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Freidl M, Wegerer M, Litvan Z, König D, Alexandrowicz RW, Portela-Millinger F, Gruber M. Determinants of quality of life improvements in anxiety and depressive disorders-A longitudinal study of inpatient psychotherapy. Front Psychiatry 2022; 13:937194. [PMID: 36590609 PMCID: PMC9798124 DOI: 10.3389/fpsyt.2022.937194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Background Quality of life (QoL) is substantially impaired in patients with anxiety disorders (AD) and depressive disorders (DD) and improvements in symptom burden after psychotherapy are not always paralleled by similar improvements in QoL. So far, little is known about treatment outcome in terms of QoL and predictors of QoL improvements following inpatient psychotherapy with a focus on cognitive behavior therapy (CBT). The current study aimed at investigating the relationship between changes in symptoms and QoL across different life domains. Additionally, predictors of a positive treatment outcome were evaluated. Methods 122 patients with AD and/or DD undergoing an 8-weeks inpatient CBT program completed self-report measures of psychopathological symptoms and QoL at pre- and post-treatment. Mixed effects models were used to investigate changes, a confirmatory factor analysis was applied to analyze the latent factor structure of the anxiety sensitivity index and binary logistic regression analyses were performed for predictors of QoL improvements. Results Patients showed moderate to strong decreases in anxious and depressive symptoms and moderate to strong improvements in general QoL, particularly in the psychological and physical QoL subdomains. Changes in symptom burden correlated most strongly with psychological and physical QoL. In addition, poor QoL before treatment and low levels of specific anxiety sensitivity symptoms (items 1 and 5) significantly predicted improvement in QoL. Conclusion Patients with poor QoL who are not as inhibited to openly express their anxious feelings particularly benefit from inpatient psychotherapy (individual and group) to improve their QoL. In contrast, our research suggests that patients who are too anxious to openly express their nervousness should receive additional social skills training, more focused treatment to build sufficient self-confidence to better engage in the treatment program.
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Affiliation(s)
- Marion Freidl
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Melanie Wegerer
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Zsuzsa Litvan
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Daniel König
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | - Filipe Portela-Millinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Maria Gruber
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Audet S. L’étude du changement humain dans le cadre de la consultation d’un professionnel de la relation d’aide : un modèle systémique. PSYCHOLOGIE FRANCAISE 2020. [DOI: 10.1016/j.psfr.2019.06.003] [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: 12/01/2022]
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Camacho KS, Page AC, Hooke GR. An exploration of the relationships between patient application of CBT skills and therapeutic outcomes during a two-week CBT treatment. Psychother Res 2020; 31:778-788. [PMID: 33186064 DOI: 10.1080/10503307.2020.1845414] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The application of Cognitive Behavioural Therapy (CBT) skills are believed to be a mechanism of therapeutic change in treatment. Research has shown that the application of CBT skills affects outcomes, however, the way these relationships may change during treatment has not been explored. In this study, a naturalistic observational approach is used to examine the relationships between patients' wellbeing, symptoms, and the application of CBT skills throughout treatment. It is hypothesized that the application of CBT skills would lead to an increase in patients reported wellbeing, and a decrease in symptoms. Additionally, it was hypothesized that the application of CBT skills affects wellbeing and symptoms at different points in therapy. A sample of 584 patients in a two-week CBT treatment completed session-to-session measures of wellbeing, symptoms, and their application of CBT skills. Results of an autoregressive cross-lagged path analysis indicated that in the early stages of treatment the application of CBT skills predicted patient wellbeing but not symptoms. At the later stages of therapy, the application of CBT skills predicted both patient wellbeing and symptoms. At no point in treatment did patient wellbeing or symptoms predict the later application of CBT skills. Implications and future directions for research are discussed.
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Affiliation(s)
- Kathleen S Camacho
- School of Psychological Science M304, The University of Western Australia, Crawley, Australia
| | - Andrew C Page
- School of Psychological Science M304, The University of Western Australia, Crawley, Australia
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The Relationship between Symptoms and Social Functioning over the Course of Cognitive Behavioral Therapy for Social Anxiety Disorder. PSYCHIATRY JOURNAL 2020; 2020:3186450. [PMID: 33062660 PMCID: PMC7539070 DOI: 10.1155/2020/3186450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/03/2020] [Accepted: 09/22/2020] [Indexed: 11/17/2022]
Abstract
Background The present study is aimed at investigating the relationship between changes in symptoms and changes in social functioning during cognitive behavioral therapy (CBT) for social anxiety disorder (SAD). Methods Ninety-six patients with SAD were treated with manualized group CBT. Measures of social anxiety symptoms, depression symptoms, cognition, and social functioning were administered at baseline and endpoint. Using multiple regression analysis, we examined the associations between the changes in four aspects (work, home management, social leisure activities, and private leisure activities) of social functioning as dependent variables and the changes in four factors (social interaction, public speaking, observation by others, and eating and drinking in public) in social anxiety symptoms, depression symptoms, and cognition as independent variables. Results The changes in work functioning were predicted by the changes in the public speaking factor in social anxiety symptoms. The changes in depression symptoms predicted the changes in home management. The significant predictors of changes in social leisure activities were the changes in the social interaction factor and depression symptoms. The changes in private leisure activities were predicted by the changes in the observation by others factor. The changes in cognition predicted nothing. Conclusion The present study suggested that the changes in social anxiety or depression symptoms may predict several aspects of social functioning changes in patients with SAD over the course of CBT. In order to improve social functioning, our results may be useful for selecting the fear or feared situation in CBT for SAD. Trial Registration. The clinical study registration number in the Japanese trials registry is UMIN CTR 000031147.
