Psychiatric Treatment Centers Research Articles

Effectiveness of Neurofeedback Therapy on Emotional Processing, Irrational Beliefs, and Aggression in Female Patients with Generalized Anxiety Disorder

Objective: The present research aimed to examine the effectiveness of neurofeedback therapy on emotional processing, irrational beliefs, and aggression in patients with generalized anxiety disorder. Method: This study was a quasi-experimental pre-test, post-test, and follow-up design with a control group. The research population comprised all women with generalized anxiety disorder visiting psychiatric treatment centers in Golpayegan in the first half of 2019, from which 30 female patients were purposefully selected based on inclusion criteria and randomly assigned to either the experimental or control groups. The experimental group received eight 30-minute sessions of neurofeedback therapy. Meanwhile, the control group did not receive this intervention during the research process. The questionnaires used in this research included the Spitzer Generalized Anxiety Scale (2006), the Baker Emotional Processing Scale (2007), the Jones Irrational Beliefs Questionnaire (1968), and the Buss and Perry Aggression Questionnaire (1992). Data were analyzed using repeated measures analysis of variance with SPSS-24 software. Findings: The results of the data analysis indicated that neurofeedback therapy significantly affected emotional processing (F=10.89, P<0.001), irrational beliefs (F=10.83, P<0.001), and aggression (F=8.16, P<0.008). Conclusion: Given the confirmed effectiveness of neurofeedback therapy on emotional processing, irrational beliefs, and aggression in patients with generalized anxiety disorder, it is recommended that workshops be organized to familiarize counselors and therapists more thoroughly with the principles and techniques of this treatment in the field of this disorder.

Urban vs. rural differences in psychiatric diagnoses, symptom severity, and functioning in a psychiatric sample.

Identifying whether certain groups of people experience elevated rates or severities of psychiatric symptoms provides information to guide healthcare allocation. People living in urban areas have higher rates of some psychiatric disorders relative to people living in rural settings, however, it is unclear if psychiatric severity is more elevated in urban vs. rural settings. This study investigates the urban vs. rural differences in rates of psychiatric disorders and severity of psychiatric symptoms. A cohort of patients (63% women, 85% White) presenting to an outpatient psychiatric treatment center in the U.S. completed patient-reported outcomes at all clinic visits as part of standard care. Rurality was determined by municipality population density. Sociodemographic characteristics, psychiatric diagnoses, trauma exposure, psychiatric symptom severity, functioning, and suicidality were compared by rural vs. urban municipality. There were virtually no differences between patients living in rural vs. urban municipalities on rates of psychiatric disorders, severity of psychiatric symptoms, functional impairment, and suicidality (ps≥.09). The only difference was that patients living in rural municipalities had higher exposure to serious accidents than patients living in urban municipalities (p < .01); exposure to nine other traumatic events did not differ between groups (p≥.07). People living in urban and rural municipalities have a similar need for mental health treatment. Access to care may be one explanatory factor for the occasional rural-urban differences in rates of psychiatric disorders. In other words, if people living in rural areas can access care, their symptom presentations appear unlikely to differ from those of people living in urban areas.

Evictions and psychiatric treatment.

Stable housing is critical for health, employment, education, and other social outcomes. Evictions reflect a form of housing instability that is experienced by millions of Americans each year. Inadequately treated psychiatric disorders have the potential to influence evictions in several ways. For example, these disorders may impede labor market performance and thus the ability to pay rent, or increase the likelihood of risky and/or nuisance behaviors that can lead to a lease violation. We estimate the effect of local access to psychiatric treatment on eviction rates. We combine data on the number of psychiatric treatment centers that offer outpatient and residential care within a county with eviction rates in a two-way fixed-effects framework. Our findings imply that 10 additional psychiatric treatment centers in a county lead to a reduction of 2.1% in the eviction rate.

