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P.3.022 Efficacy of intensive behavior therapy camp for OCD patients. Part I.: Clinical results
P.3 Anxie~" disorders and anxiolytics diagnosis according to the DIS. The most prevalent comorbid conditions were dysthymia, panic disorder and major depression. 79% of the patients had never sought help from the health care services.
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Clinico-pharmacokinetic assessment of cassadan ,n persons with borderline states
I. Kupriyanova, V. Semke, T. Shushpanova, T. Novozheyeva. Mental
Health Institute, Tomsk, Russia Statement on the Purpose of the Study: To study processes of elimination of cassadan (firm AWD) in patients with borderline neuro-mental states with regard to clinical dynamics. Methods Used: Pharmacokinetics of antipirine is generally recognized test for assessment of condition of elimination processes of xenobiotypes and intermediatly serves as a pharmacokinetic indicator of benzodiazepines in blood. Assessment of parameters of pharmacokinetics of antipirine was determined according to time of elimination (T 1/2), clearance (CI+) characterizing speed of elimination of antipirine out of plasma of blood and saliva. Cassadan was administered in doses 0.75-1.5 mg a day. Healthy persons (9 persons) and a group of volunteers received cassadan (7 persons) served as controls. Results: Clinical manifestations were characterized by anxious-phobic disorders evaluated on Hamilton Anxiety Scale of 21.5 4- 2.7 scores. In 7-8 days of the therapy decrease of anxiety level was observed in men up to 8.6 4- 1.3 scores, in women up to 16 4- 1.8 scores. Haft-elimination period of antipirine (T 1/2) was in men 10.3, in women 5.7 (in control group 10.5, in volunteers 10.0). Costant of elimination was 0.065 in men and 0.120 in women (in the control group 0.068 and 0.045 in volunteers). Therapeutical efficacy was achieved on the 3-4th week quicker in men. Pharmacocinetic indices remained stable. Conclusion: Clinical efficacy of application of cassadan is determined by pharmacocinetic dynamics. In this investigation a higher level of elimination of the preparation has been exposed in women what determines a more active level of metabolization of medicines and proves relevance noninvasive medicinal monitoring.
•
Effects of D,L-kavain and kava spiss. On extracellular field potentials and long term potentiation in hippocampal slices
J.M. Langosch, J. Walden. Department of Psychiatry, University of
Freiburg, Germany Little is known about the mechanisms of action of kava pyrones. We investigated the effects of the synthetic kava pyrone D,L-kavain and of kava spissum on the CAl-region of hippocampal slices from guinea pigs. Long-term potentiation (LTP) is a widely accepted model for synaptic plasticity, with suggested involvement in learning and memory. D,L-kavain and kava spissum were found to reduce the amplitudes of extracellular field potential (fp) changes evoked by electrical stimulation in a concentration dependent manner. These effects were reversible. In other experiments LTP was evoked by tetanic stimulation. No changes with respect to baseline values were found in the presence of D,L-kavain (100 /zM). Furthermore, under the influence of kava spiss, tetanic stimulation failed to induce LTP and only small transient post-tetanic potentiations were scen. In conclusion, our findings suggest kava pyrones to be effective drugs in modulating fast excitatory synaptic transmission in the hippocampus of guinea pigs, possibly by affecting glutamate receptors. Additionally, no effects of D,L-kavain were found on LTP, because of which no alterations on synaptic plasticity in hippocampal neurons for this kava pyrone can be presumed.
~ T h e
therapy of war-traumatized adolescents
N. Ljubomirovid, M. Munjiza, S. Popovid-Deugid. The Institute for
mental health, Belgrade, FR, Yugoslavia The paper represents the analysis of therapy of adolescents affected by war traumas in the period 1992-96. Reactions of adolescents are observed
$233
in relation to kind andduration of trauma. The most prevalent symptoms are: anxiety; depressive reactions: agressive or impulsive behaviour is observed in refugee adolescents placed at boarding schools in Belgrade. Research is designed as an open clinical prospective study. Standardized instruments are used for evaluation: CGI, Organisation Interview of British Save the Children, social questionnaries; diagnostic criteria of ICD-X were included too. Sample consisted of 60 refugee adolescents 15-19 years old (x = 17.9 4- 1.8) affected by severe trauma. Combination of pharmacotherapy and reconstructive psychotherapy is applied. Besides mentioned psychosocial and psychotherapeutical treatment of patients, following combination of psychopharmacs are included: l?dM's (moclobemide), Auromid a 10, seu Aurorix 150-450 mglday, benzodiazepines (bromazepam 1.5~.5 mg/day); carbamazepiner a 40(~600 mg/day. Duration of the treatment was 90 days. At the end of clinical treatment, the best results are ibserved at combined treatment. Relating to monotherapy of psychopharmacs, statistically important difference is achieved in patients subject to combined approach (37.3:78.4% improvement}. In reactions to trauma, important difference is observed according to sex. Regarding to a great increase of traumatic adolescents, especially affected by war-trauma, where symptomatology is polymorphous, we are stressing importance of combined treatment, which proved itself (sociotherapeutical group with psychotherapeutic support, including psychopharmcs).
