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Zhang M, Fan C, Ma L, Wang H, Zu Z, Yang L, Chen F, Wei W, Li X. Assessing the effectiveness of internet-based interventions for mental health outcomes: an umbrella review. Gen Psychiatr 2024; 37:e101355. [PMID: 39040128 PMCID: PMC11261690 DOI: 10.1136/gpsych-2023-101355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 06/13/2024] [Indexed: 07/24/2024] Open
Abstract
Internet-based interventions (IBIs) for behavioural health have been prevalent for over two decades, and a growing proportion of individuals with mental health concerns prefer these emerging digital alternatives. However, the effectiveness and acceptability of IBIs for various mental health disorders continue to be subject to scholarly debate. We performed an umbrella review of meta-analyses (MAs), conducting literature searches in PubMed, Web of Science, Embase, Cochrane and Ovid Medline from their inception to 17 January 2023. A total of 87 MAs, reporting on 1683 randomised controlled trials and 295 589 patients, were included. The results indicated that IBIs had a moderate effect on anxiety disorder (standardised mean difference (SMD)=0.53, 95% CI 0.44 to 0.62) and post-traumatic stress disorder (PTSD) (SMD=0.63, 95% CI 0.38 to 0.89). In contrast, the efficacy on depression (SMD=0.45, 95% CI 0.39 to 0.52), addiction (SMD=0.23, 95% CI 0.16 to 0.31), suicidal ideation (SMD=0.23, 95% CI 0.16 to 0.30), stress (SMD=0.41, 95% CI 0.33 to 0.48) and obsessive-compulsive disorder (SMD=0.47, 95% CI 0.22 to 0.73) was relatively small. However, no significant effects were observed for personality disorders (SMD=0.07, 95% CI -0.13 to 0.26). Our findings suggest a significant association between IBIs and improved mental health outcomes, with particular effectiveness noted in treating anxiety disorders and PTSD. However, it is noteworthy that the effectiveness of IBIs was impacted by high dropout rates during treatment. Furthermore, our results indicated that guided IBIs proved to be more effective than unguided ones, playing a positive role in reducing dropout rates and enhancing patient adherence rates. PROSPERO registration number: CRD42023417366.
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Affiliation(s)
- Mi Zhang
- Research Centre for Translational Medicine, the Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Chuan Fan
- Department of Psychiatry, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Lijun Ma
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Huixue Wang
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Zhenyue Zu
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Linxi Yang
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Fenglan Chen
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Wenzhuo Wei
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Xiaoming Li
- Research Centre for Translational Medicine, the Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- Department of Medical Psychology, School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
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Opie JE, Vuong A, Welsh ET, Gray R, Pearce N, Marchionda S, Mutch R, Khalil H. Outcomes of Best-Practice Guided Digital Mental Health Interventions for Youth and Young Adults with Emerging Symptoms: Part I. A Systematic Review of Socioemotional Outcomes and Recommendations. Clin Child Fam Psychol Rev 2024; 27:424-475. [PMID: 38489101 PMCID: PMC11222273 DOI: 10.1007/s10567-024-00469-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/17/2024]
Abstract
Youth-specific digital mental health interventions (DMHI) represent an emerging field of study, and aim to increase access, improve socioemotional outcomes, and, where required, support triage to targeted interventions. However, prior reviews have reported inconsistent findings on the clinical effectiveness of such interventions in young adults (12-25 years). Further, shortfalls remain for the impact of guided interventions based on the mode of delivery and the type of human support personnel (e.g., professional or peer) guiding the intervention. In response, this systematic review, co-designed with Australia's leading mental health organization, aims to assess the effectiveness of guided digital programs in improving youth socioemotional outcomes. Included studies involve young people experiencing mental ill-health, receiving brief (i.e., 1-12 sessions), digitally delivered (at least partially) psychological interventions that were guided or partially guided, tested in a type of experimental study, with a socioemotional outcome. Specific socioemotional outcomes examined were depression, anxiety, stress, wellbeing, mindfulness, and quality of life. A systematic search of the contemporary published and grey literature identified 22,482 records with 32 relevant records published between 2018 and 2023. A narrative synthesis guided integration of findings. Results demonstrated strong evidence for the effectiveness of guided interventions on socioemotional outcomes (i.e., depression, anxiety, stress) yet these effects were short-lived. When factoring in the use of different control groups (i.e., active vs. inactive), inconsistent effects were observed for the socioemotional outcomes of depression, anxiety, and stress. The mode of delivery (i.e., asynchronous, synchronous, combined) and the type of human support personnel did not appear to impact socioemotional outcomes. Results indicate efficacious brief digital interventions for depression and anxiety include refresher/follow-up content, goal setting content, and relapse prevention content. In contrast, poor efficacy is associated with interventions that include homework tasks, self-monitoring, and log-keeping content.PROSPERO, ID CRD42023405812.
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Affiliation(s)
- Jessica E Opie
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia.
- La Trobe University, Melbourne, VA, 3000, Australia.
| | - An Vuong
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia
- La Trobe University, Melbourne, VA, 3000, Australia
| | - Ellen T Welsh
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia
- La Trobe University, Melbourne, VA, 3000, Australia
| | - Richard Gray
- La Trobe University, Melbourne, VA, 3000, Australia
| | - Natalie Pearce
- La Trobe University, Melbourne, VA, 3000, Australia
- Latrobe University, Bendigo, VIC, 3551, Australia
| | - Sonia Marchionda
- School of Psychology & Public Health, The Bouverie Centre, La Trobe University, 8 Gardiner Street, Brunswick, Melbourne, VA, 3056, Australia
- La Trobe University, Melbourne, VA, 3000, Australia
| | | | - Hanan Khalil
- La Trobe University, Melbourne, VA, 3000, Australia
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Zalaznik D, Zlotnick E, Barzilay S, Ganor T, Sorka H, Ebert DD, Andersson G, Huppert JD. Interpersonal factors in internet-based cognitive behavioral therapy for depression: Attachment style and alliance with the program and with the therapist. Psychother Res 2024:1-16. [PMID: 38581409 DOI: 10.1080/10503307.2024.2325510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/27/2024] [Indexed: 04/08/2024] Open
Abstract
Objective This open-trial study examined effects of a culturally-adapted Hebrew version of guided internet-based cognitive behavioural therapy (ICBT) for depression. We examined therapeutic alliance with the therapist and with the programme (content) as potential predictors of outcomes. Furthermore, we examined whether anxious and avoidant attachment styles improved, although relationships were not the focus of treatment. Method: We examined alliance with therapist and alliance with programme and their time-lagged (1 week), longitudinal relationship with depression outcomes, and change in anxious and avoidant attachment during treatment. Results: Depression and insomnia improved significantly (Cohen's d: depression = 1.34, insomnia = 0.86), though dropout was relatively high (49%). Alliance with programme and with the therapist predicted adherence and dropout, whereas only alliance with therapist predicted symptom improvement. Avoidant attachment decreased over treatment whereas anxious attachment did not. Conclusion: A culturally-adapted version of ICBT for depression showed that alliance with therapist and alliance with programme both can play an important role in its effectiveness: alliance with programme and the therapist drive adherence and dropout and alliance with therapist is related to symptom improvement. Although the focus of treatment is not interpersonal, avoidant attachment style can improve following ICBT.
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Affiliation(s)
- Dina Zalaznik
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Elad Zlotnick
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Snir Barzilay
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tal Ganor
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hila Sorka
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - David Daniel Ebert
- Faculty of Behavioural and Movement Sciences, Clinical, Neuro- & Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jonathan D Huppert
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
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Eriksson-Liebon M, Westas M, Johansson P, Mourad G. Long-term effects and predictors of change of internet-delivered cognitive behavioural therapy on cardiac anxiety in patients with non-cardiac chest pain: a randomized controlled trial. BMC Psychiatry 2024; 24:216. [PMID: 38504157 PMCID: PMC10953164 DOI: 10.1186/s12888-024-05661-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/05/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Approximately half of patients who seek care at Emergency Departments due to chest pain are diagnosed with Non-Cardiac Chest Pain (NCCP). Concerns for heart disease and misinterpretation of the symptoms increase cardiac anxiety and have a negative impact on patients' lives. Psychological interventions such as internet-delivered cognitive behavioral therapy (iCBT) are effective in treating psychological conditions such as anxiety, by helping patients to learn how to manage chest pain. AIMS To evaluate the effects of a nurse-led iCBT program on cardiac anxiety and secondary outcomes, as bodily sensations, depressive symptoms, health-related quality of life and chest pain frequency in patients with NCCP at 6- and 12-month follow-up, and to explore predictors that can have impact on the effects of the iCBT program on psychological distress. METHODS A longitudinal study of a Randomized Controlled Trial (RCT) evaluating the long-term effects of an iCBT program (n = 54) in patients with NCCP, compared to psychoeducation (n = 55). The primary outcome, cardiac anxiety was measured using the Cardiac Anxiety Questionnaire (CAQ), and the secondary outcomes were measured with The Body Sensations Questionnaire (BSQ), Patient Health Questionnaire-9 (PHQ-9), The EuroQol Visual Analog Scale (EQ-VAS) and a self-developed question to measure chest pain frequency. All measurements were performed before and after the intervention, and 3, 6 and 12 months after the intervention. Linear mixed model was used to test between-group differences in primary and secondary outcomes and multiple regression analysis was used to explore factors that may have an impact on the treatment effect of iCBT on cardiac anxiety. RESULTS A total of 85% (n = 93/109) participants completed the 12-month follow-up. Mixed model analysis showed no statistically significant interaction effect of time and group between the iCBT and psychoeducation groups regarding cardiac anxiety over the 12-month follow-up. However, there was a statistically significant interaction effect of time and group (p = .009) regarding chest pain frequency favouring the iCBT group. In addition, we found a group effect in health-related quality of life (p = .03) favouring the iCBT group. The regression analysis showed that higher avoidance scores at baseline were associated with improvement in cardiac anxiety at 12-month follow-up. CONCLUSIONS Cardiac anxiety was reduced in patients with NCCP, but iCBT was not more effective than psychoeducation. Patients with a high tendency to avoid activities or situations that they believe could trigger cardiac symptoms may benefit more from psychological interventions targeting cardiac anxiety. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov NCT03336112 on 08/11/2017.
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Affiliation(s)
- Magda Eriksson-Liebon
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
- Department of Emergency Medicine in Norrköping, and, Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden.
| | - Mats Westas
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Peter Johansson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Internal Medicine in Norrköping, and, Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Ghassan Mourad
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Fernandez MDS, da Silva NRJ, Bielavski CH, da Silva JA, Silva AER. Generalized anxiety disorder in Brazilian undergraduate dental students during the COVID-19 pandemic: A cross-sectional study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:117-129. [PMID: 37277980 DOI: 10.1111/eje.12927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/30/2022] [Accepted: 05/14/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Explore the prevalence of generalized anxiety disorder (GAD) and associated factors in undergraduate dental students during the first wave of the COVID-19 pandemic in Brazil. MATERIALS AND METHODS Cross-sectional study. A semi-structured questionnaire addressing the variables of interest was shared with dental students between July 8 and 27 2020. The outcome was determined using the seven-item generalized anxiety disorder (GAD-7) scale. A 'positive' diagnosis was defined as a total of ≥10 points on the scale. Statistical analysis involved descriptive, bivariate and multivariate analyses, with the significance level set at 5%. RESULTS Among the 1050 students evaluated, 53.8% had a positive diagnosis for GAD. The multivariate analysis revealed that the prevalence of symptoms was higher among individuals who resided with more than three people, those enrolled at teaching institutions that suspended all clinical and laboratory activities, those who did not have an adequate home situation to maintain distance learning, those who had been diagnosed with COVID-19, those who felt anxious about having to see patients with a suspicion or diagnosis of COVID-19 and those who preferred to interrupt in-person academic activities until the population is vaccinated for the COVID-19 virus. CONCLUSION The prevalence of GAD was high. Aspects related to the composition and organization of the home, the suspension of academic activities, a history of COVID-19 contamination, feelings of anxiety in providing dental care to patients with symptoms/suspected of COVID-19 infection and the preference to interrupt in-person academic activities until the population is vaccinated for COVID-19 were factors predisposing the students to anxiety during the first wave of the pandemic.
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Affiliation(s)
| | | | | | - Jandilson Avelino da Silva
- Department of Psychology, School of Medicine, Federal University of Pelotas (UFPel), Pelotas, RS, Brazil
| | - Alexandre Emidio Ribeiro Silva
- School of Dentistry, Federal University of Pelotas (UFPel), Pelotas, RS, Brazil
- Graduate Program in Dentistry, Federal University of Pelotas (UFPel), Pelotas, RS, Brazil
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Claro HG, Menezes PR, Fernandes IF, Seward N, Miranda JJ, Saidel MGB, Baquete AGDL, Daley KL, Aschar S, Cruz DV, Castro HCM, Rocha T, Quayle J, Peters TJ, Araya R. Do baseline participant characteristics impact the effectiveness of a mobile health intervention for depressive symptoms? A post-hoc subgroup analysis of the CONEMO trials. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2024; 46:e20233172. [PMID: 38345934 PMCID: PMC11189110 DOI: 10.47626/1516-4446-2023-3172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/23/2023] [Indexed: 06/20/2024]
Abstract
OBJECTIVE To ascertain whether sociodemographic and health-related characteristics known from previous research to have a substantive impact on recovery from depression modified the effect of a digital intervention designed to improve depressive symptoms (CONEMO). METHODS The CONEMO study consisted of two randomized controlled trials, one conducted in Lima, Peru, and one in São Paulo, Brazil. As a secondary trial plan analysis, mixed logistic regression was used to explore interactions between the treatment arm and subgroups of interest defined by characteristics measured before randomization - suicidal ideation, race/color, age, gender, income, type of mobile phone, alcohol misuse, tobacco use, and diabetes/hypertension - in both trials. We estimated interaction effects between the treatment group and these subgroup factors for the secondary outcomes using linear mixed regression models. RESULTS Increased effects of the CONEMO intervention on the primary outcome (reduction of at least 50% in depressive symptom scores at 3-month follow-up) were observed among older and wealthier participants in the Lima trial (p = 0.030 and p = 0.001, respectively). CONCLUSION There was no evidence of such differential effects in São Paulo, and no evidence of impact of any other secondary outcomes in either trial. CLINICAL TRIAL REGISTRATION NCT02846662 (São Paulo, Brazil - SP), NCT03026426 (Lima, Peru - LI).