Prescribing Practices at a Residential Treatment Center – from Paper to Plastic (Computers)

ABSTRACT Medication prescription procedures were reviewed at psychiatric residential treatment centers (RTC), and a quality improvement project was conducted in order to implement integrated electronic medical records (EMR) and computerized provider order entry (CPOE). To assess the impact of preexisting prescribing practices on RTCs, surveys were sent anonymously to current and past providers of regional and local RTCs. The surveys assessed the impact of the prescribing protocol on workflow, the frequency of medication errors, the impact such errors had on patient care, the overall provider satisfaction, and the discrepancies between electronic and paper charts. Current providers were then re-surveyed after implementing the integrated CPOE system in May 2020, during the COVID-19 pandemic. The first round of provider survey results revealed that the majority of staff (n = 10, 70%) observed frequent medication errors and were largely dissatisfied with the current medication ordering and administration process (n = 10; 70%). Incident Response Improvement System (IRIS) reports revealed the most common medication errors were omissions, incorrect dosing, and incorrect medications administered. After the initiation and implementation of the CPOE, staff satisfaction increased with the process (n = 14; 50%) noting that medication errors were less frequent than before (n = 14; 50%).

Effectiveness of Acceptance and Commitment Therapy (ACT) on Emotional Processing, Irrational Beliefs and Rumination in Patients with Generalized Anxiety Disorder

Background and Aim: Generalized Anxiety Disorder is one of the most common anxiety disorders. The purpose of this study was to investigate Effectiveness of Acceptance and Commitment Therapy (ACT) on Emotional Processing, Irrational Beliefs and Rumination in Patients with Generalized Anxiety Disorder. Methods: The research method was quasi-experimental pretest-posttest with a control group. 30 patients with generalized anxiety disorder referred to daily psychiatric treatment centers in Golpayegan in the first half of 2019 were selected and randomly assigned to experimental and control groups. The experimental group received Acceptance and Commitment Therapy program in 8 sessions of 90 minutes. However, the control group did not receive this intervention during the research process. The questionnaires used in this study included Spitzer Generalized Anxiety Disorder Scale (2006), Baker Emotional Processing Scale (2007), Jones Irrational Beliefs Questionnaire (1968), Nolen-Hoeksema and Morrow (1991) Rumination Questionnaire. The data were analyzed by analysis of covariance using SPSS 24 software. Results: The results of data analysis showed that Acceptance and Commitment Therapy has significantly influenced Emotional Processing (p&lt;0.001), Irrational Beliefs (p&lt;0.001) and Rumination (p&lt;0.001). Conclusion: Considering the effectiveness of acceptance and commitment-based therapy on emotional processing, irrational beliefs and rumination in patients with generalized anxiety disorder, it is suggested that training workshops be held to become more familiar with the principles and techniques of this training for counselors and therapists active in the field of this disorder.

Evaluating the Effectiveness of Short-term Clinical Guideline to Treat Sexual Addiction Disorder in People With Sexual Addiction: A Clinical Trial

Objectives Sex addiction is one type of behavioral addiction that is characterized by extreme fantasies and hard-to-control sexual behaviors. This disorder causes problems in the lives of affected people and their victims. The treatment is non-pharmacological and psychological, which are time-consuming and expensive. Short-term interventions are one of the ways to help these people. This study aims to evaluate the effectiveness of short-term clinical guidelines to treat sexual addiction disorder in affected individuals. Methods This was a randomized clinical trial study with pre-test-post-test and follow-up. The studied population in this research included all people with sexual addiction disorder who live in Isfahan City, Iran. The statistical population was those who had the chance to be included in the study. These were individuals who were referred to outpatient and residential drug abuse treatment centers, psychiatric treatment centers, and sexual disorders treatment clinics. Using the balance block randomization method, 30 male subjects who were diagnosed with sex addiction disorder based on the cut-off point of the hypersexual behavior inventory (HBI) with a score of 53 and above were randomly divided into 2 intervention and comparison groups. The intervention group received ten 120-min therapy sessions held weekly. Because of the coronavirus pandemic, the treatment sessions had to be held virtually (Skype). The comparison group was put on hold so that they could benefit from the treatment if the guide was effective. Both groups completed the HBI three times. The first time was immediately before the treatment, the second time immediately after the intervention, and the third time 3 months later in the follow-up phase. The results were analyzed via repeated measures analysis of variance (RM-ANOVA) in the SPSS software, v. 22. Results In the present study, there were 30 patients with a sexual addiction disorder, of which 15 were in the intervention group and 15 were in the comparison group (the Mean age of the participants was 26.4 years). The Mean scores of HBI in the intervention group in the pretest, post-test, and follow-up stages were 67, 49, and 57, respectively, while the mean scores of HBI in the comparison group were 64, 60, and 59 for the pretest, post-test, and the follow-up, respectively. Repeated measurement findings showed that this clinical guideline is effective in reducing participants’ sexual addiction symptoms (P‌&lt;‌0.01). Conclusion Clinical guideline for short-term treatment of sexual addiction disorder is effective in reducing the symptoms of sexual addiction disorder. Using this method, which can be held online, and considering its short time and reduced cost of treatment, allows more people to benefit from it.

