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Geurts DEM, Haegens NM, Van Beek MHCT, Schroevers MJ, Compen FR, Speckens AEM. Putting mindfulness-based cognitive therapy to the test in routine clinical practice: A transdiagnostic panacea or a disorder specific intervention? J Psychiatr Res 2021; 142:144-152. [PMID: 34352560 DOI: 10.1016/j.jpsychires.2021.07.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/08/2021] [Accepted: 07/21/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Over the past two decades there has been a growing number of randomized clinical trials supporting the efficacy of mindfulness-based cognitive therapy (MBCT) in the treatment of several psychiatric disorders. Since evidence for its effectiveness in routine clinical practice is lagging behind, we aimed to examine adherence, outcome and predictors of MBCT in a well-characterized, heterogeneous outpatient population in routine clinical practice. METHODS Data were collected from a naturalistic uncontrolled cohort of 998 patients formally diagnosed with mainly depression, anxiety disorders, personality disorders, somatoform disorders and/or ADHD. Patients received protocolized MBCT and completed self-report questionnaires pre- and post-treatment on overall functioning (Outcome Questionnaire, primary outcome), depressive symptoms, worry, mindfulness skills and self-compassion. Pre-to post-treatment changes were analysed for the overall sample and each diagnostic category separately with paired sample t-tests, reliable change indices (only overall sample) and repeated measures ANOVA for groups with and without comorbidity. Multiple linear regression was carried out to assess possible predictors of adherence and change in overall functioning. RESULTS Adherence was high (94%) but negatively affected by lower levels of education, more comorbidity and presence of ADHD. Outcome in terms of improvement in overall functioning was good in the overall sample (Cohen's d = 0.50, 30% showed reliable improvement vs. 3.5% reliable deterioration) and within each diagnostic category (Cohen's d range = 0.37-0.61). Worse overall functioning at baseline was the only predictor for a larger treatment effect. CONCLUSIONS After MBCT, overall functioning improved in a large heterogeneous psychiatric outpatient population independent of diagnosis or comorbidity.
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Affiliation(s)
- Dirk E M Geurts
- Department of Psychiatry, University Medical Centre for Mindfulness, Radboud University, P.O.Box 9101, 6500 HB, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University, P.O.Box 9010, 6500 GL, Nijmegen, the Netherlands.
| | - N Marlou Haegens
- Department of Psychiatry, University Medical Centre for Mindfulness, Radboud University, P.O.Box 9101, 6500 HB, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University, P.O.Box 9010, 6500 GL, Nijmegen, the Netherlands.
| | - Marleen H C T Van Beek
- Department of Psychiatry, University Medical Centre for Mindfulness, Radboud University, P.O.Box 9101, 6500 HB, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University, P.O.Box 9010, 6500 GL, Nijmegen, the Netherlands.
| | - Maya J Schroevers
- Department of Health Sciences, Section Health Psychology, University of Groningen, P.O.Box FA12, 9713 AV, Groningen, the Netherlands.
| | - Félix R Compen
- Department of Psychiatry, University Medical Centre for Mindfulness, Radboud University, P.O.Box 9101, 6500 HB, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University, P.O.Box 9010, 6500 GL, Nijmegen, the Netherlands.
| | - Anne E M Speckens
- Department of Psychiatry, University Medical Centre for Mindfulness, Radboud University, P.O.Box 9101, 6500 HB, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University, P.O.Box 9010, 6500 GL, Nijmegen, the Netherlands.
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Hanssen I, van Dord MI, Compen FR, Geurts DEM, Schellekens MPJ, Speckens AEM. Exploring the clinical outcome of Mindfulness-Based Cognitive Therapy for bipolar and unipolar depressive patients in routine clinical practice: a pilot study. Int J Bipolar Disord 2019; 7:18. [PMID: 31456020 PMCID: PMC6712126 DOI: 10.1186/s40345-019-0153-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/24/2019] [Indexed: 01/25/2023] Open
Abstract
Background Mindfulness Based Cognitive Therapy (MBCT) has been adopted as an evidence-based treatment for unipolar depressive disorder (UDD). Although MBCT has not been included in the treatment guidelines for bipolar disorder (BD), MBCT is regularly being offered to patients with BD in routine clinical practice. In this pilot study we used routine outcome monitoring (ROM) data to explore whether there are indications that patients with BD might benefit less from MBCT than patients with UDD in terms of feasibility and effectiveness. Methods The study population consisted of patients with BD (n = 30) or UDD (n = 501) who received MBCT at the Radboudumc Centre for Mindfulness in Nijmegen, the Netherlands. Patients completed self-report measures of depressive symptom severity, worry, well-being, mindfulness skills and self-compassion pre- and post MBCT as part of the ROM. Results There were significant less patients with BD who decided to start MBCT after intake than patients with UDD. No differences in dropout between groups were found. Results showed significant moderate to large improvements in both groups after MBCT, while no differences between groups were found, on all outcome measures. Conclusions This study demonstrates that there are no indications that MBCT, when delivered in heterogeneous patient groups in routine clinical practice, is less beneficial for patients with BD than patients with UDD in terms of feasibility and effectiveness. This lends support to conduct an adequately powered RCT to examine the (cost-)effectiveness of MBCT in BD as the next step before implementing MBCT on a larger scale in patients with BD.