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Affiliation(s)
- Heloísa Garcia Claro
- Faculdade de Enfermagem, Universidade Estadual de Campinas, Campinas, SP, Brazil
- Núcleo de Apoio à Pesquisa em Saúde Mental Populacional, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Paulo Rossi Menezes
- Núcleo de Apoio à Pesquisa em Saúde Mental Populacional, Universidade de São Paulo (USP), São Paulo, SP, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Ivan Filipe Fernandes
- Centro de Engenharia, Modelagem e Ciências Sociais Aplicadas, Universidade Federal do ABC, Santo André, SP, Brazil
| | - Nadine Seward
- Centre for Global Mental Health and Primary Care Research, Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Juan Jaime Miranda
- Centre for Global Mental Health and Primary Care Research, Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | | | | | - Kate L. Daley
- Núcleo de Apoio à Pesquisa em Saúde Mental Populacional, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Suzana Aschar
- Faculdade de Enfermagem, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Daniela Vera Cruz
- Núcleo de Apoio à Pesquisa em Saúde Mental Populacional, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | - Thais Rocha
- Departamento de Medicina Preventiva, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Julieta Quayle
- Núcleo de Apoio à Pesquisa em Saúde Mental Populacional, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Tim J. Peters
- Bristol Medical and Dental Schools, University of Bristol, Bristol, UK
| | - Ricardo Araya
- Centre for Global Mental Health and Primary Care Research, Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
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Pettitt AK, Nelson BW, Forman-Hoffman VL, Goldin PR, Peiper NC. Longitudinal outcomes of a therapist-supported digital mental health intervention for depression and anxiety symptoms: A retrospective cohort study. Psychol Psychother 2024. [PMID: 38270220 DOI: 10.1111/papt.12517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE This study examined treatment outcomes (depression and anxiety symptoms) up to 24 months after completion of a therapist-supported digital mental health intervention (DMHI). METHODS The sample consisted of 380 participants who participated in an eight-week DMHI from February 6, 2017 to May 20, 2019. Participants reported depression and anxiety symptoms at eight timepoints from baseline to 24 months. Mixed-effects modelling was used to investigate symptom changes over time. The proportion of participants meeting criteria for treatment response, clinically significant change, and remission of depression and anxiety symptoms were calculated, including proportions demonstrating each outcome sustained up to each timepoint. RESULTS Multivariate analyses yielded statistically significant reductions in depression (β = -5.40) and anxiety (β = -3.31) symptoms from baseline to end of treatment (8 weeks). Symptom levels remained significantly reduced from baseline through 24 months. The proportion of participants meeting criteria for clinical treatment outcomes remained constant over 24 months, although there were linear decreases in the proportions experiencing sustained clinical outcomes. CONCLUSIONS Treatment gains were made for depression and anxiety symptoms at the end of treatment and up to 24 months. Future studies should determine the feasibility of integrating post-treatment programmes into DMHIs to address symptom deterioration.
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Affiliation(s)
- Adam K Pettitt
- Meru Health, San Mateo, California, USA
- Center for Digital Mental Health, University of Oregon, Eugene, Oregon, USA
| | - Benjamin W Nelson
- Meru Health, San Mateo, California, USA
- Department of Psychology and Neuroscience, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
| | - Valerie L Forman-Hoffman
- Meru Health, San Mateo, California, USA
- Department of Epidemiology, The University of Iowa, Iowa City, Iowa, USA
| | - Philippe R Goldin
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California, USA
| | - Nicholas C Peiper
- Meru Health, San Mateo, California, USA
- Department of Epidemiology and Population Health, University of Louisville, Louisville, Kentucky, USA
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Mide M, Mattiasson J, Norlin D, Sehlin H, Rasmusson J, Ljung S, Lindskog A, Petersson J, Saavedra F, Gordh AS. Internet-delivered therapist-assisted cognitive behavioral therapy for gambling disorder: a randomized controlled trial. Front Psychiatry 2023; 14:1243826. [PMID: 38146277 PMCID: PMC10749366 DOI: 10.3389/fpsyt.2023.1243826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/23/2023] [Indexed: 12/27/2023] Open
Abstract
Objectives Cognitive behavioral therapy (CBT) is the most promising treatment for gambling disorder (GD) but only 21% of those with problematic gambling seek treatment. CBT over the Internet might be one way to reach a larger population. The aim of this study was to assess the effectiveness of Internet-delivered CBT with therapist guidance compared to an active control treatment. Methods Using a single-blinded design, 71 treatment-seeking gamblers (18-75 years) diagnosed with GD were randomized to 8 weeks of Internet-delivered CBT guided by telephone support, or 8 weeks of Internet-delivered motivational enhancement paired with motivational interviewing via telephone (IMI). The primary outcome was gambling symptoms measured at a first face-to-face assessment, baseline (treatment start), every 2 weeks, post-treatment, and 6-month follow-up. Gambling expenditures, time spent gambling, depression, anxiety, cognitive distortions, and quality of life were assessed as secondary outcomes. Analysis was performed on the full analysis sample (n = 60), with intention-to-treat sensitivity analyses (n = 69). Results In the CBT group, 80% stayed in treatment until the final week, compared to 67% in IMI. Post-treatment and at 6-month follow-up, no differences were found between CBT and IMI for any outcome measure. An exploratory analysis of the total sample (n = 60) showed a significant effect of time during treatment on gambling symptoms (d, [95% CI] 0.52, [-1.15, 2.02]) and all secondary outcomes except the gambling diary (depression (0.89, [-1.07-2.65]); anxiety (0.69, [-1.20-2.38])); cognitive distortions (0.84, [-0.73-2.29]); quality of life (0.60, [-0.61-1.70])). Post-treatment, there were no clinical gambling symptoms in either group. Some deterioration was seen between post-treatment and 6-month follow-up on gambling symptoms (0.42, [-1.74-2.43]), depression (0.59, [-0.82-1.86]), and anxiety (0.30, [-0.99-1.48]). Additionally, it was observed that the largest reduction in gambling symptoms was between the first assessment and baseline. Conclusion Both treatments offered in this study were effective at reducing gambling symptoms. It is also possible that the process of change started before treatment, which gives promise to low-intensity interventions for GD. Additional research is needed as this approach could be both cost-effective and has the potential to reach more patients in need of treatment than is currently possible. Clinical trial registration https://www.isrctn.com/, identifier ISRCTN38692394.
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Affiliation(s)
- Mikael Mide
- Department of Addiction Medicine, Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jessica Mattiasson
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - David Norlin
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helena Sehlin
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Josefine Rasmusson
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sofia Ljung
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Amanda Lindskog
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jonna Petersson
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Fanny Saavedra
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Söderpalm Gordh
- Department of Addiction Medicine, Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
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Pereira-Payo D, Denche-Zamorano Á, Mayordomo-Pinilla N, Franco-García JM, Castillo-Paredes A, Garcia-Gordillo MA, Rojo-Ramos J, Barrios-Fernández S. Higher physical activity level and perceived social support is associated with less psychological distress in people with anxiety. PeerJ 2023; 11:e16000. [PMID: 37933255 PMCID: PMC10625759 DOI: 10.7717/peerj.16000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/09/2023] [Indexed: 11/08/2023] Open
Abstract
Introduction Anxiety is one of the most prevalent mental illnesses in first world societies, generating discomfort in the people who suffer from it, and high expenses and economic losses in the society. The physical activity (PA) performed, together with the perceived social support (PSS) by people with anxiety could be related to the psychological distress of people with anxiety. Objectives To study the relationships between mental health and its dimensions, through Golberg's General Health Questionnaire (GHQ12), and the level of PA (PAL) and the PSS in the Spanish adult population with anxiety. Hypothesis A higher PAL, and a higher PSS, is related to a lower psychological distress in this population. Design and Methodology This study included 1,661 adults with anxiety, residents in Spain. It was a cross-sectional study with data obtained from the Spanish National Health Survey. A Kolmogorov-Smirnov test was applied to examine the data distribution of the variables. The median and interquartile range were used to characterize the sample for continuous variables, and absolute and relative frequencies were used for categorical variables. The Mann-Whitney U test was used to examine the differences between sexes. Dependence between PAL and sex was studied using the chi-square statistic. A Krustal-Wallis test was used to evaluate the existence of differences in the baseline medians on the GHQ-12, according to PAL level. Finally, the correlations between mental health and its dimensions with PAL and the Duke-UNC-11 scores were analysed, obtaining Spearman's rho and Pearson's correlation coefficient. Results Moderate inverse correlations were found between the GHQ-12 and: PAL (rho: -0.219); PSS (r: -0.347). PAL and PSS presented moderate inverse correlations with successful coping (rho: -0.206 and r: -0.325), self-esteem (rho: -0.222 and r: -0.333) and stress (rho: -0.158 and r: -0.288). Conclusions Greater PAL and social support are associated with reduced psychological distress in people with anxiety.
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Affiliation(s)
- Damián Pereira-Payo
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, Cáceres, Extremadura, Spain
| | - Ángel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, Cáceres, Extremadura, Spain
| | - Noelia Mayordomo-Pinilla
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, Cáceres, Extremadura, Spain
| | - Juan Manuel Franco-García
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, Cáceres, Extremadura, Spain
| | - Antonio Castillo-Paredes
- Grupo AFySE, Investigación en Actividad Física y Salud Escolar, Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad de Las Americas, Santiago, Santiago, Chile
| | | | - Jorge Rojo-Ramos
- Physical Activity for Education, Performance and Health, Faculty of Sport Sciences, University of Extremadura, Cáceres, Extremadura, Spain
| | - Sabina Barrios-Fernández
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Extremadura, Spain
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10
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Li X, Kang Q, Gu H. A comprehensive review for machine learning on neuroimaging in obsessive-compulsive disorder. Front Hum Neurosci 2023; 17:1280512. [PMID: 38021236 PMCID: PMC10646310 DOI: 10.3389/fnhum.2023.1280512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a common mental disease, which can exist as a separate disease or become one of the symptoms of other mental diseases. With the development of society, statistically, the incidence rate of obsessive-compulsive disorder has been increasing year by year. At present, in the diagnosis and treatment of OCD, The clinical performance of patients measured by scales is no longer the only quantitative indicator. Clinical workers and researchers are committed to using neuroimaging to explore the relationship between changes in patient neurological function and obsessive-compulsive disorder. Through machine learning and artificial learning, medical information in neuroimaging can be better displayed. In this article, we discuss recent advancements in artificial intelligence related to neuroimaging in the context of Obsessive-Compulsive Disorder.
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Affiliation(s)
- Xuanyi Li
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qiang Kang
- Department of Radiology, Xing’an League People’s Hospital of Inner Mongolia, Mongolia, China
| | - Hanxing Gu
- Department of Geriatric Psychiatry, Qingdao Mental Health Center, Qingdao, Shandong, China
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11
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Tsai CH, Christian M, Lai F. Enhancing panic disorder treatment with mobile-aided case management: an exploratory study based on a 3-year cohort analysis. Front Psychiatry 2023; 14:1203194. [PMID: 37928915 PMCID: PMC10620526 DOI: 10.3389/fpsyt.2023.1203194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Background Individuals with panic disorder frequently face ongoing symptoms, suboptimal treatment adherence, and increased relapse rates. Although mobile health interventions have shown promise in improving treatment outcomes for numerous mental health conditions, their effectiveness, specifically for panic disorder, has yet to be determined. Objective This study investigates the effects of a mobile-aided case management program on symptom reduction and quality of care among individuals with panic disorder. Methods This 3-year cohort study enrolled 138 participants diagnosed with panic disorder. One hundred and eight participants joined the mobile-aided case management group and 30 in the treatment-as-usual group. Data were collected at baseline, 3-month, 6-month, and 12-month treatment checkpoints using self-report questionnaires, in-depth interviews, direct observation, and medical record analysis. Results During the maintenance treatment phase, the mobile-assisted case management group decreased both panic severity (p = 0.008) and state anxiety (p = 0.016) more than the control group at 6 months. Participants who underwent case management experienced enhanced control over panic symptoms, heightened self-awareness, and elevated interpersonal support. Conclusion The mobile-aided case management is beneficial in managing panic disorder, especially maintenance treatment.
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Affiliation(s)
- Chan-hen Tsai
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Mesakh Christian
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Feipei Lai
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
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12
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Lisi DM, Hawley LL, McCabe RE, Rowa K, Cameron DH, Richter MA, Rector NA. Online versus in-person delivery of cognitive behaviour therapy for obsessive compulsive disorder: An examination of effectiveness. Clin Psychol Psychother 2023. [PMID: 37699581 DOI: 10.1002/cpp.2908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/13/2023] [Accepted: 08/28/2023] [Indexed: 09/14/2023]
Abstract
Cognitive behavioural therapy (CBT) including exposure and response prevention is the first-line psychological treatment for obsessive compulsive disorder (OCD). Given changes in the clinical landscape, there are increasing efforts to evaluate its effectiveness in online contexts. Mirroring the traditional in-person delivery, few studies have assessed the role of therapist-guided, manual-based CBT for OCD delivered in real-time via videoconferencing methods. The present study sought to fill this gap by comparing in-person and online delivery of group-based CBT for the treatment of OCD. A convenience sample of participants with moderate to severe OCD (n = 144) were recruited from a naturalistic database from two large OCD specialty assessment and treatment centres. Patients received group-based CBT that was provided in-person (pre-COVID-19 pandemic; March 2018 to March 2020) or online via videoconferencing (during the COVID-19 pandemic; March 2020 to April 2021). In both delivery methods, treatment consisted of 2-h weekly sessions led by trained clinicians. Analyses revealed that, regardless of treatment modality, both in-person and online groups demonstrated significant, reliable, and statistically equivalent improvements in OCD symptoms post-treatment. Videoconferenced, clinician-led CBT may be a promising alternative to in-person delivery for those with moderate to severe OCD symptoms.
