Deep Brain Stimulation is an increasingly viable, well-established treatment for medication refractory obsessive-compulsive disorder. Yet, its neuromodulatory effects on the brain have led to varying and opposing neuroethical debates about its potential influence on a range of phenomena such as human agency, sense of nonauthenticity and identity.

Establish the importance of maintaining the psychotherapeutic alliance in a long-term DBS patient who reported minimal device side effect and no brain-technology interface interpersonal issues; yet struggled with a paradoxical phenomenon of psychic distress surrounding issues of agency and identity, not through device implantation, but through morphology of cognitions from negativistic interpersonal dynamics and spousal victim-blaming due to the necessity for such a device.

Case-report of a 60+-year-old gentleman with a history of childhood-onset, treatment refractory OCD with a 15-year history of bilateral DBS lead placed via a ventral caudate/ ventral striatum trajectory through the anterior limb of the internal capsule to the nucleus accumbens.

Years later he was only minimally improved above baseline; yet now with a few-years increasing degree of distress over a perceived atrophy of his capabilities that he felt was validated through what he described as his failure of artificial bionics. Extensive device setting re-optimization did not improve efficacy and with supportive therapy, the DBS device was weaned, and turned off.

The following year the therapeutic foci were on interpersonal identity, existential acceptance of breakthrough symptoms, and engagement of spouse into marital counseling leading to subsequent resolution of distress with improved quality of life.

No significant relationships.

Postpartum and peripartum depression are debilitating disorders that impact the mother and their ability to care for their children’s emotional, social, and physical needs. Current treatments include psychotherapy, pharmacotherapy, and electroconvulsive therapy. These treatments are moderately effective or come with side effects that can negatively impact mother and child. As a result, many mothers view some treatments as unacceptable while pregnant or breastfeeding. Over the last decade, repetitive transcranial magnetic stimulation (rTMS) has shown promise as an effective and safe treatment option for postpartum and peripartum depression. However, little is known regarding people’s knowledge and attitudes towards this emerging technology, with no research assessing this in Canada.

We aim to identify gaps in knowledge and to assess attitudes toward rTMS as a treatment for postpartum and peripartum depression in mental health professionals, patients, and the general public living in Canada.

A mixed methods study design will be employed. The qualitative portion will consist of individual semi-structured interviews. An inductive thematic analysis will be completed. The quantitative portion will consist of an anonymous, self-administered survey shared through REDCap. Focus groups with rTMS experts will be conducted to inform survey creation.

No resulst at this time.

Understanding gaps in knowledge and attitudes toward rTMS is the first step toward ensuring that everyone is well informed and able to access safe and effective treatments. With limited treatment options available to a postpartum and/or peripartum depression patients being well informed on all treatments is crucial towards accessing treatments that best suit their needs.

No significant relationships.

Catatonia is one of the most common severe motor syndromes, with an estimated prevalence among psychiatric inpatients of about 15 %. Benzodiazepines and electroconvulsive therapy (ECT) are the most widely studied treatment methods recommended as first-line therapy. We present the case of a 55-year-old female patient with paranoid schizophrenia and severe life-threatening catatonia who remitted under a short series of rTMS.

s. Introduction

The point of resting motor threshold (RMT) for the musculus rectus femoris was determined for the left hemisphere. A straight line 3 cm anterior and parasagittal from that point defined the SMA. A total of three sessions, each with 1000 pulses at intensity 66 % of the RMT, were performed within 24 and 120 hours apart. Stimulation protocol was set to 1Hz in the area of the left SMA with 25 series of 40 pulses, pulse width 25 ms, angle of attack 45°. Hardware: MagVenture, 8-coil “cool-B65 butterfly-shaped coil from Medtronic.

Within 24 hours after the first session, a marked improvement of catatonic symptoms like independent locomotion and verbal communication was recognized. One week after the whole rTMS treatment, a food intake without a gastric tube was possible.

The present case demonstrates that pronounced catatonia may be successfully treated with inhibitory rTMS. Our results underline the importance of non-invasive brain stimulation as a valuable addition to the existing treatment spectrum for catatonia. Future research is empowered to path the way for a significant expansion of treatment.

No significant relationships.

Electroconvulsive therapy (ECT) is a medical treatment for those patients with high suicide risk or refractory psychiatric disorders. It is currently a safe technique, and its effectiveness has been widely demonstrated.

Presentation of a clinical case about a patient with drug-resistant delusional disorder and high suicide risk, who eventually received ECT treatment.

