Though the prevalence for PIMs and side effects was high in old aged psychiatric inpatients and outpatients, PIMs could not be identified as major determinants of overall unwanted side effects. Nevertheless, prescription of PIMs should be minimized, especially of hypnotic drugs, to improve safety.
Psychotherapeutic treatments of borderline personality disorder (BPD) often focus on severe behavioral problems. Until now, few techniques have been developed to specifically address low self-esteem in BPD. We developed a 6-session psychoeducative group therapy module to treat low self-esteem in BPD patients. After developing and piloting the therapy module, a controlled outpatient pilot study was performed. Nineteen female BPD patients participated in the group module after discharge from an inpatient DBT program. Twenty-four female BPD patients served as controls. Outcome was assessed by different self-esteem measures. Results showed a greater improvement in self-esteem in the intervention group. The findings suggest that the therapy module is an effective adjunctive treatment in increasing self-esteem in BPD.
We report about a patient (66 years) who was referred to our psychiatric hospital because of a progressive confusional state with acute onset. The colleagues of the referring psychiatric hospital considered a first manic episode as the cause of the symptoms and under therapy with haloperidol the confusional state had shown a progression.The clinical examination's findings were a mild central facial paresis on the right side and a mild hemiparesis on the right side with elevated reflex levels.The patient was disoriented, he had cognitive and mnestic deficits. His reasoning was slowed, incoherent and perseverating. The patient had a slight euphoria.An EEG recording showed a continuous regional EEG-seizure pattern. In combination with the clinical symptoms we diagnosed a nonconvulsive status epilepticus. Under anticonvulsive treatment with Lorazepam and Valproic acid the status epilepticus sustended but a control EEG recording showed signs of a Valproate-encephalopathy. Under treatment with Topiramate symptoms ameliorated but due to a vascular dementia the patient still showed fluctuating symptoms of cognitive and mnestic disturbances.
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