Motilin-and neuropeptide Y-like immunoreactivity in a psychophysiological stress experiment on patients with functional dyspepsia

Background  The aim of the study was to compare plasma motilin-like immunoreactivity (MOT-LI) and neuropeptide Y (NPY)-like immunoreactivity (NPY-LI) in patients with functional dyspepsia (FD) during a controlled psychophysiological experiment. Method  25 patients (12 men, 13 women), age 24–50, with recurrent FD, and 25 pair-wise sex- and age-matched community control subjects were studied. In an experiment, after a rest period, subjects were studied during a 15-min stress interview. The aim of the interview was to elicit anxiety. Before and during the intervention blood samples were drawn for peptide analyses. Outcome measures were the Gastrointestinal Symptom Rating Scale, fasting blood glucose, heart rate and blood pressure as well as the subjects’ self-ratings on visual analogue scales. The plasma concentrations of MOT-LI and NPY-LI are given as anti-logarithms. Results  Mean plasma MOT-LI concentration was 7.3 (CI: 5.7–9.4) pmol/L in the patient group, and 7.9 (CI: 6.1–10.2) pmol/L in the control group. Mean plasma NPY-LI concentration was 14.2 (CI: 12.3–16.4) pmol/L in the patient group, and 13.4 (CI: 11.8–15.3) pmol/L in the control group. Using ANCOVA (covariates: group, gender, age, body mass index and smoking) MOT-LI was related to lower indigestion symptomatology (p<0.04) and positive change in joyfulness during the interview (p<0.03). In the patient group delta motilin correlated with increased joyfulness (p<0.03) and decreased sadness (p<0.03). The NPY-LI increase during the interview was related to higher fasting blood glucose before the interview (p<0.01) and a stronger increase in systolic blood pressure during the test (p<0.05). Conclusion: During a stress interview plasma MOT-LI is positively related to less indigestion symptomatology and joyfulness, while changes in plasma NPY-LI were positively related to sympathetic nervous system activity, but not to gastrointestinal symptoms.     

Guided Internet-Based CBT for Common Mental Disorders

The Internet has become a part of most people’s lives in many parts of the world. Since the late 1990s there has been an intensive research activity in which psychological treatments, such as cognitive behavior therapy (CBT), have been found to be effective when delivered via the Internet. Most research studies indicate that the effects are larger when some form of guidance is provided from a therapist, and unguided treatments tend to lead to more dropout and smaller effects. Guided Internet treatments often consists of book length text materials, but can also include other components such as audio files and video clips. Homework assignment is often included and feedback is given for completed homework. Guided Internet-based CBT (iCBT) has been found to work for problems such as depression, panic-, social anxiety-, and generalized anxiety disorders. There are many research trials in which participants have been recruited via media, and there has been less research conducted in representative clinical settings. Most research has been conducted on adults and in university settings with nationwide recruitment. There is a need for treatments and studies on older adults, children and adolescents. In conclusion, dissemination of the research findings on guided iCBT to regular clinical settings is warranted.     

Invited commentary on the interview with Jan Stensson

Abstract

The potential of psychoanalysis as social criticism is explored in the context of the major social divides of gender, sexual orientation, race, social class, and ethnicity. It is argued that these divides play central roles in constructing individual psyches, and that their influence is inseparable from other social/ familial forces. Further, analyst and patient alike, inevitably enact the imperatives of class, race, gender, and sexuality in the analytic dyad. It is crucial that psychoanalytic theory be extended to account for the formative power of these cultural categories both in the construction of individual identity, and on the course of analytic work. Further, individual psychoanalysts must be aware of cultural countertransference in the analytic engagement. Finally, as a profession we have an obligation publicly to oppose the destructive imperatives of our economic, political, and social systems in the interest of individual and community psychic well-being.     

Historiography and psychoanalysis

Abstract

The act of writing the history of psychoanalysis poses crucial questions with regard to the openness of society. This article examines the fundamental issues faced by researchers when they set about writing the history of psychoanalysis in a specific country. The significance of reconstructing features of the psychoanalytical practice is discussed. The opposition that exists between the current academic ideals and those of the psychoanalytic societies is outlined with reference to the changes that society has undergone, particularly during the past 30 years. In this context, the stance maintained by psychoanalysts with regard to psychiatry, academic psychology, and the university education of psychotherapists is defined. Government accreditation processes for psychologists and psychotherapists are likewise illustrated in the light of the opinions held by psychoanalysts at different moments in time.