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Molho W, Raymond N, Reinhart RMG, Trotti R, Grover S, Keshavan M, Lizano P. Lesion network guided delta frequency neuromodulation improves cognition in patients with psychosis spectrum disorders: A pilot study. Asian J Psychiatr 2024; 92:103887. [PMID: 38183737 DOI: 10.1016/j.ajp.2023.103887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Transcranial electric stimulation (tES) may improve cognition in psychosis spectrum disorders. However, few studies have used novel tES approaches, such as high definition tES (HD-tES) to target specific brain circuits. Recently, the extrastriate visual cortex (V5/MT) has been causally linked to visual hallucinations through lesion network mapping and this may be a promising approach for improving cognition. OBJECTIVE We aim to determine if causal lesion network guided HD-tES to V5/MT improves cognitive performance as measured by the Brief Assessment of Cognition in Schizophrenia (BACS). METHODS A single-blind pilot study with a within-subjects crossover design was performed to characterize the effect of cathodal HD-transcranial direct current stimulation (tDCS) and 2 Hz HD-transcranial alternating current stimulation (tACS) on cognition. Enrolled patients received 20 mins of HD-tES twice daily for 5 consecutive days applied bilaterally to V5/MT with a washout between conditions. BACS assessments were performed at baseline, day-5, and 1-month. RESULTS 6 participants with psychosis spectrum disorder were enrolled. 6 individuals received cathodal HD-tDCS. 4 individuals received 2 Hz HD-tACS. HD-tACS resulted in significant (p < 0.1 baseline to 1-month improvements for Digit Sequencing, Verbal Fluency, and Tower of London. HD-tDCS did not result in significant improvement on any task. CONCLUSIONS HD-tACS targeting V5/MT may be a promising treatment to improve cognitive abilities in individuals with psychosis. By promoting delta oscillations, tACS may enhance cortico-cortico communications across brain networks to improve verbal working memory, processing speed, and executive function. Large-scale investigations are needed to replicate these results.
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Affiliation(s)
- Willa Molho
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Nicolas Raymond
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Robert M G Reinhart
- Department of Psychological and Brain Science, Boston University, Boston, MA, USA
| | - Rebekah Trotti
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Shrey Grover
- Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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Donohue JF, Elborn JS, Lansberg P, Javed A, Tesfaye S, Rugo H, Duddi SRD, Jithoo N, Huang PH, Subramaniam K, Ramanjinappa N, Koltun A, Melamed S, Chan JCN. Bridging the "Know-Do" Gaps in Five Non-Communicable Diseases Using a Common Framework Driven by Implementation Science. J Healthc Leadersh 2023; 15:103-119. [PMID: 37416849 PMCID: PMC10320809 DOI: 10.2147/jhl.s394088] [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: 10/19/2022] [Accepted: 04/12/2023] [Indexed: 07/08/2023] Open
Abstract
According to the United Nations High-Level Meeting 2018, five non-communicable diseases (NCDs) including cardiovascular diseases, chronic respiratory diseases, diabetes mellitus, cancer, and mental health conditions accounted for two-thirds of global deaths. These five NCDs share five common risk factors including tobacco use, unhealthy diets, physical inactivity, alcohol use, and air pollution. Low- and middle-income countries (LMICs) face larger burden of NCDs than high-income countries (HICs), due to differences in ecological, technological, socioeconomic and health system development. Based on high-level evidence albeit mainly from HICs, the burden caused by NCDs can be reduced by affordable medicines and best practices. However, "know-do" gaps, ie, gaps between what we know in science and what we do in practice, has limited the impact of these strategies, especially in LMICs. Implementation science advocates the use of robust methodologies to evaluate sustainable solutions in health, education and social care aimed at informing practice and policies. In this article, physician researchers with expertise in NCDs reviewed the common challenges shared by these five NCDs with different clinical courses. They explained the principles of implementation science and advocated the use of an evidence-based framework to implement solutions focusing on early detection, prevention and empowerment, supplemented by best practices in HICs and LMICs. These successful stories can be used to motivate policymakers, payors, providers, patients and public to co-design frameworks and implement context-relevant, multi-component, evidence-based practices. In pursuit of this goal, we propose partnership, leadership, and access to continuing care as the three pillars in developing roadmaps for addressing the multiple needs during the journey of a person with or at risk of these five NCDs. By transforming the ecosystem, raising awareness and aligning context-relevant practices and policies with ongoing evaluation, it is possible to make healthcare accessible, affordable and sustainable to reduce the burden of these five NCDs.
