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Bognár SA, Teutsch B, Bunduc S, Veres DS, Szabó B, Fogarasi B, Zahariev OJ, Vörhendi N, Almog O, Hadani Y, Gergő D, Mihály E, Erőss B, Bunduc S, Márta K, Hegyi P. Psychological intervention improves quality of life in patients with early-stage cancer: a systematic review and meta-analysis of randomized clinical trials. Sci Rep 2024; 14:13233. [PMID: 38853187 PMCID: PMC11162999 DOI: 10.1038/s41598-024-63431-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 05/29/2024] [Indexed: 06/11/2024] Open
Abstract
The effectiveness of psychological interventions (PI) for malignant diseases is controversial. We aimed to investigate the effect of PI on survival and quality of life (QoL) in patients with cancer. We performed a systematic search of MEDLINE, Cochrane, and Embase databases to identify randomized controlled trials comparing PI to standard care (PROSPERO registration number CRD42021282327). Outcomes were overall survival (OS), recurrence-free survival (RFS), and different domains of QoL. Subgroup analysis was performed based on the provider-, type-, environment-, duration of intervention; cancer stage, and type. Pooled hazard ratios (HR) and standardized mean difference (SMD) with 95% confidence intervals (CI) were calculated using a random-effects model. The OS and RFS did not differ significantly between the two groups (OS:HR = 0.97; CI 0.87-1.08; RFS:HR = 0.99; CI 0.84-1.16). However, there was significant improvement in the intervention group in all the analyzed domains of QoL; in the global (SMD = 0.65; CI 0.35-0.94), emotional (SMD = 0.64; CI 0.33-0.95), social (SMD = 0.32; CI 0.13-0.51) and physical (SMD = 0.33; CI 0.05-0.60) domains. The effect of PI on QoL was generally positive immediately, 12 and 24 weeks after intervention, but the effect decreased over time and was no longer found significant at 48 weeks. The results were better in the breast cancer group and early stages of cancer. PIs do not prolong survival, but they significantly improve the QoL of cancer patients. PI should be added as standard of care 3-4 times a year, at least for patients with early-stage cancer.
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Affiliation(s)
- Sára Anna Bognár
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7623, Pecs, Hungary
| | - Stefania Bunduc
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Dániel Sándor Veres
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Department of Biophysics and Radiation Biology, Semmelweis University, 1085, Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Beatrix Fogarasi
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary
| | - Olga Júlia Zahariev
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Nóra Vörhendi
- Institute for Translational Medicine, Medical School, University of Pécs, 7623, Pecs, Hungary
- Department of Internal Medicine, Siófok City Hospital and Outpatient Clinic, 8601, Siófok, Hungary
| | - Omer Almog
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Yael Hadani
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
| | - Dorottya Gergő
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Department of Pharmacognosy, Semmelweis University, Üllői út 26, 1085, Budapest, Hungary
| | - Emese Mihály
- Department of Internal Medicine and Hematology, Medical School, Semmelweis University, 1088, Budapest, Hungary
| | - Bálint Erőss
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, 7623, Pecs, Hungary
| | - Stefania Bunduc
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Center for Digestive Diseases and Liver Transplant, Fundeni Clinical Institute, 022328, Bucharest, Romania
| | - Katalin Márta
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary
- Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation University of Szeged, 6725, Szeged, Hungary
| | - Péter Hegyi
- Institute of Pancreatic Diseases, Semmelweis University, 1083, Budapest, Hungary.
- Centre for Translational Medicine, Semmelweis University, 1085, Budapest, Hungary.
- Institute for Translational Medicine, Medical School, University of Pécs, 7623, Pecs, Hungary.
- Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation University of Szeged, 6725, Szeged, Hungary.