Adverse Childhood Experiences: Piloting a Group Therapy Program Using Psychoeducation, Music Therapy, and the Creative Arts for Adults with Complex Concurrent Disorders in an Inpatient Setting

Research shows a significant correlation between adverse childhood experiences (ACEs) and later adult mental health and addiction issues. There is currently no literature on therapeutic interventions to begin to redress their complex issues. Mental health, psychiatric, and addiction treatment centers often avoid tackling the manifold roots of dysfunction in clients' lives. We present the implementation of group therapy for clients with significant ACE histories, inspired by an initial in-service for clients on the subject of ACEs in mental health and addictions. Establishing group therapy for a broad spectrum of adverse childhood events proved to be an ambitious yet rewarding task. We discuss developing a comprehensive curriculum with a psychoeducational focus, a trauma-informed lens to support symptom management and resilience, and expressive elements by incorporating music therapy and the creative arts because of emerging evidence of the need for trauma recovery to engage in expressive and embodied outlets. Group observations and anecdotal evidence from clients' evaluations of the group support the urgent need for moving from research findings on ACEs to the implementation of group therapy.

Depression facilitators from the perspective of Iranian patients with major depressive disorder: a qualitative research

BackgroundMajor depressive disorder is the most common psychological disorder and affects many people worldwide. Therefore, it is important to identify the factors that cause or facilitate this disorder.ObjectivesThe aim of this qualitative study was to identify the facilitating factors of depression from the perspective of Iranian patients with major depressive disorder.MethodsThis qualitative study was conducted by content analysis method. Data were collected via purposeful sampling (maximum variation sampling) by conducting semi-structured interviews until reaching data saturation. In-depth interviews were conducted with 12 participants, including patients with major depressive disorder and their families in Razi Psychiatric Training and Treatment Center in Urmia (RPsTT) from November 2018 to February 2020. The process of data analysis was based on the Landman and Grenheim method. The accuracy and trustworthiness of the data were obtained through the Lincoln and Guba criteria.ResultsThe analysis of interviews with the participants indicated four major categories: a. Environmental factors (approved by 8 participants), b. Attitudinal factors (approved by 12 participants), c. Economic factors (approved by 9 participants) and d. Situational factors (approved by 10 participants).ConclusionIn order to prevent major depressive disorder or to reduce the signs of this disorder and improve these patients quality of life, paying attention to the facilitating factors from patient’s perspective based on their community culture can be effective. Among facilitating factors, attitudinal factors have the most impact on the incidence and exacerbation of this disorder from the perspective of patients.

Microbial Induced Autoimmune Inflammation as a Cause of Mental Illness in Adolescents: A Case Series

The incidence of mental health disorders in adolescents continues to rise. The cause of the increase in mental illness is multifactorial, including both environmental and biological causes. To investigate the latter, ten adolescents at a psychiatric residential treatment center in Colorado with the DSM-5 diagnosis of major depressive disorder (MDD), of whom seven were additionally diagnosed with generalized anxiety disorder (GAD), were chosen at random for further serologic study. Testing revealed exposureto group A Streptococcus(GAS) in 2 of 10 (20%); Borrelia Burgdorferi sensulato (Bbsl)in 2 of 10 (20%); and Bartonella speciesin 3 of 10 (30%). In addition, 9 of 10 (90%) subjects had abnormal Cunningham Panels, which measures levels of antineuronal antibodies that have been associated with psychiatric disturbances. Given the degree of psychological dysfunction in these adolescents requiring intensive residential treatment, this case series lends support to the hypothesis that exposure to infectious agents may play a role, perhaps by autoimmune mechanisms, in the significant and ongoing rise in the rate of neuropsychiatric illness in adolescents. This preliminary report adds to this premise and requires further investigation.

