1
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Updyke A, Ghose T. "We're the CHATS old-heads": Engaging with evidence-based practice in a reentry agency. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:945-961. [PMID: 36383698 DOI: 10.1002/jcop.22964] [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: 07/18/2022] [Revised: 10/04/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Philadelphia has one of the country's largest populations re-entering society after incarceration. Reentry services have been critiqued for their ineffectiveness. Scholars note the lack of evidence-based practices (EBPs) in the field, and the challenges of translating them. Through a case study of one reentry agency implementing an EBP, we examine engagement with the intervention by clients and service providers. Qualitative interviews were conducted with clients and staff (n = 35). A grounded theory using sensitizing concepts approach was used to analyze the data. Productive engagement with the intervention was facilitated by: (1) translatability of the core EBP elements so that they addressed client and staff needs, (2) accessibility to the intervention by enhancing subjective ownership and successfully navigating logistical barriers, and (3) collectivity among participants and staff that helped them address societal and structural barriers. Productive engagement with an EBP can resist carceral processes in reentry service-provision.
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Affiliation(s)
- Alison Updyke
- Department of Graduate Social Work, West Chester University, West Chester, Pennsylvania, USA
| | - Toorjo Ghose
- School of Social Policy and Practice, University of Pennsylvania, Pennsylvania, Philadelphia, USA
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2
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Rogiers R, Baeken C, Watkins ER, van den Abbeele D, Remue J, de Raedt R, Lemmens GMD. A Psychoeducational CBT-based Group Intervention ("Drop It") for Repetitive Negative Thinking: Theoretical Concepts and Treatment Processes. Int J Group Psychother 2022; 72:257-292. [PMID: 38446560 DOI: 10.1080/00207284.2022.2066535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Repetitive negative thinking (RNT)-such as worry and rumination-is an important transdiagnostic factor in the onset, course, and recurrence of depressive and anxiety disorders. This article describes a psychoeducational cognitive behavioral therapy (CBT)-based group intervention entitled "Drop It" that focuses exclusively on treating RNT in patients with major depressive disorder and/or generalized anxiety disorder. The theoretical concepts and treatment goals of the intervention are outlined. The organization and therapeutic processes of the different sessions are described and illustrated with statements of participants. Special attention is given to how the intervention capitalizes on the group structure and process to maximize the effectiveness of psychoeducation and CBT-based techniques. We also provide practical guidelines for clinicians treating patients with RNT.
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3
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Hussain-Shamsy N, McMillan I, Cook S, Furfaro-Argier A, Sadler A, Delos-Reyes F, Wasserman L, Bhatia S, Martin D, Seto E, Vigod SN, Zaheer J, Agarwal P, Mukerji G. Operationalizing and Evaluating Synchronous Virtual Group Health Interventions: Wide-Scale Implementation at a Tertiary Care Academic Hospital. J Med Internet Res 2022; 24:e29841. [PMID: 35389350 PMCID: PMC9030913 DOI: 10.2196/29841] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/24/2021] [Accepted: 12/17/2021] [Indexed: 12/03/2022] Open
Abstract
Group-based health interventions are an important component of health promotion and management. To provide continuity of care throughout the COVID-19 pandemic, our institution undertook a rapid pivot to delivering group-based health interventions via a videoconferencing service which was securely embedded into both the electronic medical record and the patient portal to sustainably address immediate health service delivery needs during the pandemic and beyond. In this paper, we (1) describe the institutionally driven operationalization of a system to provide integrated synchronous video group visits across our hospital and (2) present a proposed strategy to comprehensively evaluate outcomes regarding their implementation, quality, and impact. Lessons for other institutions and the potential future role of synchronous video group visits to enhance how care can be scaled for delivery are discussed.
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Affiliation(s)
- Neesha Hussain-Shamsy
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Ian McMillan
- Women's Virtual, Women's College Hospital, Toronto, ON, Canada
| | | | - Alyssa Furfaro-Argier
- Department of Information Management and Technology, Women's College Hospital, Toronto, ON, Canada
| | - Andrea Sadler
- Department of Psychiatry, Women's College Hospital, Toronto, ON, Canada
| | - Faith Delos-Reyes
- Department of Cardiology, Women's College Hospital, Toronto, ON, Canada
| | - Lori Wasserman
- Reproductive Life Stages Program, Women's College Hospital, Toronto, ON, Canada
| | - Sacha Bhatia
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Danielle Martin
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Emily Seto
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
| | - Simone N Vigod
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Juveria Zaheer
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Payal Agarwal
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
- Family Practice Health Centre, Women's College Hospital, Toronto, ON, Canada
| | - Geetha Mukerji
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Women's College Hospital, Toronto, ON, Canada
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4
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Bernhardt M, Schwert C, Aschenbrenner S, Weisbrod M, Schröder A. Longitudinal Changes of Cognitive Deficits and Treatment Outcome of Cognitive Behavioral Therapy for Major Depression. J Nerv Ment Dis 2021; 209:336-342. [PMID: 33555821 DOI: 10.1097/nmd.0000000000001301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT The current study examined neuropsychological changes over the course of cognitive behavioral therapy (CBT) in outpatients with major depressive disorder and the influence of cognitive deficits as predictors of clinical outcome in depression. A neuropsychological test battery was carried out on depressed outpatients (N = 54) at the beginning and at the end of CBT. Small improvements were found in divided attention, figural memory, and processing speed from pre- to posttreatment. Cognitive deficits in executive functions before treatment predicted the clinical outcome at the end of CBT. The present study reveals that attention and memory deficits are most likely to improve over the course of treatment, whereas executive functions remain stable in the long term. Depressed patients with worse executive functions at the beginning of treatment seem to benefit more from long-term CBT therapy.
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Affiliation(s)
- Maren Bernhardt
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Landau
| | - Christine Schwert
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Landau
| | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad
| | | | - Annette Schröder
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Landau
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5
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Xue W, Zeng Z, Liu Z, Marks ADG. The role of cultural worldviews in predicating gambling risk perception and behavior in a Chinese sample. Brain Behav 2021; 11:e02015. [PMID: 33350101 PMCID: PMC7994702 DOI: 10.1002/brb3.2015] [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: 12/02/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES We investigated the relationships between cultural worldviews, gambling risk perception, and gambling behavior with a sample of tourists in Macao. METHODS Participants were enrolled at famous landmarks and casinos in Macao, China. Data were collected using several instruments to assess an individual's cultural worldviews, gambling risk perceptions, and gambling intentions. RESULTS We found that the three-dimensional solution was valid for the Chinese version of the gambling expectancy scale. Correlational and mediational analyses revealed that the relationship between an individualistic worldview and gambling intention was fully mediated by gambling risk perception. Respondents with an egalitarian worldview perceived greater risk associated with gambling than those with other worldviews. CONCLUSION These findings demonstrated the important influence of cultural variables on perceived risk and behavior in gambling. Moreover, understanding gamblers' worldviews could be beneficial for problem gambling interventions. Future research directions and the limitations of the findings were discussed.
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Affiliation(s)
- Wen Xue
- College of Teacher Education, Ningbo University, Ningbo, China.,Gaming Teaching and Research Centre, Macao Polytechnic Institute, Macau, Macao.,Centre for Studies of Hong Kong, Macao and Pearl River Delta, Sun Yat-sen University, Guangzhou, China
| | - Zhonglu Zeng
- Gaming Teaching and Research Centre, Macao Polytechnic Institute, Macau, Macao
| | - Zuyun Liu
- Centre for Studies of Hong Kong, Macao and Pearl River Delta, Sun Yat-sen University, Guangzhou, China
| | - Anthony D G Marks
- Psychology, School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, NSW, Australia
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6
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The effects of social group interventions for depression: Systematic review. J Affect Disord 2021; 281:67-81. [PMID: 33302192 DOI: 10.1016/j.jad.2020.11.125] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is a growing prevalence of prolonged antidepressant use globally. Social group interventions may be an effective way to manage mild to moderate depression, especially with patients seeking to discontinue antidepressant use. This systematic review evaluates studies that used social group interventions to manage depression. METHODS Studies published up to June 2019 in nine bibliographic databases were identified using search terms related to depression, social interventions, and social participation. Formal therapies for depression (cognitive behaviour therapy, music therapy) were excluded as they have been reviewed elsewhere. RESULTS 24 studies met inclusion criteria; 14 RCTs, 6 non-randomised controlled trials and 4 pre-post evaluations. In total, 28 social group programs were evaluated, 10 arts-based groups, 13 exercise groups and 5 others. Programs ranged in 'dose' from 5 to 150 hours (M = 31 hours) across 4 to 75 weeks (M = 15 weeks) and produced effect sizes on depression in the small to very large range (Hedge's g = .18 to 3.19, M = 1.14). A regression analysis revealed no participant variables, study variables or intervention variables were related to effect size on depression. LIMITATIONS Risks of bias were found, primarily in the non-randomised studies, which means the findings must be regarded as preliminary until replicated. CONCLUSION These findings indicate that social group interventions are an effective way to manage mild to moderate depression symptoms in a variety of populations. This approach may also help to prevent relapse among patients tapering off antidepressant medication.