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Pedro LMR, de Oliveira MF, Pereira MD, da Fonseca AD, Canavarro MC. Factors Associated with Prospective Acceptability and Preferences for Unified Transdiagnostic Cognitive-Behavioral Treatments and Group Therapy in the Portuguese General Population. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01391-1. [PMID: 38839662 DOI: 10.1007/s10488-024-01391-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/07/2024]
Abstract
Group transdiagnostic cognitive-behavioral therapy (CBT) offers a promising solution for limited mental health access in Portugal. Understanding barriers to patient adherence is crucial for successful implementation. This study aimed to characterize the prospective acceptability and preferences for unified transdiagnostic CBT and group therapy in the Portuguese general population and explore their correlates. A sample of 243 participants (18-88 years old), recruited online, completed an online survey collecting information on sociodemographic and clinical characteristics, acceptability of transdiagnostic CBT treatments, specifically of Unified Protocol (UP), acceptability of group therapy, therapeutic format preferences, beliefs about group therapy and help-seeking attitudes. Most participants were receptive to and perceived as useful both unified transdiagnostic CBT and group therapy. Overall, participants presented significantly more favorable attitudes than unfavorable attitudes toward unified transdiagnostic CBT and group therapy (p < .001). Multivariate analyses revealed that (1) favorable attitudes toward transdiagnostic treatments were negatively associated with being employed and positively associated with living in an urban area, and higher efficacy scores; (2) unfavorable attitudes toward transdiagnostic treatments were positively associated with being married/cohabitating and negatively associated with vulnerability scores; (3) being female, living in an urban area, and higher efficacy and myth scores emerged as positive predictors of favorable attitudes toward group therapy; and (4) efficacy and vulnerability scores and help-seeking propensity emerged as negative predictors of unfavorable attitudes toward group therapy. These findings highlight the importance of delineating strategies to increase knowledge and acceptance of unified transdiagnostic CBT and group therapy in the Portuguese population, addressing specific individual characteristics.
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Affiliation(s)
- Liliana Maria Rodrigues Pedro
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal.
| | | | - Marco Daniel Pereira
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
| | - Ana Dias da Fonseca
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
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Waumans RC, Muntingh ADT, Veldwijk J, W Hoogendoorn A, van Balkom AJLM, Batelaan NM. Treatment Preferences of Adolescents and Young Adults with Depressive Symptoms: A Discrete Choice Experiment. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:401-413. [PMID: 38109008 DOI: 10.1007/s40258-023-00857-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Depression in adolescents and young adults is common and causes considerable disease burden while hampering their development, leading to adverse consequences in later life. Although treatment is available, young people are a vulnerable group regarding uptake and completion of treatment. To improve this, insight into youth's preferences for treatment is essential. OBJECTIVE The aim of this study was to investigate patient preferences for depression treatment in a Dutch sample aged 16-24 years using a discrete choice experiment (DCE). METHODS The study was conducted in The Netherlands between October 2018 and June 2019, and included 236 adolescents and young adults with current depressive symptoms or previous treatment. The DCE included five attributes (treatment type, frequency of appointment, waiting time, effectiveness, evaluation of therapeutic alliance) with corresponding levels. Results were analysed using latent class analysis. RESULTS Results show a general preference for individual psychotherapy, treatment with high frequency, high effectiveness, short waiting time and a standard evaluation of the therapeutic alliance ('click' with the therapist) early in treatment. Latent class analysis revealed three different patterns of preferences regarding treatment type and willingness to engage in therapy. The first class showed a strong preference for individual therapy. The second class, including relatively older, higher educated and treatment-experienced participants, preferred high frequency treatment and was more open to different forms of therapy. The third class, including lower educated, younger and treatment-naïve adolescents showed reluctance to engage in therapy overall and in group therapy specifically. CONCLUSION In this DCE, three classes could be identified that share similar preferences regarding treatment effectiveness, waiting time and evaluation of the therapeutic alliance, but varied considerably in their preference for treatment type (individual, group, or combined psychotherapy) and their willingness to engage. The results from this study may inform mental health care providers and institutions and help optimize professional care for adolescents and young adults with depressive symptoms, improving engagement in this vulnerable group.