Drug addiction profile and monitoring liver functions tests of addicts at a specialized psychiatric treatment center

Drug addiction profile and monitoring liver functions tests of addicts at a specialized psychiatric treatment center

An Embodied Artistic Inquiry into Attachment-Oriented Therapeutic Relationships

In this study, I utilized an embodied artistic inquiry self-study to explore my experience of attachment in the therapeutic movement relationships (TMR) created as a dance/movement therapy intern at a psychiatric residential treatment center for children. The research was guided by three questions: How do I experience the TMR with children in a psychiatric residential treatment setting using attachment theory? How is my personal attachment style influencing and guiding the therapeutic relationship? How does my identification of salient moments relate to my own attachment style and aesthetic preference? Data were collected using journal entries that reflected on the researcher’s experience of attachment, saliency, and Tortora’s D.A.N.C.E. qualities of attachment (Clin Soc Work J 38(1):37–50, https://doi.org/10.1007/s10615-009-0254-9, 2010). I analyzed the data using discussion and Authentic Movement with a research consultant in order to synthesize and describe the experience of each salient moment. Repeated movements included grounded and unstable walking, changing of levels, core-distal movements, circling and carving arms, and recuperation. The themes that resulted from repeated movements and discussion with the research consultant include foundational movements, holding discomfort, connection to a specific client, and playfulness. These results reinforced the importance of stability and self-awareness for a therapist especially in relationship to how their movement and nonverbal preferences may have been learned from attachment relationships. Furthermore, results show the impact of saliency and the clinician’s aesthetic preference. In addition, the results reflected the strong relationship among nonverbal qualities of attachment and the TMR. These results suggested that qualities of attachment underlie the effectiveness of the TMR. Although limitations of the study prevented me from drawing correlative conclusions, the therapist may be able to strengthen the therapeutic relationship by targeting primary attachment models, and suggestions for further research are included.

21.5 USING DBT TO IMPROVE FUNCTIONAL OUTCOMES IN A PSYCHIATRIC RESIDENTIAL TREATMENT CENTER

Adolescents residing in a psychiatric residential treatment center (RTC) often experience comorbid behavior issues, which are influenced by untreated or undertreated mental health disorders. Optimal rehabilitation of these patients requires minimizing problem behavior and improving functioning. Unfortunately, evidence-based treatment (EBT) models for attaining meaningful change in this population are scarce. In an effort to improve outcomes at the RTC, DBT—an EBT for adolescents at high risk for suicide and significant behavioral problems—was implemented. Our a priori hypothesis was that adolescents at the RTC who received DBT would have better overall functioning compared to adolescents at the RTC who received treatment as usual.

Access to and use of health and social services among people who inject drugs in two urban areas of Mozambique, 2014: qualitative results from a formative assessment

BackgroundPrior to 2014, data about health seeking behaviors or service uptake for People who inject drugs (PWID) in Mozambique did not exist. We present the results from the formative assessment component of the Biological and Behavioral Survey (BBS).MethodsStandardized interview guides were used during key informant interviews (KII) and focus group discussions (FGD) in Maputo and Nampula/Nacala to discuss issues related to risk behaviors and access to and utilization of health and social services by PWID. The target sample size was not defined a priori, but instead KII and FGD were conducted until responses reached saturation. Data analysis was based on the principles of grounded theory related to qualitative research.ResultsEighty-eight respondents, ages 15 to 60, participated in KIIs and FGDs. Participants were majority male from diverse income and education levels and included current and former PWID, non-injection drug users, health and social service providers, peer educators, and community health workers. Respondents reported that PWID engage in high-risk behaviors such as needle and syringe sharing, exchange of sex for drugs or money, and low condom use. According to participants, PWID would rather rent, share or borrow injection equipment at shooting galleries than purchase them due to stigma, fear of criminalization, transportation and purchase costs, restricted pharmacy hours, personal preference for needle sharing, and immediacy of drug need. Barriers to access and utilization of health and social services include distance, the limited availability of programs for PWID, lack of knowledge of the few programs that exist, concerns about the quality of care provided by health providers, lack of readiness as a result of addiction and perceived stigma related to the use of mental health services offering treatment to PWID.ConclusionsMozambique urgently needs to establish specialized harm reduction programs for PWID and improve awareness of available resources. Services should be located in hot spot areas to address issues related to distance, transportation and the planning required for safe injection. Specific attention should go to the creation of PWID-focused health and social services outside of state-sponsored psychiatric treatment centers.