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7
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Oral M, Tuncay T. Effectiveness of Group Interpersonal Psychotherapy Among Women with Major Depression in Turkey. Int J Group Psychother 2021; 71:180-202. [PMID: 38449139 DOI: 10.1080/00207284.2020.1742125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Depression is a common psychiatric disorder and the leading cause of disability worldwide. The purpose of this study was to investigate the effectiveness of group interpersonal psychotherapy (IPT-G) on the levels of depression and social adaptation among married Turkish women with interpersonal relationship problems and to determine whether the intervention was compatible with Turkish culture. A pretest-posttest nonequivalent-control-groups design was used. Twenty-two female participants who received a diagnosis of major depression at an outpatient psychiatry clinic were assigned to receive either IPT-G and pharmacotherapy or treatment as usual (pharmacotherapy) for 12 weeks. Quantitative data were collected from bogggth groups using the Beck Depression Inventory and Social Adaptation Self-Evaluation Scale before and after the interventions. Findings indicate statistically significant improvements on both outcome measures. IPT-G intervention used in this study was effective in decreasing the depression levels and increasing the social adaptation of women with major depression in the eastern part of Turkey.
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8
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What are the recovery and attrition outcomes for group CBT and individual CBT for generalised anxiety disorder in an IAPT service? An exploratory study. COGNITIVE BEHAVIOUR THERAPIST 2020. [DOI: 10.1017/s1754470x20000045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Group cognitive behavioural therapy (gCBT) is commonly used in Increasing Access to Psychological Therapies (IAPT) services. However, there is limited knowledge of the efficacy of gCBT as a delivery format for generalised anxiety disorder (GAD). To address gaps in literature, this study aims to explore the efficacy and attrition of individual and group CBT interventions, respectively, at Step 3 for GAD using data from a routine IAPT service over a 24-month period. Data were retrospectively derived from a routine serviceʼs IAPTus database, separating those eligible for comparison into group (n = 44) and individual (n = 55) CBT for GAD. Outcomes were differences in pre–post self-reported anxiety (GAD-7) and depression (PHQ-9) scores, clinical recovery and attrition for gCBT and individual CBT. Both gCBT and individual CBT yielded significant reductions in self-reported anxiety and depression scores over time. Results indicate that 53% of patients attending individual CBT achieved clinical recovery, with similar but less competitive rates of 41% in gCBT. Attrition rates were similar between gCBT (29.5%) and individual CBT (27.3%), respectively. Preliminary results suggest that both individual and gCBT are effective interventions for GAD patients in IAPT, offering symptom alleviation and comparable recovery and attrition rates post-intervention. This observational design offers credibility and insight into a pragmatic evaluative and explorative comparison. gCBT may offer an acceptable and potentially economical alternative.
Key learning aims
(1)
To explore whether gCBT and individual CBT yield significant symptom reduction in self-reported anxiety and depression in GAD patients from a routine IAPT service.
(2)
To explore gCBT and individual CBT clinical recovery rates in non-optimum routine conditions.
(3)
To explore whether gCBT for GAD produces unacceptable attrition rates and if this differs from attrition rates in individual CBT for GAD in a routine IAPT service.
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9
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Saw JA, Tam CL, Thanzami V, Bonn G. Contextualized School-Based Cognitive Behavioral Therapy (CBT) Intervention for Malaysian Secondary School Students. Front Psychiatry 2020; 11:565896. [PMID: 33408652 PMCID: PMC7779468 DOI: 10.3389/fpsyt.2020.565896] [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: 07/07/2020] [Accepted: 11/10/2020] [Indexed: 11/13/2022] Open
Abstract
This study investigates the effectiveness of the school-based Shine Through Any Roadblocks (STAR) CBT intervention, by a screening conducted on 634 students from eight secondary schools in Malaysia. Participants (n = 85) who fulfilled the eligibility criteria were assigned randomly to either the intervention group (n = 42) or the assessment-only waitlist control group (n = 43). The intervention consisted of eight group-based sessions over a period of 2 months. Sessions were 60-min each and conducted according to the STAR module. Outcome measures (depressive symptoms and automatic negative thoughts) were administered at five intervals: baseline/pre-intervention, mid-intervention, post-intervention, 1-month after intervention, and 3-months after intervention. Results showed significant and lasting lower levels of depressive symptoms and automatic negative thoughts in the intervention group, indicating that the STAR intervention could be an effective means of reducing depressive symptomatology among adolescents. Clinical implications for the Malaysian secondary school context are further discussed.
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Affiliation(s)
- Jo Anne Saw
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor, Malaysia.,Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia
| | - Cai Lian Tam
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia.,GA21 Multidisciplinary Platform & Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia
| | - Vanlal Thanzami
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia
| | - Gregory Bonn
- The Chicago School of Professional Psychology, Chicago, IL, United States
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10
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Hvenegaard M, Moeller SB, Poulsen S, Gondan M, Grafton B, Austin SF, Kistrup M, Rosenberg NGK, Howard H, Watkins ER. Group rumination-focused cognitive-behavioural therapy (CBT) v. group CBT for depression: phase II trial. Psychol Med 2020; 50:11-19. [PMID: 30630555 DOI: 10.1017/s0033291718003835] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although cognitive-behavioural therapy (CBT) is an effective treatment for depression, less than half of patients achieve satisfactory symptom reduction during treatment. Targeting known psychopathological processes such as rumination may increase treatment efficacy. The aim of this study was to test whether adding group rumination-focused CBT (RFCBT) that explicitly targets rumination to routine medical management is superior to adding group CBT to routine medical management in treating major depression. METHODS A total of 131 outpatients with major depression were randomly allocated to 12 sessions group RFCBT v. group CBT, each in addition to routine medical management. The primary outcome was observer-rated symptoms of depression at the end of treatment measured on the Hamilton Rating Scale for Depression. Secondary outcomes were rumination at post-treatment and depressive symptoms at 6 months follow-up (Trial registered: NCT02278224). RESULTS RFCBT significantly improved observer-rated depressive symptoms (Cohen's d 0.38; 95% CI 0.03-0.73) relative to group CBT at post-treatment on the primary outcome. No post-treatment differences were found in rumination or in depressive symptoms at 6 months follow-up, although these secondary analyses may have been underpowered. CONCLUSIONS This is the first randomized controlled trial providing evidence of benefits of RFCBT in major depression compared with CBT. Group RFCBT may be a beneficial alternative to group CBT for major depression.
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Affiliation(s)
- Morten Hvenegaard
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Stine B Moeller
- Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Hillerød, Denmark
| | - Stig Poulsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Matthias Gondan
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Ben Grafton
- Cognition and Emotion Lab, School of Psychology, University of Western Australia, Crawley, Australia
| | - Stephen F Austin
- Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Hillerød, Denmark
| | - Morten Kistrup
- Psychiatric Outpatient Service, Mental Health Centre North Zealand, Hillerød, Denmark
| | - Nicole G K Rosenberg
- Psychotherapeutic Clinic Nannasgade, Mental Health Centre Copenhagen, Capital Region Mental Health Services, Copenhagen, Denmark
| | - Henriette Howard
- Mental Health Centre for Child and Adolescent Psychiatry, Glostrup, Denmark
| | - Edward R Watkins
- Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, UK
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11
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Assogna F, Pellicano C, Savini C, Macchiusi L, Pellicano GR, Alborghetti M, Caltagirone C, Spalletta G, Pontieri FE. Drug Choices and Advancements for Managing Depression in Parkinson's Disease. Curr Neuropharmacol 2019; 18:277-287. [PMID: 31622207 PMCID: PMC7327944 DOI: 10.2174/1570159x17666191016094857] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/27/2019] [Accepted: 10/15/2019] [Indexed: 12/21/2022] Open
Abstract
Depression is a frequent non-motor symptom of Parkinson’s disease (PD), and may even precede the onset of motor symptoms of parkinsonism. Beyond its negative influence on mood, depression in PD is frequently associated with other neuropsychiatric symptoms and with late-stage complications such as dementia. Despite its profound impact on the quality of life and cognitive functioning in PD, depression in PD is often under-recognized and poorly treated. Pathophysiological studies demonstrated that depression in PD is associated with global dysfunction of interactions between discrete brain areas rather than focal structural or functional abnormalities, and that it is sustained by pathological changes of several neurotransmitter/receptor complexes. In general, all traditional antidepressants and some dopamine agonists have been found to be safe and well-tolerated to treat depressive symptoms in PD, despite initial warning on worsening of parkinsonism. Available data suggest that the time-course of response differs among antidepressants. Efficacy results from clinical trials with antidepressant in PD are, however, rather uncertain,
although pooled analysis suggests a moderate benefit. Several issues may critically impact the
results of clinical trials with antidepressants in PD, including the correct psychiatric diagnosis, the overlap of symptoms between depression and PD, and the selection of appropriate end-points and rating scales.