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Affiliation(s)
- Diana M Lisi
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Lance L Hawley
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Randi E McCabe
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Karen Rowa
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Duncan H Cameron
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Margaret A Richter
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Neil A Rector
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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13
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Karpov B, Lipsanen JO, Ritola V, Rosenström T, Saarni S, Pihlaja S, Stenberg JH, Laizane P, Joffe G. The Overall Anxiety Severity and Impairment Scale as an Outcome Measure in Internet-Delivered Cognitive Behavioral Therapy for Anxiety Disorders: Observational Study. J Med Internet Res 2023; 25:e45362. [PMID: 37590055 PMCID: PMC10472172 DOI: 10.2196/45362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 06/20/2023] [Accepted: 06/30/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Internet-delivered cognitive behavioral therapy (iCBT) is effective in the treatment of anxiety disorders. iCBT clinical trials use relatively long and time-consuming disorder-specific rather than transdiagnostic anxiety measurements. Overall Anxiety Severity and Impairment Scale (OASIS) is a brief self-report scale that could offer a universal, easy-to-use anxiety measurement option in disorder-specific and transdiagnostic iCBT programs. OBJECTIVE We aimed to investigate relationships between OASIS and disorder-specific instruments in iCBT. We expected these relationships to be positive. METHODS We investigated patients in original nationwide iCBT programs for generalized anxiety disorder (GAD), obsessive-compulsive disorder, panic disorder, and social anxiety disorder, which were administered by Helsinki University Hospital, Finland. In each program, anxiety symptoms were measured using both disorder-specific scales (the 7-item Generalized Anxiety Disorder scale, Penn State Worry Questionnaire, revised Obsessive-Compulsive Inventory, Panic Disorder Severity Scale, and Social Phobia Inventory) and by OASIS. A general linear model for repeated measures (mixed models) and interaction analysis were used for investigating the changes and relationships in the mean scores of OASIS and disorder-specific scales from the first session to the last one. RESULTS The main effect of linear mixed models indicated a distinct positive association between OASIS and disorder-specific scale scores. Interaction analysis demonstrated relatively stable associations between OASIS and the revised Obsessive-Compulsive Inventory (F822.9=0.09; 95% CI 0.090-0.277; P=.32), and OASIS and the Panic Disorder Severity Scale (F596.6=-0.02; 95% CI -0.108 to -0.065; P=.63) from first the session to the last one, while the 7-item Generalized Anxiety Disorder scale (F4345.8=-0.06; 95% CI -0.109 to -0.017; P=.007), Penn State Worry Questionnaire (F4270.8=-0.52; 95% CI -0.620 to -0.437; P<.001), and Social Phobia Inventory (F862.1=-0.39; 95% CI -0.596 to -0.187; P<.001) interrelated with OASIS more strongly at the last session than at the first one. CONCLUSIONS OASIS demonstrates clear and relatively stable associations with disorder-specific symptom measures. Thus, OASIS might serve as an outcome measurement instrument for disorder-specific and plausibly transdiagnostic iCBT programs for anxiety disorders in regular clinical practice.
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Affiliation(s)
- Boris Karpov
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | | | - Ville Ritola
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Tom Rosenström
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Suoma Saarni
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Satu Pihlaja
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Jan-Henry Stenberg
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - Grigori Joffe
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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14
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Peiper NC, Nelson BW, Aschbacher K, Forman-Hoffman VL. Trajectories of depression symptoms in a therapist-supported digital mental health intervention: a repeated measures latent profile analysis. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1237-1246. [PMID: 36651947 PMCID: PMC9847436 DOI: 10.1007/s00127-022-02402-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 12/12/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE Major depression affects 10% of the US adult population annually, contributing to significant burden and impairment. Research indicates treatment response is a non-linear process characterized by combinations of gradual changes and abrupt shifts in depression symptoms, although less is known about differential trajectories of depression symptoms in therapist-supported digital mental health interventions (DMHI). METHODS Repeated measures latent profile analysis was used to empirically identify differential trajectories based upon biweekly depression scores on the Patient Health Questionnaire-9 (PHQ-9) among patients engaging in a therapist-supported DMHI from January 2020 to July 2021. Multivariate associations between symptom trajectories with sociodemographics and clinical characteristics were examined with multinomial logistic regression. Minimal clinically important differences (MCID) were defined as a five-point change on the PHQ-9 from baseline to week 12. RESULTS The final sample included 2192 patients aged 18 to 82 (mean = 39.1). Four distinct trajectories emerged that differed by symptom severity and trajectory of depression symptoms over 12 weeks. All trajectories demonstrated reductions in symptoms. Despite meeting MCID criteria, evidence of treatment resistance was found among the trajectory with the highest symptom severity. Chronicity of major depressive episodes and lifetime trauma exposures were ubiquitous across the trajectories in a multinomial logistic regression model. CONCLUSIONS These data indicate that changes in depression symptoms during DMHI are heterogenous and non-linear, suggesting a need for precision care strategies to address treatment resistance and increase engagement. Future efforts should examine the effectiveness of trauma-informed treatment modules for DMHIs as well as protocols for continuation treatment and relapse prevention.
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Affiliation(s)
- Nicholas C Peiper
- Meru Health, Inc., 720 South B Street, Second Floor, San Mateo, CA, 94401, USA.
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, USA.
| | - Benjamin W Nelson
- Meru Health, Inc., 720 South B Street, Second Floor, San Mateo, CA, 94401, USA
- Department of Psychology and Neuroscience, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Kirstin Aschbacher
- Meru Health, Inc., 720 South B Street, Second Floor, San Mateo, CA, 94401, USA
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Valerie L Forman-Hoffman
- Meru Health, Inc., 720 South B Street, Second Floor, San Mateo, CA, 94401, USA
- Department of Epidemiology, The University of Iowa, Iowa, IA, USA
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15
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Reangsing C, Trakooltorwong P, Maneekunwong K, Thepsaw J, Oerther S. Effects of online mindfulness-based interventions (MBIs) on anxiety symptoms in adults: a systematic review and meta-analysis. BMC Complement Med Ther 2023; 23:269. [PMID: 37507747 PMCID: PMC10386675 DOI: 10.1186/s12906-023-04102-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND An increasing number of studies have documented the effectiveness on various types of face-to-face and online mindfulness-based interventions (MBIs) in reducing anxiety among general population, but there is a scarcity of systematic reviews evaluating evidence of online MBIs on anxiety in adults. Therefore, we examined the effects of online mindfulness-based interventions (MBIs) on anxiety symptoms in adults and explored the moderating effects of participant, methods, and intervention characteristics. METHODS We systematically searched nine databases through May 2022 without date restrictions. Inclusion criteria were primary studies evaluating online mindfulness-based interventions with adults with anxiety measured as an outcome, a comparison group, and written in English. We used random-effects model to compute effect sizes (ESs) using Hedges' g, a forest plot, and Q and I2 statistics as measures of heterogeneity; we also examined moderator analyses. RESULTS Twenty-six primary studies included 3,246 participants (39.9 ± 12.9 years old). Overall, online mindfulness-based interventions showed significantly improved anxiety (g = 0.35, 95%CI 0.09, 0.62, I2 = 92%) compared to controls. With regards to moderators, researchers reported higher attrition, they reported less beneficial effects on anxiety symptoms (β=-0.001, Qmodel=4.59, p = .032). No other quality indicators moderated the effects of online mindfulness-based interventions on anxiety. CONCLUSION Online mindfulness-based interventions improved anxiety symptoms in adult population. Thus, it might be used as adjunctive or alternative complementary treatment for adults. However, our findings must be interpreted with caution due to the low and unclear power of the sample in primary studies; hence, high-quality studies are needed to confirm our findings.
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Affiliation(s)
| | | | | | - Jintana Thepsaw
- School of Nursing, Mae Fah Laung University, Chiangrai, Thailand
| | - Sarah Oerther
- Trudy Busch Valentine, School of Nursing, Saint Louis University, Missouri, MO, USA
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16
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Nissling L, Weineland S, Vernmark K, Radvogin E, Engström AK, Schmidt S, Nieto Granberg E, Larsson E, Hursti T. Effectiveness of and processes related to internet-delivered acceptance and commitment therapy for adolescents with anxiety disorders: a randomized controlled trial. RESEARCH IN PSYCHOTHERAPY (MILANO) 2023; 26:681. [PMID: 37401474 PMCID: PMC10481424 DOI: 10.4081/ripppo.2023.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/02/2023] [Indexed: 07/05/2023]
Abstract
Early access to evidence-based help is crucial for adolescents with anxiety disorders. Internet-delivered acceptance and commitment therapy (iACT) may offer adolescents increased access to care and more flexibility in engaging with treatment when and how they prefer. Process-based therapies, such as ACT, focus on theoretically derived and empirically tested key mechanisms in treatment that enable change. This study aimed to investigate the effectiveness of iACT for adolescents with anxiety disorders. The study also assessed the relationship between psychological flexibility and treatment outcomes and the relationship between participating adolescents' and therapists' perceived alliance and treatment outcomes. This was a randomized controlled trial comparing a 10-week intervention group with a wait-list control group. The 52 participants, aged 15 to 19, were recruited from all over Sweden. The treatment was effective in increasing quality of life and psychological flexibility, with moderate between-group effect sizes based on observed values. Changes in psychological flexibility was associated with changes in anxiety symptoms. The results further showed a statistically significant between-group difference in post-treatment diagnoses. No significant time per group interaction was found for anxiety symptoms, as both groups improved. Working alliance was rated as high by both participating adolescents and therapists but showed no significant relationship with treatment outcomes. Participants found the treatment an acceptable intervention. This study shows promising results for iACT in treating adolescents with anxiety disorders. The results suggest the model of psychological flexibility as an important process of change in treatment outcomes. Future research should validate these findings in larger samples and clinical contexts.
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Affiliation(s)
- Linnea Nissling
- Department of Psychology, Faculty of Social Sciences, University of Gothenburg; Research, Development, Education and Innovation, Primary Health Care, Västra Götaland Region; General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
| | - Sandra Weineland
- Department of Psychology, Faculty of Social Sciences, University of Gothenburg; Research, Development, Education and Innovation, Primary Health Care, Västra Götaland Region; General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
| | - Kristofer Vernmark
- Department of Behavioural Sciences and Learning (IBL), University of Linköping.
| | - Ella Radvogin
- Department of Behavioural Sciences and Learning (IBL), University of Linköping.
| | - Anna-Karin Engström
- Department of Psychology, Faculty of Social Sciences, University of Uppsala.
| | - Sara Schmidt
- Department of Psychology, Faculty of Social Sciences, University of Uppsala.
| | - Eva Nieto Granberg
- Department of Psychology, Faculty of Social Sciences, University of Uppsala.
| | - Elin Larsson
- Department of Psychology, Faculty of Social Sciences, University of Uppsala.
| | - Timo Hursti
- Department of Psychology, Faculty of Social Sciences, University of Uppsala.
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17
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Teixido L, Andreeva E, Gartmann J, Lemhöfer C, Sturm C, Gutenbrunner C. [Outpatient rehabilitative care for patients with Long-COVID - a guideline-based clinical practice guideline]. Laryngorhinootologie 2023. [PMID: 37130538 DOI: 10.1055/a-1985-0450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Even after weeks and months, persisting and also newly occurring symptoms after SARS-CoV-2 infection are common and lead in many cases to a broad spectrum of impairments and participation restrictions in all areas of daily life. Scientific evidence on therapeutic options still is limited. The aim of this work is therefore to provide pragmatic treatment recommendations analogous to the current therapeutic appliances guideline. METHOD In addition to a search in six electronic databases, the experiences from the treatment of more than hundred affected persons from the post-COVID outpatient rehabilitation service were used. Additionally, experiences with patients with similar symptoms from other diseases were included. All authors worked together to develop the pragmatic recommendations for the treatment of the main symptoms within the framework of outpatient therapy measures. A list of recommended diagnostics and functional assessments prior to therapy was also developed. RESULTS For the main symptoms fatigue, dyspnoea and cognitive impairment, the catalog of therapeutic products offers a wide range of therapeutic options under the diagnosis U09.9. The therapy packages should be composed individually and adapted to the patient's performance level that regularly should be (re-)assessed. Informing the patient about possible relapses and deteriorations and how to deal with them should be also part of the treatment regimen. DISCUSSION Physical modalities and rehabilitation interventions should be used in out-patient rehabilitation setting for the treatment of Long-COVID. In this regard, it is also important to take into account and treat serious complications after the disease, such as post-intensive care syndrome. Due to the rapid evolution of the knowledge a frequent review of scientific papers and recommendations should be conducted. High-quality intervention studies are necessary to achieve greater evidence in this field.
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Affiliation(s)
- Lidia Teixido
- Klinik für Rehabilitationsmedizin, Medizinische Hochschule Hannover, Hannover, Germany
| | - Elena Andreeva
- Klinik für Rehabilitationsmedizin, Medizinische Hochschule Hannover, Hannover, Germany
| | - Judith Gartmann
- Klinik für Rehabilitationsmedizin, Medizinische Hochschule Hannover, Hannover, Germany
| | | | - Christian Sturm
- Klinik für Rehabilitationsmedizin, Medizinische Hochschule Hannover, Hannover, Germany
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18
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Zhang H, Yuan X, Mohd Zain NB, Gao Y. Analysis of therapeutic effect of subliminal cognition combined with hypnotherapy on anxiety disorder via neural network. Biotechnol Genet Eng Rev 2023:1-18. [PMID: 37129528 DOI: 10.1080/02648725.2023.2204604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Hypnotherapy combined with cognitive therapy is an effective way to intervene anxiety problems, which also responds to the call that using hypnotherapy to treat somatic disorders should become a trend in the future. This paper constructs an evaluation index of the intervention effect of cognitive hypnotherapy on anxiety patients, and then uses neural network to evaluate its effect. At last, we have completed the following work: 1) This paper constructs the theoretical basis related to this topic after searching and sorting out the related literature on anxiety disorders and hypnotherapy at home and abroad. 2) This paper constructs the evaluation index system of the intervention effect of cognitive hypnotherapy on anxiety patients, and then introduces the basic principle and structure of DBN model. 3) Experiments are used to determine the best values for the DBN model's parameters. To accomplish this, you will need to input the experimental data into the trained model and compare the evaluation results from experts with the model's predictions. The experimental findings of this study demonstrate the great accuracy of the DBN model presented in this work for assessing the effectiveness of cognitive combination hypnotherapy for anxiety disorders.