References Ved V.: Coping with children in stress, London 1996.
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Efficacy of intensive behavior therapy camp for OCD patients. Part I.: Clinical results
E. Luk~ics, A. Ntmeth, K. Mtrotz, K. Moln~ir, B. Bfibel. Semmelweis
Universi~' of Medicine, Haynal Imre Universi~' of Healtt~ Sciences, National Scientific Institute of Neurosurgery, Budapest, Hungary ]'he behavior therapy of patients with OCD is based on exposure to trigger stimuli and response prevention methods. The efficacy of the therapy can be increased by in vivo provision of a wide range of stimuli for long duration with simultaneous exclusion of passive and active avoidance. Based on these principles we organized an 8-day intensive behavior therapy camp for 13 patients with OCD. The majority of patients had compulsions related to washing. Patients and the therapists lived in tents. There were very limited facilities for washing in the camp and it was a highly anxiety provoking situation. The daily routine activities, performed together by patients and therapists, provided many opportunities for observation of symptomatic behavior. Spontaneous and planned behavioral interventions were possible. The therapeutic process was facilitated by thematic group sessions and special games. The efficacy of therapy was measured using the following psychometric scales: Yale-Beck Depression Inventory, Visual Analog Scale, Clinical Global Improvement Scale. Data collected on the first and last days of camp, showed that the patients improved significantly. They rem,Tined stable during the one and six months follow-up. According to our knowledge this special camp therapy was the first such a trial for the continuos, intensive behavior therapy of patients with OCD. r_-z------7 | P . 3 . 0 2 3 ] Social phobia: A follow up study D. Madaro, C. Socci, S. Nassini, E. Simonini, G. Ruffolo, L. Moretti, (3. Pemgi. Institute of Psychiatry, Universi~, of Pisa, lta(v With the aim to evaluate course and outcome of Social Phobia, we conducted a 1 year follow up study on 45 outpatients diagnosed according to DSM llI R criteria. Standardized interviews (SCID-P) ~aad rating scales (Liebowitz Anxiety Scale, etc) were administred at baseline and during the period of follow up. Longitudinal data were recorded by Longitudinal Interval Follow up Evaluation (LIFE-UP) (Keller et at., 1987). The analysis of the course of Social Phobia, by the means of life-table statistical method, highlights a progressive encrease of remission at the successive observations. We compared epidemiological and clinical features., course, family
•
Clinico-pharmacokinetic assessment of cassadan ,n persons with borderline states
I. Kupriyanova, V. Semke, T. Shushpanova, T. Novozheyeva. Mental
Health Institute, Tomsk, Russia Statement on the Purpose of the Study: To study processes of elimination of cassadan (firm AWD) in patients with borderline neuro-mental states with regard to clinical dynamics. Methods Used: Pharmacokinetics of antipirine is generally recognized test for assessment of condition of elimination processes of xenobiotypes and intermediatly serves as a pharmacokinetic indicator of benzodiazepines in blood. Assessment of parameters of pharmacokinetics of antipirine was determined according to time of elimination (T 1/2), clearance (CI+) characterizing speed of elimination of antipirine out of plasma of blood and saliva. Cassadan was administered in doses 0.75-1.5 mg a day. Healthy persons (9 persons) and a group of volunteers received cassadan (7 persons) served as controls. Results: Clinical manifestations were characterized by anxious-phobic disorders evaluated on Hamilton Anxiety Scale of 21.5 4- 2.7 scores. In 7-8 days of the therapy decrease of anxiety level was observed in men up to 8.6 4- 1.3 scores, in women up to 16 4- 1.8 scores. Haft-elimination period of antipirine (T 1/2) was in men 10.3, in women 5.7 (in control group 10.5, in volunteers 10.0). Costant of elimination was 0.065 in men and 0.120 in women (in the control group 0.068 and 0.045 in volunteers). Therapeutical efficacy was achieved on the 3-4th week quicker in men. Pharmacocinetic indices remained stable. Conclusion: Clinical efficacy of application of cassadan is determined by pharmacocinetic dynamics. In this investigation a higher level of elimination of the preparation has been exposed in women what determines a more active level of metabolization of medicines and proves relevance noninvasive medicinal monitoring.
