Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 26

I ABSTRACTS / 27TH NORDIC PSYCHIATRIC CONGRESS
Method: The sample comprised 55 patients. Character was assessed
with the Karolinska Psychodynamic Profile, and relationship pat-
terns with the Core Conflictual Relationship Theme. The DSM-III-
R, self-report questionnaires assessing symptoms and personality
were used. Thirty-six patients who engaged in psychotherapy com-
pleted follow-up assessments 6 months after treatment termination,
and 10 patients, who did not enter treatment, completed follow-up
assessments 3 years after intake. The psychotherapists involved
were all well trained and had long professional experience.
Results: After long-term psychotherapy, patients reported a de-
creased level of character pathology and symptomatic suffering, as
well as improved relationship patterns. There were, however, very
few significant associations between change in character and
change in symptoms or maladaptive relationships. Duration of
treatment and frequency of sessions were not related to change.
Conclusions: The patients benefited from treatment, but neither
the psychoanalytic theory regarding a close association between
character, symptoms and relationship patterns, nor the psychoana-
lytic theory of structural change received support from our results.
S-IV/1 Thursday 14/8,11:00-12:30
Psychodynamic personality profile in early severe mental
disorders
Jyrki Heikkila MD, Psychiatric Services, City of Turku and Department of Psychiatry,
University of Turku, Turku, Kunnallissairaalantie 20, rak. 4, FIN-20700 Tlirku, Finland.
Hasse Karlsson, Hilkka Virtanen, Raimo K.R. Salokangas
jyrki.heikkila@turkii.fi
Objective: Personality may alter liability/vulnerability, manifesta-
tion, and course of a disorder. The aim of this study was to investi-
gate how enduring psychodynamic personalily traits are associated
with psychopathology in early severe mental disorders.
Methods: The study included 61 successive patients suffering from
their first episode of schizophrenia, bipolar disorder or severe
niajor depression. Personality was assessed with the Karolinska
Psychodynaniic Profile (KAPP) -interview, including 18 items.
Results: Personality profile differed only weakly a) in the three
diagnostic groups, b) in patients with and without schizophrenia,
and c) in patients with and without psychosis. However, in a logistic
regression adjusting for age, sex, and diagnosis, several KAPP items
were strongly associated with symptoms clusters derived from the
BPRS. The cluster including emotional withdrawal, psychomotor
retardation, and blunted affect had the most frequent associations
with the KAPP items.
Conclusions: We found no significant evidence of a diagnosis-speci-
fic psychodynamic personality profile in severe mental disorders.
Certain personality traits may predict negative emotional symp-
toms in a manifest disorder. A comparison with a non-psychiatric
control group from another study suggests that there may be
significant dysfunctional personality traits which are common to all
severe mental disorder groups in our study.
S-IV/2 Thursday 14/8,11:00-12:30
Screening for prodromal symptoms of psychosis
Hcininiaa M, Research Psychiatrist, University of Turku, Department of Psychiatry,
Kunnallissairaalantie 20, SF-20700 Turku, Finland. Salokangas RKR, Huttunen J,
Rekola J, Heinisuo AM, Ristkari T, McGlashan TH.
markus.heinimaa@utu.fi
Background: In connection with the DEEP-study we developed the
PROD-screen, an instrument for screening for prodromal sympto-
matology, both for self-rating and telephone interviews. According
to the data from this study PROD-screen functions well with mixed
samples and with first degree relatives of schizophrenic patients,
being able to distinguish prodromal cases (as defined by SIPS
instrument, McGlashan) from noncases. However, when used in
clinically highly relevant population of new psychiatric outpatients,
PROD-screen scores do not differentiate between SIPS positive
and SIPS negative cases, presumably due to high Ievels of symp-
toms reported in this sample in general. This is a major drawback as
clinical samples probably contain a higher base rate of true pro-
dromal cases, only effective screening is achieved.
Aims: We developed this screening procedure to more qualitative
direction by also including reports of verbal responses to symptom
queries presented in the screen, and using these verbal responses as
the basis for deciding screen positivity.
Method: On all symptom questions responded with “Yes” the
subject was asked to give a detailed description of what kind of
symptom prompted him/her to respond positively. The evaluation
of these symptom descriptions was made independently by two
experienced psychiatrists, who made a consensus decision on which
subjects were asked for more extensive research interview.
Rcsults: We have screened new attenders to psychiatric open care
systematically and as for now 406 screens have been evaluated.
Positive predictive value of positive screening result for prodromal
state according to SIPS has been 61%.
Condusion: Adding evaluation of qualitative data to PROD-screen
makes it a powerful tool for detecting prodromal syndromes.
S-IV/3 Thursday 14/8, 11:00-12:30
General health and vulnerability to psychosis
Korkcila JA, Clinical Lecturer, Psychiatric Clinic, Univeristy of Turku, Kunnallissairaa-
lantie 20,20700 Turku, Finland. Suomela T, Heinimaa M, Huttunen J, Ristkari T, Plathin
M, Salokangas RKR.
jyrki. korkeila@postikaista.net
The sample comprises 157 subjects from the Detection of Early
Psychosis project. The SIPS was used as a gold standard to deter-
mine the presence of vulnerability to psychosis. The psychiatric
diagnoses were made according to SCID. General health and re-
lated symptoms were also probed. There were significant differen-
ces between those without psychiatric symptoms (58%) and those
witli mild psychiatric symptoms (9%), those vulnerable to psychosis
(1 %) or psychotic (16%) in respect to reporting excellent general
health (p<0.01). There were no significant differences between the
groups pertaining to diagnosed CNS illnesses. The level of general
26 L/EKNABLAÐIÐ / FYLGIRIT 48 2003/89