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Affiliation(s)
- I Hanssen
- Department of Psychiatry, Centre for Mindfulness, Radboud University Medical Centre, Postbus 9101, 6500 HB, Nijmegen, The Netherlands. .,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
| | - M I van Dord
- Department of Psychiatry, Centre for Mindfulness, Radboud University Medical Centre, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - F R Compen
- Department of Psychiatry, Centre for Mindfulness, Radboud University Medical Centre, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - D E M Geurts
- Department of Psychiatry, Centre for Mindfulness, Radboud University Medical Centre, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - M P J Schellekens
- Department of Psychiatry, Centre for Mindfulness, Radboud University Medical Centre, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.,Centre for Psycho-Oncology, Helen Dowling Institute, Bilthoven, The Netherlands
| | - A E M Speckens
- Department of Psychiatry, Centre for Mindfulness, Radboud University Medical Centre, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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Abstract
OBJECTIVES This narrative review article provides an overview of current psychotherapeutic approaches specific for adjustment disorders (ADs) and outlines future directions for theoretically-based treatments for this common mental disorder within a framework of stepped care. METHODS Studies on psychological interventions for ADs were retrieved by using an electronic database search within PubMed and PsycINFO, as well as by scanning the reference lists of relevant articles and previous reviews. RESULTS The evidence base for psychotherapies specifically targeting the symptoms of AD is currently rather weak, but is evolving given several ongoing trials. Psychological interventions range from self-help approaches, relaxation techniques, e-mental-health interventions, behavioural activation to talking therapies such as psychodynamic and cognitive behavioural therapy. CONCLUSIONS The innovations in DSM-5 and upcoming ICD-11, conceptualising AD as a stress-response syndrome, will hopefully stimulate more research in regard to specific psychotherapeutic interventions for AD. Low intensive psychological interventions such as e-mental-health interventions for ADs may be a promising approach to address the high mental health care needs associated with AD and the limited mental health care resources in most countries around the world.
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Affiliation(s)
- Matthias Domhardt
- a Department of Clinical Psychology and Psychotherapy , University of Ulm , Ulm , Germany.,b Department of Child and Adolescent Psychiatry/Psychotherapy , University of Ulm , Ulm , Germany
| | - Harald Baumeister
- a Department of Clinical Psychology and Psychotherapy , University of Ulm , Ulm , Germany
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Lovas DA, Schuman-Olivier Z. Mindfulness-based cognitive therapy for bipolar disorder: A systematic review. J Affect Disord 2018; 240:247-261. [PMID: 30086469 PMCID: PMC7448295 DOI: 10.1016/j.jad.2018.06.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/16/2018] [Accepted: 06/04/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Persisting high levels of relapse, morbidity and mortality in bipolar disorder (BD) in spite of first-line, evidence-based psychopharmacology has spurred development and research on adjunctive psychotherapies. Mindfulness-based cognitive therapy (MBCT) is an emerging psychotherapy that has shown benefit in related and comorbid conditions such as major depressive, anxiety, and substance disorders. Furthermore, neurocognitive studies of MBCT suggest that it may have effects on some of the theorized pathophysiological processes in BD. METHODS We conducted a systematic literature review using PsychINFO and PubMed databases to identify studies reporting clinical and/or neurocognitive findings for MBCT for BD. RESULTS This search revealed 13 articles. There was a wide range in methodological quality and most studies were underpowered or did not present power calculations. However, MBCT did not appear to precipitate mania, and there is preliminary evidence to support a positive effect on anxiety, residual depression, mood regulation, and broad attentional and frontal-executive control. LIMITATIONS As meta-analysis is not yet possible due to study heterogeneity and quality, the current review is a narrative synthesis, and therefore net effects cannot be estimated. CONCLUSIONS MBCT for BD holds promise, but more high-quality studies are needed in order to ascertain its clinical efficacy. Recommendations to address the limitations of the current research are made.