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Affiliation(s)
| | | | | | - Afzal Javed
- Warwick Medical School, University of Warwick, Warwick, UK & Pakistan Psychiatric Research Centre, Coventry, UK
| | - Solomon Tesfaye
- Sheffield Teaching Hospitals and the University of Sheffield, Sheffield, UK
| | - Hope Rugo
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA, USA
| | - Sita Ratna Devi Duddi
- International Alliance of Patients’ Organisations, London, United Kingdom
- DakshamA Health and Education, Delhi, India
| | | | | | | | | | | | | | - Juliana C N Chan
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Special Administrative Regions of the People’s Republic of China
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Bagheri L, Chaman R, Ghiasi A, Motaghi Z. Cognitive behavioral counselling in post abortion grief: A randomized controlled trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:120. [PMID: 37397123 PMCID: PMC10312394 DOI: 10.4103/jehp.jehp_474_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/09/2022] [Indexed: 07/04/2023]
Abstract
BACKGROUND Abortion is can led to certain psychological problems that may decreased self-esteem, and concerns about future fertility. Abortions have multiple psychological consequences such as grief, anxiety, depression, and post-traumatic stress. The purpose of this study is to examine the effect of cognitive behavioral counseling intervention on women in post-abortion period. MATERIAL AND METHODS This research was a randomized, controlled trial study that was conducted on 168 women during the post-abortion period at the Khalill Azad Center of Larestan (Iran), where the women were selected randomly from February 2019 to January 2020. Data were collected using post-abortion grief questionnaire. All women in the post-abortion period answered the perinatal grief scale questions at the beginning of the intervention, immediately after the intervention and three months after the end of the intervention. Data were analyzed through descriptive statistics and repeated measures analysis of variance (ANOVA) with time and group were used to evaluate the effect of intervention. RESULTS By using repeated measures ANOVA, the comparison of the mean score of grief in the two groups indicated that the scores decreased over time and it was lower in the intervention group. The mean score of grief between the intervention and control groups at the end of the intervention was 67.59 ± 13.21 and 75.42 ± 12.7, respectively (P < 0.001). Mean post-abortion grief score in the intervention and control groups three months after the intervention were 59.41 ± 13.71 and 69.32 ± 12.45, respectively (P < 0.001). CONCLUSION According to results of this study, it can be concluded that the use of cognitive behavioral counselling can reduce post-abortion grief intensity or prevent the occurrence of complicated grief. Therefore, this method can be used as a preventive or therapeutic approach to control post-abortion grief and other psychological disorders.
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Affiliation(s)
- Leila Bagheri
- Faculty of Nursing and Midwifery, Assistant Professor of Reproductive Health, Islamic Azad University of Larestan, Larestan, Iran
| | - Reza Chaman
- Department of Epidemiology, School of Health Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ashraf Ghiasi
- Department of Midwifery, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - Zahra Motaghi
- Associate Professor of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Hudays A, Gallagher R, Hazazi A, Arishi A, Bahari G. Eye Movement Desensitization and Reprocessing versus Cognitive Behavior Therapy for Treating Post-Traumatic Stress Disorder: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16836. [PMID: 36554717 PMCID: PMC9778888 DOI: 10.3390/ijerph192416836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
This meta-analysis review compared eye movement desensitization and reprocessing and cognitive behavior therapy efficacy in reducing post-traumatic stress disorder (PTSD), anxiety, and depression symptoms. A systematic search for articles published between 2010 and 2020 was conducted using five databases. The RevMan software version 5 was used. Out of 671 studies, 8 fulfilled the inclusion criteria and were included in this meta-analysis. Three studies reported that eye movement desensitization and reprocessing reduced depression symptoms better than cognitive behavior therapy in both children, adolescents, and adults (SDM (95% CI) = -2.43 (-3.93--0.94), p = 0.001). In three other studies, eye movement desensitization and reprocessing were shown to reduce anxiety in children and adolescents better than cognitive behavior therapy (SDM (95% CI) = -3.99 (-5.47--2.52), p < 0.001). In terms of reducing PTSD symptoms, eye movement desensitization and reprocessing and cognitive behavior therapy did not demonstrate any statistically significant differences (SDM (95% CI) = -0.14 (-0.48-0.21), p = 0.44). There was no statistically significant difference at the three-month follow-up and at the six-month follow-up for depression (p = 0.31), anxiety (p = 0.59), and PTSD (p = 0.55). We recommend randomized trials with larger samples and longer follow-up times in the future.