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Affiliation(s)
| | - Clelia Pellicano
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy.,Neurology Unit, "Belcolle" Hospital, Str. Sammartinese-01100 Viterbo, Italy
| | - Cinzia Savini
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy
| | - Lucia Macchiusi
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy
| | - Gaia R Pellicano
- Dipartimento di Psicologia Dinamica e Clinica, "Sapienza" Università di Roma, Via degli Apuli, 1-00185 Roma, Italy
| | - Marika Alborghetti
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), "Sapienza" Universita di Roma, Via di Grottarossa, 1035-00189 Roma, Italy
| | | | | | - Francesco E Pontieri
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306-00179 Roma, Italy.,Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), "Sapienza" Universita di Roma, Via di Grottarossa, 1035-00189 Roma, Italy
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12
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López-López JA, Davies SR, Caldwell DM, Churchill R, Peters TJ, Tallon D, Dawson S, Wu Q, Li J, Taylor A, Lewis G, Kessler DS, Wiles N, Welton NJ. The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis. Psychol Med 2019; 49:1937-1947. [PMID: 31179960 PMCID: PMC6712954 DOI: 10.1017/s003329171900120x] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 05/01/2019] [Accepted: 05/07/2019] [Indexed: 11/05/2022]
Abstract
Cognitive-behavioural therapy (CBT) is an effective treatment for depressed adults. CBT interventions are complex, as they include multiple content components and can be delivered in different ways. We compared the effectiveness of different types of therapy, different components and combinations of components and aspects of delivery used in CBT interventions for adult depression. We conducted a systematic review of randomised controlled trials in adults with a primary diagnosis of depression, which included a CBT intervention. Outcomes were pooled using a component-level network meta-analysis. Our primary analysis classified interventions according to the type of therapy and delivery mode. We also fitted more advanced models to examine the effectiveness of each content component or combination of components. We included 91 studies and found strong evidence that CBT interventions yielded a larger short-term decrease in depression scores compared to treatment-as-usual, with a standardised difference in mean change of -1.11 (95% credible interval -1.62 to -0.60) for face-to-face CBT, -1.06 (-2.05 to -0.08) for hybrid CBT, and -0.59 (-1.20 to 0.02) for multimedia CBT, whereas wait list control showed a detrimental effect of 0.72 (0.09 to 1.35). We found no evidence of specific effects of any content components or combinations of components. Technology is increasingly used in the context of CBT interventions for depression. Multimedia and hybrid CBT might be as effective as face-to-face CBT, although results need to be interpreted cautiously. The effectiveness of specific combinations of content components and delivery formats remain unclear. Wait list controls should be avoided if possible.
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Affiliation(s)
- José A. López-López
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
- Department of Basic Psychology & Methodology, Faculty of Psychology, University of Murcia, Murcia, Spain
| | - Sarah R. Davies
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Deborah M. Caldwell
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Tim J. Peters
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Deborah Tallon
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah Dawson
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Qi Wu
- Faculty of Health Sciences, University of York, York, UK
| | - Jinshuo Li
- Faculty of Health Sciences, University of York, York, UK
| | - Abigail Taylor
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - David S. Kessler
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicola Wiles
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicky J. Welton
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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13
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Weinberg H. Discussion of “Taking the Sting Out: Manifesting Aggression and Containing Difficult States in a Relational Group Psychotherapy”. PSYCHOANALYTIC DIALOGUES 2019. [DOI: 10.1080/10481885.2019.1587997] [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: 10/26/2022]
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14
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Tay KW, Subramaniam P, Oei TP. Cognitive behavioural therapy can be effective in treating anxiety and depression in persons with dementia: a systematic review. Psychogeriatrics 2019; 19:264-275. [PMID: 30548731 DOI: 10.1111/psyg.12391] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 05/23/2018] [Accepted: 10/21/2018] [Indexed: 11/28/2022]
Abstract
Dementia is a neurocognitive disorder that affects a person's abilities in daily functioning. Anxiety and depression symptoms are common among persons with dementia. Cognitive behavioural therapy (CBT) has been tested to manage their depression and anxiety symptoms. However, the purpose of CBT in managing these symptoms is unclear. Therefore, this paper aims to clarify whether CBT can be used to reduce depression and anxiety symptoms in persons with dementia. The electronic databases PubMed, PsycINFO, MEDLINE, and CINAHL were used to locate relevant studies. Eleven studies, which involved a total of 116 older adults, were identified. The findings suggest that CBT can be effective in reducing depression and anxiety symptoms. Based on our current review, the findings from previous studies form a promising foundation on which to conduct a major randomized controlled trial with a larger sample size. This review discusses some of the most important considerations in applying CBT to persons with dementia, and these may be beneficial for future studies that explore this area and seek more conclusive evidence on the use of CBT.
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Affiliation(s)
- Kok-Wai Tay
- Department of Psychology and Counselling, Faculty of Arts and Social Science, Universiti Tunku Abdul Rahman, Kampar, Malaysia.,Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan, Kuala Lumpur, Malaysia
| | - Ponnusamy Subramaniam
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan, Kuala Lumpur, Malaysia.,Geriatric Mental Health Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tian P Oei
- School of Psychology, University of Queensland, Brisbane, St Lucia, Queensland, Australia.,Department of Psychology, James Cook University, Singapore.,Department of Psychology, Nanjing University, Nanjing, China
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15
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Cruwys T, Steffens NK, Haslam SA, Haslam C, Hornsey MJ, McGarty C, Skorich DP. Predictors of social identification in group therapy. Psychother Res 2019; 30:348-361. [DOI: 10.1080/10503307.2019.1587193] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Tegan Cruwys
- Research School of Psychology, Australian National University, Canberra, ACT, Australia
| | - Niklas K. Steffens
- School of Psychology, University of Queensland, St Lucia, QLD, Australia
| | | | - Catherine Haslam
- School of Psychology, University of Queensland, St Lucia, QLD, Australia
| | | | - Craig McGarty
- School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Daniel P. Skorich
- School of Psychology, University of Queensland, St Lucia, QLD, Australia
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16
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McCormack D, Chalder T. Horses for courses: choosing an evidence-based psychological therapy for your patient. BJPSYCH ADVANCES 2018. [DOI: 10.1192/bja.2018.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARYChoosing an intervention for a patient experiencing distressing symptoms and/or suffering with a mental disorder is part of routine practice for clinicians. While there are now many effective pharmacological and psychological therapies for mental health problems, syndromes and persistent physical symptoms (e.g. chronic pain), choosing the ‘right’ therapy can sometimes be a challenge. This can certainly be the case when it comes to psychological therapies. There are many different approaches to choose from and many have not been subjected to rigorous study.In this article, we aim to help inform and guide the busy clinician in choosing a psychological therapy for their patient. We give a brief overview of the major psychotherapy modalities and consider which guidelines to refer to and which psychological therapies have been found to be most effective for the presenting problem(s) seen in clinic. Lastly, we discuss the limitations of the current guidelines in relation to comorbid presentations and consider how this can be best addressed.LEARNING OBJECTIVES•Develop knowledge regarding the major psychotherapy approaches•Be aware that there is no psychotherapy equivalence•Learn that there is good evidence that some approaches are more effective than others for specific problems and be better able to choose a psychological therapyDECLARATION OF INTERESTD. McC. works on research trials funded by the Guy's and St Thomas’ Charity. T. C. receives salary support from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, and receives several grants for evaluating the efficacy of different cognitive–behavioural approaches. This article received no specific grant from any funding agency, or from the commercial or not-for-profit sectors. The views expressed in this article are those of the authors and not necessarily those of the NIHR or the NHS.
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17
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Sawaguchi N, Onaka H, Hikima R, Kuroki A, Hatayama E, Yano H, Mikami K, Yamamoto K. Effectiveness of outpatient-based group cognitive-behavioral therapy in Japanese patients with mood disorders and neurotic disorders. ARCH CLIN PSYCHIAT 2018. [DOI: 10.1590/0101-60830000000169] [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: 11/22/2022] Open
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18
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Implementing Group CBT for Depression Among Latinos in a Primary Care Clinic. COGNITIVE AND BEHAVIORAL PRACTICE 2018; 25:135-144. [PMID: 29606848 DOI: 10.1016/j.cbpra.2017.03.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Depression in low-income Latino populations can be treated using group cognitive behavioral therapy (GCBT). However, effective delivery of GCBT for depression in primary care settings is often impeded by high dropout rates and poor homework adherence. In this study, we describe the structure, processes, and outcomes (including attendance, homework completion, and symptom measures) of GCBT for Spanish-speaking Latino patients with depression in an urban public sector primary care setting. For this study, 96 Latino patients in a primary care clinic participated in at least 1 session of GCBT. Although depressive symptoms among these patients, as measured by the PHQ-9, significantly decreased during treatment, attendance and homework completion were limited. Even with a strategy in place to allow patients to continue in treatment after missing several sessions, 23% of patients dropped out of therapy following their initial session, and approximately half of all patients completed less than 50% (or 8) therapy sessions. Homework was only completed 23% of the time it was checked. Greater session attendance prospectively predicted lower depressive symptoms over time. We discuss potential strategies to increase engagement, treatment effects, and symptom reduction for depression in primary care settings.
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Abstract
SummaryCognitive–behavioural therapy (CBT) is a psychological treatment approach that can be delivered not only on a one-to-one basis but also to groups and in self-help formats. However, the evidence base supporting individual CBT is more extensive than the research regarding group CBT. This is likely to influence the choice of services that develop in the Improving Access to Psychological Therapies (IAPT) programme for the treatment of depression and anxiety disorders in primary care in England. This article outlines the different forms that group CBT takes, the way in which it may benefit people and the current evidence base supporting its use for anxiety and depression. It also outlines the advantages of group or individual CBT and describes those patients who appear to be best suited to a specific delivery.
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20
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Sinniah A, Oei TPS, Maniam T, Subramaniam P. Positive effects of Individual Cognitive Behavior Therapy for patients with unipolar mood disorders with suicidal ideation in Malaysia: A randomised controlled trial. Psychiatry Res 2017; 254:179-189. [PMID: 28463716 DOI: 10.1016/j.psychres.2017.04.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 03/25/2017] [Accepted: 04/15/2017] [Indexed: 11/29/2022]
Abstract
The aim of this study was to investigate the effectiveness of Individual Cognitive Behavior Therapy (ICBT) in treating patients with mood disorders with suicidal ideation. A total of 69 patients (48 females, 21 males) with the diagnoses above were randomly allocated to either the group of Treatment As Usual (TAU)+ICBT (n=33) or the TAU group (n=36). All participants completed the Beck Depression Inventory (BDI), Beck Scale for Suicide Ideation (BSS), Positive and Negative Suicide Ideation Inventory (PANSI), Beck Hopelessness Scale (BHS), and Depression Anxiety Stress Scale-21 (DASS-21). These questionnaires were administered at pre-treatment, midway through treatment (week 4), post-treatment (week 8), and at follow-ups after three months (week 20) and six months (week 32). Factorial ANOVA results showed that the TAU+ICBT patients improved significantly and at faster rate as compared to the TAU group, which showed improvement only from pre to mid treatment on DASS-D and BHS-T measures. The effect size (Cohen's d), for the TAU+ICBT group showed large effect (1.47) for depressive symptoms and suicidal ideation (1.00). These findings suggest that ICBT used in addition to the TAU, was effective in enhancing treatment outcome of patients with unipolar mood disorders as well as, reducing risk for suicide behavior.