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Affiliation(s)
- Ruth C Waumans
- Amsterdam Public Health Institute and GGZ inGeest Specialized Mental Health care, Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The Netherlands.
| | - Anna D T Muntingh
- Amsterdam Public Health Institute and GGZ inGeest Specialized Mental Health care, Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The Netherlands
| | - Jorien Veldwijk
- Erasmus School of Health Policy and Management, Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Adriaan W Hoogendoorn
- Amsterdam Public Health Institute and GGZ inGeest Specialized Mental Health care, Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The Netherlands
| | - Anton J L M van Balkom
- Amsterdam Public Health Institute and GGZ inGeest Specialized Mental Health care, Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The Netherlands
| | - Neeltje M Batelaan
- Amsterdam Public Health Institute and GGZ inGeest Specialized Mental Health care, Department of Psychiatry, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The Netherlands
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Borowska M, Religioni U, Mańczuk M. Hospital Care for Cancer Patients-Education and Respect for Patient Rights. Healthcare (Basel) 2024; 12:494. [PMID: 38391869 PMCID: PMC10887647 DOI: 10.3390/healthcare12040494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024] Open
Abstract
This study aims to examine cancer patients' opinions of safety, the observance of patient's rights, and the quality of healthcare. Such an analysis will allow for the identification of areas for improvement in quality, safety, and communication between medical staff and patients. Cancer patients are a special kind of patients with chronic and complex diseases, so we need to observe the type of communication they use, which is a critical issue in a hospital ward but also has a significant impact on how the patient follows recommendations at home. Observing a patient's rights impacts the safety and quality of medical care. This information allows for the identification of areas requiring deeper analysis and improvement. This study was based on a survey conducted at an oncology hospital. The survey contained questions divided into seven sections related to the study areas. Our study emphasizes the importance of knowledge and understanding regarding patient rights among medical staff and patients, underscoring their role in ensuring quality and safety in healthcare settings. We found a strong correlation between the politeness of medical receptionists and staff and patient perceptions of the clarity and exhaustiveness of the information provided.
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Affiliation(s)
- Mariola Borowska
- Department of Cancer Epidemiology and Primary Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-813 Warsaw, Poland
| | - Marta Mańczuk
- Department of Cancer Epidemiology and Primary Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
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Palmer Molina A, Palinkas L, Hernandez Y, Garcia I, Stuart S, Sosna T, Mennen FE. Implementation of the "Healthy Moms, Healthy Kids" Program in Head Start: An Application of the RE-AIM QuEST Framework Centering Equity. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:69-84. [PMID: 37898595 DOI: 10.1007/s10488-023-01312-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Marginalized mothers are disproportionately impacted by depression and face barriers in accessing mental health treatment. Recent efforts have focused on building capacity to address maternal depression in Head Start; however, it is unclear if mental health inequities can be addressed by two-generation programs in Head Start settings. Therefore, this study examined the implementation outcomes and processes of a two-generation program called "Healthy Moms, Healthy Kids" (HMHK) that provided an evidence-based depression treatment to ethnic minority Head Start mothers. METHOD Quantitative and qualitative data were collected and merged in a convergent mixed method design in accordance with the RE-AIM Qualitative Evaluation for Systematic Translation (RE-AIM QuEST) framework. Qualitative data included interviews with 52 key stakeholders, including intervention participants and staff members, and 176 sets of meeting minutes from the implementation period. Quantitative data included intervention study data and administrative data. RESULTS It was difficult for HMHK to reach the target population, with only 16.8% of eligible mothers choosing to participate. However, mothers who participated experienced reductions in depressive symptoms and parenting stress and shared a variety of positive impacts in interviews. The program was also more successful in enrolling Latinx mothers who were Spanish-speaking or bilingual rather than English-speaking and Black/African American mothers, limiting its reach. CONCLUSION Providing IPT therapy groups was effective in reducing maternal depressive symptoms and stress for those who enrolled, but additional work should focus on reducing barriers to participation, considering other delivery models to meet participants' needs, and identifying culturally relevant ways to meet the needs of Black mothers.