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Affiliation(s)
- Ali Hudays
- Community, Psychiatric and Mental Health Nursing Department, College of Nursing, King Saud University, Riyadh 11543, Saudi Arabia
| | - Robyn Gallagher
- Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2050, Australia
| | - Ahmed Hazazi
- Department of Public Health, Faculty of Health Science, Saudi Electronic University, Riyadh 13316, Saudi Arabia
| | - Amal Arishi
- Medical Surgical Department, College of Nursing, King Saud University, Riyadh 11543, Saudi Arabia
| | - Ghareeb Bahari
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh 11543, Saudi Arabia
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Tan RXR, Goh YS. Community mental health interventions for people with major depressive disorder: A scoping review. Int J Ment Health Nurs 2022; 31:1315-1359. [PMID: 35695678 DOI: 10.1111/inm.13029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 12/30/2022]
Abstract
People with major depressive disorder continue to be marred by chronically pernicious yet preventable outcomes in the biopsychosocial aspects. With the reallocation of healthcare resources towards the fight against the coronavirus 2019 pandemic, much emphasis has been placed on existing community mental health interventions to ameliorate the disruption of mental health services. Moreover, the recent propulsion of community mental health services by the World Health Organization Mental Health Action Plan 2013-2030 ignited the need to bolster existing community interventions by providing comprehensive, responsive and integrated mental healthcare. The enhanced emphasis on mental healthcare in the community and the heightened demands of people with major depressive disorder underscores the need to explore the current state of community mental health interventions. This scoping review examined 51 primary studies published from year 2010 to 2020 using Arskey & O'Malley's five-stage framework and provided an overview of the impact of existing community mental health interventions for people with major depressive disorder. Findings using thematic analysis have recommended the adoption of person-centred community mental healthcare via the biopsychosocial approach for people with major depressive disorder. Enablers of community mental health interventions were driven by culturally appropriate care and augmented by technology-driven modalities. Challenges and gaps of community mental health interventions include the perpetuation of stigma and misconception, complex demands of persons with major depressive disorder and lack of holistic and long-term outcomes. Given the impact of major depressive disorder on the various biopsychosocial aspects, it is envisioned that our insights into the enablers and barriers of community mental health interventions will guide prospective interdisciplinary and nurse-led interventions in holistically improving the care of persons with major depressive disorder in the community settings.
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Affiliation(s)
- Ronel Xian Rong Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yong Shian Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Allen GEK, Masuda A, Griner D, Beecher M, Cline J, Hee C, Ming M. Examining Expectations Among Polynesian Americans About Seeking Psychotherapy. Am J Psychother 2022; 75:154-160. [PMID: 36018598 DOI: 10.1176/appi.psychotherapy.20210031] [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: 12/01/2022]
Abstract
OBJECTIVE Research on culturally diverse clients has investigated expectations about psychotherapy and intention to seek counseling. However, few studies have investigated how these factors may be linked to specific client expectations, such as advice-seeking (the client expecting the therapist to give advice) and audience-seeking (the client expecting to lead the sessions) behaviors, particularly for U.S. racial-ethnic minority populations. METHODS This study used a survey to investigate 593 Polynesian Americans' gender and ethnic preferences for therapists, as well as the mediating effects of advice- and audience-seeking behaviors and their associations with intention to seek counseling and expectations about psychotherapy. RESULTS Results indicated that audience-seeking behavior mediated the association between expectations about the psychotherapy process and intention to seek counseling for psychological and interpersonal concerns and between expectations about psychotherapy outcomes and intention to seek counseling for academic concerns. CONCLUSIONS Culturally competent counseling for Polynesian Americans, a fast-growing yet understudied population in the United States, is needed, particularly by psychotherapists working with these individuals. Expectations about the process of therapy, such as audience-seeking behavior, may be important to consider in working with this population.