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Affiliation(s)
- Hanyue Zhang
- Department of Medical Psychology, Nanjing Brain Hospital, Jiangsu, China
| | - Xuejiao Yuan
- Department of Medical Psychology, Nanjing Brain Hospital, Jiangsu, China
| | | | - Ying Gao
- Department of Medical Psychology, Nanjing Brain Hospital, Jiangsu, China
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Liou KT, McConnell KM, Currier MB, Baser RE, MacLeod J, Walker D, Casaw C, Wong G, Piulson L, Popkin K, Lopez AM, Panageas K, Bradt J, Mao JJ. Virtual Music Therapy versus Virtual Cognitive Behavioral Therapy for Anxiety in Cancer Survivors: Rationale and Protocol for a Comparative Effectiveness Trial (Preprint). JMIR Res Protoc 2023; 12:e46281. [PMID: 37103999 PMCID: PMC10176150 DOI: 10.2196/46281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/19/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND Cancer survivors represent one of the fastest growing populations in the United States. Unfortunately, nearly 1 in 3 survivors experience anxiety symptoms as a long-term consequence of cancer and its treatment. Characterized by restlessness, muscle tension, and worry, anxiety worsens the quality of life; impairs daily functioning; and is associated with poor sleep, depressed mood, and fatigue. Although pharmacological treatment options are available, polypharmacy has become a growing concern for cancer survivors. Music therapy (MT) and cognitive behavioral therapy (CBT) are evidence-based, nonpharmacological treatments that have demonstrated effectiveness in treating anxiety symptoms in cancer populations and can be adapted for remote delivery to increase access to mental health treatments. However, the comparative effectiveness of these 2 interventions delivered via telehealth is unknown. OBJECTIVE The aims of the Music Therapy Versus Cognitive Behavioral Therapy for Cancer-related Anxiety (MELODY) study are to determine the comparative effectiveness of telehealth-based MT versus telehealth-based CBT for anxiety and comorbid symptoms in cancer survivors and to identify patient-level factors associated with greater anxiety symptom reduction for MT and CBT. METHODS The MELODY study is a 2-arm, parallel-group randomized clinical trial that aims to compare the effectiveness of MT versus CBT for anxiety and comorbid symptoms. The trial will enroll 300 English- or Spanish-speaking survivors of any cancer type or stage who have experienced anxiety symptoms for at least 1 month. Participants will receive 7 weekly sessions of MT or CBT delivered remotely via Zoom (Zoom Video Communications, Inc) over 7 weeks. Validated instruments to assess anxiety (primary outcome), comorbid symptoms (fatigue, depression, insomnia, pain, and cognitive dysfunction), and health-related quality of life will be administered at baseline and at weeks 4, 8 (end of treatment), 16, and 26. Semistructured interviews will be conducted at week 8 with a subsample of 60 participants (30 per treatment arm) to understand individual experiences with the treatment sessions and their impact. RESULTS The first study participant was enrolled in February 2022. As of January 2023, 151 participants have been enrolled. The trial is expected to be completed by September 2024. CONCLUSIONS This study is the first and largest randomized clinical trial to compare the short- and long-term effectiveness of remotely delivered MT and CBT for anxiety in cancer survivors. Limitations include the lack of usual care or placebo control groups and the lack of formal diagnostic assessments for psychiatric disorders among trial participants. The study findings will help guide treatment decisions for 2 evidence-based, scalable, and accessible interventions to promote mental well-being during cancer survivorship. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46281.
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Affiliation(s)
- Kevin T Liou
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | | | - Raymond E Baser
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jodi MacLeod
- Society for Integrative Oncology, Washington, DC, United States
| | | | - Camila Casaw
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Greta Wong
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Lauren Piulson
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Karen Popkin
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Ana Maria Lopez
- Thomas Jefferson University, Philadelphia, PA, United States
| | | | - Joke Bradt
- Drexel University, Philadelphia, PA, United States
| | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
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20
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Theurer C, Wilz G. Opportunities for fostering a positive therapeutic relationship in an Internet‐based cognitive behavioural therapy for dementia caregivers. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Christina Theurer
- Institute of Psychology, Department of Counseling and Clinical Psychology Friedrich Schiller University Jena Jena Germany
| | - Gabriele Wilz
- Institute of Psychology, Department of Counseling and Clinical Psychology Friedrich Schiller University Jena Jena Germany
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Rutkowska A. Telemedicine Interventions as an Attempt to Improve the Mental Health of Populations during the COVID-19 Pandemic-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14945. [PMID: 36429660 PMCID: PMC9690156 DOI: 10.3390/ijerph192214945] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/24/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
Published reports indicate the need for psychological interventions and the integration of psychiatric care into crisis management plans in people with mental health issues caused by the COVID-19 pandemic. It seems crucial to identify the root causes of the health-social-economic crisis and identify potential opportunities for widely implemented psychological assistance. This narrative literature review aims to identify the types of interventions deployed as telemedicine-based mental health support and their effectiveness. The PubMed and Web of Science electronic databases were searched. From a total of 48 articles, 46 were analysed after removing duplicates. From these, thirty-seven records were excluded according to the inclusion criteria and nine (eight RCT and one cross-over) were assessed as full texts. The included publications were randomised clinical trials or cross-over studies focused on remote mental support interventions. In all studies, participants represented both sexes and had an average age range of 6-64. Studies included participants from seven countries and the overall number of participants in the included studies was 687. The content of these intervention programmes includes both established psychotherapeutic programmes, as well as new interventions. Remote support was implemented through three approaches: phone/video calls, mobile applications, and internet-based programs. The results of the included studies indicate a higher or equal efficacy of telemedicine interventions compared to traditional forms. The review also revealed a relatively wide range of targeted research groups: from children with social anxiety through to their caregivers; adolescents with neurological disorders; and from college students to adults with psychiatric or orthopaedic disorders. Analysis of the included papers found that telemedicine interventions show promising results as an attempt to improve population mental health during the COVID-19 pandemic.
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Affiliation(s)
- Anna Rutkowska
- Department of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland
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22
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Maroti D, Hallberg H, Lindqvist K, Mechler J. Using psychodynamic principles in guided internet-delivered therapy (IPDT). PSYCHOANALYTIC PSYCHOTHERAPY 2022. [DOI: 10.1080/02668734.2022.2124441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
- Daniel Maroti
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Henrik Hallberg
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Karin Lindqvist
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Jakob Mechler
- Department of Psychology, Stockholm University, Stockholm, Sweden
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Obesity-Associated Anxiety Is Prevalent among College Students and Alleviated by Calorie Restriction. Nutrients 2022; 14:nu14173518. [PMID: 36079775 PMCID: PMC9460559 DOI: 10.3390/nu14173518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 11/22/2022] Open
Abstract
Anxiety is a common disorder among college students, especially those with obesity. Obesity contributes to metabolic disorders and disturbs the neural functions, further leading to anxiety. In this cross-sectional study, we aimed to determine the association between obesity and anxiety among college students and identified the potential factors for obesity-associated anxiety. We evaluated the intervention effects of calorie restriction on anxiety. Self-reported questionnaires were distributed to 1381 college students from January to March in 2021. Anxiety was measured by the State-Trait Anxiety Inventory (STAI). Participants were classified into anxiety and non-anxiety groups according to their STAI scores. Chi-squared test and logistic regression were used to analyze the potential factors. We found that 383 college students exhibited anxiety, accounting for 30.1% among all included college students, which was higher than the global average. The association between anxiety and obesity was observed among college students (p = 0.009), especially in males (p = 0.007). We identified that pre-obesity (p = 0.012), unhealthy calorie intake (p = 0.001), dieting (p = 0.003) and high academic year (p = 0.006) as the risk factors for anxiety and found that the long sleep duration was a protective factor for anxiety (p < 0.001). We found that more obese students showed an improvement of anxiety than the underweight students after calorie restriction (p < 0.001). Collectively, our findings suggest that obesity-associated anxiety is prevalent among the college students and could be alleviated by moderate calorie restriction. It is necessary for students to receive anxiety management in their college life. Additionally, the proper calorie restriction should be promoted to help students protect against obesity and obesity-associated anxiety.
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Dunn N, Walton CJ, Matsunaga E, Williams C, Dimeff LA. Acceptability of Telehealth for Multidiagnostic Suicidal Patients in a Real-World Dialectical Behavior Therapy Clinic During the COVID-19 Pandemic. Telemed J E Health 2022; 29:593-601. [PMID: 35984847 DOI: 10.1089/tmj.2022.0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: This study aimed to evaluate the acceptability of Dialectical Behavior Therapy (DBT) delivered through telehealth to complex, suicidal patients during the COVID-19 pandemic. Methods: We surveyed 163 adult participants enrolled in outpatient services at a private, free-standing DBT clinic certified by the DBT-Linehan Board of Certification for its fidelity to the treatment. Treatment satisfaction was assessed, as well as ease of telehealth over time, differences in satisfaction between patients who had previously experienced face-to-face treatment and those who had only experienced telehealth, patients' beliefs regarding the impact of telehealth on their progress, and preference for face-to-face versus telehealth services. Additionally, participants' reasons for liking and disliking telehealth were reported. Results: The average overall satisfaction rating was 82.26 (±18.71) on a 100-point scale. Factors identified as being relevant to satisfaction included increased access to care, saving time and money, and increased comfort participating in therapy from home. Factors identified as relevant to dissatisfaction included feeling less connected to therapists and other patients. The majority of participants reported that telehealth positively impacted or did not impact treatment progress. Satisfaction was significantly related to participants' perception of telehealth's impact on progress in treatment. Demographic variables were also included in the analyses, but were unrelated to satisfaction. Conclusions: Findings indicate that, from the point of view of consumer satisfaction, telehealth appears satisfactory for delivery of DBT and may play an increased role in behavioral health care postpandemic.
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Affiliation(s)
| | - Carla J Walton
- Hunter New England Mental Health Service, Newcastle, New South Wales, Australia
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25
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Farrell D, Fadeeva A, Zat Z, Knibbs L, Miller P, Barron I, Matthess H, Matthess C, Gazit N, Kiernan MD. A Stage 1 Pilot Cohort Exploring the Use of EMDR Therapy as a Videoconference Psychotherapy During COVID-19 With Frontline Mental Health Workers: A Proof of Concept Study Utilising a Virtual Blind 2 Therapist Protocol. Front Psychol 2022; 13:901855. [PMID: 35874361 PMCID: PMC9298740 DOI: 10.3389/fpsyg.2022.901855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/19/2022] [Indexed: 02/05/2023] Open
Abstract
Objective The COVID-19 pandemic has had a major impact on the delivery of psychological treatment. Due to social distancing requirements, the provision moved to videoconferencing psychotherapy (VCP). There is a paucity of empirical data supporting the efficacy of EMDR therapy as a VCP. This stage 1 pilot study tested an EMDR therapy scripted protocol, such as Virtual Blind 2 Therapist (VB2Tr), on frontline mental health workers as a VCP regarding fitness for purpose, distinctiveness, relevance, and efficiency. Methods A total of 24 participants were recruited for the study. The design included a one-session treatment intervention with pre, post, 1-month, and 6-month follow-up (FU) measurements. This treatment session used a “Blind 2 Therapist” EMDR therapy scripted protocol as videoconference psychotherapy that involves non-disclosure of traumatic memory. The research explored the treatment effect on the core characteristics of trauma memory, including subjective disturbance, belief systems, memory intensity (MI), vividness, and levels of emotionality. Additionally, the research explored participants’ experiences of adverse and benevolent childhood experiences (ACEs/BCEs) during their childhood. Results Regarding the four tests, namely, fitness for purpose, distinctiveness, relevance, and efficiency, results are favourably suggesting potential clinical benefits of using EMDR as videoconference psychotherapy. Although this is a proof-of-concept study showing positive results, no clinical population or control group was used. The purpose of the study is to explore the potential for scalability toward a larger clinical trial. The treatment intervention was achieved irrespective of either ACEs/BCEs during childhood. Conclusion The research tentatively supports the case for EMDR therapy as a credible treatment when used as video conference psychotherapy and in using the Blind 2 Therapist protocol. However, more research is needed to scale toward a clinical trial. Clinical Trial Registration Clinical Trial Registration:https://www.isrctn.com/ISRCTN12099530, identifier ISRCTN12099530.