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Affiliation(s)
- Aishvarya Sinniah
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia; University of Queensland, Australia
| | - T P S Oei
- University of Queensland, Australia; James Cook University, Singapore; Nanjing University, PR China
| | - T Maniam
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
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21
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Skule C, Ulleberg P, Berge T, Lending HD, Egeland J, Landrø NI. Interventions for Subjects with Depressive Symptoms with or without Unhealthy Alcohol Use: Are There Different Patterns of Change? Front Psychol 2017; 8:788. [PMID: 28588525 PMCID: PMC5440776 DOI: 10.3389/fpsyg.2017.00788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/28/2017] [Indexed: 01/28/2023] Open
Abstract
Background: It has been suggested that alcohol problems negatively affect therapeutic interventions for depression. This study examines the patterns of change in depressive symptoms following an intervention for depression, in participants with or without comorbid unhealthy alcohol use. Methods: Depressive symptoms (BDI–II), perceived control of depressive symptoms (UNCONTROL) and unhealthy alcohol use (AUDIT) were assessed in 116 patients before and after attending a cognitive behavioral psychoeducational intervention for depression. At pretest the mean score of AUDIT was 8.1, indicating a, on average, risk of harmful level of alcohol abuse. At pretest the majority of the total sample had a moderate degree of depressive symptoms, with a mean BDI–II score of 25.1 and 36.2% had a risky use of alcohol as measured with AUDIT score at 8 points or above. To assess the relationship between depressive symptoms, perceived uncontrollability of depression and alcohol use across time, a cross-lagged panel model was estimated. Results: A clinical significant reduction of depressive symptoms, and a parallel and statistically significant increase in the perceived control of depressive symptoms, was identified after attending a cognitive behavioral psychoeducational intervention for depression. At posttest, the mean BDI–II score was 17.8, demonstrating a statistically significant decrease of 7.3 points in depressive symptoms from before starting the course to 6 months later. The effect size (d-value) of 0.83 can be interpreted as a large decrease in depressive symptoms. In this sample alcohol use and depressive symptoms seemed to be unrelated. The cross-lagged correlation panel analysis indicated that a high degree of perceived control of depressive symptoms leads to a reduction in depressive symptoms, and not vice versa. Conclusion: We found that this intervention for depression were effective in reducing depressive symptoms. The patterns of change seemed to be independent of risky use of alcohol, although leaving the study was systematically associated with higher AUDIT-scores. As participants with or without unhealthy alcohol use show the same patterns of change regarding reduction of depressive symptoms and perceived control of depression, both groups could be offered the same cognitive behavioral psychoeducational interventions for depression.
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Affiliation(s)
- Cecilie Skule
- Department of Psychiatry, Diakonhjemmet HospitalOslo, Norway
| | - Pål Ulleberg
- Department of Psychology, University of OsloOslo, Norway
| | - Torkil Berge
- Department of Psychiatry, Diakonhjemmet HospitalOslo, Norway
| | | | - Jens Egeland
- Department of Psychology, University of OsloOslo, Norway.,Psychiatric Department, Hospital of VestfoldTønsberg, Norway
| | - Nils Inge Landrø
- Department of Psychiatry, Diakonhjemmet HospitalOslo, Norway.,Clinical Neuroscience Research Group, Department of Psychology, University of OsloOslo, Norway
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22
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Motta CCLD, Moré CLOO, Nunes CHSDS. Psychological assistance provided to patients diagnosed with depression in primary care. CIENCIA & SAUDE COLETIVA 2017; 22:911-920. [PMID: 28300998 DOI: 10.1590/1413-81232017223.27982015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 04/16/2016] [Indexed: 11/21/2022] Open
Abstract
The scope of this research was to understand the assistance provided by psychologists to patients diagnosed with depression in the municipal health care network. In this study, the phenomenon is examined from its broader perspective, taking the psychosocial dimensions of health into account. A group of 22 psychologists participated in this study of a qualitative nature. Data collection began with participant in-field observation of the institutional context followed by semi-structured interviews. Grounded theory methodology was used to analyze information, thereby facilitating its integration and categorization.The results revealed that in the primary care network the treatment of depression is essentially restricted to its biological aspect; the choice of individual psychotherapy as the main form of treatment refers to traditional practices of psychological care for depression; the use of institutional and community methods as part of the therapeutic approach suggests mental health interventions that address the psychosocial dimension. The findings indicate that transcending the traditional models of care for patients with depression and the construction of forms of treatment using psychosocial resources are ongoing, indicating that comprehensive care needs to be further consolidated in primary care.
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Affiliation(s)
- Cibele Cunha Lima da Motta
- Departamento de Psicologia, Universidade Federal de Santa Catarina. Campus Universitário Laboratorio de Psicologia da Saúde, Família e Comunidade/Sala 10B, Trindade. 88040-970 Florianopolis SC Brasil.
| | - Carmen Leontina Ojeda Ocampo Moré
- Departamento de Psicologia, Universidade Federal de Santa Catarina. Campus Universitário Laboratorio de Psicologia da Saúde, Família e Comunidade/Sala 10B, Trindade. 88040-970 Florianopolis SC Brasil.
| | - Carlos Henrique Sancineto da Silva Nunes
- Departamento de Psicologia, Universidade Federal de Santa Catarina. Campus Universitário Laboratorio de Psicologia da Saúde, Família e Comunidade/Sala 10B, Trindade. 88040-970 Florianopolis SC Brasil.
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23
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O'Brien AP, McNeil KA, Fletcher R, Conrad A, Wilson AJ, Jones D, Chan SW. New Fathers' Perinatal Depression and Anxiety-Treatment Options: An Integrative Review. Am J Mens Health 2016; 11:863-876. [PMID: 27694550 PMCID: PMC5675308 DOI: 10.1177/1557988316669047] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
More than 10% of fathers experience depression and anxiety during the perinatal period, but paternal perinatal depression (PPND) and anxiety have received less attention than maternal perinatal mental health problems. Few mainstream treatment options are available for men with PPND and anxiety. The aim of this literature review was to summarize the current understanding of PPND and the treatment programs specifically designed for fathers with perinatal depression. Eight electronic databases were searched using a predefined strategy, and reference lists were also hand searched. PPND and anxiety were identified to have a negative impact on family relationships, as well as the health of mothers and children. Evidence suggests a lack of support and tailored treatment options for men having trouble adjusting to the transition to fatherhood. Of the limited options available, cognitive behavioral therapy, group work, and blended delivery programs, including e-support approaches appear to be most effective in helping fathers with perinatal depression and anxiety. The review findings have important implications for the understanding of PPND and anxiety. Future research is needed to address the adoption of father-inclusive and father-specific models of care to encourage fathers' help-seeking behavior. Inclusion of male-specific requirements into support and treatment options can improve the ability of services to engage new fathers. Psychotherapeutic intervention could assist to address the cognitive differences and dissonance for men adjusting to the role of father, including male identity and role expectations.
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Affiliation(s)
| | - Karen A McNeil
- 1 University of Newcastle, Callaghan, New South Wales, Australia
| | - Richard Fletcher
- 1 University of Newcastle, Callaghan, New South Wales, Australia
| | - Agatha Conrad
- 1 University of Newcastle, Callaghan, New South Wales, Australia
| | - Amanda J Wilson
- 1 University of Newcastle, Callaghan, New South Wales, Australia
| | - Donovan Jones
- 1 University of Newcastle, Callaghan, New South Wales, Australia
| | - Sally W Chan
- 1 University of Newcastle, Callaghan, New South Wales, Australia
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24
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Bélanger C, Courchesne C, Leduc AG, Dugal C, El-Baalbaki G, Marchand A, Godbout N, Marcaurelle R, Perreault M. Predictors of Dropout From Cognitive-Behavioral Group Treatment for Panic Disorder With Agoraphobia. Behav Modif 2016; 41:113-140. [DOI: 10.1177/0145445516656614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Panic disorder and agoraphobia are both characterized by avoidance behaviors, which are known correlates of treatment discontinuation. The aim of this exploratory study is to distinguish the profile of participants suffering from panic disorder with agoraphobia that complete treatment from those who discontinue therapy by assessing four categories of predictor variables: the severity of the disorder, sociodemographic variables, participants’ expectations, and dyadic adjustment. The sample included 77 individuals diagnosed with panic disorder with agoraphobia who completed a series of questionnaires and participated in a cognitive-behavioral group therapy consisting of 14 weekly sessions. Hierarchical linear regression analyses revealed the importance of anxiety, prognosis, and role expectations as well as some individual variables as predictors of therapeutic dropout, either before or during treatment. Among the most common reasons given by the 29 participants who discontinued therapy were scheduling conflicts, dissatisfaction with treatment, and conflicts with their marital partner. These results suggest that expectations and dyadic relationships have an impact on therapeutic discontinuation. The clinical implications of these findings are discussed.