Bibliographic review including the latest articles in Pubmed about ECT procedure, effects and use.

We present a 45-year-old man, who visited different doctors several times by reporting he had the feeling of “having a brain tumor or a vascular disorder”, so he requested imaging tests (computed tomography and magnetic resonance). These tests were absolutely normal, but he kept thinking something was wrong, and eventually attempted suicide by hanging (his family founded him before it was too late). The patient was admitted to hospital, and started psychopharmacological treatment, with minimal response. He desperately insisted that he had “something inside his head”. At this point, it was proposed to start ECT, and the patient accepted. After 6 bilateral ECT sessions, he was visibly more relaxed and less worried, and he no longer presented autolytic ideation. He was still a little bit suspicious about the feeling of having a neurological disease. Currently, the patient runs a follow-up consultation.

Electroconvulsive therapy is a safe and effective technique for those patients with high suicide risk. It may be useful to perform imaging tests in certain cases, for detecting intracranial pressure, acute hemorrhage, tumors… A follow-up of these patients must be performed

No significant relationships.

Intelectual disability is an illness with an important burden on patients and caregivers, especially when severe and when comorbidities such as other psychiatric disorders are present. There are case reports of treatment resistant self-aggression, agitation, epilepsy, catatonia and psychosis successfully treated with electroconvulsive therapy although controlled studies were not found.

This work reviewed the current evidence for the use of electroconvulsive therapy in the management of patients with intellectual disability as well as its ethical and methodological implications.

Non-systematic review of the literature with selection of scientific articles published in the past 20 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “electroconvulsive therapy”, “intellectual disability”.

Patients with intellectual disability can have incapacitating comorbilities that greatly impair quality of life, and may require withdrawl from the community Treatment often differs from the general population as psychotropic medication can worsen other comorbilities. Electroconvulsive therapy can be a relevant treatment option for comorbidities in this population due to its safety profile. Ethical considerations should be taken into account, especially with non-verbal patients or when adequate representatives have not been chosen or cannot be reached. Different legal challenges may be present on different countries.

Electroconvulsive therapy and intellectual disability share the burdens of heavy stigma and low investment. Intellectual disability and it’s commorbidites present both a diagnostic and treatment challenge. Electroconvulsive therapy is an important weapon capable of restoring patients to their families and diminishing the burdens of caregivers and healthcare systems

No significant relationships.

Depressive symptoms are common in individuals with tinnitus, however, the mechanisms of their interaction are not fully understood. There is neurobiological evidence that might help understanding the interplay between tinnitus and depression which, in turn, helps in making the right choice for treating both conditions.

This case report describes a 70-year old female patient that presented with tinnitus and depressive symptoms lasting for the past 5 years.

The patient showed limited treatment results with different antidepressants. The otorhinolaryngologist ruled out any possible somatic causes of her tinnitus. Tinnitus was causing her sleep disturbances, which worsened her everyday functioning that was already quite poor even further.

After being administered with 30 rounds of TMS, her symptoms either completely resolved or at least reached a level that was adequate for her to start functioning normally on a day-to-day basis.

TMS is a technique that provides non-invasive cortical stimulation, more specifically, when used for depression treatment it stimulates the left dorsolateral prefrontal cortex, a brain region synaptically connected to the limbic system involved in mood regulation that is proven to be hypoactive in depression. The limbic system is where tinnitus-related brain networks and regions involved in the pathophysiology of depression overlap. Further research is needed to deepen the understanding of this topic.

No significant relationships.

Differentiation of targets for psychotherapy allows determining certain ways and priorities in psychological treatment of a patient.

To work out a multi-level system of psychotherapeutic targets for clinical groups of cardiac surgery patients (CSPs).

Clinical and psychological analysis of 152 CSPs who were to undergo different types of cardiac surgery treatment.

We have established four levels of psychotherapeutic targets: a patient’s response to surgery, psychopathologic manifestations, personality’s dysfunctional characteristics, and social interaction specificities. Towards CSPs with open-heart coronary artery bypass grafting, the targets appeared to be as follows: low expectations from surgery, low hopes for recovery, low level of satisfaction with life, depressive disorders with somatic manifestations, cognitive abnormalities, anxiety manifestations, manifestation of hostility, rejection of the past, inclination for fatality, reduced vitality, reduced social activity, expectation of help from closest people.Towards CSPs indicated to open-heart aortic valve repair surgery, psychotherapeutic targets were as follows: high expectations from surgery; moderate fear of death; not feeling well; low spirits; depressive disorders with somatic and cognitive-and-affective manifestations; cognitive abnormalities; anxiety manifestations; manifestation of hostility; rejection of the past; reduced hedonism; expectation of help from closest people; reduced social activity. Towards CSPs indicated to minimally invasive surgery, we set such targets as: moderate expectations from surgery; apparent fear of death; depressive disorders with somatic manifestations; anxiety manifestations; cognitive abnormalities; rejection of the past; expectation of help from closest people; reduced social activity.