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Affiliation(s)
- David A Lovas
- IWK Health Centre, Department of Psychiatry, Dalhousie University; 5980 University Ave, Halifax, Nova Scotia, B3K 6R8.
| | - Zev Schuman-Olivier
- Cambridge Health Alliance, Department of Psychiatry, Harvard Medical School, USA
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Fletcher K, Foley F, Thomas N, Michalak E, Berk L, Berk M, Bowe S, Cotton S, Engel L, Johnson SL, Jones S, Kyrios M, Lapsley S, Mihalopoulos C, Perich T, Murray G. Web-based intervention to improve quality of life in late stage bipolar disorder (ORBIT): randomised controlled trial protocol. BMC Psychiatry 2018; 18:221. [PMID: 30001704 PMCID: PMC6044003 DOI: 10.1186/s12888-018-1805-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 07/02/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The primary objective of this randomised controlled trial (RCT) is to establish the effectiveness of a novel online quality of life (QoL) intervention tailored for people with late stage (≥ 10 episodes) bipolar disorder (BD) compared with psychoeducation. Relative to early stage individuals, this late stage group may not benefit as much from existing psychosocial treatments. The intervention is a guided self-help, mindfulness based intervention (MBI) developed in consultation with consumers, designed specifically for web-based delivery, with email coaching support. METHODS/DESIGN This international RCT will involve a comparison of the effectiveness and cost-effectiveness of two 5-week adjunctive online self-management interventions: Mindfulness for Bipolar 2.0 and an active control (Psychoeducation for Bipolar). A total of 300 participants will be recruited primarily via social media channels. Main inclusion criteria are: a diagnosis of BD (confirmed via a phone-administered structured diagnostic interview), no current mood episode, history of 10 or more mood episodes, no current psychotic features or active suicidality, under the care of a medical practitioner. Block randomisation will be used for allocation to the interventions, and participants will retain access to the program for 6 months. Evaluations will be conducted at pre- and post- treatment, and at 3- and 6- months follow-up. The primary outcome measure will be the Brief Quality of Life in Bipolar Disorder Scale (Brief QoL.BD), collected immediately post-intervention at 5 weeks (T1). Secondary measures include BD-related symptoms (mania, depression, anxiety, stress), time to first relapse, functioning, sleep quality, social rhythm stability and resource use. Measurements will be collected online and via telephone assessments at baseline (T0), 5 weeks (T1), three months (T2) and six months (T3). Candidate moderators (diagnosis, anxiety or substance comorbidities, demographics and current treatments) will be investigated as will putative therapeutic mechanisms including mindfulness, emotion regulation and self-compassion. A cost-effectiveness analysis will be conducted. Acceptability and any unwanted events (including adverse treatment reactions) will be documented and explored. DISCUSSION This definitive trial will test the effectiveness and cost-effectiveness of a novel QoL focused, mindfulness based, online guided self-help intervention for late stage BD, and investigate its putative mechanisms of therapeutic action. TRIAL REGISTRATION ClinicalTrials.gov : NCT03197974 . Registered 23 June 2017.
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Affiliation(s)
- Kathryn Fletcher
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Fiona Foley
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Neil Thomas
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Erin Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Lesley Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University Barwon Health, Geelong, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University Barwon Health, Geelong, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Florey Institute for Neuroscience and Mental Health, Melbourne, Australia
| | | | - Sue Cotton
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | | | | | - Steven Jones
- Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | | | - Sara Lapsley
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - Tania Perich
- Western Sydney University, Sydney, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
- Centre for Mental Health, Swinburne University of Technology, PO Box 218, Hawthorn, VIC 3122 Australia
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O'Donnell ML, Metcalf O, Watson L, Phelps A, Varker T. A Systematic Review of Psychological and Pharmacological Treatments for Adjustment Disorder in Adults. J Trauma Stress 2018; 31:321-331. [PMID: 29958336 DOI: 10.1002/jts.22295] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 02/28/2018] [Accepted: 03/05/2018] [Indexed: 11/10/2022]
Abstract
Adjustment disorder is a common psychiatric disorder, yet knowledge of the efficacious treatments for adjustment disorder is limited. In this systematic review, we aimed to examine psychological and pharmacological interventions that target adjustment disorder in adults to determine which interventions have the best evidence for improving adjustment disorder symptoms. We performed database searches for literature published between January 1980 and September 2016 and identified studies that included both a sample majority of individuals diagnosed with adjustment disorder and findings on adjustment disorder symptom outcomes. There were 29 studies that met the inclusion criteria for qualitative synthesis; the majority of studies (59%) investigated psychological therapies rather than pharmacological treatments (35%). The range of psychological therapies tested was diverse, with the majority containing cognitive behavioral therapy (CBT) components (53%), followed by three studies that were psychodynamic-related, three studies that were behavioral therapy-based, and two studies that involved relaxation techniques. We rated individual studies using a modified National Health and Medical Research Council quality and bias checklist and then used the Grading of Recommendations Assessment, Development and Evaluation (GRADE; Grade Working Group, 2004) system to rate the overall quality of the evidence. Despite several randomized controlled trials, the quality of the evidence for positive effects of all psychological and pharmacological treatments on symptoms of adjustment disorder was ranked as low to very low. Future high-quality research in the treatment of adjustment disorder has the potential to make a significant difference to individuals who struggle to recover after stressful events.
