[show abstract][hide abstract] ABSTRACT: In the past, the first goal of schizophrenia treatment was to reduce psychotic symptoms, mainly positive symptoms. Recently, as a result of an emphasis on patient needs, the concept of quality of life (QoL) has been brought into the treatment. The goal has therefore changed from the alleviation of symptoms to improvement of the patient's satisfaction with social activities. Self-evaluations by people with schizophrenia were previously thought to lack reliability because of the presence of psychopathological symptoms and poor awareness of the disease. Recently the importance of evaluating the satisfaction of patients themselves, however, has been recognized in schizophrenia. Studies on this field showed us, that QoL data from patients with chronic mental illness were reliable and concluded that subjective QoL evaluation was applicable to such patients.
The purpose of the present study was to compare the QoL in patients suffering from schizophrenia in clinical remission with healthy controls and examine the extent of the effects of subjective cognitive functioning on QoL in these patients.
Data were obtained using the quality of life questionnaire (Quality of Life Enjoyment and Satisfaction--Q-LES-Q), and subjective questionnaire for cognitive dysfunction (Cognitive Failures Questionnaire--CFQ) for 40 schizophrenia patients in clinical remission and 40 healthy controls.
Cognitive function correlates negatively with subjective QoL in patients with schizophrenia.
Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 06/2011; 155(2):173-80. · 0.99 Impact Factor
[show abstract][hide abstract] ABSTRACT: Both patients and psychotherapists can experience strong emotional reactions towards each other in what are termed transference and countertransference within therapy. In the first part of this review, we discuss transference issues. Although not usually part of the obvious language of cognitive behavioral therapy (CBT), examination of the cognitions related to the therapist, is an integral part of CBT, especially in working with difficult patients. In the second part, we cover counter-transference issues. We describe schematic issues that give rise to therapist counter-transference and explain how this interacts in different types of patient therapist encounter. We also examine ways in which the therapist can use CT to help him/her modify the countertransference and, in the process, assist the patient.
PUBMED data base was searched for articles using the key words "therapeutic relations", "transference", "countertransference", "cognitive behavioral therapy", "cognitive therapy", "schema therapy", "dialectical behavioral therapy". The search was repeated by changing the key word. No language or time constraints were applied. The lists of references of articles detected by this computer data base search were examined manually to find additional articles. We also used the original texts of A. T. Beck, J. Beck, M. Linehan, R. Leahy, J. Young and others. Basically this is a review with conclusions about how therapists can manage transference issues.
Transference. The therapist should pay attention to negative or positive reactions towards him/ her but should not deliberately provoke or ignore them. He/she should be vigilant for signs of strong negative emotions, such as a disappointment, anger, and frustration experienced in the therapeutic relationship by the patient. Similarly he/ she should be alert to exaggerated positive emotions such as love, excessive idealization, praise or attempts to divert the attention of therapy onto the therapist. These reactions open space for understanding the patient's past and actual relations outside the therapy. Countertransference. The therapist should be aware of countertransference schemas as they apply to him/her. He/she should monitor his/her own feelings that indicate countertransference. Further, the assistance of and discussion with supervisors and colleagues is useful in regard to countertransference even in experienced therapists. Countertransference can be used as an open window into the interpersonal relations of the patient.
Both the literature and our experience underscore the importance of careful and open examination of both transference and counter-transference issues in CBT and their necessary incorporation in the complete management of all patients undergoing CBT.
Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 09/2010; 154(3):189-97. · 0.99 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of our study is to examine if the dissociation can influence the intensity of psychopathology in patients suffering from obsessive compulsive disorder and to compare the levels of dissociation in the groups of the patients and healthy subjects. Method. Fifty five patients suffering from obsessive compulsive disorder and 123 healthy controls were included into the study. The patients were psychiatrically assessed. The diagnosis was made using ICD-10 research criteria confirmed with structured interview MINI. The subjective intensity of anxiety and depressive symptoms was evaluated using Beck Anxiety Inventory and Beck Depression Inventory. The intensity of obsessions and compulsions was evaluated using Yale Brown Obsessive Compulsive Scale. All participants were assessed with the Dissociative Experiences Scale (DES). Results. Level of the psychological dissociation assessed with the DES was correlated with the severity of subjective anxiety (p<0.0001), depression (p<0.0001), and with the severity of obsessive-compulsive symptoms (p<0.005). Patients have significantly lower mean score on the DES than healthy controls (p<0.0001). Conclusion. Our results suggest that the level of psychological dissociation in OCD patients is lower than in healthy controls, and is associated with the severity of anxiety, depression and obsessive compulsive symptoms.
Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 06/2010; 154(2):179-83. · 0.99 Impact Factor