Psychotherapy of CSPs that includes the established targets can contribute to personalized approach in a patient’s treatment.

No significant relationships.

Peritoneal dialysis (PD) is an equal method of treating patients with end stage renal disease ( ESRD). The patients are left to themselves in the new situation. The psychiatrist recognizes their needs and through group therapy enables them to heal quality intrapsychic conflicts.

The study analized data on the intensity of depression, anxiety of an individual patient respectively, but also of his family member (caregiver) too. The control questionnaires are foreseen for both groups one year after group therapy participation. The assumption is that symptoms of depression and anxiety will be less expressed with group support by the psychiatrist.

Two questionnaires were used: Hamilton’s rating scale for depression and Hamilton’s anxiety rating scale and identical questionnaires for member of the family caring for the patients. 13 patients who accepted group therapy were examined in our institution. They were of different gender and age, mean age 53±13.46 mini-max 25-72 years.

Average months of dialysis duration 29.15±21.84 min-max 6-84 Dialysis was performed without an assistant but with some help n 13( 100%) from the patient. They describe ailments from anxiety (30.77%) and depression ( 38.46% ) which they did not have premorbidly, and feel rejected on the emotional sphere, although not on the part of organic medicine.

Emphasis is placed on the emotional state and needs of the patient with severe physical ailments, in other words, demanding treatment methods, as well as the importance of emotional support from family members without whom these patients would have a poorer quality of life.

No significant relationships.

At present, the mental health of members in international Buddhist organizations is often damaged by decontextualized concepts and misleading meditation training. As the treatment of resulting mental diseases presents therapeutic challenges, currently diagnostic and related therapeutic considerations are crucial.

Since subjects predominantly reported having received several diagnoses, with depression, anxiety disorder, and post-traumatic stress disorder being the most frequently assigned, a diagnostic assessment device was employed for further differentiation.

The questionnaire SCL-90 was used to evaluate the nine dimensions: interpersonal sensitivity, depression, anxiety, paranoid ideation, psychoticism, somatization, obsessive-compulsive disorder, hostility and phobic anxiety.

In a pilot group of eight German-speaking subjects of different Buddhist groups the general psychological burden (GSI) was significantly elevated in six of them. However, the intensity of responses in precisely those two individuals in whom it was not increased was far below the norm (PSDI). Furthermore, seven of the subjects had an above-average number of symptoms indicating burden (PST). All of them showed a heightened level of interpersonal sensitivity and for most of the subjects anxiety, depression, paranoid ideation and psychoticism were above the mean value of the norm group.

As for psychiatric treatment and psychotherapy, extended research with a larger group of such subjects and at the beginning of their treatment is crucial. Particularly, hypotheses on the causes of their social insecurity, depressivity, paranoid thinking as well as psychoticism based on the distorted concepts and neologisms these persons were exposed to (e.g. ‘karma-purification’) as well as their ways of ‘meditation-training’ seems to hold core relevance.

This research was funded by the German Federal Ministry of Education and Research, funding reference number: 01UL1823X.

Numerous studies point to a high effectiveness of psychosocial rehabilitation using psychopharmacological treatment, psychosocial methods and spiritually oriented care technologies.

Description of the experience of using a spiritually oriented approach in complex rehabilitation of patients with mental disorders.

Clinical, pathopsychological, statistic. The study involved two groups of patients with illness (ICD-10 F 20.04 – F 20.05, F25.х, F21.3-21.4, F 33.4, F31.7, F32.2 – 18 patients) and comorbid addictive disorders (ICD-10 F10.2х1- F10.2х2 - 17 patients). “The Social Adjustment Scale–Self-Report SAS-SR” (М. Weissman, S. Bothwell, 1976); “Medical Outcomes Study 36-item short form health survey” (SF-36, John E.Ware, 1992); “Methodology of the severity of anti-drug potential” (Kopeyko G.I. et al, 2018); “The Scale of Religiosity” (Kaz’mina O.Y., 2000) were used to assess the effectiveness.