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Affiliation(s)
- Meaghan L O'Donnell
- Phoenix Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Olivia Metcalf
- Phoenix Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Loretta Watson
- Phoenix Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Andrea Phelps
- Phoenix Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Tracey Varker
- Phoenix Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
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The effectiveness of adjunct mindfulness-based intervention in treatment of bipolar disorder: A systematic review and meta-analysis. J Affect Disord 2018; 225:234-245. [PMID: 28841486 DOI: 10.1016/j.jad.2017.08.025] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 06/14/2017] [Accepted: 08/11/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Mindfulness-based interventions (MBIs) have been increasingly used as an adjunctive treatment to pharmacotherapy for a few psychiatric disorders. However, few studies have investigated the efficacy of MBIs in bipolar disorder (BD). METHODS We performed a systematic review and meta-analysis to evaluate the efficacy of MBIs as an adjunctive treatment in BD. Major electronic databases were independently searched by two authors for controlled and uncontrolled studies which examined the effects of MBIs on psychiatric symptoms in subjects with BD. Data from original studies were synthesized by using a random effects model. RESULTS Twelve trials were eligible for inclusion into current meta-analysis, including three controlled studies (n=132) and nine uncontrolled studies (n=142). In within-group analysis, MBIs significantly reduced depressive (7 studies, n=100, Hedges' g=0.58, p<0.001) and anxiety (4 studies, n=68, Hedges' g=0.34, p=0.043) symptoms, but not manic symptoms (6 studies, n=89, Hedges' g=0.09, p=0.488) and cognition (3 studies, n=43, Hedges' g=0.35, p=0.171), compared to baseline. In between-group analysis (intervention group versus waiting list group, all patients with BD), MBIs did not reduce depressive (3 studies, n=132, Hedges' g=0.46, p=0.315) or anxiety (3 studies, n=132, Hedges' g=0.33, p=0.578) symptoms. LIMITATIONS Only three controlled trials compared MBIs to control conditions. CONCLUSIONS Our meta-analysis showed significantly beneficial effects on depressive and anxiety symptoms of BD patients in within-group analysis. However, this significance was not observed in comparison with the control groups. Further clinical trials are warranted to investigate the differences in the benefits of MBIs between treatment and control subjects.
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Bartels-Velthuis AA, Schroevers MJ, van der Ploeg K, Koster F, Fleer J, van den Brink E. A Mindfulness-Based Compassionate Living Training in a Heterogeneous Sample of Psychiatric Outpatients: a Feasibility Study. Mindfulness (N Y) 2016; 7:809-818. [PMID: 27429664 PMCID: PMC4923083 DOI: 10.1007/s12671-016-0518-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We developed a novel compassion-focused training (mindfulness-based compassionate living; MBCL) and examined its effects in a heterogeneous psychiatric outpatient population with regard to feasibility and changes in levels of depression, anxiety, mindfulness and compassion. The training consisted of nine weekly 2.5-h sessions. Thirty-three patients, who had followed a mindfulness-based stress reduction (MBSR) program or a mindfulness-based cognitive therapy (MBCT) program beforehand, participated in the study (mean age 48.1 years; 82 % female). Participants completed self-report questionnaires before and directly after the MBCL training. Levels of depression, but not of anxiety, reduced, and levels of mindfulness and self-compassion increased. Serious limitations of this study are the small sample size, the lack of a control group and the fact that about half of the participants did not complete the posttraining questionnaires. However, we determined that it is feasible to conduct further research on this novel MBCL training program as a basis for more robust empirical investigation in the future, more specifically examining the effects of MBCL and preferably also the underlying working mechanisms.