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Affiliation(s)
| | - Lawrence Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Yuliana Hernandez
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Iliana Garcia
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | | | - Todd Sosna
- Optimist Youth Homes, Los Angeles, CA, USA
| | - Ferol E Mennen
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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Aafjes-van Doorn K, Horne S. Beyond treatment modalities: Clinical decisions and relational dynamics that facilitate change in group treatments. J Clin Psychol 2022; 78:1637-1649. [PMID: 35818762 DOI: 10.1002/jclp.23396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/09/2022]
Abstract
This commentary on six articles comprising this Journal of Clinical Psychology: In Session issue on the therapeutic process in group psychotherapy brings together relevant clinical challenges and opportunities concerning the unique processes of change in group treatments. As illustrated by these six inspiring group therapy cases, therapy groups may vary widely in content and context. To balance the rich clinical illustrations of successful group treatments and the different theoretical formulations offered in these case studies, we highlight the processes that these treatments appear to have in common. Specifically, we describe the clinical considerations about the group format and the group members. We also reflect on the relational dynamics as they play out within the complex interplay between group leaders and group members; the facilitation of the corrective emotional experience as a change mechanism in group therapy, as well as the relational challenges and opportunities inherent in group treatments more generally. It is hoped that in this issue, clinicians will not only be inspired by the clinical description of successful change processes in group treatments but will also be reminded of the therapeutic nuances and opportunities of this multilayered treatment format.
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Affiliation(s)
| | - Sarah Horne
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, New York, USA
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Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol. BMC Psychiatry 2022; 22:99. [PMID: 35139809 PMCID: PMC8826705 DOI: 10.1186/s12888-022-03726-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/22/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Emotional disorders are common, and they have become more prevalent since the COVID-19 pandemic. Due to a high attendance burden at the specialized level, most emotional disorders in Spain are treated in primary care, where they are usually misdiagnosed and treated using psychotropic drugs. This contributes to perpetuate their illness and increase health care costs. Following the IAPT programme and the transdiagnostic approach, the PsicAP project developed a brief group transdiagnostic cognitive-behavioural therapy (tCBT) as a cost-effective alternative. However, it is not suitable for everyone; in some cases, one-on-one sessions may be more effective. The objective of the present study is to compare, in cost-benefit terms, group and individual tCBT with the treatment usually administered in Spanish primary care (TAU). METHODS A randomized, controlled, multicentre, and single-blinded trial will be performed. Adults with mild to moderate emotional disorders will be recruited and placed in one of three arms: group tCBT, individual tCBT, or TAU. Medical data and outcomes regarding emotional symptoms, disability, quality of life, and emotion regulation biases will be collected at baseline, immediately after treatment, and 6 and 12 months later. The data will be used to calculate incremental cost-effectiveness and cost-utility ratios. DISCUSSION This trial aims to contribute to clinical practice research. The involvement of psychologists in primary care and the implementation of a stepped-care model for mental disorders are recommended. Group therapy and a transdiagnostic approach may help optimize health system resources and unblock waiting lists so that people can spend less time experiencing mental health problems. TRIAL REGISTRATION ClinicalTrials.gov: NCT04847310; Protocols.io: bx2npqde. (April 19, 2021).