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Affiliation(s)
- Derek Farrell
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Anastasia Fadeeva
- Northern Hub for Veteran and Military Families' Research, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Zeynep Zat
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Lorraine Knibbs
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Paul Miller
- Mirabilis Health Institute, Newtownabbey, United Kingdom
| | - Ian Barron
- Centre for International Education, College of Education, University of Massachusetts, Amherst, MA, United States
| | - Helga Matthess
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Cordula Matthess
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | | | - Matthew D Kiernan
- Northern Hub for Veteran and Military Families' Research, Northumbria University, Newcastle upon Tyne, United Kingdom
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Nguyen P, Heisey R, Quenneville C, Goulbourne E, Khan R, Rinaldo E, Chagigiorgis H, Shields R, Townsley C. An examination of depression, anxiety, and fear of recurrence among cancer survivors who participated in a virtual cognitive behavioral therapy (CBT)-based telephone coaching program. Support Care Cancer 2022; 30:7323-7332. [PMID: 35606479 DOI: 10.1007/s00520-022-07148-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/13/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Depression, anxiety, and fear of recurrence (FOR) are prevalent among cancer survivors, and it is recommended that they have access to supportive services and resources to address psychosocial needs during follow-up care. This study examined the impact of a virtual cognitive behavioral therapy (CBT)-based telephone coaching program (BounceBack®) on depression, anxiety, and FOR. METHOD Through the After Cancer Treatment Transition (ACTT) clinic at the Women's College Hospital (Toronto, Canada), eligible participants were identified, consented, and referred to the BounceBack® program. Program participation involved completion of self-selected online workbooks and support from trained telephone coaches. Measures of depression (PHQ-9), anxiety (GAD-7), and FOR (fear of cancer recurrence inventory, FCRI) were collected at pre-intervention (baseline) and post-intervention (6-month and 12-month time points). For each psychosocial measure, paired t-tests compared mean scores between study time points. Participant experiences and perceptions were collected through a survey. RESULTS Measures of depression and anxiety significantly improved among participants from pre-intervention to post-intervention. Scores for PHQ-9 and GAD-7 decreased from moderate to mild levels. Measure of FOR also significantly improved, while FCRI sub-scale scores significantly improved for 5 of the 7 factors that characterize FOR (triggers, severity, psychological distress, functional impairment, insight). Participants rated the intervention a mean score of 7 (out of 10), indicating a moderate level of satisfaction and usefulness. CONCLUSION This study suggested that a virtual CBT-based telephone coaching program can be an effective approach to managing depression, anxiety, and fear of recurrence in cancer survivors.
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Affiliation(s)
- Patricia Nguyen
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, ON, Toronto, Canada.
| | - Ruth Heisey
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, ON, Toronto, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Elaine Goulbourne
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, ON, Toronto, Canada
| | - Rumaisa Khan
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, ON, Toronto, Canada
| | - Emma Rinaldo
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, ON, Toronto, Canada
| | | | - Rebecca Shields
- Canadian Mental Health Association York Region and South Simcoe Branch, Newmarket, ON, Canada
| | - Carol Townsley
- After Cancer Treatment Transition Program, Women's College Hospital, Toronto, ON, Canada
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Liu X, Huang S, Hu Y, Wang G. The effectiveness of telemedicine interventions on women with postpartum depression: A systematic review and meta-analysis. Worldviews Evid Based Nurs 2022; 19:175-190. [PMID: 35349219 DOI: 10.1111/wvn.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/23/2021] [Accepted: 12/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is a public health problem that has significant adverse effects on mothers, couple's relationships, newborn neurodevelopment, and child emotional and cognitive development. This study reviewed the effectiveness of telemedicine interventions in postparturient women with postpartum depression. AIMS To evaluate the effectiveness of telemedicine intervention in women with postpartum depression. METHODS Cochrane Library, PubMed, EMBASE, Web of Science, CINAHL, and PsycINFO were searched for relevant articles published between 2003 and March 2021. We also manually reviewed the reference lists of the retrieved articles. The present study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias for individual studies was evaluated according to the Cochrane Handbook. RevMan 5.4 software was used to carry out the meta-analysis. RESULTS The meta-analysis included 20 randomized controlled trials with a total of 3252 patients. The results demonstrated that telemedicine was an effective intervention for treating PPD and anxiety and for improving functional impairment in women during their postpartum period. LINKING EVIDENCE TO ACTION This meta-analysis provided evidence that telemedicine was an effective intervention for treating PPD in women. Telemedicine also has significant effects on anxiety and improved functional impairment in women during their postpartum period. Our findings may provide accurate evidence-based guidance for postpartum women's mental health management. In the future, more high-quality studies are required for verifying these results.
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Affiliation(s)
- Xueyan Liu
- School of Nursing, Shandong University, Jinan City, China
| | - Sasa Huang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Ying Hu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Guangpeng Wang
- Xiangya School of Nursing, Central South University, Changsha, China
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Braun P, Drüge M, Hennemann S, Nitsch FJ, Staeck R, Apolinário-Hagen J. Acceptance of E-Mental Health Services for Different Application Purposes Among Psychotherapists in Clinical Training in Germany and Switzerland: Secondary Analysis of a Cross-Sectional Survey. Front Digit Health 2022; 4:840869. [PMID: 35295621 PMCID: PMC8918841 DOI: 10.3389/fdgth.2022.840869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Despite solid evidence supporting the efficacy of electronic mental health (EMH) services, their acceptance among psychotherapists is limited and uptake rates remain low. However, the acceptance of different EMH services has yet barely been examined in future generations of psychotherapists in a differentiated manner. The aims of this study were (1) to elaborate the intention to use various EMH services for different application purposes and (2) to determine predictors of EMH service acceptance among psychotherapists in clinical training (PiT). Materials and Methods Our paper is based on a secondary data analysis of a cross-sectional survey. Respondents were recruited via recognized educational institutions for psychotherapy within Germany and the German-speaking part of Switzerland between June and July of 2020. The survey contained items on the intention to use different EMH services (i.e., guided and unguided programs, virtual reality, psychotherapy by telephone and videoconference) for various application purposes (i.e., prevention, treatment addition, treatment substitute, aftercare). Potential predictors of EMH service acceptance (e.g., barriers and advantages) were examined based on an extension of the Unified Theory of Acceptance and Use of Technology (UTAUT). Results Most of the n = 216 respondents were female (88.4%) and located in Germany (72.2%). General acceptance of EMH was moderate (M = 3.4, SD = 1.12, range 1-5), while acceptance of psychotherapy via videoconference was highest (M = 3.7, SD = 1.15) and acceptance of unguided programs was lowest (M = 2.55, SD = 1.14). There was an interaction effect of EMH service and application purpose (η2 = 0.21). Barriers and advantages both had a uniform influence on EMH service acceptance (Pr > 0.999), while impersonality, legal concerns, concerns about therapeutic alliance, simplified information provision, simplified contact maintenance, time flexibility, and geographic flexibility were significant predictors (all p < 0.05). Results showed that the extended UTAUT model was the best fitting model to predict EMH service acceptance (Pr > 0.999). Conclusions The intention to use different EMH services varied between application purposes among PiT. To increase acceptance of EMH services and reduce misconceptions, we identified predictors that should be addressed in future acceptance-facilitating interventions when educating PiT.
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Affiliation(s)
- Pia Braun
- Faculty of Medicine, Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Marie Drüge
- Department of Clinical Psychology/Psychotherapy Research, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Severin Hennemann
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Institute of Psychology, University of Mainz, Mainz, Germany
| | - Felix Jan Nitsch
- Marketing Area, INSEAD, Fontainebleau, France
- Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France
| | - Robert Staeck
- Department of Clinical Psychology/Psychotherapy Research, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Jennifer Apolinário-Hagen
- Faculty of Medicine, Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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De Fabritiis M, Trisolini F, Bertuletti G, Fagadau ID, Ginelli D, Lalopa KP, Peverelli L, Pirola A, Sala G, Maisto M, Madeddu F, Lopez-Castroman J, Romano D, Gabbiadini A, Preti E, Micucci D, Calati R. An Internet-Based Multi-Approach Intervention Targeting University Students Suffering from Psychological Problems: Design, Implementation, and Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052711. [PMID: 35270403 PMCID: PMC8910035 DOI: 10.3390/ijerph19052711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/11/2022] [Accepted: 02/17/2022] [Indexed: 11/16/2022]
Abstract
Despite the widespread prevalence of mental health problems, most psychological distress remains untreated. Internet-based psychological interventions can be an essential tool for increasing treatment availability and accessibility. The main objective of the MindBlooming project is to design and implement an innovative Internet-based multi-approach treatment for university students suffering from psychological or physical problems. The intervention will focus on symptoms of depression, anxiety, sleep problems, self-destructive thoughts, job- and study-related stress and burnout, and chronic pain. It will be based on different approaches, primarily psychoeducation, Cognitive-Behavioral Treatment (CBT), and third-wave CBT. At the end of the treatment, user satisfaction and usability will be assessed. In addition, two further aims will be evaluating the treatment efficacy through a randomized controlled trial and tuning a predictive model through Machine Learning techniques. The intervention consists of a 7-week treatment on two problematic areas according to each students’ personal needs, identified through an initial assessment. Besides the treatment assigned following the initial screening, participants will also be assigned to a different module to improve their relational skills. The treatment, which can be accessed through a mobile app, consists of psychoeducational videos followed by related exercises. We expect MindBlooming to be a remarkable tool for promoting the mental health of university students.
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Affiliation(s)
- Marlene De Fabritiis
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
| | - Federica Trisolini
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
| | - Gloria Bertuletti
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
| | - Ionut Daniel Fagadau
- Department of Informatics, Systems and Communication (DISCo), University of Milano-Bicocca, 20126 Milan, Italy; (I.D.F.); (D.G.); (D.M.)
| | - Davide Ginelli
- Department of Informatics, Systems and Communication (DISCo), University of Milano-Bicocca, 20126 Milan, Italy; (I.D.F.); (D.G.); (D.M.)
| | - Katiuscia Pia Lalopa
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
| | - Lisa Peverelli
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
| | - Alessia Pirola
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
| | - Gaia Sala
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
| | - Marta Maisto
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
| | - Fabio Madeddu
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
- BICAPP—Bicocca Center for Applied Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Jorge Lopez-Castroman
- Department of Adult Psychiatry, Nîmes, University Hospital, 30900 Nîmes, France;
- IGF, CNRS-INSERM, Université Montpellier, 34094 Montpellier, France
- CIBERSAM, 28029 Madrid, Spain
| | - Daniele Romano
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
| | - Alessandro Gabbiadini
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
| | - Emanuele Preti
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
- BICAPP—Bicocca Center for Applied Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Daniela Micucci
- Department of Informatics, Systems and Communication (DISCo), University of Milano-Bicocca, 20126 Milan, Italy; (I.D.F.); (D.G.); (D.M.)
| | - Raffaella Calati
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (M.D.F.); (F.T.); (G.B.); (K.P.L.); (L.P.); (A.P.); (G.S.); (M.M.); (F.M.); (D.R.); (A.G.); (E.P.)
- BICAPP—Bicocca Center for Applied Psychology, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Adult Psychiatry, Nîmes, University Hospital, 30900 Nîmes, France;
- Correspondence:
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Bondesson E, Jöud A, Stigmar K, Ringqvist Å, Kraepelien M, Kaldo V, Wettermark B, Forsell Y, Petersson IF, Schelin ME. Utilization of healthcare and prescription medicines after non-pharmacological interventions for depression - A 3-year register follow-up of an RCT in primary care. Prev Med Rep 2022; 25:101658. [PMID: 35127347 PMCID: PMC8800057 DOI: 10.1016/j.pmedr.2021.101658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022] Open
Abstract
A 3-year register follow-up of an RCT for depression interventions was conducted. Healthcare utilization and dispensed medicines were used as register outcomes. The interventions had no effect on consultations for mental illness during follow-up. Both interventions are appropriate additions to mild-moderate depression care.
Depression is a common, recurrent disorder. There is a need for readily available treatments with few negative side effects, that demands little resources and that are effective both in the short- and long term. Our aim was to investigate the long-term effectiveness of two different interventions; physical exercise and internet-based cognitive behavioural therapy (internet-CBT), compared to usual care in patients with mild to moderate depression in a Swedish primary care setting. We performed a register-based 3-year follow-up study of participants in the randomized controlled trial REGASSA (n = 940) using healthcare utilization and dispensed medicines as outcomes. We found no difference between the three groups regarding proportion of participants consulting healthcare due to mental illness or pain during follow-up. Regarding number of consultations, there was no difference between the groups, except for consultations related to pain. For this outcome both treatment arms had significantly fewer consultations compared to usual care, during year 2–3, the risk ratio (RR) for physical exercise and internet-CBT was 0.64 (95% CI = 0.43–0.95) and 0.61 (95% CI = 0.41–0.90), respectively. A significantly lower proportion of patients in both treatment arms were dispensed hypnotics and sedatives year 2–3 compared to the usual care arm, RR for both physical exercise and internet-CBT was 0.72 (95% CI = 0.53–0.98). No other differences between the groups were found. In conclusion, considering long-term effects, both physical exercise and internet-CBT, being resource-efficient treatments, could be considered as appropriate additions for patients with mild to moderate depression in primary care settings. Trial registration: The original RCT was registered with the German Clinical Trial Register (DRKS study ID: DRKS00008745).
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Bradley DF, Ching TH, Languido L, Brady RE. Application of a Quality Improvement Process to Evaluate Self-Directed Therapy for Patients on a Waitlist in an Outpatient Anxiety Disorders Specialty Clinic. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Staples LG, Webb N, Asrianti L, Cross S, Rock D, Kayrouz R, Karin E, Dear BF, Nielssen O, Titov N. A Comparison of Self-Referral and Referral via Primary Care Providers, through Two Similar Digital Mental Health Services in Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:905. [PMID: 35055727 PMCID: PMC8775987 DOI: 10.3390/ijerph19020905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/16/2022]
Abstract
Digital mental health services (DMHSs) deliver mental health information, assessment, and treatment, via the internet, telephone, or other digital channels. The current study compares two DMHSs operating in Western Australia (WA)-The Practitioner Online Referral System (PORTS) and MindSpot. Both provide telephone and online psychological services at no cost to patients or referrers. However, PORTS is accessed by patients via referral from health practitioners, and is designed to reach those who are financially, geographically, or otherwise disadvantaged. In contrast, MindSpot services are available to all Australian residents and patients can self-refer. This observational study compares characteristics and treatment outcomes for patients of PORTS and MindSpot in WA. Eligible patients were people who resided in WA and registered with either clinic from January 2019 to December 2020. Results showed that PORTS patients were more likely to be older, male, and unemployed. They were less likely to report a tertiary education and were more likely to live in areas with higher levels of socioeconomic disadvantage. Despite these differences, treatment outcomes were excellent for patients from both clinics. Results provide further evidence for the accessibility, acceptability, and effectiveness of DMHSs regardless of referral pathway or patient characteristics.