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Affiliation(s)
- Agna A Bartels-Velthuis
- Center for Integrative Psychiatry, Lentis Mental Health Organization, Groningen, The Netherlands ; University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Maya J Schroevers
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Karen van der Ploeg
- Center for Integrative Psychiatry, Lentis Mental Health Organization, Groningen, The Netherlands
| | - Frits Koster
- Center for Integrative Psychiatry, Lentis Mental Health Organization, Groningen, The Netherlands
| | - Joke Fleer
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erik van den Brink
- Center for Integrative Psychiatry, Lentis Mental Health Organization, Groningen, The Netherlands
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Caughill A. Preserving the Art and Science of Psychotherapy for Advance Practice Psychiatric Mental Health Nurses. Issues Ment Health Nurs 2016; 37:268-72. [PMID: 27077508 DOI: 10.3109/01612840.2016.1147625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Psychiatric Mental Health (PMH) Nurses are challenged to maintain the viability of their roles in today's healthcare climate as advances in research and complexity of mental healthcare needs of society continue to unfold. Today's mental health practice environment includes disciplines with marketable credentials. Roles for PMH nurses in recent decades are less clearly defined than for other disciplines, much of this related to changes in educational and practice settings. This article reviews literature on the topic of psychotherapy and a call for a renewed emphasis on this mode of treatment for psychiatric mental health advance practice nurses.
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Affiliation(s)
- Ann Caughill
- a D'Youville College, School of Nursing , Buffalo , New York , USA
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Abstract
Facilitating mindfulness programmes within an inpatient mental health setting is discussed. The difficulty in effectively engaging patients at this acute stage in their illness is focussed upon. Other challenges discussed are identifying appropriate inclusion and exclusion criteria; identifying the optimal programme format for this setting; promoting mindfulness within the environment of the inpatient unit and the training requirements for programme facilitators. The article concludes that due attention should be given to these challenges in order to maintain the integrity of mindfulness as an effective intervention for mental health difficulties.
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Holthouser B, Bui NH. Meditative interventions and antisocial personality disorder. COUNSELLING PSYCHOLOGY QUARTERLY 2015. [DOI: 10.1080/09515070.2015.1026311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Miziou S, Tsitsipa E, Moysidou S, Karavelas V, Dimelis D, Polyzoidou V, Fountoulakis KN. Psychosocial treatment and interventions for bipolar disorder: a systematic review. Ann Gen Psychiatry 2015; 14:19. [PMID: 26155299 PMCID: PMC4493813 DOI: 10.1186/s12991-015-0057-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 06/29/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a chronic disorder with a high relapse rate, significant general disability and burden and with a psychosocial impairment that often persists despite pharmacotherapy. This indicates the need for effective and affordable adjunctive psychosocial interventions, tailored to the individual patient. Several psychotherapeutic techniques have tried to fill this gap, but which intervention is suitable for each patient remains unknown and it depends on the phase of the illness. METHODS The papers were located with searches in PubMed/MEDLINE through May 1st 2015 with a combination of key words. The review followed the recommendations of the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses statement. RESULTS The search returned 7,332 papers; after the deletion of duplicates, 6,124 remained and eventually 78 were included for the analysis. The literature supports the usefulness only of psychoeducation for the relapse prevention of mood episodes and only in a selected subgroup of patients at an early stage of the disease who have very good, if not complete remission, of the acute episode. Cognitive-behavioural therapy and interpersonal and social rhythms therapy could have some beneficial effect during the acute phase, but more data are needed. Mindfulness interventions could only decrease anxiety, while interventions to improve neurocognition seem to be rather ineffective. Family intervention seems to have benefits mainly for caregivers, but it is uncertain whether they have an effect on patient outcomes. CONCLUSION The current review suggests that the literature supports the usefulness only of specific psychosocial interventions targeting specific aspects of BD in selected subgroups of patients.
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Affiliation(s)
- Stella Miziou
- Aristotle University of Thessaloniki, Thessaloníki, Greece
| | | | | | - Vangelis Karavelas
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos Street (1st Parodos, Ampelonon Str.), Pournari Pylaia, 55535 Thessaloníki, Greece
| | - Dimos Dimelis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos Street (1st Parodos, Ampelonon Str.), Pournari Pylaia, 55535 Thessaloníki, Greece
| | | | - Konstantinos N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos Street (1st Parodos, Ampelonon Str.), Pournari Pylaia, 55535 Thessaloníki, Greece
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