Effectiveness of Schema Therapy in Psychological Distress, Body Image, and Eating Disorder Beliefs in Patients with Anorexia Nervosa

Background and Objective: Due to the role of recognition in eating disorders, the identification of core beliefs and cognitive schemas becomes debatable. This study aimed to determine the effectiveness of schema therapy in psychological distress, body image, and eating disorder beliefs in anorexic patients. Materials and Methods: This was an applied quasi-experimental study with a pretest and posttest design and control group. The statistical population of the study included patients with an eating disorder, attending the psychological, clinical psychiatric, and obesity treatment centers in Ahvaz, Iran, within the age range of 16-23 years in 2019. The subjects were selected using the purposive sampling method. In this study, the pretest (i.e., filling out the Eating Disorder Beliefs Questionnaire [EDBQ]) was performed before the schema therapy intervention. Then, the intervention was conducted on the experimental group; however, no intervention was carried out for the control group. After the termination of the treatment sessions (12 sessions of 45 min), the posttest was performed. Finally, 3 months following the termination of the treatment, the follow-up test was conducted. The data were obtained using the EDBQ, Psychological Distress Questionnaire, and Body Image Concern Inventory. The data were analyzed using multivariate analysis of covariance and SPSS software (version 22). Results: The results of the present study showed that schema therapy led to a decrease in psychological distress (F=157.36, P&lt;0.0001, Eta=0.89), body image concern (F=8.03, P&lt;0.001, Eta=0.29), and eating disorder beliefs (F=13.85, P&lt;0.0001, Eta=0.91). Conclusion: It can be concluded that schema therapy reduces psychological distress, body image concerns, and eating disorder beliefs

The Role of Childhood Abuse Experience and Early Maladaptive Schemas in Predicting Impulsivity Among Patients with Psychiatric Disorders

Background: The lifelong consequences of child abuse encompasses mental health problems, to have experience of child abuse and early maladaptive schemas (EMSs), could result to impulsive behavior, in a wide range of psychiatric disorders. Objectives: This study aimed to examine the role of childhood abuse experience and EMSs in predicting impulsivity among patients with psychiatric disorders in Zahedan, Sistan and Baluchestan Province, Iran. Patient and Methods: The present research was a descriptive-analytical study. The research sample included 151 patients referring to psychiatric treatment centers. The sampling process was carried out following a pilot study, and the samples were selected from the patients who referred to psychiatric treatment centers in Zahedan from December 30, 2017 to July 29, 2018. The participants then filled out Barratt Impulsiveness scale (BIS-11), the short version of Young Schema questionnaire (YSQ), and Mohammadkhani’s Child Abuse questionnaire (CASRS). The collected data was analyzed with SPSS software version 21, using descriptive statistics (i.e., frequency, mean, and standard deviation), and inferential statistics (i.e., stepwise linear regression model). Results: The result showed that there was a significant positive correlation between childhood abuse and EMSs with impulsivity. Disconnection/rejection and other-directedness could predict motor impulsiveness (F = 38.17, p < 0.001). On the other hand, cognitive impulsiveness could be predicted by neglect and disconnection/rejection (F = 18.60, P < 0.001). Impaired autonomy, performance and impaired limits were also the predictors of non-planning impulsiveness (F = 39.73, P < 0.001). Conclusions: Childhood abuse experience and EMSs may lead to inefficient interpersonal relationships, risky behaviors, self-harm, harmful behaviors towards others, and decreased mental health during an individual’s lifetime.

The Alcoholism Treatment Centre in Bratislava-Dúbravka – Its Establishment and Operation

BACKGROUND: In post-war Czechoslovakia, as in other countries, alcoholism was one of the gravest social problems. In addition to medical interventions, legislative and organisational measures were needed to deal with this problem, including the creation of specialised facilities for the long-term treatment of alcoholics. AIMS: To shed light on the process of the establishment and shaping of the Alcoholism Treatment Centre of the Municipal Institute of National Health in Bratislava-Dúbravka and to analyse its activities over the period 1961-1966. METHOD: This work is based on the study and content analysis of original archive materials, especially those stored at the Slovak National Archive in Bratislava, as well as focused articles from the specialist literature of the period. The authors’ aim is to place the Alcoholism Treatment Centre in Bratislava-Dúbravka into the legislative and institutional developmental framework of the battle against alcoholism in Czechoslovakia and in Slovakia. RESULTS AND CONCLUSION: Since the attention of psychiatric clinics and departments was especially dedicated to the treatment of acute complications linked to alcoholism and other addictions, the establishment of specialised facilities for the long-term treatment of alcoholics was a very valuable step. The Alcoholism Treatment Centre of the Municipal Institute of National Health in Bratislava- -Dúbravka was founded in 1961 by Michal Turček, MD, who headed it until 1965. The centre, with a capacity of 25 beds, provided comprehensive healthcare to patients with an alcohol addiction. In addition to the inpatient care, the centre also included outpatient care with alcohol counselling and sobering-up centres. After the Treatment Centre closed in 1966, its inpatient section was transferred to the Regional Psychiatric Treatment Centre in Pezinok. Despite its short-lived operation, the activity of the Treatment Centre was considered to have made a positive contribution, and it represents a significant period in the development of the prevention and treatment of alcoholism in Slovakia.