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Moore L, Carr A, Hodgins S, Duffy D, Rooney B. What Works Best for Reducing Symptoms and Improving Quality of Life? A 6-Months Follow-up Study on the Effectiveness of Group Cognitive Behaviour Therapy and Group Information and Support for Adults Suffering from Depression. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2017. [DOI: 10.1007/s10879-017-9358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Terides MD, Dear BF, Fogliati VJ, Gandy M, Karin E, Jones MP, Titov N. Increased skills usage statistically mediates symptom reduction in self-guided internet-delivered cognitive–behavioural therapy for depression and anxiety: a randomised controlled trial. Cogn Behav Ther 2017; 47:43-61. [DOI: 10.1080/16506073.2017.1347195] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Matthew D. Terides
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Blake F. Dear
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Vincent J. Fogliati
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Milena Gandy
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Eyal Karin
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Michael P. Jones
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Nickolai Titov
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
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Ogawa S, Kondo M, Okazaki J, Imai R, Ino K, Furukawa TA, Akechi T. The relationships between symptoms and quality of life over the course of cognitive-behavioral therapy for panic disorder in Japan. Asia Pac Psychiatry 2017; 9. [PMID: 27481539 DOI: 10.1111/appy.12249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 06/20/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This study examined the relationships between changes in symptoms and changes in quality of life (QOL) during cognitive-behavioral therapy (CBT) for panic disorder (PD). METHODS We treated 198 PD patients with group CBT in Japan. Using multiple regression analysis, we examined the associations between changes in QOL and changes in PD symptoms or comorbid psychological symptoms during CBT. RESULTS Changes in anticipatory anxiety, agoraphobic fear/avoidance, and somatization were significant predictors of changes in some aspects of QOL. DISCUSSION It might be useful to decrease somatization, anticipatory anxiety, and agoraphobic fear to improve QOL in CBT for PD.
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Affiliation(s)
- Sei Ogawa
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masaki Kondo
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Jynya Okazaki
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Risa Imai
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Keiko Ino
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Naughton MJ, Brunner RL, Hogan PE, Danhauer SC, Brenes GA, Bowen DJ, Snively BM, Goveas JS, Saquib N, Zaslavsky O, Shumaker SA. Global Quality of Life Among WHI Women Aged 80 Years and Older. J Gerontol A Biol Sci Med Sci 2016; 71 Suppl 1:S72-8. [PMID: 26858327 DOI: 10.1093/gerona/glv056] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The number of older adults living to age 80 and older is increasing rapidly, particularly among women. Correlates of quality of life (QOL) in very advanced ages are not known. We examined the association of demographic, social-psychological, lifestyle, and physical health variables with global QOL in a Women's Health Initiative (WHI) cohort of women aged 80 and older. METHODS 26,299 WHI participants, who had completed a recent psychosocial and medical update, were included in these analyses. Global QOL was assessed by a single item, asking the women to rate their overall QOL on a scale from 0 to 10. Characteristics of the women were examined by the level of their transformed global QOL scores (≤50, 50-70, ≥70), and multiple regression was used to examine which demographic, social-psychological, lifestyle and health variables were independently associated with higher global QOL. RESULTS Social-psychological and current health variables were more strongly associated with global QOL than a history of selected comorbid conditions. In particular, higher self-rated health and fewer depressive symptoms were the most strongly associated with better global QOL in WHI women ≥80 years. CONCLUSIONS Interventions to reduce depressive symptoms and improve health may lead to better self-reported health and global QOL among older women. Physical and mental health screenings followed by evidence-based interventions are imperative in geriatric care.
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Affiliation(s)
- Michelle J Naughton
- Division of Population Sciences, Department of Internal Medicine, The Ohio State University, Columbus, Ohio.
| | | | - Patricia E Hogan
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Suzanne C Danhauer
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Gretchen A Brenes
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington, School of Medicine, Seattle, Washington
| | - Beverly M Snively
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Joseph S Goveas
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Nazmus Saquib
- College of Medicine, Sulaiman Al-Rajhi Colleges, Kingdom of Saudi Arabia
| | - Oleg Zaslavsky
- Health Sciences and Social Welfare, University of Haifa, Haifa, Israel
| | - Sally A Shumaker
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
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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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