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Abstract
There are many psychotherapy varieties, but all are delivered through two predominant modalities-individual and group. This article outlines differences between individual and group treatment and the advantages and disadvantages of each. The author focuses on psychodynamic treatment, but the differences between the two modalities apply across all theoretical orientations. Human beings are social animals with an innate drive for relationships. With the advent of mass transit and mass communication, many historic bastions of relationships, such as the family, the neighborhood, and religious institutions, have been disrupted, and the roots of relationships have become shallow. As a result, many people seek psychotherapy to help build and sustain more intimate and healthier relationships, a goal for which group therapy is well suited. As relationships develop in group psychotherapy, group members demonstrate the assets and liabilities of their relational styles. Their defenses against intimacy become apparent. For these reasons, group therapy is the treatment of choice for many people. The interpersonal nature of group psychotherapy provides an opportunity to recognize interpersonal behavior patterns and thus may provide tools to allow for more intimate relationships. When meeting a new patient, the therapist seeks not only the theoretical treatment that might be most amenable to the patient's individual needs but also the form of therapy that might work best. The aim of this article is to examine the unique features of group therapy and of the patients this modality may especially help.
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Schuit AS, Holtmaat K, van Zwieten V, Aukema EJ, Gransier L, Cuijpers P, Verdonck-de Leeuw IM. Organizing Psycho-Oncological Care for Cancer Patients: The Patient's Perspective. Front Psychol 2021; 12:625117. [PMID: 33967892 PMCID: PMC8100060 DOI: 10.3389/fpsyg.2021.625117] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/15/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cancer patients often suffer from psychological distress during or after cancer treatment, but the use of psycho-oncological care among cancer patients is limited. One of the reasons might be that the way psycho-oncological care is organized, does not fit patients' preferences. This study aimed to obtain detailed insight into cancer patients' preferences regarding the organization of psycho-oncological care. METHODS 18 semi-structured interviews were conducted among cancer patients. Patients completed psycho-oncological treatment between 2015 and 2020 at the psychology department in a general hospital or a center specialized in psychological cancer care in the Netherlands. The interview comprised questions related to preferences regarding the institute where to receive treatment, the psychologist who provides treatment, and the type of treatment, as well as questions related to experienced barriers and facilitators to receive psycho-oncological care. Interviews were digitally recorded and transcribed verbatim. Data were analyzed individually by two coders into key issues and themes. RESULTS Regarding the institute, easy accessibility and prompt availability of psychol-oncological care were considered important. Regarding the psychologist, most participants had a strong preference to be treated by a psychologist specialized in cancer or other somatic diseases. Individual face-to-face therapy was preferred above other types of treatment. Several barriers were mentioned to receive psycho-oncological treatment, among which poor accessibility to psycho-oncological care, lack of knowledge on the possibilities for psycho-oncological treatment, and stigma. Most frequently mentioned facilitators were being assertive to ask for help, having a good relationship with the healthcare professional, and the integration of psycho-oncological support within medical cancer care. CONCLUSION From the patient's perspective, the organization of psycho-oncological care for cancer patients should focus on easy accessibility and availability, delivered by specialized psychologists, and integration in medical cancer care. Online and group therapy are acceptable, but individual face-to-face therapy is preferred. It is warranted to increase awareness on psycho-oncological care targeting both patients and healthcare providers.
