No abstract

attachment is a promising area for elucidating psychosocial mechanisms important for development, prevention, and treatment of schizophrenia. This report gives a short summary of studies of attachment in psychosis. it was found that dismissing and disorganized forms of attachment were over-represented in psychosis. evidence pointed to associations between a dismissing attachment pattern and positive psychotic symptoms, negative symptoms, and poor engagement with services. Furthermore, insecure attachment was found to predict impaired recovery from negative symptoms. possible major risk processes in development linking dismissing attachment to symptom development were externalizing and deactivation of affects and poor mentalization. For a disorganized form of attachment, possible risk mechanisms were heightened stress-sensitivity and dissociation. Based on this initial evidence, further research in attachment in psychosis focusing on these risk mechanisms seems warranted. in addition, the evidence supported a focus on attachment-related risk processes to enhance the prevention and treatment of psychosis.

Editorial S1 Context and cooperation S3 Responsibility S4 Composition of the Guideline Group S4 Autonomy S4 Aims and method S4 Multimedication guideline S5 Summary S6 Prescription process S6 General measures for reducing undesirable multimedication S7 Multimedication guideline S8 Aims and target groups of the guidelines S8 Explanation S8 Key questions for general practitioners This journal is included in the abstracting and indexing coverage of the Bio-Sciences Information Service of Biological Abstracts, and is listed in Current Contents (Life Sciences), MEDLINE, International Pharmaceutical Abstracts, EMBASE/Excerpta Medica, Elsevier BIOBASE/Current Awareness in Biological Sciences, SCOPUS. All articles published in the International Journal of Clinical Pharmacology and Therapeutics must be contributed to it exclusively. The following types of papers are acceptable: original papers, outline summaries of special problems, letters to the editor, short news items on new developments and other topics of current interest. All experimental data should be obtained from humans. Animal and in vitro investigations can be published only occasionally and only on condition that they have a close relationship to human pharmacological investigations. The editor responsible reserves the right of selection from submitted manuscripts (after consulting at least two reviewers) and the right to make stylistic changes or abridgements. The manuscripts may not be submitted elsewhere for printing or publication; following acceptance the publisher acquires all copyrights.

During recent decades, the field of treatment of schizophrenia has lacked empirical, systematic outcome studies that support psychodynamic psychotherapy as an evidence-based intervention for patients with schizophrenia. The Danish schizophrenia project (DNS) compared psychodynamic psychotherapy for psychosis with standard treatment in patients with a first-episode schizophrenia spectrum disorder. The study was designed as a prospective, comparative, longitudinal multi-site investigation of consecutively referred patients who were included during two years. The patients were treated with either manualized individual supportive psychodynamic psychotherapy (SPP) in addition to treatment as usual or with treatment as usual alone (TaU). Symptoms and functional outcomes were measured using the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning scale (GAF). The study included 269 consecutively admitted patients, age 18-35, of whom 79% remained in the study after two years. The intervention group improved significantly on measures of both PANSS and GAF scores, with large effect sizes at two years follow-up after inclusion. Further, improvement on GAF(function) (p = 0.000) and GAF(symptom) (p = 0.010) significantly favored SPP in combination with TaU over TaU alone. In spite of limitations, this study speaks in favor of including supportive psychodynamic psychotherapy in the treatment for patients with schizophrenic first-episode psychoses.

Integrated treatment and supportive psychodynamic psychotherapy in addition to treatment as usual may improve outcome after 1 year of treatment for people with first-episode psychosis, compared with treatment as usual alone.