All patients received psychopharmacological treatment and participated in rehabilitation work in patient community organizations using psychosocial and spiritually oriented therapy. The rehabilitation program included psychoeducation, skills training, group and individual psychotherapy, social activity. Spiritually oriented assistance was realized in the tradition of dialogical approach (Florenskaya T.A., 1992) and included conversations on Evangelical topics, work in therapeutic groups on the principles of a religious community. Longer remission times, a social functioning improvement, a tendency to change lifestyle based on the values of religious worldview, anti-drug potential increase and a higher understanding of religious life with an orientation towards internal religiosity were revealed among the participants of complex rehabilitation program.

Perspective of using biopsychosociospiritual approach in psychiatry in work with patients with schizophrenia and patients with comorbid addictive disorders was shown.

No significant relationships.

Cognitive-behavioral therapy (CBT) is recognized as an effective treatment for anxiety disorders. Transdiagnostic group CBT (tCBT) targets cognitive and behavioural intervention strategies common to anxiety disorders. tCBT allows the treatment of a larger number of patients simultaneously and therapists only need to master a single intervention protocol. However, tCBT may present several challenges for therapists, particularly regarding group management.

To explore therapists’ perceptions and experience of group management during tCBT for mixed anxiety disorders.

A qualitative study embedded in a randomized controlled trial of group tCBT (Roberge & Provencher; CIHR, 2015-2021). Semi-structured interviews were conducted with 18 of the 21 therapists to document their perceptions and to identify improvements for tCBT delivery. The data were analyzed using a deductive approach and based on the interactive cyclical process of data reduction, display and conclusion drawing.

Therapists raised the challenge of the heterogeneous characteristics of participants’ anxious profile, since they had to be creative to provide exercises that were suitable for a whole group. Exposure exercises, a key component of tCBT, were particularly affected by the composition of the groups. Previous group animation experience and the ability to establish a therapeutic alliance from a group perspective were important facilitators. Co-therapy also facilitated the intervention, since it allowed the therapists to be more vigilant to group dynamics and favored the organization of tCBT.

This study highlights the importance of exploring therapists’ perceptions and experience about group management in order to identify facilitators and barriers of group tCBT in community-based care.

No significant relationships.

Embitterment is an emotion which is known to everybody in reaction to injustice, humiliation, and breach of trust. In greater intensity it can cause severe suffering for the affected person and the social envirnment, can result in lasting impairment, and even lead to dysfunctional behavior, including aggression. Embittered patients need therapeutic help and are regularly seen in psychotherapy. The problem is often not properly recognized, because of the multiple accompanying symptoms and accusations against the environment.

Goal of the present study was to learn about the prevalence of embitterment in psychotherapy patients

Outpatients in routine psychotherapy filled in the PTED scale (post-traumatic embitterment disorder selfrating scale), the K-FAF (short assessment of aggression) and the SCL-90 (symptom-checklist-90). Additionally, sociodemographic data were available.

Included were 118 patients, of whom 22% showed a relevant severity of embitterment, 23.7% a relevant score for reactive aggression, and 54.2% a relevant score for irritable aggression. There was a significant correlation between the PTED scale and the aggression scale.

The data show that embitterment and related aggression are frequent phenomena in psychotherapy patients. Therapists should be aware of this emotion and take proper action to diagnose embitterment and aggressive ideation, which are often covered by other complaints. Special treatments are needed, as the aggressive and negativistic features of embitterment complicate the psychotherapy process.

No significant relationships.

Reviews suggest that family interventions including family therapy are effective for a range of disorders in youth. Family sculpting is used in different clinical settings to help young patients, their parents and siblings when words are not enough.

Participants will be able to understand the clinical relevance of family sculpting: shifting from discussions about family problems to physical representations of family dynamics and how to apply in their practice.

There will be a brief overview of the general principle of family sculpting followed by clinical vignettes of patients combined with videos of the intervention. These examples will guide the discussion on how relevant in our clinical work this therapeutic practice may be. This variation on sculpting incorporates theater warmup exercises and therapists joining the family experience.

Family sculpting captures an immediate picture of the family dynamics that is a therapeutic turning point for families and gives voice to the children. The clinical cases and videos will guide clinicians on how to integrate into their own practice.

This presentation will make possible integrating family sculpting into your own practice, providing an engaging alternative modality for complex cases.

No significant relationships.