Comparison of Primary Incompatible Schemas with Regard to the Age Gap of Sisters in People with the Major Depressive Disorder with Normal People

Objective : The purpose of this study was to compare the primary incompatible schemas with respect to age range among people with the major depressive disorder and normal people.Research Method: the post-traumatic (event) research method and the statistical population included two groups of the major depression with normal people in Tehran. Among them, a group of 30 patients chose to refer to psychiatric treatment centers and counseling centers with available sampling method (for groups with the major depressive disorder) and a group of 30 patients’ accompaniment (rellies (مخفف relatives ) by classification randomly (for the normal group) method. The research tools consisted of a questionnaire of the primary incompatible schemas of Young's short form and questionnaire of the demographic information. Data were analyzed by multivariate analysis of variance (MANOVA). Results: The results of the analysis showed that in all subscales of the primary incompatible schemas, except the subscales of sacrifice, obedience, and magnanimity, were significantly different between the two study groups (P <0.01). Also, logistic regression analysis showed that 34 to 45% of the major depressive disorder was explained by the subscales of the primary incompatible schemas.Conclusion: It seems that consideration of such variables plays an important role in the primary and secondary prevention, and it is necessary for psychologists and counselors to pay attention to these variables in clinical and counseling environments. Keywords: The Primary Incompatible Schemas, Age Difference, The major Depressive Disorder. DOI : 10.7176/RHSS/9-10-09 Publication date :May 31 st 2019

The Evolution of Psychological Testing at the Austen Riggs Center: A Theoretical Analysis

ABSTRACTTheoretical perspectives on personality and the development of psychopathology have shifted markedly over the last 7 decades. However, it remains unclear how those changes affect mental health practice. Comprehensive and conscientiously recorded reports of psychological testing provide a clear window on this process because they comprise distinctive records of how patients are assessed and understood. For this study, we conducted an exploratory, qualitative analysis of the narratives of the testing reports over the past 65 years at the Austen Riggs Center, a private psychiatric hospital and residential treatment center, to assess changes over time and to evaluate the influence that various factors had on the reports. The data revealed significant changes in psychologists' ways of assessing and conceptualizing personality and identity, adaptive functioning, and psychological development. Additionally, we evaluated how the evolving theoretical influences, such as institutional, professional, and sociohistorical factors affected the psychologist's model of psychopathology and development. This study raises important questions about how theoretical innovations affect clinical practice over time.

Prescribing patterns of psychiatric drugs in major depressive disorder – Findings from a large European multicenter, cross-sectional study

IntroductionThe multicenter, cross-sectional survey summarizes the current prescription patterns of psychopharmacological medications in patients with major depressive disorder (MDD) treated in European university psychiatric centers.MethodsThe study included a total of 1181 MDD patients who were recruited in 9 academic sites across 8 European countries. Socio-demographic, clinical, and psychopharmacological characteristics were collected within a detailed clinical interview and the current depressive symptom severity was measured by the Montgomery and Åsberg Depression Rating Scale (MADRS). Symptom reduction during the present MDD episode was analyzed by calculating retrospective MADRS scores. Descriptive statistics, analyses of variance (ANOVAs), and Spearman correlation analyses were performed to examine the impact of various features on the applied pharmacological strategies.ResultsRegarding first-line antidepressant medication, the most frequently prescribed drug classes were selective serotonin reuptake inhibitors (SSRIs) (53.4%), serotonin-norepinephrine reuptake inhibitors (SNRIs) (23.6%), noradrenergic and specific serotonergic antidepressants (NaSSAs) (8.2%), tricyclic antidepressants (TCA) (5.1%), and the melatonergic antidepressant agomelatine (5.0%). The most commonly used individual antidepressants were escitalopram (18.4%), venlafaxine (15.2%), sertraline (12.9%), paroxetine (9.1%), mirtazapine (8.2%), duloxetine (7.0%), and fluoxetine (6.5%). Among the patients, 59.4% were treated with polypsychopharmaceutical medications (mean: 2 drugs) and for the number of individual drugs, we found a significant correlation with the present MADRS total score and the MADRS total score change during the current depressive episode.ConclusionConsistent with surveys investigating primarily municipal psychiatric treatment centers, we could replicate the observation that SSRIs are the most commonly used antidepressants in MDD for the first time for European university centers.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Photographer’s Images Reach Out Across Half a Century