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Affiliation(s)
- Claude Bélanger
- University of Quebec in Montreal, Canada
- McGill University, Canada
| | | | | | | | | | | | | | | | - Michel Perreault
- University of Quebec in Montreal, Canada
- McGill University, Canada
- Douglas Mental Health University Institute, Montreal, Canada
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25
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Holas P, Suszek H. Group Process and Therapeutic Protocol of Intensive Transdiagnostic Group Cognitive-Behavioral Therapy for Anxiety and Personality Disorders in a Day Clinic. Int J Group Psychother 2016; 66:422-430. [PMID: 38449128 DOI: 10.1080/00207284.2016.1156405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This brief report presents group processes and the treatment protocol of intensive, transdiagnostic group cognitive-behavior therapy for anxiety with comorbid personality disorders in a day clinic. It describes the history of and rationale for the development of this 3-month, 15-hour a week group treatment and the utilization of group processes during this therapy. The authors argue that the group format presented here allows the treatment of personality disorders that are frequently comorbid with anxiety disorders.
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26
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Fansi A, Jehanno C, Lapalme M, Drapeau M, Bouchard S. Efficacité de la psychothérapie comparativement à la pharmacothérapie dans le traitement des troubles anxieux et dépressifs chez l’adulte : une revue de la littérature. SANTE MENTALE AU QUEBEC 2016. [DOI: 10.7202/1036098ar] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Dans l’optique de l’amélioration d’une couverture de la psychothérapie au Québec, le ministère de la Santé et des Services sociaux a confié à l’Institut national d’excellence en santé et en services sociaux le mandat d’évaluer l’efficacité de la psychothérapie comparée à la pharmacothérapie dans le traitement des adultes souffrant de troubles anxieux et dépressifs. Une mise à jour d’une revue de la littérature récente et de bonne qualité a été effectuée grâce à une revue des revues systématiques traitant de la psychothérapie comparée à la pharmacothérapie dans le traitement des adultes anxieux et dépressifs avec un horizon temporel compris entre 2009 et 2013. Le niveau de l’ensemble de la preuve scientifique permet de dire que de manière générale, il n’y a pas de différence significative entre la psychothérapie et la pharmacothérapie sur le plan de la réduction des symptômes des patients souffrant de troubles anxieux ou dépressifs modérés, ce qui indique une efficacité comparable de ces deux modes de traitement. Cependant, les avantages de la psychothérapie sont maintenus plus longtemps après la fin du traitement que ceux des médicaments. La psychothérapie offre donc une meilleure protection contre la rechute. Par ailleurs, la combinaison de la psychothérapie et de la pharmacothérapie présente une efficacité supérieure à celle de la psychothérapie seule dans les cas chroniques ou graves.
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Affiliation(s)
- Alvine Fansi
- M.D., Ph. D., Institut national d’excellence en santé et en services sociaux (INESSS)
- Département des sciences de la santé communautaire
- Centre de recherche Hôpital Charles-LeMoyne
- Chaire de recherche du Canada en Évaluation et Amélioration du Système de Santé
- EASY, Université de Sherbrooke
| | - Cedric Jehanno
- B. Sc., MBA, Institut national d’excellence en santé et en services sociaux (INESSS)
| | - Micheline Lapalme
- Ph. D., Institut national d’excellence en santé et en services sociaux (INESSS)
| | - Martin Drapeau
- Ph. D., Département de psychologie du counselling et de psychiatrie, Université McGill
| | - Sylvie Bouchard
- B. Pharm., D.P.H., M. Sc., MBA, Institut national d’excellence en santé et en services sociaux (INESSS)
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27
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Cui L, He F, Han Z, Yang R, Xiao J, Oei TPS. A Brief Group Cognitive-Behavioral Program for the Prevention of Depressive Symptoms in Chinese College Students. Int J Group Psychother 2016; 66:291-307. [PMID: 38449182 DOI: 10.1080/00207284.2015.1111098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Depression is a problem among college students in China. Yet the use of preventative group cognitive-behavioral (CB) intervention is rare. One hundred and eighty Chinese college students who were identified as being at risk for depression were randomly assigned to three groups: 1) a brief group cognitive-behavioral (CB) intervention, 2) a supportive group (SG) intervention, and 3) a wait-list control condition. The Zung Self-Rating Depression Scale (SDS), the Zung Self-Rating Anxiety Scale (SAS), and the Chinese College Student Adjustment Scale (CCSAS) were administered at pre-test, post-test, and six-month follow-up. Analysis of variance (ANOVA) conducted among the three groups revealed that the CB group demonstrated significantly less increase in measures of primary symptoms of anxiety and depression than the wait-list controls at post-test and six-month follow-up. The prevention effect of the SG group was significant only at the six-month follow-up. CB participants also showed significantly greater improvements in social adjustment than did SG participants and controls at the post-test and six-month follow-up.
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28
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Cruwys T, Haslam SA, Fox NE, McMahon H. “That's not what we do”: Evidence that normative change is a mechanism of action in group interventions. Behav Res Ther 2015; 65:11-7. [DOI: 10.1016/j.brat.2014.12.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/26/2014] [Accepted: 12/05/2014] [Indexed: 11/29/2022]
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29
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Changes in quality of life following group CBT for anxiety and depression in a psychiatric outpatient clinic. Psychiatry Res 2014; 220:1012-8. [PMID: 25256885 DOI: 10.1016/j.psychres.2014.08.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 08/11/2014] [Accepted: 08/13/2014] [Indexed: 11/23/2022]
Abstract
The present study examined the relationship between quality of life and symptom change following group CBT treatment for anxiety or depression in a psychiatric hospital outpatient setting. One hundred seventy seven outpatients undergoing eight sessions of group CBT for anxiety (n=124) or mood disorders (n=53) participated. The Beck Anxiety Inventory (BAI), Zung Self-Rating Depression Scale (Zung-SRDS), Quality of Life Inventory (QOLI), and Satisfaction with Life Scale (SWLS) were administered at baseline and post-treatment. Additionally, the QOLI and SWLS scores of those who achieved reliable improvement or clinically significant symptom change were compared to those who experienced no reliable symptom improvement. There were significant changes across the QOLI, SWLS, BAI and Zung-SRDS outcome measures between baseline and post-treatment, with moderate to very large effect sizes observed. Patients with reliable or clinically significant change in their symptoms experienced significant increases in QOLI and SWLS scores when compared to those whose symptoms did not change reliably. Overall, in a psychiatric hospital outpatient setting, group CBT appeared to be successful in increasing quality of life and satisfaction with life in addition to reducing anxiety and depression symptoms.
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30
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Mori M, Tajima M, Kimura R, Sasaki N, Somemura H, Ito Y, Okanoya J, Yamamoto M, Nakamura S, Tanaka K. A web-based training program using cognitive behavioral therapy to alleviate psychological distress among employees: randomized controlled pilot trial. JMIR Res Protoc 2014; 3:e70. [PMID: 25470499 PMCID: PMC4275471 DOI: 10.2196/resprot.3629] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 08/31/2014] [Accepted: 11/06/2014] [Indexed: 11/30/2022] Open
Abstract
Background A number of psychoeducational programs based on cognitive behavioral therapy (CBT) to alleviate psychological distress have been developed for implementation in clinical settings. However, while these programs are considered critical components of stress management education in a workplace setting, they are required to be brief and simple to implement, which can hinder development. Objective The intent of the study was to examine the effects of a brief training program based on CBT in alleviating psychological distress among employees and facilitating self-evaluation of stress management skills, including improving the ability to recognize dysfunctional thinking patterns, transform dysfunctional thoughts to functional ones, cope with stress, and solve problems. Methods Of the 187 employees at an information technology company in Tokyo, Japan, 168 consented to participate in our non-blinded randomized controlled study. The training group received CBT group education by a qualified CBT expert and 1 month of follow-up Web-based CBT homework. The effects of this educational program on the psychological distress and stress management skills of employees were examined immediately after completion of training and then again after 6 months. Results Although the training group did exhibit lower mean scores on the Kessler-6 (K6) scale for psychological distress after 6 months, the difference from the control group was not significant. However, the ability of training group participants to recognize dysfunctional thinking was significantly improved both immediately after training completion and after 6 months. While the ability of participants to cope with stress was not significantly improved immediately after training, improvement was noted after 6 months in the training group. No notable improvements were observed in the ability of participants to transform thoughts from dysfunctional to functional or in problem-solving skills. A sub-analysis of participants who initially exhibited clinically significant psychological distress (K6 score ≥5) showed that the mean K6 score was significantly improved immediately after training completion for the training group compared to the control group (−2.50 vs −0.07; mean difference 2.43, 95% CI 0.55-4.31; d=0.61), with this effect remaining even after 6 months (−3.49 vs −0.50; mean difference 2.99, 95% CI 0.70-5.29; d=0.60). Conclusions Our results suggest that a brief stress management program that combines group CBT education with Web-based CBT homework moderately alleviates the distress of employees with clinically significant psychological distress. In addition, the program might help improve employees’ ability to evaluate their own stress management skills.
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Affiliation(s)
- Makiko Mori
- Department of Occupational Mental Health, Graduate School of Medical Sciences, Kitasato University, Sagamihara-City Kanagawa, Japan.