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Affiliation(s)
- Lauren G. Staples
- MindSpot and PORTS Clinics, MQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (N.W.); (L.A.); (S.C.); (R.K.); (E.K.); (B.F.D.); (O.N.); (N.T.)
| | - Nick Webb
- MindSpot and PORTS Clinics, MQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (N.W.); (L.A.); (S.C.); (R.K.); (E.K.); (B.F.D.); (O.N.); (N.T.)
| | - Lia Asrianti
- MindSpot and PORTS Clinics, MQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (N.W.); (L.A.); (S.C.); (R.K.); (E.K.); (B.F.D.); (O.N.); (N.T.)
| | - Shane Cross
- MindSpot and PORTS Clinics, MQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (N.W.); (L.A.); (S.C.); (R.K.); (E.K.); (B.F.D.); (O.N.); (N.T.)
| | - Daniel Rock
- WA Primary Health Alliance, Psychiatry, Medical School, University of Western Australia, Perth 6907, Australia;
| | - Rony Kayrouz
- MindSpot and PORTS Clinics, MQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (N.W.); (L.A.); (S.C.); (R.K.); (E.K.); (B.F.D.); (O.N.); (N.T.)
| | - Eyal Karin
- MindSpot and PORTS Clinics, MQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (N.W.); (L.A.); (S.C.); (R.K.); (E.K.); (B.F.D.); (O.N.); (N.T.)
| | - Blake F. Dear
- MindSpot and PORTS Clinics, MQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (N.W.); (L.A.); (S.C.); (R.K.); (E.K.); (B.F.D.); (O.N.); (N.T.)
| | - Olav Nielssen
- MindSpot and PORTS Clinics, MQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (N.W.); (L.A.); (S.C.); (R.K.); (E.K.); (B.F.D.); (O.N.); (N.T.)
| | - Nickolai Titov
- MindSpot and PORTS Clinics, MQ Health, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia; (N.W.); (L.A.); (S.C.); (R.K.); (E.K.); (B.F.D.); (O.N.); (N.T.)
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Zhang W, Du Y, Yang X, Wang E, Fang J, Liu Z, Wu S, Liu Q, Hu Y. Comparative efficacy of face-to-face and internet-based cognitive behavior therapy for generalized anxiety disorder: A meta-analysis of randomized controlled trial. Front Psychiatry 2022; 13:832167. [PMID: 35966496 PMCID: PMC9366007 DOI: 10.3389/fpsyt.2022.832167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The study aimed to ascertain the comparative efficacy of these two forms on reducing anxiety scores of scales in patients with a generalized anxiety disorder (GAD) by examining the available evidence for face-to-face cognitive behavior therapy (CBT) and internet-based cognitive behavior therapy (ICBT). Moreover, this study attempted to determine whether ICBT can obtain similar benefits as CBT for GAD patients during coronavirus disease 2019 (COVID-19) due to the quarantine policy and the requirement of social distance. METHODS This meta-analysis was registered with the International Prospective Register of Systematic Reviews (PROSPERO) according to the guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement (registration number CRD42021241938). Therefore, a meta-analysis of randomized controlled trials (RCTs) examining CBT or ICBT was conducted in this study to treat GAD patients diagnosed with DMS-IV. The researchers searched PubMed, MEDLINE, Embase, PsycINFO, and the Cochrane Database of Systematic Reviews for relevant studies published from 2000 to July 5, 2022. Evidence from RCTs was synthesized by Review Manager 5.4 as mean difference (MD) for change in scores of scales through a random-effects meta-analysis. RESULTS A total of 26 trials representing 1,687 participants were pooled. The results demonstrated that ICBT and CBT were very close in the effect size of treating GAD (MD = -2.35 vs. MD = -2.79). Moreover, they still exhibited a similar response (MD = -3.45 vs. MD = -2.91) after studies with active control were removed. CONCLUSION Regarding the treatment of GAD, ICBT can achieve a similar therapeutic effect as CBT and could be CBT's candidate substitute, especially in the COVID-19 pandemic era, since the internet plays a crucial role in handling social space constraints. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=241938, identifier CRD42021241938.
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Affiliation(s)
- Wenle Zhang
- Department of Psychological Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,Department of Clinical Psychology, Capital Medical University, Beijing, China
| | - Yun Du
- Department of Psychological Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,Department of Clinical Psychology, Capital Medical University, Beijing, China
| | - Xiangyun Yang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Encong Wang
- Department of Psychological Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jiexin Fang
- Department of Psychological Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ziqi Liu
- School of Foreign Languages, Shanghai University, Shanghai, China
| | - Shanqian Wu
- Beijing Anding Hospital, Capital Medical University, Beijing, China.,Department of Psychiatry, Capital Medical University, Beijing, China
| | - Qinqin Liu
- Department of Clinical Psychology, Capital Medical University, Beijing, China.,Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yongdong Hu
- Department of Psychological Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Matsumoto K, Hamatani S, Shimizu E. Effectiveness of Videoconference-Delivered Cognitive Behavioral Therapy for Adults With Psychiatric Disorders: Systematic and Meta-Analytic Review. J Med Internet Res 2021; 23:e31293. [PMID: 34898445 PMCID: PMC8713091 DOI: 10.2196/31293] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/14/2021] [Accepted: 10/29/2021] [Indexed: 12/23/2022] Open
Abstract
Background Cognitive behavioral therapy (CBT) is the gold standard of psychotherapy for psychiatric disorders. However, the format of delivering CBT in person limits access to the intervention. The advancements in information and communication technology, especially the internet, present an opportunity for cognitive behavioral therapists to service patients or clients in remote areas through videoconferencing. Although many randomized controlled trials of videoconference-delivered cognitive behavioral therapy (VCBT) have already been conducted, the overall estimated effect size of VCBT for psychiatric disorders has not been examined by systematic reviews and meta-analyses. Objective This study attempts to evaluate the effectiveness of VCBT for psychiatric disorders through a systematic and meta-analytic review. Methods A systematic review and meta-analysis of studies in which VCBT was directly compared to control groups (such as treatment as usual, attention control, wait-list control, and other minimal supports) was carried out. To identify previous studies that meet our study objective, 2 independent reviewers undertook a systematic search through seven databases: MEDLINE (via PubMed), Web of Science, Science Direct, PsycINFO, CINAHL, LILACS, and SciELO. Other databases (ClinicalTrials.gov and Cochrane Central Resister of Controlled Trials) were also checked. All studies included in the review were assessed using the quality criteria of the Cochrane Collaboration. Statistical analysis was performed by using Cochrane Review Manager (RevMan, version 5.4.0). Standardized mean difference was used in major meta-analyses where a P value of .05 or less was the threshold for statistical significance. A heterogeneity test and the chi-square test were performed to assess the presence and extent of statistical heterogeneity with significance set at P<.10. Funnel plots were visually inspected to assess the risk of bias. Subgroup analyses were conducted for each disorder to estimate intervention effects. Results The systematic search resulted in 16 studies (total N=1745) that met the criteria for this study and were included in the review. There were 10 studies on depressive symptoms, 3 on chronic pain, 1 on generalized anxiety disorder, 1 on obsessive-compulsive disorder, and 1 on hypochondriasis. The quality and risk of bias was also assessed. Results showed a pooled effect size (Hedge g) post treatment of −0.49 (95% CI –0.68 to –0.29), indicating that VCBT is effective for clients with psychiatric disorders. Study quality did not affect outcomes. Conclusions While the overall results indicate the effectiveness of VCBT, there are still only a limited number of studies on specific psychiatric and somatic conditions. Therefore, more randomized controlled trials are needed to establish the effectiveness of VCBT for different disorders. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42021224832; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=224832
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Affiliation(s)
- Kazuki Matsumoto
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,Laboratory of Neuropsychology, Institute of Liberal Arts and Science, Kanazawa University, Kanazawa, Japan
| | - Sayo Hamatani
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Cognitive Behavioral Therapy Center, Chiba University Hospital, Chiba, Japan
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Wynter K, Redley B, Holton S, Manias E, McDonall J, McTier L, Hutchinson AM, Kerr D, Lowe G, Phillips NNM, Rasmussen B. Depression, anxiety and stress among Australian nursing and midwifery undergraduate students during the COVID-19 pandemic: a cross-sectional study. Int J Nurs Educ Scholarsh 2021; 18:ijnes-2021-0060. [PMID: 34889085 DOI: 10.1515/ijnes-2021-0060] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 11/17/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess depression, anxiety and stress among undergraduate nursing and midwifery students during the COVID-19 pandemic, and identify socio-demographic and educational characteristics associated with higher depression, anxiety and stress scores. METHODS Cross-sectional study during August-September 2020, using an anonymous, online, self-administered survey. E-mail invitations with a survey link were sent to 2,907 students enrolled in the Bachelor of Nursing suite of courses, offered across four campuses of a single university in Victoria, Australia. Depression, anxiety and stress were assessed using the DASS-21. Data on socio-demographic and educational characteristics, self-rated physical health and exposure to COVID-19 were also collected. DASS-21 subscale scores were compared with existing data for various pre-pandemic and COVID-19 samples. Multiple regression was used to investigate factors associated with higher scores on depression, anxiety and stress subscales. RESULTS The response rate was 22% (n=638). Mean scores on all DASS-21 subscales were significantly higher (p<0.001) than means from all comparative sample data. The proportions of students reporting moderate to severe symptoms of depression, anxiety and stress were 48.5%, 37.2% and 40.2% respectively. Being a woman, being younger, having completed more years of study and having poorer self-rated general health were all significantly associated (p<0.05) with higher scores on at least one DASS-21 subscale. CONCLUSIONS Almost half of participants reported at least moderate symptoms of depression; more than a third reported at least moderate symptoms of anxiety or stress. Poor psychological wellbeing can impact students' successful completion of their studies and therefore, has implications for nursing and midwifery workforce recruitment and retention. During and after pandemics, universities should consider screening undergraduate students not only for anxiety and stress, but also for depression. Clear, low-cost referral pathways should be available, should screening indicate that further diagnosis or treatment is required.
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Affiliation(s)
- Karen Wynter
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.,The Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, VIC, Australia
| | - Bernice Redley
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.,The Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, VIC, Australia
| | - Sara Holton
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.,The Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, VIC, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Jo McDonall
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Lauren McTier
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Alison M Hutchinson
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.,The Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, VIC, Australia
| | - Debra Kerr
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Grainne Lowe
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Nicole Nikki M Phillips
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Bodil Rasmussen
- School of Nursing and Midwifery, The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.,The Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, VIC, Australia.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Currie CL, Larouche R, Voss ML, Trottier M, Spiwak R, Higa E, Scott D, Tallow T. Effectiveness of live health professional-led group eHealth interventions for adult mental health: A systematic review of randomized controlled trials. J Med Internet Res 2021; 24:e27939. [PMID: 34878409 PMCID: PMC8790691 DOI: 10.2196/27939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 11/03/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022] Open
Abstract
Background The COVID-19 pandemic has had adverse impacts on mental health and substance use worldwide. Systematic reviews suggest eHealth interventions can be effective at addressing these problems. However, strong positive eHealth outcomes are often tied to the intensity of web-based therapist guidance, which has time and cost implications that can make the population scale-up of more effective interventions difficult. A way to offset cost while maintaining the intensity of therapist guidance is to offer eHealth programs to groups rather than more standard one-on-one formats. Objective This systematic review aims to assess experimental evidence for the effectiveness of live health professional–led group eHealth interventions on mental health, substance use, or bereavement among community-dwelling adults. Within the articles selected for our primary aim, we also seek to examine the impact of interventions that encourage physical activity compared with those that do not. Methods Overall, 4 databases (MEDLINE, CINAHL, PsycINFO, and the Cochrane Library) were searched in July 2020. Eligible studies were randomized controlled trials (RCTs) of eHealth interventions led by health professionals and delivered entirely to adult groups by videoconference, teleconference, or webchat. Eligible studies reported mental health, substance use, or bereavement as primary outcomes. The results were examined by outcome, eHealth platform, and intervention length. Postintervention data were used to calculate effect size by study. The findings were summarized using the Synthesis Without Meta-Analysis guidelines. Risk of bias was assessed using the Cochrane Collaboration Tool. Results Of the 4099 identified studies, 21 (0.51%) RCTs representing 20 interventions met the inclusion criteria. These studies examined mental health outcomes among 2438 participants (sample size range: 47-361 participants per study) across 7 countries. When effect sizes were pooled, live health professional–led group eHealth interventions had a medium effect on reducing anxiety compared with inactive (Cohen d=0.57) or active control (Cohen d=0.48), a medium to small effect on reducing depression compared with inactive (Cohen d=0.61) or active control (Cohen d=0.21), and mixed effects on mental distress and coping. Interventions led by videoconference, and those that provided 8-12 hours of live health professional–led group contact had more robust effects on adult mental health. Risk of bias was high in 91% (19/21) of the studies. Heterogeneity across interventions was significant, resulting in low to very low quality of evidence. No eligible RCT was found that examined substance use, bereavement, or physical activity. Conclusions Live eHealth group interventions led by health professionals can foster moderate improvements in anxiety and moderate to small improvements in depression among community-based adults, particularly those delivered by videoconference and those providing 8-12 hours of synchronous engagement. Trial Registration PROSPERO CRD42020187551; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=187551 International Registered Report Identifier (IRRID) RR2-10.1186/s13643-020-01479-3
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Affiliation(s)
- Cheryl L Currie
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, CA
| | - Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, CA
| | - M Lauren Voss
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, CA
| | - Maegan Trottier
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, CA
| | - Rae Spiwak
- Max Rady College of Medicine, University of Manitoba, Winnipeg, CA
| | - Erin Higa
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, CA
| | - David Scott
- Library Services, University of Lethbridge, Lethbridge, CA
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Schønning A, Nordgreen T. Predicting Treatment Outcomes in Guided Internet-Delivered Therapy for Anxiety Disorders-The Role of Treatment Self-Efficacy. Front Psychol 2021; 12:712421. [PMID: 34744872 PMCID: PMC8566333 DOI: 10.3389/fpsyg.2021.712421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/22/2021] [Indexed: 11/26/2022] Open
Abstract
Aim: Guided Internet-delivered therapy has shown to be an effective treatment format for anxiety disorders. However, not all patients experience improvement, and although predictors of treatment outcome have been identified, few are consistent over time and across studies. The current study aimed to examine whether treatment self-efficacy (self-efficacy regarding the mastery of obstacles during treatment) in guided Internet-delivered therapy for anxiety disorders in adults could be a predictor of lower dropout rates and greater symptom reduction. Method: The analyzed data comes from an open effectiveness study including 575 patients receiving guided Internet-delivered therapy for panic disorder or social anxiety disorder. Treatment self-efficacy was measured at pre-treatment. Symptom reduction was measured at 10 measurement points, including a 6-month follow-up. A mixed linear model was applied in the analysis. Results: The results showed that high treatment self-efficacy was a predictor of both lower dropout rates and greater symptom reduction. Significant interaction effects between time and treatment self-efficacy were found for several of the nine modules that constitutes the treatment program, suggesting that treatment self-efficacy could be a moderator of symptom reduction. Three of nine modules in the panic disorder treatment and six of nine in the social anxiety disorder treatment showed significant interaction effects. Conclusion: The results suggest that measuring treatment self-efficacy may be a valuable tool to identify patients at risk of dropping out, and that treatment self-efficacy could be a predictor and moderator of symptom reduction in guided Internet-delivered therapy. The implications of the results are discussed.
