Læknablaðið : fylgirit - 01.08.2003, Qupperneq 26

Læknablaðið : fylgirit - 01.08.2003, Qupperneq 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
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