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Affiliation(s)
- G E Kawika Allen
- Department of Counseling Psychology and Special Education (Allen, Cline), Department of Counseling and Psychological Services (Griner, Beecher), Department of Marriage and Family Therapy (Hee), and Department of Psychology (Ming), Brigham Young University, Provo, Utah; Department of Psychology, University of Hawai'i at Mānoa, Honolulu (Masuda)
| | - Aki Masuda
- Department of Counseling Psychology and Special Education (Allen, Cline), Department of Counseling and Psychological Services (Griner, Beecher), Department of Marriage and Family Therapy (Hee), and Department of Psychology (Ming), Brigham Young University, Provo, Utah; Department of Psychology, University of Hawai'i at Mānoa, Honolulu (Masuda)
| | - Derek Griner
- Department of Counseling Psychology and Special Education (Allen, Cline), Department of Counseling and Psychological Services (Griner, Beecher), Department of Marriage and Family Therapy (Hee), and Department of Psychology (Ming), Brigham Young University, Provo, Utah; Department of Psychology, University of Hawai'i at Mānoa, Honolulu (Masuda)
| | - Mark Beecher
- Department of Counseling Psychology and Special Education (Allen, Cline), Department of Counseling and Psychological Services (Griner, Beecher), Department of Marriage and Family Therapy (Hee), and Department of Psychology (Ming), Brigham Young University, Provo, Utah; Department of Psychology, University of Hawai'i at Mānoa, Honolulu (Masuda)
| | - Jared Cline
- Department of Counseling Psychology and Special Education (Allen, Cline), Department of Counseling and Psychological Services (Griner, Beecher), Department of Marriage and Family Therapy (Hee), and Department of Psychology (Ming), Brigham Young University, Provo, Utah; Department of Psychology, University of Hawai'i at Mānoa, Honolulu (Masuda)
| | - Cameron Hee
- Department of Counseling Psychology and Special Education (Allen, Cline), Department of Counseling and Psychological Services (Griner, Beecher), Department of Marriage and Family Therapy (Hee), and Department of Psychology (Ming), Brigham Young University, Provo, Utah; Department of Psychology, University of Hawai'i at Mānoa, Honolulu (Masuda)
| | - Mason Ming
- Department of Counseling Psychology and Special Education (Allen, Cline), Department of Counseling and Psychological Services (Griner, Beecher), Department of Marriage and Family Therapy (Hee), and Department of Psychology (Ming), Brigham Young University, Provo, Utah; Department of Psychology, University of Hawai'i at Mānoa, Honolulu (Masuda)
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Cao B, Li R, Ding L, Xu J, Ma H, Liu J, Xue J. Does cognitive behaviour therapy affect peripheral inflammation of depression? A protocol for the systematic review and meta-analysis. BMJ Open 2021; 11:e048162. [PMID: 34857553 PMCID: PMC8640668 DOI: 10.1136/bmjopen-2020-048162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Cognitive-behavioural therapy (CBT) is becoming the most commonly implemented and standard treatment for depression. Up to date, only a few numbers of studies have investigated the potential relationship between CBT and the change of inflammatory biomarkers in individuals of depression. And the results are inconsistent among studies. The current study aims to provide a comprehensive, systematic review of the association between CBT and changes of peripheral inflammation of individuals with depression, and clarify the alterations of inflammatory cytokines pre-CBT and post-CBT treatment by meta-analysis, anti-inflammatory. METHODS AND ANALYSIS This study will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search of predetermined terms will be conducted with electronic databases of CENTRAL, MEDLINE, EMBASE and PsycINFO from inception to July 2021. Database searches will be supplemented by expert contact, reference and citation checking, and grey literature. Primary outcomes of interest will be validated measures for levels of inflammatory cytokines pre-CBT and post- CBT treatment in individuals with depression. Hedges' g will be used to represent the effect size. SYSTEMATIC REVIEW REGISTRATION The protocol of current meta-analysis has been registered at the Open Science Framework (https://doi.org/10.17605/osf.io/tr9yh). ETHICS AND DISSEMINATION Formal ethical approval is not required by the National Ethical Review Board in China as primary data will not be collected. The results alterations of peripheral inflammatory cytokines pre-CBT and post-CBT treatment in individuals with depression will be disseminated through a peer-reviewed publication and inform the most up-to-date evidence of the roles of CBT treatment for depression.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Ruonan Li
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Ling Ding
- Department of Pharmacy, JiangJin Central Hosptial of Chongqing, Chongqing, China
| | - Jiatong Xu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Haijing Ma
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Jie Liu
- Department of Pharmacy, JiangJin Central Hosptial of Chongqing, Chongqing, China
| | - Jian Xue
- Department of Health Management, Zunyi Medical and Pharmaceutical College, Zunyi, Guizhou, China
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Mahnashi MH. Synthesis of three-dimensional nickel ferrite nanospheres decorated activated graphite nanoplatelets for electrochemical detection of vortioxetine with pharmacokinetic insights in human volunteers. Mikrochim Acta 2020; 187:519. [PMID: 32852618 DOI: 10.1007/s00604-020-04523-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/19/2020] [Indexed: 12/23/2022]
Abstract
An innovative electrochemical nanoprobe was developed for determination of vortioxetine (VORT), a serotonergic antidepressant drug, for the first time. The fabrication of the nanoprobe is based on decoration of a glassy carbon electrode with three-dimensional nickel ferrite nanospheres modified activated graphite nanoplatelets (3D NiFe2O4 NS/AGNP/GCE). The morphological characterization of the nanoprobe was carried out via scanning electron microscope (SEM), transmission electron microscope (TEM), Fourier transform infrared spectroscopy (FT-IR), Raman spectroscopy, energy dispersive X-ray spectroscopy (EDS), N2-adsorption-desorption isotherm, and powder X-ray spectroscopy (PXRD). In addition, the electrochemical behavior of the nanoprobe was described using cyclic voltammetry (CV), differential pulse voltammetry (DPV), and electrochemical impedance spectroscopy (EIS). A well-defined and irreversible peak at 0.82 V was seen at the surface of 3D NiFe2O4 NS/AGNP/GCE. The proposed nanoprobe exhibited outstanding electro-catalytic activity towards VORT oxidation. Under the optimized conditions, the anodic oxidation currents were linearly proportional to VORT concentration at the working range 1.8-90 nM with a LOD of 0.55 nM. The nanoprobe was used to determine VORT in pharmaceutical tablets and human plasma samples. Satisfactory recoveries and RSD percentages were obtained in the range 103.8-107.7% (RSD% = 2.7-3.1%) and 101.4-105.3% (RSD % = 2.8-3.4%) for tablets and plasma samples, respectively. Moreover, the method was used to monitor VORT during a pharmacokinetic study in human volunteers with satisfactory results. The 3D NiFe2O4 NS/AGNP/GCE shows excellent sensitivity, reproducibility, and selectivity towards VORT detection. The proposed electrode could be utilized as simple, rapid, and inexpensive sensing tool for routine analysis and during pharmacokinetic/pharmacodynamic investigations. Graphical abstract.
