ABSTRACTS - World Psychiatric Association

RS1.3.
BRIEF INTERPERSONAL PSYCHOTHERAPY
WITH A PRE-TREATMENT ENGAGEMENT SESSION
FOR PATIENTS IN ROUTINE PRACTICE SETTINGS
H.A. Swartz, E. Frank, N.K. Grote, A. Zuckoff
University of Pittsburgh School of Medicine, Department
of Psychiatry, Pittsburgh, PA; Department of Social Work,
University of Washington, Seattle, WA, USA
High rates of mental health treatment dropout and low rates of therapy
attendance are common problems in the delivery of effective psychiatric
care. These issues are especially prominent among socially
disadvantaged and ethnic minority cultural groups. The authors
developed a one-session intervention based on principles derived
from motivational interviewing and ethnographic interviewing,
designed to improve depressed patients’ participation in subsequent
psychiatric treatment. This “engagement session” focuses on communicating
the therapist’s understanding of patients’ individual and culturally-embedded
perspectives, helping patients see how the potential
benefits of treatment align with their own priorities and concerns,
facilitating identification and resolution of ambivalence, and problem-solving
barriers to treatment engagement. When administered in
combination with a brief form of IPT (IPT-B), designed for individuals
who are unlikely to remain in psychotherapy for longer durations,
this approach can be used to treat depression in difficult-to-engage
patient populations. In this paper, we describe the intervention itself
(engagement session plus IPT-B) and present empirical data supporting
its efficacy derived from two clinical trials with non-treatmentseeking
patient populations: depressed mothers of children with psychiatric
disorders and low-income, depressed, pregnant women
receiving treatment in the obstetrics clinic of a large public hospital.
We also report on our experiences training a diverse group of community
mental health clinicians to deliver the engagement session
and IPT-B in routine practice settings.
RS1.4.
ADAPTATION, TESTING AND DISSEMINATION
OF GROUP INTERPERSONAL PSYCHOTHERAPY
IN SUB-SAHARAN AFRICA
H. Verdeli, K.F. Clougherty, M.M. Weissman
Teachers College, Department of Clinical and Counseling
Psychology, Columbia University; New York State Psychiatric
Institute, Columbia College of Physicians and Surgeons,
Columbia University, New York, NY, USA
Historically interpersonal psychotherapy (IPT) has been developed,
adapted, tested, and disseminated in Western academic and community
mental health settings. Its use in resource-poor non-Western
societies had not been attempted until recently. We adapted group
IPT (IPT-G) for depressed adults in southern Uganda and adolescents
in internally displaced (IDP) camps in northern Uganda. These adaptations
were tested in randomized clinical trials showing efficacy of
IPT-G in both sites. The process of adapting and training in IPT for
each site is discussed, focusing on how: local communities’ expression
and experience of depression were taken into account; conceptual
and technical adaptation of IPT-G were negotiated, given profound
local differences in communication patterns and interpersonal/social
roles from western ones; feasible and culturally meaningful
IPT training and supervision of local facilitators was set up in each
site; and systemic factors, such as partnerships with non-governmental
organizations, local sanctioning by traditional healers, and fostering
of local IPT training, facilitated the adoption of IPT-G by each
local community. Following the termination of the two clinical trials,
IPT-G has been disseminated in a number of provinces in Uganda and
other sub-Saharan countries. A conclusion is drawn about elements
of IPT that “hold constant” across our work in the USA, Europe and
sub-Saharan Africa.
RS2.
NEW ADVANCES IN DIFFUSION MAGNETIC
RESONANCE IMAGING AND THEIR APPLICATION
TO SCHIZOPHRENIA
RS2.1.
TRENDS IN THE ANALYSIS OF DIFFUSION
MRI DATA FOR GROUP STUDIES
S. Peled, M. Kubicki, M.E. Shenton
Brigham and Women’s Hospital and Harvard Medical School,
Boston, MA; Veterans Affairs Boston Healthcare System,
Brockton, MA, USA
Diffusion magnetic resonance imaging (dMRI) is an MRI modality
that has gained tremendous popularity over the past five years and is
especially promising for imaging white matter in the brain. Diffusion
imaging is one of the first methods that make it possible to visualize
and to quantify the organization of white matter in the human brain
in vivo. It has the potential to aid in the diagnosis and subsequent
treatment of disorders of the central nervous system and is likely to
have a major impact on assessment of white matter pathologies. In
addition to direct clinical impact, dMRI has the potential to contribute
to basic neurosciences, improving our understanding of physiological
white matter development, aging, and connectivity. Extracting
connectivity information from dMRI, termed “tractography’’, is an
especially active area of research, as it promises to model the pathways
of white matter tracts in the brain, by connecting local diffusion
measurements into global trace-lines. In this paper, an overview is
provided of existing tractography methods, and the strengths and
weaknesses of different approaches are discussed. An overview of
current methods for group studies based on dMRI are also presented,
including the methods of Regions Of Interest (ROI) based statistics,
voxel-based morphometry (VBM), tract-based morphometry (TBM),
and tract-based spatial statistics (TBSS). In neurological studies of
white matter using tractography, it is often important to identify
anatomically meaningful fiber bundles. Available technologies for
group studies comparing normal controls and subjects with schizophrenia
are also discussed.
RS2.2.
NEW METHODS FOR ASSESSING WHOLE BRAIN
DTI ABNORMALITIES IN SCHIZOPHRENIA
M. Kubicki, U. Khan, L. Bobrow, L. O’Donnell, S. Pieper,
C.-F. Westin, M.E. Shenton
Brigham and Women’s Hospital and Harvard Medical School,
Boston, MA; Veterans Affairs Boston Healthcare System,
Brockton, MA, USA
Diffusion tensor imaging (DTI), particularly new advances in DTI
data processing and analysis, makes it possible to conduct a more
thorough investigation of anatomical connectivity in schizophrenia.
Numerous studies to-date report white matter (WM) abnormalities in
schizophrenia. However, findings from these studies have been very
inconsistent. Such inconsistencies are at least in part due to the differences
in methodological approaches that have been used. More
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