Lege Artis Medicinae

[Classical methods in modern approach. Training for the recognition of emotions using bibliotherapy-techniques]

SZABÓ József, SIPOS Mária

JANUARY 20, 2018

Lege Artis Medicinae - 2018;28(01-02)

[BACKGROUND - Nowadays it is an understood fact, that theory of mind has a great psychological significance. Deficits of theory of mind skills are observed in schizophrenia such as depression, dementia, autism and some personality disorders as well. Conceptions of theory of mind and emotion recognition ability have been coming in front at the expanse of the older empathy also in the present-day research in connection with helper connections and their effects. It is probably due to popular approach of cognitive neuroscience exact methods. METHODS - We intended to demonstrate, that the ability of emotion recognition can be developed, or partially restored, even in case of patients suffering from schizophrenia. We compiled an 8-seat training. Our method was a bibliotherapy training, each of chosen novels expressed one of basic emotions (by Ekman). After a common reading we projected validated portraits expressing also those emotions. Participants had to choose reflecting the emotional state of the characters photos. Then they shared stories from their own lives experiencing similar emotions. We measured the effectiveness of our method by the Reading the Mind in the Eyes measured (RMET) test. RESULTS - Comparing data before and after the training in t-test we detected significant difference (p=0.000608 <0.05). Verifying that the observed changes are not only the common effects of the other types of treatment, the same tests were performed on a similar in-patient treated control group. There was no significant difference between the RMET first time and two weeks later values of the control group (p=0.467). The rate of changes in the test and control group (RMET) was compared in a paired-sample t-test, and we also found a significant difference: p=0.000786 <0.005. CONCLUSIONS - The deficit of theory of mind in schizophrenia can be reduced, which indirectly can improve our patients' communication and adaptation skills, or worse, their deterioration can be reduced.]



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[Is the evolvement of schizophrenia preventable?]


[Considering the developmental nature of the majority of mental disorders, these days prevention has increasingly come into the focus of psychiatry. Schizophrenia - one of the disorders that are most frequently associated with psychosis, one of the most serious psychiatric syndromes - is the leading cause of permanent disability of the young adult generation. A prodrome lasting for several years precedes the onset of the first psychotic episode, which offers an opportunity for preventive interventions. Currently, we have two strategies for the predicition of the outburst of psychotic disorders. The Ultrahigh-risk approach can predict the first psychotic episode regardless of diagnosis, while the Basic symptom strategy predicts the development of schizophrenia specifically. However, there is an inverse relationship between the sensitivity and the specificity of different predictive criteria, which raises clinical and ethical dilemmas for the doctors. The methods of repeated assessments of the help-seeking individuals’ clinical states with designation of syndrome stages, and multivariate analyses of emprirically derived markers have proven promising tools for establishing more balance between the sensitivity and specificity of predictive criteria. Interven­tions of the secondary prevention aim to decrease the morbidity of the underlying pathomechanisms, and to help individuals’ coping with alterations of their experiences. We can consider here the psychosocial interventions as evidence based choices, which we can combine with certain food supplements and well-chosen psychopharmacons de­pending on the clinical state. With our in­terventions, we can influence the process of the individual development with vulnerable basis and steer it toward resilience. ]

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[Complementary and alternative medicine (CAM) use is increasing in the plural healthcare market of our globalized world. Aside from a healthcare market, we may also speak of a “worldview market” in which various concepts of health and illness compete with each other and in which patients strive to orient themselves. In a milieu of prolific information production, “facts” are increasingly under subjective judgement. Thus topics such as mechanisms underlying the appraisal of information sources regarding healthcare, as well as processes behind decision-making and building or losing trust have risen in significance. Orientation in the sea of information is largely determined by global trends, societal-level phenomena, as well as cultural dispositions or preferences that take root in the individual; these factors also influence therapy choice. Such preferences include that of “holism” and the “natural”, as well as a desire for initiation; these dispositions play a vital role in information processing and decision-making, for example when the patient is weighing whether to turn to a psychiatrist or a CAM specialist. ]

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