Participating in Longitudinal Observational Research on Psychiatric Rehabilitation: Quantitative Results From a Patient Perspective Study

Secondary effects of dialectical behaviour therapy on social functioning, quality of life, and autism traits in autistic adults with suicidality

The effect of psychological treatment on social functioning, quality of life and autism traits in autistic people with suicidal behaviour remains largely unknown. At six Dutch mental health centres, 123 adult outpatients with Diagnostic and Statistical Manual of Mental Disorders (5th edition) diagnosed autism spectrum condition and suicidal behaviours were randomly assigned to dialectical behaviour therapy (n = 63) or treatment as usual (n = 60) to address their suicidal behaviours. This article analysed secondary outcomes on social functioning, quality of life and autism traits. Outcomes were compared at baseline, post-treatment at 6 months, and 12-month follow-up. At post-treatment, both social functioning (p < 0.001) and quality of life (p = 0.002) were significantly improved in the treatment condition compared to the control condition and remained so at 12-month follow-up (p = 0.003; p = 0.002). Autism traits did not differ between conditions. Autistic individuals with suicidal behaviours benefit modestly from treatment with dialectical behaviour therapy in social functioning and quality of life.Lay abstractDialectical behaviour therapy is a comprehensive treatment that helps individuals improve distress tolerance, mindfulness, interpersonal effectiveness and emotion regulation. It is commonly used to assist those experiencing self-harm and suicidal thoughts or behaviours. Despite its broad application, our understanding of how dialectical behaviour therapy impacts autistic individuals with suicidal behaviour remains limited. This study compared dialectical behaviour therapy with treatment as usual in 123 autistic adults experiencing suicidal behaviours. Participants were recruited from six mental health centres, with 63 receiving dialectical behaviour therapy and 60 receiving treatment as usual. The study assessed outcomes such as social functioning, quality of life and specific autism traits over 12 months. Findings revealed that dialectical behaviour therapy led to significant improvements in social functioning and quality of life compared to treatment as usual, though there were no effects on autism traits. These improvements suggest that dialectical behaviour therapy holds promise as an effective treatment for autistic individuals grappling with suicidal behaviour. The findings strongly support the broader implementation of dialectical behaviour therapy in mental health centres, especially given the limited treatment options available for autistic individuals with suicidal tendencies.

First-episode olfactory hallucination in a patient with anxiety disorder: A case report

BACKGROUND

Olfactory hallucination refers to olfactory perception in the absence of chemical stimuli. Although it has been associated with many neurological and psychotic disorders, it has rarely been reported as the first and only symptom in patients with anxiety disorder, and its treatment remains inadequate.

CASE SUMMARY

A 66-year-old woman who had been experiencing gradually worsening olfactory hallucinations for almost 4 years was diagnosed with generalized anxiety disorder. Olfactory hallucination disappeared after treatment with anti-anxiety drugs.

CONCLUSION

Olfactory hallucination can be the first and only symptom in patients with anxiety disorder and may be effectively treated with anti-anxiety medication. In fact, it can precede the diagnosis of anxiety disorder by several years.

Acne caused by ziprasidone in a young patient with bipolar disorder: A case report

BACKGROUND

Ziprasidone is a second-generation antipsychotic drug commonly used to treat schizophrenia and bipolar disorder. Acne is a common inflammatory disease of sebaceous glands in adolescents that is often co-morbid with anxiety and depression, which may reduce treatment compliance. Through unknown mechanisms, ziprasidone may cause a range of inflammatory responses. Whether ziprasidone can cause acne in young patients with bipolar disorder has not been reported.

CASE SUMMARY

We report a 23-year-old woman with a 5-year history of bipolar disorder who experienced acne during use of ziprasidone. She was admitted to our hospital during 1-month aggravation of her symptoms and was diagnosed with bipolar I disorder (current or most recent episode of depression) with psychotic features. She was given ziprasidone and soon developed acne, which she never had before; the rash worsened substantially when the ziprasidone dose was increased. At the same time, levels of inflammatory factors increased. The rash resolved after ziprasidone therapy was stopped.

CONCLUSION

When prescribing ziprasidone to young people with bipolar disorder, clinicians should consider the potential for adverse skin reactions. It may be useful to assay levels of inflammatory markers during ziprasidone therapy and adjust the dose if necessary in order to ensure treatment compliance.