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Jayasekara R, Procter N, Harrison J, Skelton K, Hampel S, Draper R, Deuter K. Cognitive behavioural therapy for older adults with depression: a review. J Ment Health 2014; 24:168-71. [DOI: 10.3109/09638237.2014.971143] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Thimm JC, Antonsen L. Effectiveness of cognitive behavioral group therapy for depression in routine practice. BMC Psychiatry 2014; 14:292. [PMID: 25330912 PMCID: PMC4209079 DOI: 10.1186/s12888-014-0292-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 10/10/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Previous research has shown that cognitive- behavioral group therapy (group CBT) is an effective treatment for depression. However, the effectiveness of this approach in routine care needs more research. The current study retrospectively examines the outcomes of patients who received group CBT for depression at a psychiatric outpatient clinic between 2003 and 2013. METHODS Based on patient records, 143 patients were identified as having received the treatment, and 88 patients were included in the outcome analyses. The Beck Depression Inventory (BDI-II) score was the main outcome measure. RESULTS The dropout rate was 17.5%. The average BDI-II score decreased from 28.5 to 18.5 from pre-treatment to post-treatment and remained stable at 3-months follow-up. The effect sizes at post-treatment and follow-up were large (d = .97 and d = 1.10, respectively). At post-treatment, 44% of the patients showed a significant improvement in depression, including 30% who recovered; at follow-up, the proportions increased to 57% and 40%, respectively. No predictors of dropout or treatment response were found. CONCLUSIONS Group CBT for depression can be delivered in routine care settings with good results. However, there are still many patients who drop out or do not benefit from treatment.
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Affiliation(s)
- Jens C Thimm
- Department of Psychology, University of Tromsø, 9037 Tromsø, Norway ,Helgeland Hospital Trust, 8607 Mo i Rana, Norway
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Oei TPS, McAlinden NM, Cruwys T. Exploring mechanisms of change: the relationships between cognitions, symptoms, and quality of life over the course of group cognitive-behaviour therapy. J Affect Disord 2014; 168:72-7. [PMID: 25038294 DOI: 10.1016/j.jad.2014.06.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 06/19/2014] [Accepted: 06/25/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study aimed to explain how quality of life changes during psychotherapy, using a cognitive-behavioural theoretical framework, and examined whether changes in symptoms or changes in cognitions were more influential with regard to quality of life change. Three different hypotheses were tested that might explain the mechanisms by which quality of life changes during group cognitive-behaviour therapy (CBT) for anxiety and depression. METHODS 127 outpatients with anxiety and/or depression enrolled in a four-week group CBT programme participated. Measures of anxiety and depression symptoms, cognitive change, and quality of life were administered at baseline and post-treatment. Baseline to post-treatment change scores were calculated and entered into multiple regression analyses. RESULTS Reductions in anxiety and depression symptoms were related to increases in quality of life, whereas cognitive changes were not consistently related to changes in quality of life. LIMITATIONS The main limitation was that the study׳s design was not able to assess whether changes in cognitions or symptoms preceded changes in quality of life, as all variables were measured at the same two points in time. CONCLUSIONS These results provided evidence that quality of life changes as a result of or, simultaneously with, symptom change. It appears that group CBT does not improve quality of life through strategies designed to change patients׳ cognitions.
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Affiliation(s)
- Tian Po S Oei
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia; CBT Unit, Toowong Private Hospital, PO Box 882, Toowong, Brisbane, Queensland, Australia.
| | - Niamh M McAlinden
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Tegan Cruwys
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
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Okumura Y, Ichikura K. Efficacy and acceptability of group cognitive behavioral therapy for depression: a systematic review and meta-analysis. J Affect Disord 2014; 164:155-64. [PMID: 24856569 DOI: 10.1016/j.jad.2014.04.023] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 04/11/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Despite treatment guidelines for depression placing group cognitive behavioral therapy (group CBT) between low- and high-intensity evidence-based psychological interventions, the validity of the placement remains unknown. We aimed to systematically review evidence for the efficacy and acceptability of group CBT in patients with depression compared to four intensity levels of psychosocial interventions. METHODS We searched the Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, and Web of Science and hand-searched the references in identified publications. We selected randomized controlled trials comparing group CBT with four levels of interventions for adult patients with depression. Two authors independently assessed risk of bias. RESULTS From 7953 records, we identified 35 studies that compared group CBT to non-active (k=30), low-intensity (k=2), middle-intensity (k=8), and high-intensity (k=1) interventions. Group CBT had a superior efficacy (standardized mean difference [SMD]=-0.68) and a similar acceptability compared to non-active controls. Pooled results showed a small but non-significant excess of group CBT relative to middle-intensity interventions (SMD=-0.21). LIMITATIONS Over 60% of studies did not report enough information to judge selection and selective reporting bias. CONCLUSIONS These results suggest the need for high-quality trials of group CBT compared to low- and high-intensity interventions.
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Affiliation(s)
- Yasuyuki Okumura
- Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo 105-0003, Japan.
| | - Kanako Ichikura
- Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; Japan Society for the Promotion of Science, Tokyo 102-0083, Japan
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Cruwys T, Haslam SA, Dingle GA, Haslam C, Jetten J. Depression and Social Identity: An Integrative Review. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2014; 18:215-238. [PMID: 24727974 DOI: 10.1177/1088868314523839] [Citation(s) in RCA: 222] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Social relationships play a key role in depression. This is apparent in its etiology, symptomatology, and effective treatment. However, there has been little consensus about the best way to conceptualize the link between depression and social relationships. Furthermore, the extensive social-psychological literature on the nature of social relationships, and in particular, research on social identity, has not been integrated with depression research. This review presents evidence that social connectedness is key to understanding the development and resolution of clinical depression. The social identity approach is then used as a basis for conceptualizing the role of social relationships in depression, operationalized in terms of six central hypotheses. Research relevant to these hypotheses is then reviewed. Finally, we present an agenda for future research to advance theoretical and empirical understanding of the link between social identity and depression, and to translate the insights of this approach into clinical practice.
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Affiliation(s)
- Tegan Cruwys
- The University of Queensland, St Lucia, Australia
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Cruwys T, Alexander Haslam S, Dingle GA, Jetten J, Hornsey MJ, Desdemona Chong EM, Oei TPS. Feeling connected again: interventions that increase social identification reduce depression symptoms in community and clinical settings. J Affect Disord 2014; 159:139-46. [PMID: 24679402 DOI: 10.1016/j.jad.2014.02.019] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 02/07/2014] [Accepted: 02/07/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Clinical depression is often preceded by social withdrawal, however, limited research has examined whether depressive symptoms are alleviated by interventions that increase social contact. In particular, no research has investigated whether social identification (the sense of being part of a group) moderates the impact of social interventions. METHOD We test this in two longitudinal intervention studies. In Study 1 (N=52), participants at risk of depression joined a community recreation group; in Study 2 (N=92) adults with diagnosed depression joined a clinical psychotherapy group. RESULTS In both the studies, social identification predicted recovery from depression after controlling for initial depression severity, frequency of attendance, and group type. In Study 2, benefits of social identification were larger for depression symptoms than for anxiety symptoms or quality of life. LIMITATION Social identification is subjective and psychological, and therefore participants could not be randomly assigned to high and low social identification conditions. CONCLUSIONS Findings have implications for health practitioners in clinical and community settings, suggesting that facilitating social participation is effective and cost-effective in treating depression.
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Affiliation(s)
- Tegan Cruwys
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia.
| | - S Alexander Haslam
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - Genevieve A Dingle
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - Jolanda Jetten
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - Matthew J Hornsey
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - E M Desdemona Chong
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - Tian P S Oei
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia; CBT Unit, Toowong Private Hospital, Queensland, Australia
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Straub J, Sproeber N, Plener PL, Fegert JM, Bonenberger M, Koelch MG. A brief cognitive-behavioural group therapy programme for the treatment of depression in adolescent outpatients: a pilot study. Child Adolesc Psychiatry Ment Health 2014; 8:9. [PMID: 24655595 PMCID: PMC3994391 DOI: 10.1186/1753-2000-8-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 03/11/2014] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The goal of this pilot study was to examine the feasibility and clinical outcomes of a brief (6-session) group therapy programme in adolescent outpatients with depression. The programme had previously been assessed in in-patients, with positive results. METHODS A total of 15 outpatients aged 13 to 18 years took part in the programme between October 2010 and May 2011, in 3 separate groups of 4-6 participants each. The outcomes measured were feasibility of the programme, as assessed by attendance rate, user feedback, fidelity of implementation, and response to treatment, as assessed by pre- and post-intervention measurement of depressive symptoms, quality of life, and suicidal ideation. RESULTS The programme demonstrated good feasibility, with a mean attendance rate of 5.33 out of 6 sessions, a mean rating by participants on overall satisfaction with the programme of 7.21 out of 10 (SD = 1.89), and a 93% concurrence between the contents of the sessions and the contents of the treatment manual. Compared to baseline scores, depressive symptoms at follow-up test were significantly reduced, as assessed by the Children's Depression Rating Scale Revised (F(1, 12) = 11.76, p < .01) and the Beck Depression Inventory Revision (F(1, 32) = 11.19, p < .01); quality of life improved, as assessed by the Inventory of Quality of Life (F(1, 31) = 5.27, p < .05); and suicidal ideation was reduced. No significant changes were seen on the measures of the Parent Rating Scale for Depression and the Clinical Global Impression scale. CONCLUSIONS Based on the results of this pilot study, it is feasible to further assess this brief outpatient treatment programme in a randomized controlled trial without further modifications.
