Objectives
Treatment is shortterm, interactional, based on psychodynamic background and assessed following DC 0-3R. In the period between 11/2011 to 6/2015 we assessed all patients at the beginning, the end and 6 month post treatment by parental reports and clinical judgement through the therapist.
Aims of the observational study are to evaluate the outcome and to improve diagnostic assessment and therapeutic intervention.

Methods
Sample: 214 treated, 121 met including criteria (more than 1 consultation, no language barrier, parental agreement). 50 returns: 26 at t0, t1 and t2. 24 at t0 and t1. 60 no returns. 11 still in treatment.
t0 parents: questionnaire problems and expectations, BITSEA, KPCS, EPDS. t0 psychotherapist: PIRGAS, M-ADBB and Clinical judgement. t1 and t2 parents: questionnaire problems and treatment satisfaction, BITSEA, KPCS, EPDS. t1 psychotherapist: DC: 0-3R, M-ADBB and clinical judgement.
Fathers participation 73%, average of consultations: 3.8. Clinical disorders DC: 0-3R: 35% no, 23% adjustment, 16% regulation, 10% sleep behaviour, 16% other.

Results
Group comparisons between t0 and t1 show highly significant improvement in parental reports on children’s behaviour (BITSEA) and parental well-being (EPDS). These changes last over time between t1 und t2. Therapists’ assessment of the parentchildrelationship (PIRGAS) and infant`s symptoms between t0 and t1 show highly significant improvement. Results over time show, that the feeling of parents burden is significantly lower when the intervention time is longer. The childs symptoms and the quality of the mother-child-relationship are significantly correlated. The quality of the father-child-relationship is correlated with the mother-child-relationship.

Conclusion
Results show significant improvement in parental reports on childrens behaviour and parental well-being and in reports by therapists in parentchildrelationship and infants symptoms. The corespondence between the perception of the parents and the therapists is high. Longer treatments seem to be more effective, in particular for the well-being of the parents. Poor return may be associated with parental motivation to answer questionaires, psychodynamic issues and motivation of clinicians to go for out-comemeasurement.

Title: Evaluating parent-infant-psychotherapy in an outpatient clinic: Challenges, obstacles and possible benefits. Two case reports about the influence of psychodynamics on measurement.
(Connected to oral presentation ID 2333 of Dr. Bindernagel, makes only sense in a combined presentation).

Introduction: We compare the handling of the outcome measurement in the psychoanalytic parent-child-psychotherapy of two 3year-old-boys and their parents in relation to the course of treatment, emerging psychodynamics and related parameters such as parental ability of separation and triangulation.

Method: Comparison of a fully measured short-term-psychotherapy and an incompletely measured long-term-treatment. We compare written transcripts of the sessions with the same psychotherapist and the questionnaires of the outcome as itemized in oral presentation ID 2333. Our focus is on the way measurement is put into effect in relation to psychodynamics and the course of treatment.

Results: In the short case, there is a good ability of separation and triangulation in the parents, the therapist is put in a helpful third position and the treatment is successful. It has a clear beginning and a clear end what makes the time of measurement easy to define. The long-term treatment however shows a depressed parental couple, often insecure in decisions and having difficulties with separating from each other, from the child or from the therapist. There is a quite clear beginning, but no clear end of the treatment what makes outcome measurement difficult.

Conclusion: Psychodynamics influence the quality of outcome measurement. In this example, the main problem is the definition of the end of treatment. If there is no clear end, the time for measurement is difficult to find. And if measurement means the end of treatment it could be avoided out of psychodynamic reasons.

Individual development is relational, since it happens in relation to social interaction.
Harmful psychological, emotional and interaction issues hinder the positive development and the everyday life of a child. These issues usually manifest themselves in family, school and peer interaction.

