Research on the prevalence, diagnostic and prognostic value for treatment of personality pathology – i.e., both personality disorders and problematic personality characteristics – was... Show more Research on the prevalence, diagnostic and prognostic value for treatment of personality pathology – i.e., both personality disorders and problematic personality characteristics – was carried out within a mainly Dutch forensic mental health setting. Issues such as (dis)simulation and unintentional self-deception limit the utility of self-report instruments within a pre-trial setting. Personality disorders and psychopathic traits in suspected offenders in the Netherlands often lead to court rulings of enforced psychiatric treatment – an internationally unique situation. A prospective study on the predictive value of personality disorder isolated factors that can affect enforced treatment length, such as crime type and comorbidity, that can be a focus for policy makers and forensic mental health experts. Caution is advised when using self-report instruments within the forensic context, especially in the absence of response bias scales and in the case of (legal) incentives for certain outcomes. There is urgent need for international standardization of instruments and terminology and a test battery that is specifically designed for and validated within forensic populations. An increase in (detail of) digital registration of patient, treatment and risk characteristics is necessary for meaningful scientific research, a better assessment of personality and risks, fewer incidents, lower recidivism and shorter treatment. Show less
The general aim of this thesis is to investigate small fiber neuropathy in sarcoidosis and to asses whether ARA290 is a possible new agent to treat the neuropathic complaints in sarcoidosis... Show moreThe general aim of this thesis is to investigate small fiber neuropathy in sarcoidosis and to asses whether ARA290 is a possible new agent to treat the neuropathic complaints in sarcoidosis population. The results of the various ARA290 trials in painful sarcoidosis are discussed. Painful neuropathy is common, difficult to treat complication.The limited efficacy of current treatment options dictates a rationalized design of novel compounds. ARA290 treatment was consistently associated with a significant improvement of neuropathic pain symptoms in sarcoidosis patients, evidenced by a decrease in pain scores on validated questionnaires. Moreover,ARA290 treatment resulted in significant increases in corneal nerve fibers, improved sensory pain thresholds,improved quality of life and physical functioning. Given the excellent safety profile while reducing neuropathy symptoms,the prospects of ARA290 treatment in sarcoidosis related neuropathy seem promising.The long lasting beneficial effects of ARA290 on both pain related and non pain related symptoms in sarcoidosis patients prompt additional studies on potential disease modifying properties of ARA290. The data collected so far suggest that ARA290 will be equally effective in SFN associated with other syndromes, including diabetes mellitus. Show less
Nooij, L.S.; Brand, F.A.M.; Gaarenstroom, K.N.; Creutzberg, C.L.; Hullu, J.A. de; Poelgeest, M.I.E. van 2016
Parents are increasingly viewed as key to successful child (semi-) residential treatment. Positive outcomes for both the parents as the child with a psychiatric disorder are more likely to occur... Show moreParents are increasingly viewed as key to successful child (semi-) residential treatment. Positive outcomes for both the parents as the child with a psychiatric disorder are more likely to occur when effective levels of therapeutic alliances exist between team members and parents. Unfortunately, it remains unclear from the literature, how the establishment of the parent-treatment team alliance best contributes to child residential treatment outcome. Therefore, a more systematic approach is needed to help practitioners.The aim of this thesis is threefold: 1. Development of assessment strategies (instruments) of the parent-team alliance, 2. Longitudinal investigation of the relation between parent-team therapeutic alliance and semi-residential treatment outcome factors and 3. Examining the effect of strengthening the parent-team alliance on (semi-) residential treatment outcomes. Routine Outcome Monitoring was implemented at five semi-residential treatment units of Curium-LUMC, a Centre for Child and Adolescent Psychiatry. All newly admitted children and their parents, 46 children (6-12 years old) in total, were included in the ROM assessment. Results showed: 1)Alliance instruments are capable of assessing the parent-team alliance; 2)Parent-team alliance, parental stress and child'symptoms are interconnected, and 3)A structured investment of team members in the parent-team alliance strenghtens this alliance and positively indfluences childs'symptoms. Show less
Creemers-Schild, D.; Kroon, F.P.; Kuijper, E.J.; Boer, M.G.J. de 2016
We observed high cure rates of PCP by treatment with intermediate-dose TMP-SMX. In addition, a step-down strategy to low-dose TMP-SMX during treatment in selected patients appears to be safe and... Show moreWe observed high cure rates of PCP by treatment with intermediate-dose TMP-SMX. In addition, a step-down strategy to low-dose TMP-SMX during treatment in selected patients appears to be safe and does not compromise the outcome of treatment. Show less
Aardoom, J.J.; Dingemans, A.E.; Furth, E.F. van 2016
Background: In Europe, the number of females exhibiting oppositional defiant disorder (ODD) and conduct disorder (CD) is growing. Many of these females live in youth welfare institutions.... Show moreBackground: In Europe, the number of females exhibiting oppositional defiant disorder (ODD) and conduct disorder (CD) is growing. Many of these females live in youth welfare institutions. Consequently, there is a great need for evidence-based interventions within youth welfare settings. A recently developed approach targeting the specific needs of girls with ODD and CD in residential care is START NOW. The aim of this group-based behavioural skills training programme is to specifically enhance emotional regulation capacities to enable females with CD or ODD to appropriately deal with daily-life demands. It is intended to enhance psychosocial adjustment and well-being as well as reduce oppositional and aggressive behaviour. We present the study protocol (version 4.1; 10 February 2016) of the FemNAT-CD intervention trial titled 'Group-Based Treatment of Adolescent Female Conduct Disorders: The Central Role of Emotion Regulation'. Methods/design: The study is a prospective, confirmatory, cluster-randomised, parallel-group, multi-centre, randomised controlled trial with 128 institutionalised female adolescents who fulfil the diagnostic criteria of ODD and/or CD. Institutions/wards will be randomised either to provide the 12-week skills training as an add-on intervention or to provide treatment as usual. Once the first cycle is completed, each institution will run a second cycle with the opposite condition. Primary endpoints are the pre-post change in number of CD/ODD symptoms as assessed by a standardised, semi-structured psychiatric interview (Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime, CD/ODD section) between baseline and the end of intervention, as well as between baseline and a 3-month follow-up point. Secondary objectives include pre-post change in CD/ODD-related outcome measures, most notably emotional regulation on a behavioural and neurobiological level after completion of START NOW compared with treatment as usual. Discussion: To our knowledge, this study is the first to date to systematically investigate the effectiveness of an adapted integrative psychosocial intervention designed for female adolescents with ODD and CD in youth welfare settings. Trial registration: German Clinical Trials Register (DRKS) identifier: DRKS00007524. Registered on 18 December 2015 and with the World Health Organisation International Clinical Trials Registry Platform. Show less
