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In this article, we present holistic and person-centered perspectives in psychiatry, with the aim of better understanding what a focus on personhood might really mean and what clinical implications it might have. We first introduce classical and philosophical concepts of personhood, in order to then outline person-centered approaches in psychiatry, which mainly focus on the person of the patient. We then argue that, for it to really be person-centered, psychiatry must necessarily also focus on the person of professionals. We thus explore the notion of stance, as the expression of the therapist's personhood. By unpacking the effects that a professional's stance can have on patients, we finally turn to a consideration of the interpersonal sphere. More specifically, we propose clinical considerations on a therapeutic stance that strives to support and to help the person of the patient unfold. Such a stance must – we argue – necessarily be a dialogical one. Drawing on these considerations, we thus claim that a truly person-centered approach in psychiatry must necessarily and automatically be interperson-centered and dialogical. In the concluding remarks, we finally discuss broader societal implications and outline future research perspectives. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, a decrease in well-being and an increase in mental health problems were registered in medical and psychotherapeutic practices, counseling centers, and clinics. According to previous studies, younger people and women seemed to be particularly affected. The aim of this study was to describe mental health problems of students and to draw consequences for the further handling of pandemics and other crises. Method: Students at the University of Heidelberg, a typical German "full university," were surveyed online using internationally comparable screening instruments like the Well-Being Index (WHO-5) and the Patient Health Questionnaire (PHQ). In addition, the students had the opportunity to describe in a narrative form their well-being and to make suggestions how to improve their situation. Results: Out of a population of 27,162 students who were contacted by email, 2,137 students completed the questionnaire. The salient finding is that according to the WHO-5 Well-Being Index, 72.2% of the respondents feel seriously impaired in their well-being. This corresponds to the finding that 75.8% of the respondents in the PHQ-D show indications of at least one syndrome diagnosis. Depression was found in 41.8% of the respondents in the PHQ-D. Indications of moderate to severe and severe depressive syndromes were present in 31.8%. Signs of somatoform syndromes are found in 25.4% and of anxiety syndromes in 20.0%. 1,089 students gave narrative reports on how they were feeling and made suggestions for improvement. About 75% reported severely reduced well-being. Their main complaints were loneliness and depression and lack of recognition for their specific academic and life situation during the pandemic. By far, the largest proportion of students supposed that their mental health issues were caused and/or intensified by the pandemic-related social contact restrictions. The vast majority of them made reasonable suggestions for controlled relaxation of contact restrictions. Conclusions: Students suffer severely from the pandemic-related social restriction. In respect to future pandemic outbreaks or other crises leading to social isolation, the dramatic consequences of social lockdowns should be taken into account. Under pandemic conditions, we especially should support persons lacking social networks. [ABSTRACT FROM AUTHOR]

Since ancient philosophy, extraordinary creativity is associated with mental disorders, emotional and cognitive destabilization, and melancholia. We here summarize the results of empirical and narrative studies and analyze the most prominent case of a highly creative person who suffered from dysthymia and major depression with suicidality. Hereby, we focus on the interaction of different phases of the creative process with "bipolar" personality traits. Finally, we offer an interdisciplinary interpretation of the creative dialectics between order and chaos. The results show that severe psychopathology inhibits creativity. Mild and moderate disorders can inspire and motivate creative work but are only leading to new and useful solutions when creators succeed in transforming their emotional instability and cognitive incoherence into stable and coherent forms. The cultural idea that creativity emerges in dialectical processes between order and chaos, is also to be found in the psychologic interplay of coherence and incoherence, and in neuro-scientific models of the dynamics between tightening and loosening of neuronal structures. Consequences are drawn for the psychotherapeutic treatment of persons striving for creativity. [ABSTRACT FROM AUTHOR]

Uterine leiomyosarcoma (uLMS) is a rare entity among malignant gynecologic tumors with a very unfavorable prognosis and the highest prevalence in the pre- and peri-menopause. Only early-stage tumors have an acceptable prognosis, provided the patient has been treated without injuring the uterus. uLMS is often diagnosed accidentally and the correct diagnosis ishampered by equivocal features similar to the far more frequent benign uterine fibroids. Surgery is the basis of therapy, and it should be done in order to remove the uterus intact. As vaginal, abdominal, and endoscopic surgery - possibly including morcellation - are the methods of choice for the treatment of uterine fibroids, pre-operatively undiagnosed leiomyosarcoma detected by pathologic examination will have a worsened prognosis. Systemic treatment and radiotherapy are of no proven value in the adjuvant setting. Thus, there is strong need for a reliable pre-operative risk score for leiomyosarcoma in order to justify diagnostic means beyond clinical routine and to choose the correct surgical pathway. The clinical problems in the diagnosis of leiomyosarcoma and treatment are exemplified by a case report of a 30-year-old childless patient. Diagnostic tools as well as treatment options in adjuvant and palliative situations are reviewed. [ABSTRACT FROM AUTHOR]