Back to table of contents Previous article Next article Association NewsFull AccessPhotographer’s Images Reach Out Across Half a CenturyAaron LevinAaron LevinSearch for more papers by this authorPublished Online:3 Jan 2017https://doi.org/10.1176/appi.pn.2017.1a26AbstractA dive into the archives of Psychiatric News finds that a picture can replace a plethora of words. This article is part of a series marking the 50th anniversary of Psychiatric News.A group of children pulling sleds in the snow. A teenage boy standing alone as ghostly, blurred figures pass in the background. A girl running through tall grass. Another in sunglasses on a rainy day. Children exploring a beach, backlit by a sparking sea. A girl leaning against a white marble sculpture of a mother and child. Is she sad or comforted? The ambiguity only adds to the allure of the photograph.The series of evocative images appeared in 1966 and 1967 in Psychiatric News in advertisements for New York’s Psychiatric Treatment Center for Adolescents. Each included a single, black-and-white photograph with—unusual for an advertisement—a credit line for the photographer: Arthur Leipzig.Leipzig, a native New Yorker who lived from 1918 to 2014, had dropped out of high school and was working in his uncle’s glass factory when someone suggested that he visit the Photo League, a photography collective that also taught the craft and art of image making. The Photo League was an incubator for many documentary photographers in the 1930s, 1940s, and 1950s, today seen as a golden age of the genre.“That changed his life,” his widow, Mimi Leipzig, told Psychiatric News. “He said, ‘When I walked in there, I knew that’s what I was going to do.’”Leipzig eventually got a job on the socially conscious newspaper PM, famous for using photography generously and for allowing its photographers great creative leeway in their choice of subjects. He later worked for International News Service before becoming a freelancer. For three decades, he taught generations of photography students at Long Island University.For more photos, click here.©Estate of Arthur Leipzig, Courtesy of Howard Greenberg Gallery, New YorkSome of Leipzig’s most enduring photos are of young people at play on the streets of New York, images that preserve a memory of a now-bygone city. In 1996, the Museum of the City of New York mounted a solo exhibition of his work focusing on that age group called “Growing Up in New York.”None of the young people in the ads were patients. Leipzig occasionally used his children and their friends as models in his photographs, some of which were used in the ads for the Psychiatric Treatment Center, said Mimi Leipzig. “Our daughter was a very good actress.”The Psychiatric Treatment Center was an inpatient facility on East 80th Street, founded in the 1960s by three psychiatrists: Julian Barish, M.D., George Naumberg, M.D., and Bruce Buchenholz, M.D. It closed in the 1980s, and the building is now a home for people with dementia.The center’s treatment model was called Program Therapy, recalled Gretchen Buchenholz, M.A., the widow of Bruce Buchenholz, in an interview.“Because teens were not so good at talk therapy, the idea was to have therapists engage them in sports and hobbies they enjoyed,” she said. The teens could choose from activities like woodworking, horseback riding, bowling, sailing, skating, bicycling, sewing, painting, boxing, weightlifting, and others. The therapists would use the activity to reinforce the psychiatrists’ treatment plan, said Gretchen Buchenholz. “The children’s activity became a kind of metaphor for what they were struggling with internally.” The psychiatrists and the photographer became close.“Arthur was creative, artistic, sensitive, and kind,” Buchenholz said. “He understood human beings and was able to express that in his art.” ■A selection of Arthur Leipzig’s photographs is posted on the website of the Howard Greenberg Gallery. “Program Therapy for Inarticulate Adolescents” by Joseph Zacker, M.A., and Bruce Buchenholz, M.D., appeared in Psychiatric Services in September 1967. ISSUES NewArchived