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Affiliation(s)
| | - Tine Nordgreen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
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Systemische Therapie goes online. PSYCHOTHERAPEUT 2021. [DOI: 10.1007/s00278-021-00544-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Miki A, Lau MA, Moradian H. An Open Trial of the Effectiveness, Program Usage, and User Experience of Internet-based Cognitive Behavioural Therapy for Mixed Anxiety and Depression for Healthcare Workers on Disability Leave. J Occup Environ Med 2021; 63:865-874. [PMID: 34597283 PMCID: PMC8478326 DOI: 10.1097/jom.0000000000002248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE An open trial of an internet-based Cognitive Behavioural Therapy (iCBT) program for healthcare workers was conducted. METHODS Healthcare workers on disability leave who used the iCBT program were assessed on: self-reported depression and anxiety symptoms using the Depression Anxiety Stress Scales-21; and, program usage. Healthcare workers' experience of using iCBT was evaluated in a separate survey. RESULTS Of the 497 healthcare workers referred to the iCBT program, 51% logged in, 25% logged in more than once, and 12% logged in more than once and completed at least two assessments. For the latter group, self-reported depression and anxiety symptoms significantly decreased from the first assessment. CONCLUSIONS This iCBT program was perceived to be of benefit to healthcare workers, with program usage and effectiveness that was similar to what has been previously reported for unguided iCBT.
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Affiliation(s)
- Andrew Miki
- Starling Minds (Dr Miki, Dr Lau, Dr Moradian); and Department of Psychiatry, Faculty of Medicine, University of British Columbia (Dr Lau), Vancouver, BC, Canada
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Mor S, Grimaldos J, Tur C, Miguel C, Cuijpers P, Botella C, Quero S. Internet- and mobile-based interventions for the treatment of specific phobia: A systematic review and preliminary meta-analysis. Internet Interv 2021; 26:100462. [PMID: 34646752 PMCID: PMC8501502 DOI: 10.1016/j.invent.2021.100462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 12/19/2022] Open
Abstract
Internet- and mobile-based interventions (IMIs) are being developed for a wide range of psychological disorders and they showed their effectiveness in multiple studies. Specific phobia (SP) is one of the most common anxiety disorders, and research about IMIs for their treatment has also been conducted in recent years. The aim of this paper was to conduct a systematic review and preliminary meta-analysis exploring IMIs for the treatment of SP. A comprehensive search conducted in five different databases identified 9 studies (4 pre-post studies, 5 randomized controlled trials) with 7 Internet-based interventions and 2 mobile-based interventions. Results showed that exposure was the main component of all interventions, and that animal phobia was the most common subtype. Samples included children, adolescents, and adults. A preliminary meta-analysis of the included studies showed that participants receiving IMIs experienced a significant reduction of SP symptoms from pre- to post-treatment (g = 1.15). This systematic review found that there is already some evidence in the literature supporting the potential benefits of IMIs for SP. However, the number of studies included is small and more research should be carried out in the field.
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Affiliation(s)
- Sonia Mor
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Jorge Grimaldos
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Cintia Tur
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Cristina Botella
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain,Corresponding author at: Universitat Jaume I, Av. Vicente Sos Baynat s/n, 12006 Castellón, (Spain).
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Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for the Discontinuation of Long-Term Benzodiazepine Use in Insomnia and Anxiety Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910222. [PMID: 34639523 PMCID: PMC8508349 DOI: 10.3390/ijerph181910222] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 01/23/2023]
Abstract
Benzodiazepines have proven to be highly effective for treating insomnia and anxiety. Although considered safe when taken for a short period of time, a major risk–benefit dilemma arises in the context of long-term use, relating to addiction, withdrawal symptoms, and potential side effects. For these reasons, benzodiazepines are not recommended for treating chronic sleep disorders, anxiety disorders, nor for people over the age of 65, and withdrawal among long-term users is a public health issue. Indeed, only 5% of patients manage to discontinue using these drugs on their own. Even with the help of a general practitioner, this rate does not exceed 25 to 30% of patients, of which approximately 7% manage to remain drug-free in the long term. Cognitive Behavioral Therapies (CBT) offer a crucial solution to this problem, having been shown to increase abstinence success to 70–80%. This article examines traditional and novel CBT techniques in this regard, such as Acceptance and Commitment Therapy, which address both the underlying condition (insomnia/anxiety) and the substance-related disorder. The theoretical framework and evidence supporting the use of these approaches are reviewed. Finally, current research gaps are discussed, and key research perspectives are proposed.
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Tsiouris A, Mayer A, Nölke C, Ruckes C, Labitzke N, Wiltink J, Beutel ME, Zwerenz R. An emotion-based online intervention for reducing anxiety and depression in cancer patients: Study protocol for a randomized controlled trial. Internet Interv 2021; 25:100410. [PMID: 34401369 PMCID: PMC8350615 DOI: 10.1016/j.invent.2021.100410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/27/2021] [Accepted: 06/02/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND A cancer diagnosis can cause severe emotional distress and affect quality of life as well as social relationships. The transition from inpatient to outpatient treatment is burdened by stressful uncertainties and a gap of psycho-oncological care. In addition, further barriers, such as information deficits or fear of stigmatization, might hinder cancer patients to use psycho-oncological face-to-face interventions. Online interventions can be a low-threshold adjunct to existing face-to-face services. This study aims to evaluate the effect of the online self-help program epos (emotion-based psycho-oncological online self-help) on improving symptoms of anxiety and depression in German-speaking cancer patients. METHODS A randomized controlled trial (RCT) is carried out in a parallel group design. N = 325 patients will be enrolled in the trial, randomly assigned to an intervention and a control group. While the intervention group has access to nine modules of epos, the control group gets access to an informational website. Participants will complete online questionnaires at baseline (T0), after the intervention (T1) and three-month follow-up (T2). Primary outcome is a combined measure of depression and anxiety. Secondary outcomes include psychological distress, anxiety, depression, quality of life, emotional control, posttraumatic growth, and satisfaction with epos. Participants are at least 18 years old, have a cancer diagnosis, currently receive cancer treatment or aftercare, have sufficient German language competence, and have access to the Internet. Exclusion criteria are severe mental comorbidities (i.e. severe depression, suicidality) or somatic comorbidities (i.e. visual disabilities). DISCUSSION The results of this study will provide information about acceptability, feasibility, and efficacy of epos in improving symptoms of depression and anxiety in cancer patients and thus contribute to the research on web-based interventions. If found efficacious, epos will improve psycho-oncological care in cancer patients in transition from inpatient to outpatient care and in those who struggle to find adequate psycho-oncological support due to other (perceived) barriers.
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Affiliation(s)
- Angeliki Tsiouris
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Corresponding author at: Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Untere Zahlbacher Str. 8, 55131 Mainz, Germany.
| | - Anna Mayer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Charlotte Nölke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Christian Ruckes
- Interdisciplinary Center for Clinical Trials, University Medical Center Mainz, Mainz, Germany
| | - Nicole Labitzke
- Center for Audiovisual Production, Johannes Gutenberg-University, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
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Barnett P, Goulding L, Casetta C, Jordan H, Sheridan-Rains L, Steare T, Williams J, Wood L, Gaughran F, Johnson S. Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews. J Med Internet Res 2021; 23:e26492. [PMID: 34061758 PMCID: PMC8335619 DOI: 10.2196/26492] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/30/2021] [Accepted: 04/30/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Telemental health care has been rapidly adopted for maintaining services during the COVID-19 pandemic, and a substantial interest is now being devoted in its future role. Service planning and policy making for recovery from the pandemic and beyond should draw on both COVID-19 experiences and the substantial research evidence accumulated before this pandemic. OBJECTIVE We aim to conduct an umbrella review of systematic reviews available on the literature and evidence-based guidance on telemental health, including both qualitative and quantitative literature. METHODS Three databases were searched between January 2010 and August 2020 for systematic reviews meeting the predefined criteria. The retrieved reviews were independently screened, and those meeting the inclusion criteria were synthesized and assessed for risk of bias. Narrative synthesis was used to report these findings. RESULTS In total, 19 systematic reviews met the inclusion criteria. A total of 15 reviews examined clinical effectiveness, 8 reported on the aspects of telemental health implementation, 10 reported on acceptability to service users and clinicians, 2 reported on cost-effectiveness, and 1 reported on guidance. Most reviews were assessed to be of low quality. The findings suggested that video-based communication could be as effective and acceptable as face-to-face formats, at least in the short term. Evidence on the extent of digital exclusion and how it can be overcome and that on some significant contexts, such as children and young people's services and inpatient settings, was found to be lacking. CONCLUSIONS This umbrella review suggests that telemental health has the potential to be an effective and acceptable form of service delivery. However, we found limited evidence on the impact of its large-scale implementation across catchment areas. Combining previous evidence and COVID-19 experiences may allow realistic planning for the future implementation of telemental health.
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Affiliation(s)
- Phoebe Barnett
- Centre for Outcomes Research and Effectiveness, Division of Psychology and Language Sciences, University College London, London, United Kingdom.,NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Lucy Goulding
- King's Improvement Science, Centre for Implementation Science, King's College London, London, United Kingdom
| | - Cecilia Casetta
- NIHR Applied Research Collaboration, King's College London, London, United Kingdom
| | - Harriet Jordan
- NIHR Applied Research Collaboration, King's College London, London, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and Maudsley NHS Trust, London, United Kingdom
| | - Luke Sheridan-Rains
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Thomas Steare
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Julie Williams
- Centre for Implementation Science, Health Service and Population Research Department, King's College London, London, United Kingdom
| | - Lisa Wood
- Division of Psychiatry, University College London, London, United Kingdom
| | - Fiona Gaughran
- NIHR Applied Research Collaboration, King's College London, London, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and Maudsley NHS Trust, London, United Kingdom
| | - Sonia Johnson
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom.,Camden and Islington NHS Foundation Trust, London, United Kingdom
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Alavi N, Stephenson C, Yang M, Shirazi A, Shao Y, Kumar A, Yee CS, Miller S, Stefatos A, Gholamzadehmir M, Abbaspour Z, Patel A, Patel C, Reshetukha T, Omrani M, Groll D. Determining the Efficacy of Electronic Cognitive Behavioral Therapy for Generalized Anxiety Disorder Compared to Pharmaceutical Interventions: Protocol for a Quasi-Experimental Study. JMIR Res Protoc 2021; 10:e27772. [PMID: 33857917 PMCID: PMC8193484 DOI: 10.2196/27772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is an extremely prevalent and debilitating mental health disorder. Currently, the gold standard treatment for GAD is cognitive behavioral therapy (CBT) and/or pharmacotherapy. The most common medications used to treat GAD are selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors. While CBT is the gold standard treatment for GAD, it is costly, time-consuming, and often inaccessible. Fortunately, the electronic delivery of CBT (e-CBT) has emerged as a promising solution to address these barriers. e-CBT has shown to offer comparable results to in-person CBT while improving accessibility for patients and time efficiency for clinicians. OBJECTIVE This study aims to investigate the treatment efficacy of e-CBT compared to and in conjunction with pharmacotherapy for GAD. METHODS This study will use a quasi-experimental design to allow patients the freedom to choose which treatment modality they would like to receive. Participants with a diagnosis of GAD will be enrolled in 1 of 3 possible treatment arms: (1) e-CBT, (2) medication, or (3) a combination of e-CBT and medication. The e-CBT program will include a 12-week psychotherapy program delivered through the Online Psychotherapy Tool-a secure, cloud-based, digital mental health platform. The treatment efficacy of e-CBT will be compared with that of medication alone and medication in combination with e-CBT. RESULTS The study received ethics approval in April 2019 and participant recruitment began in June 2019. Participant recruitment has been conducted through social media advertisements, physical advertisements, and physician referrals. To date, 146 participants (e-CBT: n=53; medication: n=49; combination: n=44) have been recruited. Data collection is expected to conclude by June 2021, and data analysis is expected to be completed by October 2021. Linear regression (for continuous outcomes) and binomial regression (for categorical outcomes) analysis will be conducted using interpretive qualitative methods. CONCLUSIONS If either the efficacy of e-CBT is shown to be comparable to that of medication or the effects of both treatments are augmented when used in tandem, these findings could have major implications on the mental health care system. e-CBT is a more accessible and affordable treatment that could increase mental health care capacity 4-fold if proven viable. TRIAL REGISTRATION ClinicalTrials.gov NCT04478526; https://clinicaltrials.gov/ct2/show/NCT04478526. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/27772.