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Affiliation(s)
- Joana Straub
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Nina Sproeber
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Joerg M Fegert
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Martina Bonenberger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
| | - Michael G Koelch
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, Ulm, Germany
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Vivantes Hospitals, Berlin, Germany
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Psychotherapeutische Behandlung von depressiven Kindern und Jugendlichen. PSYCHOTHERAPEUT 2013. [DOI: 10.1007/s00278-013-1026-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cui L, Shi G, Oei TPS. A study of cognitive vulnerability-stress model of depressive symptoms among Chinese adolescents. Stress Health 2013; 29:383-91. [PMID: 23389904 DOI: 10.1002/smi.2484] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 12/31/2012] [Accepted: 01/02/2013] [Indexed: 11/10/2022]
Abstract
The objective of the present study is to test the validity of the integrated cognitive model of depression proposed by Kwon and Oei (1994) with a Chinese adolescent sample. A two-wave panel design was used. We hypothesized that the interaction between dysfunctional attitudes measured at time 1 and adolescents' negative life events experienced between times 1 and 2 would predict changes in the frequency of automatic thoughts between times 1 and 2. We further hypothesized that changes in the frequency of automatic thoughts would, in turn, predict changes in the severity of depressive symptoms. Participants were 329 Chinese adolescents. As a comparison, we tested three other competing models: linear mediation, alternative aetiologies and symptom models. All participants completed the Adolescent Self-Rating Life Events Checklist, Dysfunctional Attitudes Scale, Automatic Thoughts Questionnaire and Center for Epidemiological Studies Depression Scale on two occasions-5 months apart. Path analysis was used to test all models. Results of the path analysis indicated that the integrated cognitive model showed an adequate fit for the Chinese adolescent data. During phases of increased depression, dysfunctional attitudes were common cognitive moderators of depression, whereas automatic thoughts were specific cognitive mediators of depression.
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Affiliation(s)
- Lixia Cui
- Beijing Key Laboratory of Learning and Cognition and Department of Psychology, Capital Normal University, Beijing, China
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Straub J, Koelch M, Fegert J, Plener P, Gonzalez-Aracil I, Voit A, Sproeber N. Innovations in Practice: MICHI, a brief cognitive-behavioural group therapy for adolescents with depression - a pilot study of feasibility in an inpatient setting. Child Adolesc Ment Health 2013; 18:247-250. [PMID: 32847305 DOI: 10.1111/j.1475-3588.2012.00678.x] [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] [Accepted: 05/14/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Group therapy is an economic intervention, allowing for fast access, for the treatment of several depressed adolescents simultaneously; evaluated manualised programs, however, are scarce. METHOD Nine depressive adolescent inpatients (M = 16.33 years; SD = 1.92) participated between October 2009 and March 2010 in a brief manualised group therapy programme (MICHI), which was evaluated with respect to feasibility and trends of efficacy. RESULTS MICHI demonstrated good feasibility, was positively evaluated by the participants by means of an evaluation questionnaire ranging from 1 (very bad) to 10 (very good) (M = 7.22; SD = 1.79), and showed significant reduction of depressive symptoms (z = -2.66, p = .008) assessed by means of a clinical interview. CONCLUSIONS Feasibility of MICHI was demonstrated and larger trials for efficacy will follow.
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Affiliation(s)
- Joana Straub
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
| | - Michael Koelch
- Vivantes Klinikum im Friedrichshain, Landsberger Allee, Kinder- und Jugendpsychiatrie, Berlin, Germany
| | - Joerg Fegert
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
| | - Paul Plener
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
| | - Inma Gonzalez-Aracil
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
| | - Anja Voit
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
| | - Nina Sproeber
- Kinder- und Jugendpsychiatrie des Universitätsklinikums Ulm, Steinhövelstraße 5, Ulm, 89075, Germany
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Parker TJ, Page AC, Hooke GR. The influence of individual, group, and relative self-esteem on outcome for patients undergoing group cognitive-behavioural therapy treatment. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2013; 52:450-63. [PMID: 24117916 DOI: 10.1111/bjc.12029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 07/07/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Despite a strong association between individual self-esteem and treatment outcome in group cognitive-behavioural therapy (GCBT), no study has investigated how patient outcomes might be influenced by an individual's self-esteem relative to other group members. DESIGN The study comprised a retrospective examination of patients' data and used a multiple regression analysis to identify predictors of treatment outcome. Patients' pre-treatment self-esteem scores were assessed on a continuum and assigned to be low, medium, or high. Therapy groups were assigned to be either low, balanced or high self-esteem groups based on averaged self-esteem scores of participants. METHODS In this study, 3,878 patients who had completed a 10-day intensive cognitive behavioural group therapy programme at a private psychiatric facility were included in the study. The Rosenberg Self-Esteem measure was chosen to assess self-esteem. The three subscales of the Depression Anxiety Stress Scales were used as the outcome measures. RESULTS Patient outcomes were influenced by pre-treatment self-esteem scores, such that higher initial self-esteem was associated with better treatment outcomes. Low group self-esteem was predictive of significantly better outcomes for depression, relative to higher self-esteem groups. Additionally, the combined influence of high individual self-esteem and low group self-esteem was associated with significantly enhanced depression improvement. CONCLUSIONS High self-esteem patients perform better on outcome measures following completion of GCBT. Low self-esteem groups show greater improvement in depression symptoms. Similar results for depression are achieved when patients with high self-esteem complete treatment in low self-esteem groups.
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Affiliation(s)
- Thomas J Parker
- School of Psychology, The University of Western Australia, Crawley, Australia
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Qiu J, Chen W, Gao X, Xu Y, Tong H, Yang M, Xiao Z, Yang M. A randomized controlled trial of group cognitive behavioral therapy for Chinese breast cancer patients with major depression. J Psychosom Obstet Gynaecol 2013; 34:60-7. [PMID: 23646866 DOI: 10.3109/0167482x.2013.766791] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aims to evaluate the effects of Group Cognitive Behavioral Therapy (GCBT) in treating major depression in Chinese women with breast cancer. METHODS Sixty-two breast cancer patients diagnosed with major depression were randomly assigned to GCBT group (N = 31) or a waiting list control group provided with an educational booklet (N = 31). The primary outcome measure was the 17-Item Hamilton Depression Rating Scale (17-HAMD). The second outcome measures were Self-Rating Anxiety Scale, Functional Assessment of Cancer Therapy - Breast and Self-Esteem Scale (SES). Assessments were carried out at completion of the study and six-month afterwards. RESULTS Patients in the GCBT group had a significant reduction in the 17-HAMD mean score by 9 points (p < 0.001), more than any reduction among patients in the control group from baseline to the end of therapy and a significant 7 points (p < 0.001) more reduction from baseline to six-month follow-up. GCBT also yielded significantly greater improvement than the control group with regard to quality of life (QoL; p < 0.01) and self-esteem (p < 0.05). No significant differences were found between groups on improving anxiety (p > 0.05). CONCLUSION The results of this trial suggest that GCBT is effective for treating major depression, as well as for improving QoL and self-esteem in breast cancer patients. TRIAL REGISTRATION Chictr.org ChiCTR-TRC-11001689.
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Affiliation(s)
- Jianyin Qiu
- Department of Clinical Psychology, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Feixas G, Bados A, García-Grau E, Montesano A, Dada G, Compañ V, Aguilera M, Salla M, Soldevilla JM, Trujillo A, Paz C, Botella L, Corbella S, Saúl-Gutiérrez LA, Cañete J, Gasol M, Ibarra M, Medeiros-Ferreira L, Soriano J, Ribeiro E, Caspar F, Winter D. Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial. Trials 2013; 14:144. [PMID: 23683841 PMCID: PMC3659066 DOI: 10.1186/1745-6215-14-144] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 05/01/2013] [Indexed: 11/28/2022] Open
Abstract
Background Depression is one of the more severe and serious health problems because of its morbidity, disabling effects and for its societal and economic burden. Despite the variety of existing pharmacological and psychological treatments, most of the cases evolve with only partial remission, relapse and recurrence. Cognitive models have contributed significantly to the understanding of unipolar depression and its psychological treatment. However, success is only partial and many authors affirm the need to improve those models and also the treatment programs derived from them. One of the issues that requires further elaboration is the difficulty these patients experience in responding to treatment and in maintaining therapeutic gains across time without relapse or recurrence. Our research group has been working on the notion of cognitive conflict viewed as personal dilemmas according to personal construct theory. We use a novel method for identifying those conflicts using the repertory grid technique (RGT). Preliminary results with depressive patients show that about 90% of them have one or more of those conflicts. This fact might explain the blockage and the difficult progress of these patients, especially the more severe and/or chronic. These results justify the need for specific interventions focused on the resolution of these internal conflicts. This study aims to empirically test the hypothesis that an intervention focused on the dilemma(s) specifically detected for each patient will enhance the efficacy of cognitive behavioral therapy (CBT) for depression. Design A therapy manual for a dilemma-focused intervention will be tested using a randomized clinical trial by comparing the outcome of two treatment conditions: combined group CBT (eight, 2-hour weekly sessions) plus individual dilemma-focused therapy (eight, 1-hour weekly sessions) and CBT alone (eight, 2-hour group weekly sessions plus eight, 1-hour individual weekly sessions). Method Participants are patients aged over 18 years meeting diagnostic criteria for major depressive disorder or dysthymic disorder, with a score of 19 or above on the Beck depression inventory, second edition (BDI-II) and presenting at least one cognitive conflict (implicative dilemma or dilemmatic construct) as assessed using the RGT. The BDI-II is the primary outcome measure, collected at baseline, at the end of therapy, and at 3- and 12-month follow-up; other secondary measures are also used. Discussion We expect that adding a dilemma-focused intervention to CBT will increase the efficacy of one of the more prestigious therapies for depression, thus resulting in a significant contribution to the psychological treatment of depression. Trial registration ISRCTN92443999; ClinicalTrials.gov Identifier: NCT01542957.