Cognitive behavioural therapy for psychosis as an adjuvant to pharmacological treatment has been been shown to be one of the most effective interventions for schizophrenia with benefits noted in even treatment resistant schizophrenia. Benefits have been mostly registered in the positive symptoms domain of schizophrenia. Acceptance and commitment therapy is a third generation Cognitive-Behavioural Therapy, empirically supported for a range of symptoms and conditions, including psychosis, with quickly increasing data. It targets experiential avoidance, which seems to be closely related with psychopathology. Its ability to also target affective symptoms can be an important advantage in the adjuvant treatment of psychosis.

To critically review the evidence of acceptance and commitment therapy in psychosis.

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “schizophrenia”, “acceptance and commitment therapy”.

Very few studies have been published on ACT and psychosis, with even less controlled trials and systematic reviews. So far there is convincing evidence for ACT reducing the frequency of hallucinations, increasing the outcomes of traumatic events associated with psychosis and having measurable effects on anxiety and help seeking behaviour.

As Acceptance and Commitment therapy evolves and more evidence arises a new kind of therapy with possible effects on both affective and positive symptoms in schizophrenia can emerge, allowing us to know what works for patients with psychosis and through what mechanisms and permitting the improvement of treatment strategies.

No significant relationships.

Patients treated for chronic mental disorders and who receive atypical antipsychotics are in most cases at risk of gaining weight, the excess of which is complicated in the long term by metabolic syndrome (MS). The management of these patients is effective if it includes Therapeutic Education.

Describe the therapeutic education program developed for patients on antipsychotics who have metabolic syndrome

In this work, we present the educational program that we have developed for patients undergoing psychiatric treatment with atypical antipsychotics, who have been stabilized for at least 3 months and who suffer from SM.

It is a program that starts with the inclusion consultation and educational diagnosis with the first step of clinical (weight, abdominal perimeter and BMI), biological (blood sugar, HbA1C, cholesterol, HDL, triglycerides) and psychometric (SF12, MAQR, food and physical activity diary) assessments. Our initial program includes 6 sessions and 2 maintenance sessions at 1 month and 3 months after the 6th session. The objectives were divided between information about DM, motivation to eat a balanced diet, physical activity and improvement of quality of life. We also included stress management and positive psychology activities. Assessments are repeated at the end of the initial program and at the last maintenance session.

Our program was developed according to the Geneva therapeutic education recommendations. We plan to apply it to groups of patients in our department

No significant relationships.

The American Psychiatric Association and NICE’s Guidelines for schizophrenia recommend psychosocial interventions as adjuvants to pharmacological treatment, highlighting the role of cognitive behavioral therapy for psychosis, psychoeducation, family intervention, cognitive remediation, autonomy training, social skills training, and supported employment. Although highly recommended in their individual forms current guidelines make no definitive statement about their group applicability.

The goal of this work was to critically review the evidence of group interventions in schizophrenia

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “schizophrenia”, “group therapy”.

Group therapy has shown important benefits in different conditions over the years, likely through mechanisms such as peer motivation, controlled confrontation, increased insight and even a tendency to homogenous results between group participants through peer influence. These results have been reproduced in schizophrenia though the benefits of applying group concepts to structured psychosocial interventions is still under study.

Recent evidence suggests some evidence-based interventions can be applicable in group form, namely social skills training, cognitive remediation, psychoeducation, and multifamily groups, synergizing the already known benefits with newer therapy models and decreasing costs for patients and healthcare systems. Adequate controlled studies between individual and group therapy will shed further light on this matter.

No significant relationships.

The term trauma comes from the ancient Greek word “titrosko” than means perforate. Sexual harassment and abuse of a person during childhood is an important risk factor for mental trauma.

Present the impact of sexual harassment and abuse in the mental health of adolescents and the imprortance of therapeutic relationship.

From the literature review the child needs love which is demostrated with tenderness. The adult (perpetrator) with a disorder responds to the child’s tenderness with the language of passion. The immature Ego of the child is not strong enough to deal with the adult behavior and this causes anxiety, helplessness, confusion and guilt about the relationship with the adult. During the psychotherapeutic process, 4 main protagonists emerge : the victim, the perpetrator, an absent mother and an omnipotent savior.

Mental trauma can adversely affect the development of the neurobiological system resulting in difficulty coping with stressful events. Untreated trauma can lead to serious psychopathology such as anxiety disorders , depressive disorder, personality disorders, addictions. The creation of a therapeutic relationship, understanding the adolescent and his family potential, the recognition and treatment of transference-countertransference phenomena and the existence of a clinical setting that acts as a restraint mechanism could contribute to the therapy of mental trauma.