Background: Alcohol and drug abuse is frequent among performers and pop musicians. Many of them hope that alcohol and drugs will enhance their creativity. Scientific studies are scarce and conclusions limited for methodological reasons. Furthermore, extraordinary creativity can hardly be grasped by empirical-statistical methods. Thus, ideographic studies are necessary to learn from extraordinarily creative persons about the relationship of creativity with alcohol and drugs. The pop icon Jim Morrison can serve as an exemplary case to investigate the interrelation between alcohol and drug abuse and creativity. Methods: Morrison's self-assessments in his works and letters as well as the descriptions by others are analyzed under the perspective of creativity research. Results: In the lyrics of Jim Morrison and in biographical descriptions, we can see how Jim Morrison tried to cope with traumatic events, depressive moods and uncontrolled impulses through creative activities. His talent, skill and motivation to write creatively were independent from taking alcohol and drugs. He used alcohol and drugs to transgress restrictive social norms, to broaden his perceptions and to reinforce his struggle for self-actualization. In short, his motivation to create something new and authentic was reinforced by alcohol and drugs. More important was the influence of a supportive group that enabled Morrison's talents to flourish. However, soon the frequent use of high doses of alcohol and drugs weakened his capacity to realize creative motivation. Conclusions: Jim Morrison is an exemplary case showing that heavy drinking and the abuse of LSD, mescaline and amphetamines damages the capacity to realize creative motivation. Jim Morrison is typical of creative personalities like Amy Winehouse, Janis Joplin, Brian Jones and Jimmy Hendrix who burn their creativity in early adulthood through alcohol and drugs. We suppose that the sacrificial ritual of their decay offers some benefits for the excited spectators. One of these is the illusion that alcohol and drugs can lead to authenticity and creativity. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: In psychiatry and psychotherapy, abstract scientific principles need to be exemplified by narrative case reports to gain practical precision. Goethe was one of the most creative writers, productive scientists, and effective statesmen that ever lived. His descriptions of feelings, emotions, and mental states related to anxieties, depressive episodes, dysthymia, and creativity are unique in their phenomenological precision and richness. His life and work can thus serve as an excellent example enhancing our understanding of the relationship between anxiety, depression and creativity. Furthermore, he described (self-)therapeutic strategies that reinforce and refine modern views. Methods: Goethe's self-assessments in his works and letters, and the descriptions by others are analyzed under the perspective of current psychiatric classification. His therapeutic techniques and recommendations are compared with cognitive-behavioral, psychodynamic, and existential psychotherapy to amplify modern concepts of psychotherapy. Results: From a scientific perspective, several distinctive depressive episodes can be diagnosed in Goethe's life. They were characterized by extended depressive moods, lack of drive, and loss of interest and self-esteem combined with social retreat. Goethe displayed diffuse and phobic anxieties as well as dysthymia. His (self-)therapeutic strategies were: (a) the systematic use of helping alliances, (b) behavioral techniques, (c) cognitive reflection on meanings and beliefs, (d) psychodynamic and psychoanalytic remembering, repeating, and working through, and (e) existential striving for self-actualization, social commitment, meaning, and creativity. Conclusions: In Goethe's life, creative incubation, illumination, and elaboration appear to have been associated with psychic instability and dysthymia, sometimes with depressive episodes in a clinical sense. On the one hand, his creative work was triggered by anxieties, dysthymia, and depressive moods. On the other hand, his creativity helped him to cope with psychic disorders and suicidal tendencies. Furthermore, Goethe described psychotherapeutic strategies that resemble modern techniques. He integrated relational, behavioral, cognitive, psychodynamic, and existential techniques and attitudes. These modern psychotherapeutic approaches can be exemplified and enhanced by reflecting upon the (self-)therapeutic efforts of one of the most creative persons that have ever lived. Hermeneutics as the art of communication and understanding derived from Goethe's (self-)therapy and creative works can serve as a meta-theoretical framework for the integration of different psychotherapeutic approaches. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]