BACKGROUND: Despite limited evidence for pharmacological efficacy in core BPD symptoms, pharmacotherapy is frequently used and may become the dominant treatment modality, often resulting in clinically significant polypharmacy. We examined whether psychotropic pharmacological burden at hospital admission is associated with perceived illness severity, internalized stigma, and childhood trauma. METHODS: In this cross-sectional study, 220 inpatients with ICD-10 BPD (mean age 30.8 years) were assessed during the first week of hospitalization. The total number of concurrently prescribed psychotropic medications at admission was extracted from medical records. Participants completed the patient-rated Clinical Global Impression-Severity scale (CGI-S-PV), the Internalized Stigma of Mental Illness scale (ISMI), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Analyses included correlations, group comparisons, and multivariable linear and logistic regression. RESULTS: The mean number of medications was 1.76 (SD = 1.37); 57% of patients received >= 2 psychotropic medications at admission. Medication count correlated with perceived illness severity (r = 0.21, p = 0.002) and increased with age (B = 0.05, p = 0.002). Patients prescribed >= 2 psychotropic medications reported significantly higher levels of emotional and sexual abuse (CTQ-SF) and higher scores in selected ISMI subscales: alienation, discrimination experience, and social withdrawal. In multivariable models, age (B = 0.05, p = 0.002) and CGI-S-PV (B = 0.19, p = 0.017) independently predicted medication count, whereas ISMI and CTQ-SF total scores did not. In subscale-level models adjusted for age and CGI-S-PV, ISMI Alienation (I = 0.21, p = 0.031) and Stereotype Endorsement (beta = 0.19, p = 0.042) independently predicted medication count, and Stereotype Endorsement (OR = 1.59) and Discrimination Experience (OR = 1.52) predicted polypharmacy in logistic regression. CONCLUSION: While childhood trauma and self-stigma contribute to between-group differences, they do not independently predict pharmacological burden after adjustment. These findings indicate that at admission, pharmacological burden is independently predicted by perceived illness severity and age, while trauma exposure and global internalized stigma do not contribute independently after adjustment.
OBJECTIVE: This preliminary study examined the feasibility of a virtual reality-based intervention and explored phase-related changes in selected cognitive functions in a person with dementia due to Alzheimer's disease. The intervention was delivered as a supplement to existing services in a social care facility. METHODS: A single-case ABAB withdrawal design (N = 1) was conducted across 12 months (January-December 2025). Phase A represented periods without the experimental intervention, and phase B represented periods in which the participant underwent structured VR-based sessions three times per week for approximately 50 minutes per session using a commercially available Meta Quest head-mounted display. Repeated assessment was conducted monthly using the Addenbrooke's Cognitive Examination (ACE). Data were analyzed using descriptive and visual methods, supplemented by the Percentage of Non-overlapping Data (PND) and the Reliable Change Index (RCI). Because the initial A1 baseline phase included only two monthly data points, baseline stability was interpreted cautiously and the study was framed as a feasibility-oriented preliminary single-case investigation rather than as evidence of efficacy. RESULTS: Performance in the monitored cognitive subdomains showed a phase-related pattern. During the intervention phases, attention/orientation scores increased from 11 to a peak of 13 points, and memory scores increased from 16 to a peak of 18 points; both domains declined during the withdrawal phase (July-August). PND values ranged from 25 % to 75 % across phases and domains. Neither RCI value (1.56; 0.99) exceeded the threshold for statistically reliable individual change (>1.96). The two initial A1 measurements were identical, but the short baseline prevents robust inference regarding baseline stability. These preliminary findings suggest that the intervention may be associated with favorable phase-related changes in selected cognitive functions, although the single-case design precludes definitive conclusions regarding efficacy. CONCLUSION: The VR-based intervention was acceptable and implementable within routine social care and was associated with phase-related changes in selected cognitive functions. These preliminary findings do not permit causal conclusions or generalization, but they support the feasibility of conducting a larger main study using this intervention format.
BACKGROUND: Integrating musical elements into schema therapy may enhance emotional access and mode work in psychiatric patients. This study explores the feasibility and potential therapeutic value of structured music-based interventions integrated with the schema mode model. OBJECTIVE: The aim of this study is to describe and illustrate an integrated therapeutic model combining music therapy and schema therapy within inpatient psychiatric care for patients with personality disorders, mood disorders, and complex trauma. METHODS: Five clinical case studies of inpatients with various diagnoses (ICD-10) were selected; three are presented in full narrative form, and two are summarized in the comparative case overview. Each case was analysed based on dominant modes, musical strategies applied, and short-and long-term effects. Qualitative data include therapist notes and patients' subjective feedback. RESULTS: Music interventions allowed emotional expression and modulation, particularly in Vulnerable Child and Angry Child modes. Patients reported enhanced internal safety and self-understanding. Observable behavioral changes included increased autonomous decision-making (Case 1), reduced hypervigilance to auditory stimuli (Case 2), and the capacity to tolerate emotional presence without dissociation (Case 3). Positive changes were observed in mode accessibility and reduction in self-stigma. CONCLUSION: Integrating musical work into schema therapy shows clinical promise in facilitating corrective emotional experience. Further research using single-case experimental design and controlled designs is recommended.