The Therapeutic Department for Adolescents could be an environment to contain, process and transform the painful into pleasant emotions, as well as aiming the authenticity of the person with a history of sexual harassment and abuse.

No significant relationships.

Although around 50% of individuals with borderline personality disorder (BPD) suffer from trauma-related disorders, literature lacks a specific treatment for these serious co-occurring problems. Dialectical Behavior Therapy Prolonged Exposure (DBT PE) is a recent protocol developed by Melanie Harned, integrating (PE) into standard (DBT). The protocol has showed promising results in treating comorbid PTSD in BPD patients. The current study, however, was the first trial to apply DBT PE protocol in Egypt.

To investigate the efficacy of (DBT PE) protocol in reducing trauma-related symptoms (psychological trauma symptoms and trauma-related cognitions) among Egyptian women with BPD.

Sixteen women diagnosed with BPD and trauma-related symptoms, were recruited from “DBT clinic”, a private outpatient clinic in Alexandria, Egypt and randomly divided into equivalent (Therapeutic & Control) groups. The therapeutic group received DBT PE protocol while the control group received Treatment as usual (TAU). Participants were assessed pre and post-intervention using: The short version of the Borderline Symptom list, The Trauma Symptom Checklist-40, and The Posttraumatic Cognitions Inventory. The therapeutic group started treatment with standard comprehensive DBT concurrently with DBT PE protocol (14 individual sessions, 120 minutes/ week), according to readiness criteria suggested by the treatment developer.

Patients who received DBT PE protocol showed significantly lower degrees of psychological trauma symptoms and trauma-related cognitions compared to patients in control group.

Despite being applied for the first time in Egypt, DBT PE protocol proved to be an effective intervention in reducing trauma-related symptoms in a sample of Egyptian BPD patients without any need to modify the original protocol.

No significant relationships.

The noun “maieutics” derives from maia (mother, midwife) and the related verbs “maieusis” and “maieonuai” mean “giving birth” and “easing childbirth”. Socrates’ maieutics aspires to give birth to the truth in the youth. Since homeric times psychotherapy has been part of medical act. Initially, the physician’s word had a magical character. Plato rationalized this in many of his dialogues, specially in “Charmides”.

The search of the essential characteristics of this therapeutic method described by Plato, as well as its ethical implications

Hermeneutic method

The consequences for doctor-patient relationship in general and psychotherapy in particular are: 1. Remedy and “epodé” (charm) must be applied in every doctor-patient relationship. 2. The body can only be healed if the soul is cured first by a charm. 3. The openness of the patient’s soul to the physician and the physician’s beautiful speech to the patient will enable the latter to reach the state of “sophrosyne” (temperance), condition of possibility of true health.

In the discussion of the meaning of “sophrosyne”, Socrates questions disciples’ propositions and concludes that the only thing one can be sure of is that “sophrosyne” is a way of searching virtue (arete). Later, in Theaetetus, Plato adds another element: temperance is a “homoiosis theó”, that is, the assimilations of patient to God. With this Plato seals the ethical character of psychotherapy for ever.

No significant relationships.

As it is well known, diabetes and depression are highly prevalent conditions and affect significantly overall health (Egede & Ellis,2010). This presentation aims to describe the impact of a chronic disease (diabetes) on mental health and its comorbidity with depression. Additionally, it presents the psychotherapeutic process and beneficial effects of coaching on an adolescent patient.

The current study tries to present the comorbidity and interaction between diabetes and depression. It explores the therapeutic path followed, so that the patient could cope effectively with the comorbidity of these diseases and break the vicious circle of sadness that he had been into.

A case study of an adolescent with diabetes is presented. It depicts how the sudden appearance and diagnosis of diabetes led to depressive impasse and cancellation of his dream to become a pilot. The role of coaching is described.

Through monthly coaching the young adolescent discovered his hidden talents and thus he was able to redirect his professional goals and to design a pathway that would lead to the fulfillment of his new life plans. Working closely together with his therapist, step by step, his depressive symptoms were diminished and anti-depressive medication was reduced gradually. Consequently, his diabetes was well regulated, and his overall health was radically improved.

Psychotherapeutic coaching is proved to be appropriate for patients with comorbidity in order to cope effectively with their chronic disease and discover new meaning in their own lives. Last, but not least, self-management skills and diabetes education are required in addition to psychological interventions.

No significant relationships.