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Affiliation(s)
- Mater H Mahnashi
- Department of Pharmaceutical Chemistry, College of Pharmacy, Najran University, Najran, Saudi Arabia.
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Efficacy of trial-based cognitive therapy, behavioral activation and treatment as usual in the treatment of major depressive disorder: preliminary findings from a randomized clinical trial. CNS Spectr 2020; 25:535-544. [PMID: 31769377 DOI: 10.1017/s1092852919001457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Major depressive disorder (MDD) is a prevalent, debilitating and disabling disorder, and its prevalence is increasing. Antidepressants (AD), cognitive-behavioral therapy (CBT) and behavioral activation (BA) are the main treatments for MDD. Trial-based cognitive therapy (TBCT) addresses and restructures dysfunctional negative core beliefs (CBs) and is a novel and promising approach. OBJECTIVE The aim of this study was to compare the efficacy of TBCT, BA and treatment as usual (TAU) in the treatment of MDD. METHODS A total of 76 patients with MDD were randomized into 1 of 3 groups and evaluated at baseline, after 6 weeks and at week 12 (final evaluation). The primary outcome was changing in HAM-D scores, and the secondary outcomes included scores on the BDI, CD-Quest, Sheehan Disability Scale (SDS) and WHOQOL. RESULTS Both TBCT and BA (which also included AD) were different from TAU (which included antidepressants alone) in reducing the HAM-D and BDI scores and other measures. TBCT and BA were different from TAU in the reduction of disability in SDS and WHOQOL physical domain scores. Besides limited by a small sample size, the dropout rate in the TAU arm was higher, and only 10 patients completed the 3 evaluations. CONCLUSION This trial provides evidence that TBCT and BA combined with antidepressants were more efficacious than the TAU (drug alone) in reducing the severity of depressive symptoms and disability, showing that this combination can be useful for clinical practice.
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Shahraki-Sanavi F, Ansari-Moghaddam A, Mohammadi M, Bakhshani NM, Salehiniya H. Effectiveness of school-based mental health programs on mental health among adolescents. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:142. [PMID: 32766327 PMCID: PMC7377131 DOI: 10.4103/jehp.jehp_421_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/28/2020] [Indexed: 06/11/2023]
Abstract
AIM This study aimed to investigate the effect of school-based interventions on mental health among adolescents in the southeast of Iran. METHODS This interventional quasi-experimental study included a total of 420 adolescent girls studying 10th grade in the public schools of Zahedan, Iran. Data were collected using general health questionnaire-28 questionnaire. After pretest, multidimensional interventions (individual education, group education, individual consultations, modern education, and parents' educational packages) were given to the intervention group from October 2015 to June 2016. After a 3-month interval, the posttest was conducted in October 2016. Data were analyzed by covariance analysis. RESULTS There was a significant statistical difference between the changes in the mental health scores after the intervention among the two study groups (P < 0.05). Furthermore, after the intervention, moderate-to-severe mental health problems decreased considerably among the students in the intervention group compared to controls. The greatest impact was on individual psychological counseling. CONCLUSIONS The results of the study showed that by applying group training and individual counseling in the schools improves mental health. Therefore, identifying student problems and parent-teacher cooperation as well as consulting with specialist counselors can be effective in providing practical and effective solutions in this regard. Therefore, findings suggest that prioritizing mental health and taking action on the field are of utmost importance.