The commonly used approach for treating children in need of psychotherapy is individual sessions, tailored for the child. In our experience this approach has proven less effective than interactive group psychotherapy. In cases where a child manifests psychological, stress or/ and trauma symptoms, the issues causing these symptoms are often relational and affect his or her entire family. As such we have found that the most efficient and emotionally cost-effective way to help these children is to treat them and their siblings in group psychotherapy. In our group psychotherapy we involve the entire family. The setting structure is stable and two psychotherapists are attending each session. Sibling groups are active, physically intensive and deeply emotional.

Referring to our clinical work and the results we have gotten from our group psychotherapy sessions, we have conducted our research by interviewing parents whose children have been attending either individual psychotherapy session, group psychotherapy our both. Additionally we have interviewed a number of clinical psychiatrists and psychologists.

Based on our clinical experience and interview analysis, group psychotherapy is more effective than individual psychotherapy with children and adolescents, since the trauma causing the child’s symptoms usually affects the entire family.

Keywords: siblings, group psychotherapy, trauma, family

Background
Individuals with IBD have triple the rate of mental disorders than that of general population and youth with IBD have higher rates of depression than youth with any other chronic illness [1]. Mindfulness-based Cognitive Therapy (MBCT) is an evidence-based group program for treatment of depression which also holds promise in reducing systemic inflammation, normalizing gut microbiome and modulating brain neuronal connectivity [2].


Objectives
The aim of this study is to conduct a randomised control trial (RCT) exploring benefits of MBCT for youth with IBD and depression. Primary outcome measure will be depression scores in Depression, Anxiety and Stress Scale (DASS). Secondary outcome measures will explore the impact of the mindfulness intervention on IBD inflammatory markers, gut microbiome and functional neuronal connectivity.

Methods
IBD patients aged 16-25 will be recruited via the IBD outpatient services at Mater Young Adult Health Centre. After completing the DASS, participants will be randomly allocated to either treatment as usual or an intervention group who will receive the MBCT.

Findings
The study has secured funding and is currently in recruitment stage with preliminary results expected in May 2017.

Conclusions
This will be the first RCT exploring beneficial impact of MBCT on depression concurrent with measuring its impact on inflammation underlying both depression and IBD, gut microbiome and functional neuroimaging changes. This study therefore holds promise to further elucidate the nature of interactions between depression, inflammation, microbiome and neuroconnectivity and support novel therapeutic interventions targeting them.

References

1. Fuller-Thomson E, Sulman J: Depression and inflammatory bowel disease: Findings from two nationally representative Canadian surveys. Inflammatory Bowel Diseases 2006, 12(8):697-707.
2. Neilson K, Ftanou M, Monshat K, Salzberg M, Bell S, Kamm MA, Connell W, Knowles SR, Sevar K, Mancuso SG et al: A Controlled Study of a Group Mindfulness Intervention for Individuals Living With Inflammatory Bowel Disease. Inflamm Bowel Dis 2016, 22(3):694-701.

Anxious and depressed people are often characterized as irrational in common language. Underlying and contributing to “irrational” behaviour are biological and psychological substrates, such as motivation and emotion. However, in mental health care a clear definition of what it constitutes to be irrational is missing. In economics, on the contrary, irrationality in behavior is precisely defined as making intransitive choices or, violating the Generalized Axiom of Revealed Preference (GARP). Previous research has shown that young children, older adults and people with ventromedial prefrontal cortex damage show intransitivity in their choices. In this study, we extend these results by investigating whether people with severe mood disorders make economically rational choices. At two time points, separated by eight weeks, we measured subjects’ rationality using a widely used economic paradigm and we quantified the severity of subject’s mood via widely used psychological self-report scales for youth disorders (Kessler Psychological Distress K10), Quick Inventory of Depressive Symptomology QIDS-A17 and SPHERE-12). We found that help-seekers, rated as severely anxious and depressed, are more likely than those who scored lower on these scales, to make choices that violate GARP. Importantly, we found that help seekers became less irrational at round two, but that little within subject variation in mood occurred.

Decision-making | rationality | depression | anxiety | affect | emotion