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Affiliation(s)
- Guillem Feixas
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, Universitat de Barcelona, Campus Mundet, Passeig Vall Hebron, 171, Barcelona, Spain.
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Baker FA, Ballantyne J. “You've got to accentuate the positive”: Group songwriting to promote a life of enjoyment, engagement and meaning in aging Australians. NORDIC JOURNAL OF MUSIC THERAPY 2013. [DOI: 10.1080/08098131.2012.678372] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Cognitive-Behavioral Group Therapy for Heterogeneous Anxiety and Mood Disorders in a Psychiatric Hospital Outpatient Clinic. J Cogn Psychother 2013; 27:138-154. [DOI: 10.1891/0889-8391.27.2.138] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recent literature has shown that group cognitive-behavioral therapy (CBT) is effective for individuals with heterogeneous anxiety disorders. However, these studies have used a narrow range of outcome measures, and have not included global measures such as quality of life. In addition, heterogeneous mood disorders have not been well researched. The aim of this study was to replicate and extend on previous studies by assessing the effectiveness of group CBT treatment programs designed for use with heterogeneous anxiety or depressive disorders. Global outcome measures of quality of life and social functioning were assessed in addition to outcome measures of anxiety and mood symptoms. There were 173 patients who completed either group CBT for anxiety disorders or for depressive disorders. Symptom measures and quality of life measures were used to determine treatment effectiveness. Results demonstrated that the treatments were effective in reducing overall symptom severity and improving quality of life. Treatment gains were maintained to 12 month follow-up. However, the degree of change was considerably lower than that found in comparable trials with diagnostically homogenous samples. Overall, group CBT for heterogeneous diagnostic populations was effective but requires further investigation and refinement.
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Chan AS, Wong QY, Sze SL, Kwong PPK, Han YMY, Cheung MC. A Chinese Chan-based mind-body intervention for patients with depression. J Affect Disord 2012; 142:283-9. [PMID: 22840618 DOI: 10.1016/j.jad.2012.05.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 05/07/2012] [Accepted: 05/07/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Given the recent growing interest and encouraging findings in studies of alternative treatments for depression, the present randomized controlled trial study aimed to compare the effect of a newly developed Chinese Chan-based Dejian Mind-Body Intervention (DMBI) with the Cognitive Behavioral Therapy (CBT) on improving depressive symptoms in patients with depression. METHODS Seventy-five participants diagnosed with major depressive disorder were randomly assigned to receive either 10-session CBT or DMBI, or placed on a waitlist. Pre-post measurements included record of anti-depressants treatment, ratings by psychiatrists who were blinded to the experimental design and self-report on mood measures, and performance in a cognitive test tapping concentration ability. RESULTS Both the CBT and DMBI groups demonstrated significantly reduced overall depressive syndrome after intervention at large effect size (0.93-1.10). Furthermore, the DMBI group (p<0.05), but not the CBT or waitlist groups, demonstrated significant reduction in intake of anti-depressants, and significant improvement in specific depression-related symptoms including difficulty in concentration (p=0.002), and problems in gastrointestinal health (p=0.02) and overall sleep quality (p<0.001). LIMITATIONS This study has provided some evidence for the short-term effect of the DMBI on Chinese population. Its long-term effect on a larger sample and on Caucasian population warrants further investigation. CONCLUSIONS The present findings suggest that a Chinese Chan-based Mind-Body intervention has positive effects on improving mood and health conditions of individuals with depression.
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Affiliation(s)
- Agnes S Chan
- Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
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Ebrahim S, Montoya L, Truong W, Hsu S, Kamal El Din M, Carrasco-Labra A, Busse JW, Walter SD, Heels-Ansdell D, Couban R, Patelis-Siotis I, Bellman M, de Graaf LE, Dozois DJA, Bieling PJ, Guyatt GH. Effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits: a systematic review and individual patient data meta-analysis. PLoS One 2012; 7:e50202. [PMID: 23209672 PMCID: PMC3510249 DOI: 10.1371/journal.pone.0050202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Accepted: 10/17/2012] [Indexed: 11/27/2022] Open
Abstract
Objectives To systematically summarize the randomized trial evidence regarding the relative effectiveness of cognitive behavioural therapy (CBT) in patients with depression in receipt of disability benefits in comparison to those not receiving disability benefits. Data Sources All relevant RCTs from a database of randomized controlled and comparative studies examining the effects of psychotherapy for adult depression (http://www.evidencebasedpsychotherapies.org), electronic databases (MEDLINE, EMBASE, PSYCINFO, AMED, CINAHL and CENTRAL) to June 2011, and bibliographies of all relevant articles. Study Eligibility Criteria, Participants and Intervention Adult patients with major depression, randomly assigned to CBT versus minimal/no treatment or care-as-usual. Study Appraisal and Synthesis Methods Three teams of reviewers, independently and in duplicate, completed title and abstract screening, full text review and data extraction. We performed an individual patient data meta-analysis to summarize data. Results Of 92 eligible trials, 70 provided author contact information; of these 56 (80%) were successfully contacted to establish if they captured receipt of benefits as a baseline characteristic; 8 recorded benefit status, and 3 enrolled some patients in receipt of benefits, of which 2 provided individual patient data. Including both patients receiving and not receiving disability benefits, 2 trials (227 patients) suggested a possible reduction in depression with CBT, as measured by the Beck Depression Inventory, mean difference [MD] (95% confidence interval [CI]) = −2.61 (−5.28, 0.07), p = 0.06; minimally important difference of 5. The effect appeared larger, though not significantly, in those in receipt of benefits (34 patients) versus not receiving benefits (193 patients); MD (95% CI) = −4.46 (−12.21, 3.30), p = 0.26. Conclusions Our data does not support the hypothesis that CBT has smaller effects in depressed patients receiving disability benefits versus other patients. Given that the confidence interval is wide, a decreased effect is still possible, though if the difference exists, it is likely to be small.
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Affiliation(s)
- Shanil Ebrahim
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.
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Cognitive Behavioural Analysis System of Psychotherapy for Treatment-Resistant Depression: Adaptation to a Group Modality. BEHAVIOUR CHANGE 2012. [DOI: 10.1017/bec.2012.2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Studies researching psychotherapeutic interventions for treatment-resistant depression (TRD) are quite new to the field. The Cognitive Behavioural Analysis System of Psychotherapy (CBASP) is the only model developed specifically to treat the chronically depressed patient. While empirical evidence indicates that CBASP is an effective treatment for chronic depression, little is known about its adaptation to a group modality. Treating these patients in a group approach would have the added benefits of being cost-effective and providing in vivo previously avoided interpersonal situations for practising social skills and role-plays. This single arm study asks whether CBASP adapted to a group modality can be effective. All patients received 12 CBASP group therapy sessions with two to four individual preparatory sessions before the group. Our results suggest that CBASP group treatment demonstrated positive effects on patient outcomes. Specifically, patients showed significant decreases in symptoms of depression and the use of emotion-oriented coping, as well as increases in overall social adjustment and interpersonal self-efficacy when compared to pretreatment levels. However, patients did not achieve normative levels in these areas by the end of treatment. These pilot results are encouraging and support further study of the effectiveness of CBASP group treatment with a control group.
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Fitzgerald ME, Roy K, Anderson EE, Letiecq BL. The Effect of Depressive Symptoms on Low-Income Men in Responsible Fathering Programs. ACTA ACUST UNITED AC 2012. [DOI: 10.3149/fth.1001.47] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Vøllestad J, Nielsen MB, Nielsen GH. Mindfulness- and acceptance-based interventions for anxiety disorders: a systematic review and meta-analysis. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2011; 51:239-60. [PMID: 22803933 DOI: 10.1111/j.2044-8260.2011.02024.x] [Citation(s) in RCA: 199] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE Mindfulness- and acceptance-based interventions (MABIs) are receiving increasing attention in the treatment of mental disorders. These interventions might be beneficial for patients with anxiety disorders, but no prior reviews have comprehensively investigated the effects of this family of interventions on clinical samples. The aim of this study was to review and synthesize extant research on MABIs for patients with diagnoses of anxiety disorders. METHODS We conducted a systematic search of relevant databases according to pre-defined criteria. Studies were eligible for inclusion if they employed MABIs for patients diagnosed with anxiety disorders. RESULTS Nineteen eligible studies were found. Meta-analysis of within-group pre- to post-treatment effects yielded overall Hedges'g effect sizes of 1.08 for anxiety symptoms and 0.85 for depression symptoms. For controlled studies, overall between-group Hedges'g was 0.83 for anxiety symptoms and 0.72 for depression symptoms. Moderator analyses examined whether intervention type, design, treatment dosage, or patient sample was associated with systematic variation in effect sizes. No significant moderating effects were found on the variables examined, apart from an observed superiority in effect size for clinical trials on samples of patients with mixed anxiety disorders. However, differential effect sizes indicated benefits of adding specific psychotherapeutic content to mindfulness training, as well as an advantage of individual over group treatment. CONCLUSIONS MABIs are associated with robust and substantial reductions in symptoms of anxiety and comorbid depressive symptoms. More research is needed to determine the efficacy of MABIs relative to current treatments of choice, and to clarify the contribution of processes of mindfulness and acceptance to observed outcome.
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Affiliation(s)
- Jon Vøllestad
- Department of Clinical Psychology, University of Bergen, Bergen, Norway.
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