[Group therapy for alcohol-dependent patients using autobiography reconstruction]
SZABÓ József, GEREVICH József
AUGUST 20, 2010
Lege Artis Medicinae - 2010;20(08)
SZABÓ József, GEREVICH József
AUGUST 20, 2010
Lege Artis Medicinae - 2010;20(08)
[A group therapy method was built on results of previous researches using narrative psychological approaches. Our primary technic was narative restructuring. Alcohol addicted patients’ language expression mode of their autobiographies was modulated similar to recovering ones’. We supposed it had therapeutic effect, that could be measured by the Hopelessness Scale (HS) and the Means Ends Problem Solving Test (MEPS). We recorded the tests before and after the therapeutic process, and the differences of their datas were compared (t-test) to similar ones from control persons, who participated in any other group therapy. Significant difference was experienced. Our method reduced hopelessness and increased problem solving more effectively, than other group therapies.]
Lege Artis Medicinae
[INTRODUCTION - Some of the recent researches based on analyses of autobiographies pointed out, that the quality and the quantity of our social relations are in connection with our life longevity, and the frequency of words referring social roles and integration gives a respective measurement possibility of it. Conception of the term “social words” had been introduced. The influence of the degree of social support to the recovery from alcohol addiction is also a well-known phenomenon. Based on the above we supposed that examining their autobiography vocabularies we find special differences which can show the distinction between the social support of the relapsed and recovering addicted persons. We planned to prove the being of these special differences via revealing bias of the frequency and pattern of social word usage. PATIENTS AND METHODS - Two separate groups were created for purpose of the examination. The first consisted of relapsed alcohol dependent persons, who were treated in hospital (department of addiction psychiatry) diagnosed alcohol-dependent (F 10.2) (and nothing else) at least twice within a year (N=30). We chose earlier treated (because of alcohol-dependency, and nothing else mental disease) persons who had been being abstinent for at least 2 years into the second group (N=20). Beside the earlier diagnosis we used the parts of the ASI test to sreen any other mental diseases. We created similar groups with regards to gender, age and qualification. We collected autobiographies from the persons, and made two common documents of them. Afterwards we compared these documents by the Atlas.ti 5.0 (trial free version) content analysing software. We defined the frequency of the found social words in the rate of these words and the sum of the words in the whole text. We found the most prominent difference between the frequency of social words referring to the family and relatives, opposite the words dealing with friendship. RESULTS - In the latter case we could not detect any difference between the two groups. We got results confirming our hypothesis in the frequency of such words as “help”, “love”, “give” and “get”. We experienced in connection with the pattern that the words referring to social organisations, for example “team”, “community”, “company”, “club”, “meeting”, “collective” and the word “guest” practically did not appear (R<0.001) in the texts of relapsed persons, while they could be detected in the case of the recovering group (R=0.023). We did khisquare test to compare the frequency in the mentioned categories and we experienced significant differences between the social word usage of the two groups. CONCLUSION - Our results confirmed that the recovery from alcohol addiction was related to the quality and quantity of person's social relations, what we can get relevant information from the frequency of social words in the autobiographies about, so the high frequency of the social words can be considered as a good predictor of recovery.]
Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.
Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.
Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithymia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share common pathology of neuroanatomical structures. We hypothesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship between WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.
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