•
Effects of D,L-kavain and kava spiss. On extracellular field potentials and long term potentiation in hippocampal slices
J.M. Langosch, J. Walden. Department of Psychiatry, University of
Freiburg, Germany Little is known about the mechanisms of action of kava pyrones. We investigated the effects of the synthetic kava pyrone D,L-kavain and of kava spissum on the CAl-region of hippocampal slices from guinea pigs. Long-term potentiation (LTP) is a widely accepted model for synaptic plasticity, with suggested involvement in learning and memory. D,L-kavain and kava spissum were found to reduce the amplitudes of extracellular field potential (fp) changes evoked by electrical stimulation in a concentration dependent manner. These effects were reversible. In other experiments LTP was evoked by tetanic stimulation. No changes with respect to baseline values were found in the presence of D,L-kavain (100 /zM). Furthermore, under the influence of kava spiss, tetanic stimulation failed to induce LTP and only small transient post-tetanic potentiations were scen. In conclusion, our findings suggest kava pyrones to be effective drugs in modulating fast excitatory synaptic transmission in the hippocampus of guinea pigs, possibly by affecting glutamate receptors. Additionally, no effects of D,L-kavain were found on LTP, because of which no alterations on synaptic plasticity in hippocampal neurons for this kava pyrone can be presumed.
~ T h e
therapy of war-traumatized adolescents
N. Ljubomirovid, M. Munjiza, S. Popovid-Deugid. The Institute for
mental health, Belgrade, FR, Yugoslavia The paper represents the analysis of therapy of adolescents affected by war traumas in the period 1992-96. Reactions of adolescents are observed
$233
in relation to kind andduration of trauma. The most prevalent symptoms are: anxiety; depressive reactions: agressive or impulsive behaviour is observed in refugee adolescents placed at boarding schools in Belgrade. Research is designed as an open clinical prospective study. Standardized instruments are used for evaluation: CGI, Organisation Interview of British Save the Children, social questionnaries; diagnostic criteria of ICD-X were included too. Sample consisted of 60 refugee adolescents 15-19 years old (x = 17.9 4- 1.8) affected by severe trauma. Combination of pharmacotherapy and reconstructive psychotherapy is applied. Besides mentioned psychosocial and psychotherapeutical treatment of patients, following combination of psychopharmacs are included: l?dM's (moclobemide), Auromid a 10, seu Aurorix 150-450 mglday, benzodiazepines (bromazepam 1.5~.5 mg/day); carbamazepiner a 40(~600 mg/day. Duration of the treatment was 90 days. At the end of clinical treatment, the best results are ibserved at combined treatment. Relating to monotherapy of psychopharmacs, statistically important difference is achieved in patients subject to combined approach (37.3:78.4% improvement}. In reactions to trauma, important difference is observed according to sex. Regarding to a great increase of traumatic adolescents, especially affected by war-trauma, where symptomatology is polymorphous, we are stressing importance of combined treatment, which proved itself (sociotherapeutical group with psychotherapeutic support, including psychopharmcs).
References Ved V.: Coping with children in stress, London 1996.
l - ~
Efficacy of intensive behavior therapy camp for OCD patients. Part I.: Clinical results
E. Luk~ics, A. Ntmeth, K. Mtrotz, K. Moln~ir, B. Bfibel. Semmelweis
Universi~' of Medicine, Haynal Imre Universi~' of Healtt~ Sciences, National Scientific Institute of Neurosurgery, Budapest, Hungary ]'he behavior therapy of patients with OCD is based on exposure to trigger stimuli and response prevention methods. The efficacy of the therapy can be increased by in vivo provision of a wide range of stimuli for long duration with simultaneous exclusion of passive and active avoidance. Based on these principles we organized an 8-day intensive behavior therapy camp for 13 patients with OCD. The majority of patients had compulsions related to washing. Patients and the therapists lived in tents. There were very limited facilities for washing in the camp and it was a highly anxiety provoking situation. The daily routine activities, performed together by patients and therapists, provided many opportunities for observation of symptomatic behavior. Spontaneous and planned behavioral interventions were possible. The therapeutic process was facilitated by thematic group sessions and special games. The efficacy of therapy was measured using the following psychometric scales: Yale-Beck Depression Inventory, Visual Analog Scale, Clinical Global Improvement Scale. Data collected on the first and last days of camp, showed that the patients improved significantly. They rem,Tined stable during the one and six months follow-up. According to our knowledge this special camp therapy was the first such a trial for the continuos, intensive behavior therapy of patients with OCD. r_-z------7 | P . 3 . 0 2 3 ] Social phobia: A follow up study D. Madaro, C. Socci, S. Nassini, E. Simonini, G. Ruffolo, L. Moretti, (3. Pemgi. Institute of Psychiatry, Universi~, of Pisa, lta(v With the aim to evaluate course and outcome of Social Phobia, we conducted a 1 year follow up study on 45 outpatients diagnosed according to DSM llI R criteria. Standardized interviews (SCID-P) ~aad rating scales (Liebowitz Anxiety Scale, etc) were administred at baseline and during the period of follow up. Longitudinal data were recorded by Longitudinal Interval Follow up Evaluation (LIFE-UP) (Keller et at., 1987). The analysis of the course of Social Phobia, by the means of life-table statistical method, highlights a progressive encrease of remission at the successive observations. We compared epidemiological and clinical features., course, family