The New Aspect of Psychotherapy in our Clinical Psychiatric Unit: The Effort it Took to Make it work; and the First Results

Introduction

Our two units take care of a rather big number of people (about 170 000). Various activities are proposed for outpatients and the idea was expressed to initiate art therapy.

Objectives

We first analysed the possibility of starting this new mediation equally in the two units. A team was formed: a clinical psychiatrist and two registered nurses, one being an art therapist as well. We started this activity with a small group of out patients in April 2016.

Aims

The registered nurse – art therapist was provided with appropriate space, art material and furniture by hospital sources. The other unit will send the nurse for training in art – therapy: leave and grant are provided by the hospital. Her project is different and yet complementary.

Methods

The group was validated and evaluated by the art therapist and the psychiatrist. The organization of the activity is left to the art therapist. A questionnaire was filled out by art therapist before beginning the art therapy and at regular intervals.

Results

Patients are engaged by this therapy and come on regular basis. They chose painting to express themselves and leave their productions in the room after they are finished.

Conclusions

The newly opened psychotherapy – art therapy has brought many positive changes in our hospital for working staff as well as for the patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Acknowledgements

We want to thank the Chiefs of our Department of Psychiatry, Grandin Pascal, MD and Benzaken-Charlier Catherine MD for their acceptance and support of this project.

LAM study: Effects of lacosamide on behaviour and quality of life in patients with epilepsy

INTRODUCTION

Psychiatric comorbidities are common in epileptic patients, and evaluating the impact of antiepileptic drugs on patients' moods is therefore essential. The aim of this study is to assess the effects of lacosamide on behaviour and quality of life in people with epilepsy.

METHODS

We conducted a multicentre prospective observational study of poorly-controlled epileptic patients who received lacosamide as an adjuvant treatment. Patients were evaluated on 4 occasions during a 12-month period. The impact of lacosamide on patients' mood and quality of life was assessed with the Quality of Life in Epilepsy Inventory-10 (QOLIE-10), the Hospital Anxiety and Depression Scale (HADS), and the Barratt Impulsiveness Scale (BIS-11). As a secondary objective, we evaluated the effectiveness and safety of lacosamide.

RESULTS

We included 55 patients with a mean age of 47.1±18.4 years. At baseline, 34.5% of the patients had psychiatric comorbidities; the mean number of crises in the previous month was 3.6±4.3. The QOLIE-10 and HADS scales revealed statistically significant improvements in patients with a poor baseline condition (anxiety, depression, and/or poor quality of life). The BIS-11 scale detected no impulsive behaviour during follow-up. After 12 months of treatment, 51.9% of the patients were seizure-free and 77.8% experienced a reduction of at least 50% in seizure frequency. Adverse effects were mild in most cases; lacosamide was discontinued in 10 patients (18.2%).

CONCLUSIONS

Lacosamide is a safe and effective treatment option for patients with epilepsy and psychiatric comorbidities.

[Lepra: an uncommon cause of infectious neuropathy]

INTRODUCTION

Lepra is an uncommon disease within our setting. However, it was considered the most frequent cause of polyneuropathy only 50 years ago.

CASE REPORT

We present the case of a 37 year-old woman who consulted due to paresthesias in both hands and feet, livedo reticularis and complaints of frequent hand lesions. Examination of the skin detected nodular lesions and the neurophysiological study confirmed distal symmetric sensitive polyneuropathy with axonal predominance. The skin biopsy also showed histocytic infiltrate and mycobacterium lepra type intracytoplasmatic bacilli. This led to the diagnosis of Multibacillary lepromatous leprosy. Multiple treatment was begun, according to the World Health Organization recommendations, with good evolution. In spite of the attempts to eradicate lepra, its incidence continues to be elevated, especially in endemic areas, among which the south of Spain is included. It is generally associated to overcrowding and low social-economic level.

CONCLUSIONS

This is the last endemic case in the Valencian Community. The possibility of lepra should be considered among the possible causes of sensitive polyneuropathy, above all in patients in endemic areas.