PubMed Health⌕ Search

Biomedical subjects

M Rudden

Publications and source records attributed to M Rudden.

10 recordsLinked to original sources

How treating psychoanalysts respond to psychotherapy research constraints.

The psychoanalytic community increasingly recognizes the importance of research on psychoanalytic treatments, yet a significant number of psychoanalysts continue to believe that research is either irrelevant to psychoanalysis or impossible to accomplish. Psychoanalysts who accept the value of research express concern that intrusions required by research protocols create significant distortions in the psychoanalytic process. The authors, all psychoanalysts, are studying the outcome of a brief (twenty-four-session) psychodynamic treatment of panic disorder. They report their experiences and struggles with the intrusions of videotaping, working with a treatment manual, and time-limited treatment. This research process required them to question old beliefs and to confront feelings of disloyalty toward their analytic training and identity, particularly with regard to keeping a "clean field" and routinely performing long-term analysis of character. The therapists' psychoanalytic knowledge, however, emerged as crucial for them in managing specific research constraints. Despite concerns about providing inadequate treatment, therapists were found to engage patients with psychoanalytic tools and focus in vibrant and productive therapies that led to significant improvements in panic symptoms and associated quality of life. The authors suggest that psychoanalysts have been overestimating the potential damage of research constraints on psychoanalytic process and outcome.

Adult↗

A pilot open trial of brief psychodynamic psychotherapy for panic disorder.

This is a complete report of an open trial of manualized psychodynamic psychotherapy for treatment of panic disorder, Panic-Focused Psychodynamic Psychotherapy (PFPP). Twenty-one patients with PD were entered into a trial of twice-weekly, 24-session treatment. Sixteen of 21 experienced remission of panic and agoraphobia. Treatment completers with depression also experienced remission of depression. Improvements in symptoms and in quality of life were substantial and consistent across all measured areas. Symptomatic gains were maintained over 6 months. This report was prepared specifically to describe 6-month follow-up on these patients. Psychodynamic psychotherapy appears to be a promising nonpharmacological treatment for panic disorder.

Adult↗

Open trial of psychodynamic psychotherapy for panic disorder: a pilot study.

OBJECTIVE: This report contains preliminary data from an open trial of brief psychodynamic psychotherapy for panic disorder. METHOD: Fourteen patients with primary DSM-IV panic disorder completed a 24-session, twice-weekly course of psychodynamic psychotherapy. Other psychiatric treatment was not permitted throughout the 12-week treatment period and the 6-month follow-up. Symptoms were assessed at baseline, treatment termination, and 6-month posttermination follow-up (40 weeks). RESULTS: Statistically significant, clinically meaningful improvements appeared in panic, depression, anxiety, and functional impairment both at treatment termination and at 6-month follow-up. CONCLUSIONS: Psychodynamic monotherapy can be used successfully to retain and treat patients with panic disorder. Psychodynamic interventions warrant further study for patients with panic disorder.

Adult↗

Oedipal dynamics in panic disorder.

Both research and clinical work have revealed factors that can lead to the onset and persistence of panic disorder. Preoedipal conflicts intensify the danger of oedipal longings for panic patients. Competition with the same-sex parent is linked with angry preoedipal fantasies and associated fears of disruption in attachments. Fantasies or actual successes can thus trigger panic episodes. Regression to a helpless, dependent state such as panic defends against the danger of aggressive, competitive fantasies and actual achievements. However, the regressive state can also be experienced as dangerous, and can be linked with frightening homosexual fantasies. A reactive aggressive oedipal stance can sometimes result, triggering escalating turmoil. The panic episode serves a series of compromise formations in dealing with these conflicted wishes.

Adult↗

Diagnosis and clinical course of erotomanic and other delusional patients.

Twenty-eight patients with erotomanic delusions were compared with 80 patients with other delusions to clarify questions about diagnosis and course of illness in erotomania. The erotomanic patients were a heterogeneous group with respect to both diagnosis and course. They had significantly more manic symptoms than the comparison group and more affective diagnoses than would be expected from the literature; 25% (N = 7) had schizoaffective disorder and 7% (N = 2) had bipolar disorder. A subgroup of monodelusional erotomanic patients was identified who met the DSM-III-R criteria for delusional disorder, thus supporting the decision to include erotomanic delusions in this diagnostic category in the revision of DSM-III.

Adolescent↗

A comparison of delusional disorders in women and men.

The authors compared delusional disorders in men and women and found that women have more frequent erotic and heterosexual delusions, more affective symptoms, and more interpersonal precipitants and that men have more delusions with a homosexual theme. Perhaps because of these differences in delusional content and affective symptoms, delusional women are more difficult to diagnose within the DSM-III nomenclature than are delusional men. The authors discuss these findings from psychodynamic, ethologic, and sociocultural perspectives and suggest ways of improving DSM-III to make it more representative of female patients.

Adult↗

Delusions: when to confront the facts of life.

Research indicates that patients do not hold delusions with as fixed a certainty as has been believed. Confrontation with reality may have an important role in the evaluation and treatment of delusional patients. The authors suggest four factors that may help predict the value of reality confrontation in a given clinical situation: 1) how understandable the delusion is in the context of the patient's life, 2) the degree of conviction with which the patient holds the delusion, 3) the phase in development of the delusional beliefs, and 4) the diagnosis of the patient.

Adaptation, Psychological↗

Psychiatric manifestations of sarcoidosis.

The case of an acutely depressed 34 year old man with a history of systemic sarcoidosis is presented with the question of the psychiatric manifestations of sarcoidosis in mind. The literature on Central Nervous System Sarcoidosis is reviewed and the possibility that this condition may present with psychiatric symptomatology is raised. An emphasis is placed on maintaining a high index of suspicion regarding organic factors in cases such as this, particularly in the setting of a complex, multi-system disease such as sarcoidosis.

Adult↗