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Affiliation(s)
- Fariba Shahraki-Sanavi
- Department of Public Health and Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza Ansari-Moghaddam
- Department of Epidemiology and Biostatistics, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahdi Mohammadi
- Department of Epidemiology and Biostatistics, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Nour-Mohammad Bakhshani
- Department of Psychiatric and Clinical Psychology, Children and Adolescents Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
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Zakhour S, Nardi AE, Levitan M, Appolinario JC. Cognitive-behavioral therapy for treatment-resistant depression in adults and adolescents: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 42:92-101. [PMID: 32130308 DOI: 10.1590/2237-6089-2019-0033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 05/12/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To conduct a systematic review of literature on use and efficacy of cognitive-behavioral therapy (CBT) for treatment of treatment-resistant depression in adults and adolescents. METHODS We performed a systematic review according to the Prisma Guidelines of literature indexed on the PubMed, SciELO, Psychiatry Online, Scopus, PsycArticles, Science Direct and the Journal of Medical Case Reports databases. Randomized controlled trials, open studies and case reports were included in the review. RESULTS The searches returned a total of 1,580 articles, published from 1985 to 2017. After applying the inclusion criteria, 17 articles were selected, their complete texts were read and 8 were included in this review. Four of these studies were randomized controlled trials with adults, one of which covered a post-study follow-up period; two were randomized controlled trials with adolescents, one of which presented follow-up data; one was an open study; and one was a case report. The studies provide good quality and robust evidence on the topic addressed. CONCLUSIONS A combination of CBT with pharmacotherapy for treatment-resistant patients shows a decrease in depressive symptoms. CBT can be an effective type of therapy for adults and adolescents with treatment-resistant depression.
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Affiliation(s)
- Stephanie Zakhour
- Ambulatório de Depressão Resistente ao Tratamento (DeReTrat), Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Antonio E Nardi
- Ambulatório de Depressão Resistente ao Tratamento (DeReTrat), Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Michelle Levitan
- Ambulatório de Depressão Resistente ao Tratamento (DeReTrat), Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Jose Carlos Appolinario
- Ambulatório de Depressão Resistente ao Tratamento (DeReTrat), Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Programa de Pós-Graduação, IPUB, UFRJ, Rio de Janeiro, RJ, Brazil.,Grupo de Obesidade e Transtornos Alimentares, IPUB, UFRJ, Rio de Janeiro, RJ, Brazil.,Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), UFRJ, Rio de Janeiro, Brazil
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12
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Dissemination and Implementation of Cognitive Behavioral Therapy for Depression in the Kaiser Permanente Health Care System: Evaluation of Initial Training and Clinical Outcomes. Behav Ther 2019; 50:446-458. [PMID: 30824258 DOI: 10.1016/j.beth.2018.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/11/2018] [Accepted: 08/12/2018] [Indexed: 11/22/2022]
Abstract
Notwithstanding its empirical status and strong recommendation in clinical practice guidelines, cognitive behavioral therapy (CBT) continues to be delivered infrequently and with low fidelity on the clinical front lines. Recently, organized efforts and policies within the public sector to disseminate and implement CBT and other evidence-based psychotherapies have yielded encouraging results and provided optimism for bridging the research-to-practice-gap. Following from these efforts, the current article examines the initial impact and experience of the implementation of an individualized approach to CBT training and treatment within the Kaiser Permanente health care system. Initial training outcomes, including changes in general and specific competencies, were assessed using divergent assessment methods within the initial cohort of therapists undergoing training. Initial patient outcomes, including changes in depression and anxiety, were assessed among patients receiving treatment from therapists in training. Results revealed training in and implementation of CBT-D was associated with overall large improvements in therapist competencies and in clinically significant improvements in both depression and anxiety among patients. Findings from the initial phase of dissemination and implementation within a large private system provide support for, and extend recent findings related to, the feasibility and effectiveness of training in and implementation of CBT-D in a real-world context.
