history questionnaire, the Schizotypal Personality Disorder Checklist, and the Global Assessment of Function (GAF)[6]
We report a case and discuss the possibility of using PD-P as a nonpharmacological intervention in subjects with UHR for psychosis
Summary
One of the most significant current discussions in psychiatry is the potential beneficial aspects of early intervention in psychosis. Mr A, male, 22 years sought our early intervention program (ASAS, Institute of Psychiatry (IPq), University of Sao Paulo, Brazil) with his parents due to changes in behavior, difficulties in his studies, social withdrawal, and suspiciousness. He took a train to nowhere, missed several college exams, and “disappeared” for a few hours without informing his parents. This change in this behavior was attributed to adolescence by his parents He was evaluated at baseline with the Structured Interview for Prodromal Symptoms (SIPS), clinical laboratory and neuropsychological assessment at baseline, and 6-, 12-, and 24-month follow-up. We took all measures to avoid publishing information that could allow someone to recognize the identity of the patient
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