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Affiliation(s)
- Nazanin Alavi
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Callum Stephenson
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Megan Yang
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Amirhossein Shirazi
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,OPTT Inc, Toronto, ON, Canada
| | - Yijia Shao
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Anchan Kumar
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Caitlin S Yee
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Shadé Miller
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Anthi Stefatos
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | | | - Zara Abbaspour
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Archana Patel
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Charmy Patel
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Taras Reshetukha
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | | | - Dianne Groll
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
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Simon N, Robertson L, Lewis C, Roberts NP, Bethell A, Dawson S, Bisson JI. Internet-based cognitive and behavioural therapies for post-traumatic stress disorder (PTSD) in adults. Cochrane Database Syst Rev 2021; 5:CD011710. [PMID: 34015141 PMCID: PMC8136365 DOI: 10.1002/14651858.cd011710.pub3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Therapist-delivered trauma-focused psychological therapies are effective for post-traumatic stress disorder (PTSD) and have become the accepted first-line treatments. Despite the established evidence-base for these therapies, they are not always widely available or accessible. Many barriers limit treatment uptake, such as the number of qualified therapists available to deliver the interventions; cost; and compliance issues, such as time off work, childcare, and transportation, associated with the need to attend weekly appointments. Delivering Internet-based cognitive and behavioural therapy (I-C/BT) is an effective and acceptable alternative to therapist-delivered treatments for anxiety and depression. OBJECTIVES To assess the effects of I-C/BT for PTSD in adults. SEARCH METHODS We searched MEDLINE, Embase, PsycINFO and the Cochrane Central Register of Controlled Trials to June 2020. We also searched online clinical trial registries and reference lists of included studies and contacted the authors of included studies and other researchers in the field to identify additional and ongoing studies. SELECTION CRITERIA We searched for RCTs of I-C/BT compared to face-to-face or Internet-based psychological treatment, psychoeducation, wait list, or care as usual. We included studies of adults (aged over 16 years), in which at least 70% of the participants met the diagnostic criteria for PTSD, according to the Diagnostic and Statistical Manual (DSM) or the International Classification of Diseases (ICD). DATA COLLECTION AND ANALYSIS Two review authors independently assessed abstracts, extracted data, and entered data into Review Manager 5. The primary outcomes were severity of PTSD symptoms and dropouts. Secondary outcomes included diagnosis of PTSD after treatment, severity of depressive and anxiety symptoms, cost-effectiveness, adverse events, treatment acceptability, and quality of life. We analysed categorical outcomes as risk ratios (RRs), and continuous outcomes as mean differences (MD) or standardised mean differences (SMDs), with 95% confidence intervals (CI). We pooled data using a fixed-effect meta-analysis, except where heterogeneity was present, in which case we used a random-effects model. We independently assessed the included studies for risk of bias and we evaluated the certainty of available evidence using the GRADE approach; we discussed any conflicts with at least one other review author, with the aim of reaching a unanimous decision. MAIN RESULTS We included 13 studies with 808 participants. Ten studies compared I-C/BT delivered with therapist guidance to a wait list control. Two studies compared guided I-C/BT with I-non-C/BT. One study compared guided I-C/BT with face-to-face non-C/BT. There was substantial heterogeneity among the included studies. I-C/BT compared with face-to-face non-CBT Very low-certainty evidence based on one small study suggested face-to-face non-CBT may be more effective than I-C/BT at reducing PTSD symptoms post-treatment (MD 10.90, 95% CI 6.57 to 15.23; studies = 1, participants = 40). There may be no evidence of a difference in dropout rates between treatments (RR 2.49, 95% CI 0.91 to 6.77; studies = 1, participants = 40; very low-certainty evidence). The study did not measure diagnosis of PTSD, severity of depressive or anxiety symptoms, cost-effectiveness, or adverse events. I-C/BT compared with wait list Very low-certainty evidence showed that, compared with wait list, I-C/BT may be associated with a clinically important reduction in PTSD post-treatment (SMD -0.61, 95% CI -0.93 to -0.29; studies = 10, participants = 608). There may be no evidence of a difference in dropout rates between the I-C/BT and wait list groups (RR 1.25, 95% CI 0.97 to 1.60; studies = 9, participants = 634; low-certainty evidence). I-C/BT may be no more effective than wait list at reducing the risk of a diagnosis of PTSD after treatment (RR 0.53, 95% CI 0.28 to 1.00; studies = 1, participants = 62; very low-certainty evidence). I-C/BT may be associated with a clinically important reduction in symptoms of depression post-treatment (SMD -0.51, 95% CI -0.97 to -0.06; studies = 7, participants = 473; very low-certainty evidence). Very low-certainty evidence also suggested that I-C/BT may be associated with a clinically important reduction in symptoms of anxiety post-treatment (SMD -0.61, 95% CI -0.89 to -0.33; studies = 5, participants = 345). There were no data regarding cost-effectiveness. Data regarding adverse events were uncertain, as only one study reported an absence of adverse events. I-C/BT compared with I-non-C/BT There may be no evidence of a difference in PTSD symptoms post-treatment between the I-C/BT and I-non-C/BT groups (SMD -0.08, 95% CI -0.52 to 0.35; studies = 2, participants = 82; very low-certainty evidence). There may be no evidence of a difference between dropout rates from the I-C/BT and I-non-C/BT groups (RR 2.14, 95% CI 0.97 to 4.73; studies = 2, participants = 132; I² = 0%; very low-certainty evidence). Two studies found no evidence of a difference in post-treatment depressive symptoms between the I-C/BT and I-non-C/BT groups (SMD -0.12, 95% CI -0.78 to 0.54; studies = 2, participants = 84; very low-certainty evidence). Two studies found no evidence of a difference in post-treatment symptoms of anxiety between the I-C/BT and I-non-C/BT groups (SMD 0.08, 95% CI -0.78 to 0.95; studies = 2, participants = 74; very low-certainty evidence). There were no data regarding cost-effectiveness. Data regarding adverse effects were uncertain, as it was not discernible whether adverse effects reported were attributable to the intervention. AUTHORS' CONCLUSIONS While the review found some beneficial effects of I-C/BT for PTSD, the certainty of the evidence was very low due to the small number of included trials. This review update found many planned and ongoing studies, which is encouraging since further work is required to establish non-inferiority to current first-line interventions, explore mechanisms of change, establish optimal levels of guidance, explore cost-effectiveness, measure adverse events, and determine predictors of efficacy and dropout.
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Affiliation(s)
- Natalie Simon
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Lindsay Robertson
- Cochrane Common Mental Disorders, University of York, York, UK
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Catrin Lewis
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Neil P Roberts
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
- Psychology & Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, UK
| | - Andrew Bethell
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
- Changing Minds UK, Warrington, UK
| | - Sarah Dawson
- Cochrane Common Mental Disorders, University of York, York, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jonathan I Bisson
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
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Johnsen HM, Haddeland K. User evaluation of a therapist-guided internet-delivered treatment program for anxiety disorders: A qualitative study. Internet Interv 2021; 25:100389. [PMID: 33996506 PMCID: PMC8091870 DOI: 10.1016/j.invent.2021.100389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/27/2021] [Accepted: 04/12/2021] [Indexed: 11/25/2022] Open
Abstract
Therapist-guided internet-based cognitive behaviour therapy (ICBT) has been proposed as a potential means to increase individuals' access to quality mental health care and effective treatment. Guided ICBT aims to increase a patient's knowledge and competence to better cope with their disorder. Despite the growing evidence supporting the effects of guided ICBT, there is remarkably little research on the different factors that are important for patients to achieve effects from using such digital treatment interventions. Thus, the aim of this study was to conduct a user evaluation of a therapist-guided ICBT program using the updated DeLone and McLean (D&M) model for measuring information systems (IS) success or effectiveness. This model includes the following six dimensions: system quality, information quality, service quality, intention to use and use, user satisfaction, and net benefits (impacts or effect). Ten users of a Norwegian therapist-guided ICBT program for treating anxiety disorders named 'Assisted Self-Help' (Assistert Selvhjelp) participated in phone-based individual interviews. Data were analysed using directed content analysis. Results showed that the participants were quite satisfied with the program's system quality and information quality. However, participants suggested improvements, including in-program instruction, improved visibility of system status, more flexibility regarding automated measurement surveys, and the inclusion of more videos with patient stories. Further, the results indicated a need for improvement in the service quality of guided ICBT introduction, instruction, follow-up, guidance, and support from therapists. The results showed that user friendliness and high educational content might not be sufficient for a therapist-guided ICBT program to be perceived as effective. It might also be necessary for therapists to provide follow-up, guidance, and support that are more in line with individual patient needs. Thus, the results suggest that guided ICBT requires active participation from all involved in the process, including the therapist.
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Affiliation(s)
- Hege Mari Johnsen
- Corresponding author at: Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, PO Box 509, 4898 Grimstad, Norway.
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Sasseville M, LeBlanc A, Boucher M, Dugas M, Mbemba G, Tchuente J, Chouinard MC, Beaulieu M, Beaudet N, Skidmore B, Cholette P, Aspiros C, Larouche A, Chabot G, Gagnon MP. Digital health interventions for the management of mental health in people with chronic diseases: a rapid review. BMJ Open 2021; 11:e044437. [PMID: 33820786 PMCID: PMC8030477 DOI: 10.1136/bmjopen-2020-044437] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Determine the effectiveness of digital mental health interventions for individuals with a concomitant chronic disease. DESIGN We conducted a rapid review of systematic reviews. Two reviewers independently conducted study selection and risk of bias evaluation. A standardised extraction form was used. Data are reported narratively. INTERVENTIONS We included systematic reviews of digital health interventions aiming to prevent, detect or manage mental health problems in individuals with a pre-existing chronic disease, including chronic mental health illnesses, published in 2010 or after. MAIN OUTCOME MEASURE Reports on mental health outcomes (eg, anxiety symptoms and depression symptoms). RESULTS We included 35 reviews, totalling 702 primary studies with a total sample of 50 692 participants. We structured the results in four population clusters: (1) chronic diseases, (2) cancer, (3) mental health and (4) children and youth. For populations presenting a chronic disease or cancer, health provider directed digital interventions (eg, web-based consultation, internet cognitive-behavioural therapy) are effective and safe. Further analyses are required in order to provide stronger recommendations regarding relevance for specific population (such as children and youth). Web-based interventions and email were the modes of administration that had the most reports of improvement. Virtual reality, smartphone applications and patient portal had limited reports of improvement. CONCLUSIONS Digital technologies could be used to prevent and manage mental health problems in people living with chronic conditions, with consideration for the age group and type of technology used.
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Affiliation(s)
- Maxime Sasseville
- Department of Health Sciences, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
- Nursing Faculty, Université Laval, Quebec, Québec, Canada
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Annie LeBlanc
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
- Family medicine and emergency medicine, Université Laval, Quebec, Québec, Canada
| | - Mylène Boucher
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Michèle Dugas
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Gisele Mbemba
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Jack Tchuente
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | | | - Marianne Beaulieu
- Nursing Faculty, Université Laval, Quebec, Québec, Canada
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
| | - Nicolas Beaudet
- Omnimed, Québec, Québec, Canada
- Department of Anesthesiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Becky Skidmore
- Independent information specialist, Ottawa, Ontario, Canada
| | - Pascale Cholette
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale du Québec, Quebec, Quebec, Canada
| | | | | | | | - Marie-Pierre Gagnon
- Nursing Faculty, Université Laval, Quebec, Québec, Canada
- VITAM Research Center on Sustainable Health, Québec, Québec, Canada
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48
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Internet-Based Behavioral Activation Program for Depression and Problem Gambling: Lessons Learned from Stakeholder Interviews. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-019-00094-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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49
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Newby J, Mason E, Kladnistki N, Murphy M, Millard M, Haskelberg H, Allen A, Mahoney A. Integrating internet CBT into clinical practice: a practical guide for clinicians. CLIN PSYCHOL-UK 2021. [DOI: 10.1080/13284207.2020.1843968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Jill Newby
- School of Psychology, Faculty of Science, UNSW Sydney, Sydney, Australia
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital Sydney, Sydney, Australia
| | - Elizabeth Mason
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital Sydney, Sydney, Australia
| | - Natalie Kladnistki
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital Sydney, Sydney, Australia
| | - Michael Murphy
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital Sydney, Sydney, Australia
- School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - Michael Millard
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital Sydney, Sydney, Australia
| | - Hila Haskelberg
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital Sydney, Sydney, Australia
| | - Adrian Allen
- Hyde Park Clinical Psychology, Sydney, Australia
| | - Alison Mahoney
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital Sydney, Sydney, Australia
- School of Psychiatry, UNSW Sydney, Sydney, Australia
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50
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Haig-Ferguson A, Cooper K, Cartwright E, Loades M, Daniels J. Practitioner review: health anxiety in children and young people in the context of the COVID-19 pandemic. Behav Cogn Psychother 2021; 49:129-143. [PMID: 32829718 PMCID: PMC7503041 DOI: 10.1017/s1352465820000636] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/04/2020] [Accepted: 08/14/2020] [Indexed: 02/06/2023]
Abstract
Health-related fear is a normal and common response in the face of the global pandemic of COVID-19. Children and young people are frequently being exposed to messages about the threat to health, including from the media and authorities. Whilst for most, their anxiety will be proportionate to the threat, for some, existing pre-occupation with physical symptoms and illness will become more problematic. There is a growing body of evidence that health anxiety may occur in childhood, however much of the literature is taken from research using adult samples. This practitioner review aims to give an overview of the assessment and treatment of health-related worries in children and young people in the context of the COVID-19 pandemic. This review is based on the limited existing evidence in this population and the more substantial evidence base for treating health anxiety in adults. We consider the adaptations needed to ensure such interventions are developmentally appropriate.
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Affiliation(s)
| | - K. Cooper
- Department of Psychology, University of Bath, Bath, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - E. Cartwright
- Department of Psychology, University of Bath, Bath, UK
| | - M.E. Loades
- Department of Psychology, University of Bath, Bath, UK
- Bristol Medical School, University of Bristol, Bristol, UK
| | - J. Daniels
- Department of Psychology, University of Bath, Bath, UK
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