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Sahranavard S, Esmaeili A, Salehiniya H, Behdani S. The effectiveness of group training of cognitive behavioral therapy-based stress management on anxiety, hardiness and self-efficacy in female medical students. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:49. [PMID: 30993142 PMCID: PMC6432834 DOI: 10.4103/jehp.jehp_327_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 11/20/2018] [Indexed: 05/25/2023]
Abstract
INTRODUCTION The present study aimed to investigate the effectiveness of cognitive behavioral therapies (CBTs) for anxiety, hardiness, and self-efficacy in female students of Birjand University of Medical Sciences. MATERIALS AND METHODS This was an interventional study. A sample of 30 participants were selected through the available sampling method and randomly assigned into experimental (CBT) and control groups (each group, 15 female student). The data collection instrument was the Beck Depression Inventory questionnaire. The questionnaires of Beck Anxiety Inventory, Ahvaz Hardiness Inventory, and Schwartz's General Self-Efficacy Scale were completed by all participants in two stages (pretest and posttest). A 6-session protocol of cognitive behavioral group therapy was performed only on the experimental group. The data were analyzed using Kolmogorov-Smirnov, Levene's F, Mbox, analysis of variance, and multivariate analysis of variance tests. RESULTS The intervention group showed that the mean of anxiety decreased, whereas (P < 0.001) the means of hardiness and self-efficacy increased in the posttest for the experimental group (P < 0.001). CONCLUSION Based on the obtained results, it can be concluded that CBT is an effective treatment for anxiety, hardiness, and self-efficacy. Therefore, through managing anxiety, the levels of hardiness and self-efficacy can be increased in students of university to be able to cope with the different challenges in their life.
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Affiliation(s)
- Sara Sahranavard
- Department of Psychology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Aliakbar Esmaeili
- Department of Psychiatry, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Hamid Salehiniya
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Susan Behdani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
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14
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Li JM, Zhang Y, Su WJ, Liu LL, Gong H, Peng W, Jiang CL. Cognitive behavioral therapy for treatment-resistant depression: A systematic review and meta-analysis. Psychiatry Res 2018; 268:243-250. [PMID: 30071387 DOI: 10.1016/j.psychres.2018.07.020] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/07/2018] [Accepted: 07/11/2018] [Indexed: 01/13/2023]
Abstract
Cognitive behavioral therapy (CBT) is a common psychotherapy characterized as treating mental diseases, such as depression. Though multiple studies have reported its effect in treatment-resistant depression, no qualified meta-analysis has ever assessed this effect before. In this study, we evaluated the efficacy of CBT for treatment-resistant depression patients and its continuous effect. We comprehensively searched PubMed, Embase, and Cochrane Library from inception to February 2018 for eligible randomized controlled trials (RCTs). A total of six RCTs involving 847 participants were included. Pooled analysis indicated that CBT was an efficient invention in reducing depression symptoms. Besides, CBT was also superior to control group in increasing response and remission rates. These effects could take effect at post-treatment, and last for 6 months, or even 1 year long. No publication bias was detected. These findings suggested that compared with routine antidepressant treatment, CBT has greater potential in taking immediate effect and has better mid-term and long-term prognosis.
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Affiliation(s)
- Jia-Mei Li
- Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Yi Zhang
- Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Wen-Jun Su
- Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Lin-Lin Liu
- Department of Nursing, The 474th Hospital of PLA, Urumqi, China
| | - Hong Gong
- Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Wei Peng
- Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Chun-Lei Jiang
- Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, China.
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15
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The Accuracy of the ADOS-2 in Identifying Autism among Adults with Complex Psychiatric Conditions. J Autism Dev Disord 2018; 47:2703-2709. [PMID: 28589494 DOI: 10.1007/s10803-017-3188-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), Module 4 is considered a "gold-standard" instrument for diagnosing autism spectrum disorder (ASD) in adults. Although the ADOS-2 shows good sensitivity and specificity in lab-based settings, it is unknown whether these results hold in community clinics that serve a more psychiatrically impaired population. This study is the first to evaluate the diagnostic accuracy of the ADOS-2 among adults in community mental health centers (n = 75). The ADOS-2 accurately identified all adults with ASD; however, it also had a high rate of false positives among adults with psychosis (30%). Findings serve as a reminder that social communication difficulties measured by the ADOS-2 are not specific to ASD, particularly in clinically complex settings.
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Schmit MK, Watson JC, Fernandez MA. Examining the Effectiveness of Integrated Behavioral and Primary Health Care Treatment. JOURNAL OF COUNSELING AND DEVELOPMENT 2018. [DOI: 10.1002/jcad.12173] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Michael K. Schmit
- Department of Counseling and Educational Psychology; Texas A&M University-Corpus Christi
- Now at Department of Counseling and Higher Education, University of North Texas
| | - Joshua C. Watson
- Department of Counseling and Educational Psychology; Texas A&M University-Corpus Christi
| | - Mary A. Fernandez
- Department of Counseling and Educational Psychology; Texas A&M University-Corpus Christi
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17
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Pahlavanzadeh S, Abbasi S, Alimohammadi N. The Effect of Group Cognitive Behavioral Therapy on Stress, Anxiety, and Depression of Women with Multiple Sclerosis. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:271-275. [PMID: 28904538 PMCID: PMC5590355 DOI: 10.4103/1735-9066.212987] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background: One of the factors that could influence the quality of life in patients with multiple sclerosis, which is usually overlooked, is its psychological aspects. Considering the increasing acceptance of complementary medicine in the health system, this study was designed and conducted to determine the effect of group cognitive therapy on the stress, anxiety, and depression of women suffering from multiple sclerosis. Materials and Methods: This clinical trial was conducted among 70 women suffering from multiple sclerosis who were referred to the health centers of Isfahan. Participants were randomly allocated into two groups of intervention and control, each containing 35 patients. The intervention group received cognitive behavioral therapy as 8 90-minute group sessions (a session per week), and the control group participated in 4 group sessions to express their feelings and experiences. Data were gathered using the Depression Anxiety Stress Scale (DASS-24). Results: There was a significant difference between the mean score of stress (P = 0.03), anxiety (P = 0.02), and depression (P = 0.03) of the intervention and the control group immediately after and 1 month after the intervention. Least squares difference test showed that the mean score of stress (P = 0.02), anxiety (P = 0.02), and depression (P = 0.03) immediately and 1 month after the intervention was significantly lower in the intervention group. Conclusions: According to the results of the present study, cognitive behavioral therapy could decrease stress, anxiety, and depression in patients suffering from multiple sclerosis.
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Affiliation(s)
- Saeid Pahlavanzadeh
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samira Abbasi
- Department of Psychiatric Nursing, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrollah Alimohammadi
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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18
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Stirman SW, Gutner CA, Langdon K, Graham JR. Bridging the Gap Between Research and Practice in Mental Health Service Settings: An Overview of Developments in Implementation Theory and Research. Behav Ther 2016; 47:920-936. [PMID: 27993341 DOI: 10.1016/j.beth.2015.12.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 12/09/2015] [Accepted: 12/12/2015] [Indexed: 10/22/2022]
Abstract
Twenty years after Sobell's (1996) influential call to integrate advances in behavior therapy into clinical settings, significant progress has been made in implementation science. In this narrative review, we provide an overview of implementation research findings and highlight recent findings that can inform efforts to bridge the gap between research and practice in mental health service settings. Key findings are summarized, organized according to levels of influence described in two implementation frameworks: The Exploration, Planning, Implementation, and Sustainment Framework (EPIS; Aarons et al., 2011) and the Consolidated Framework for Implementation Research (CFIR; Damschroder et al., 2009). Important levels of influence to consider when implementing new treatments include the outer context, inner context, characteristics of the individual, and characteristics of the innovation. Research on strategies to prepare clinicians to deliver evidence-based psychosocial treatments (EBPTs) and to address contextual barriers to implementation at each level is described, with discussion of implications for the implementation of EBPTs and next steps for research.
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Affiliation(s)
| | - Cassidy A Gutner
- National Center for PTSD, VA Boston Healthcare System; Boston University
| | - Kirsten Langdon
- Department of Psychiatry, Rhode Island Hospital, Providence, RI
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Wong DFK, Ip PSY, Lee KM. A brief cognitive behavioural therapy psychoeducational group for Chinese people with chronic illnesses: an evaluation study. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2016. [DOI: 10.1080/03069885.2016.1219018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Daniel F. K. Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Priscilla S. Y. Ip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kim Man Lee
- Community Rehabilitation Network, The Hong Kong Society for Rehabilitation, Kowloon, Hong Kong
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Abstract
Clinicians generally find individuals with personality disorders to be challenging to treat, especially compared to clients who have only a straightforward depression or anxiety disorder. In this article we will summarise research on the efficacy of cognitive behaviour therapy (CBT) for personality disorders. Then we will focus on the conceptualisation and treatment of CBT for personality disorders that is based on the work of Aaron Beck and colleagues; that is, it is predicated upon the cognitive model of psychopathology. Next, we will describe two other forms of treatment with cognitive behavioural roots: schema therapy and dialectical behaviour therapy. A final section will suggest future directions.
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Wolitzky-Taylor K, Zimmermann M, Arch JJ, De Guzman E, Lagomasino I. Has evidence-based psychosocial treatment for anxiety disorders permeated usual care in community mental health settings? Behav Res Ther 2015; 72:9-17. [DOI: 10.1016/j.brat.2015.06.010] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 06/20/2015] [Accepted: 06/22/2015] [Indexed: 11/16/2022]
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Gu EM, Huang C, Liang B, Yuan L, Lan T, Hu G, Zhou H. An UPLC–MS/MS method for the quantitation of vortioxetine in rat plasma: Application to a pharmacokinetic study. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 997:70-4. [DOI: 10.1016/j.jchromb.2015.05.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 05/06/2015] [Accepted: 05/09/2015] [Indexed: 11/30/2022]
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