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Affiliation(s)
- Anouk S. Schuit
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Karen Holtmaat
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Valesca van Zwieten
- Amsterdam UMC, Otolaryngology—Head and Neck Surgery, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Eline J. Aukema
- Ingeborg Douwes Centrum, Center for Psycho-Oncology, Amsterdam, Netherlands
| | - Lotte Gransier
- Department of Psychiatry and Medical Psychology, OLVG Hospital, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Irma M. Verdonck-de Leeuw
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam UMC, Otolaryngology—Head and Neck Surgery, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Corpas J, Moriana JA, Venceslá JF, Gálvez-Lara M. Brief psychological treatments for emotional disorders in Primary and Specialized Care: A randomized controlled trial. Int J Clin Health Psychol 2021; 21:100203. [PMID: 33363586 PMCID: PMC7753034 DOI: 10.1016/j.ijchp.2020.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/06/2020] [Indexed: 12/14/2022] Open
Abstract
Background/Objective Brief transdiagnostic psychotherapies are a possible treatment for emotional disorders. We aimed to determine their efficacy on mild/moderate emotional disorders compared with treatment as usual (TAU) based on pharmacological interventions. Method: This study was a single-blinded randomized controlled trial with parallel design of three groups. Patients (N = 102) were assigned to brief individual psychotherapy (n = 34), brief group psychotherapy (n = 34) or TAU (n = 34). Participants were assessed before and after the interventions with the following measures: PHQ-15, PHQ-9, PHQ-PD, GAD-7, STAI, BDI-II, BSI-18, and SCID. We conducted per protocol and intention-to-treat analyses. Results: Brief psychotherapies were more effective than TAU for the reduction of emotional disorders symptoms and diagnoses with moderate/high effect sizes. TAU was only effective in reducing depressive symptoms. Conclusions: Brief transdiagnostic psychotherapies might be the treatment of choice for mild/moderate emotional disorders and they seem suitable to be implemented within health care systems.
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Affiliation(s)
- Jorge Corpas
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
| | - Juan A. Moriana
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
| | - Jose F. Venceslá
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
| | - Mario Gálvez-Lara
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
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Eccles FJR, Craufurd D, Smith A, Davies R, Glenny K, Homberger M, Peeren S, Rogers D, Rose L, Skitt Z, Theed R, Simpson J. A feasibility investigation of mindfulness-based cognitive therapy for people with Huntington's disease. Pilot Feasibility Stud 2020; 6:90. [PMID: 32595978 PMCID: PMC7315515 DOI: 10.1186/s40814-020-00631-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 06/11/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Huntington's disease (HD) is an inherited neurodegenerative condition which affects movement, coordination and cognitive functioning. Psychological difficulties are commonly experienced; however, psychological interventions have been little researched with this population. We investigated the feasibility of conducting a randomised controlled trial (RCT) of mindfulness-based cognitive therapy (MBCT) with people with the HD genetic mutation, either pre-manifest (before onset of movement symptoms) or at an early disease stage. Specifically, we evaluated the willingness of participants to be recruited into and complete the intervention; the acceptability of the study measures in relation to completion; the feasibility of offering the standard MBCT course to people with HD; the acceptability of the intervention and the estimated effect sizes. METHODS Participants were recruited from two UK HD centres and took part in an 8-week course of MBCT, with three reunions throughout the following year. Stress, depression, anxiety, and mindfulness were measured pre-, mid-, and post-course, at 3 months and at 1 year. Sleep, quality of life, positive affect and coping were measured pre- and post-course, at 3 months and at 1 year. Descriptive data and approximate effect sizes were calculated. Interviews were conducted post-course and at 1 year and data pertaining to the acceptability of the course were extracted. RESULTS Twelve participants took part in two groups; all were pre-manifest. Levels of depression and anxiety were low pre-course leaving little room for improvement. Changes in stress and in some aspects of mindfulness were medium to large. The qualitative data suggested participants rated the course highly and found it helpful and no changes to the standard course were needed. Recruitment levels were below those anticipated. Most measures were found to be acceptable. CONCLUSIONS Although the course was acceptable to those who took part, given the difficulties in recruiting and the rarity of HD, conducting an RCT of MBCT teaching groups in person does not seem feasible. However, alternative modes of course delivery (e.g. online) would allow the recruitment of people from a greater geographical area and may make an RCT feasible; this revised focus would be suitable for future feasibility studies. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02464293, registered 8 June 2015.
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Affiliation(s)
- Fiona J. R. Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YT UK
| | - David Craufurd
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL UK
- Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL UK
| | - Alistair Smith
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YT UK
| | - Rhys Davies
- The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool, L9 7LJ UK
| | - Kristian Glenny
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YT UK
| | - Max Homberger
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YT UK
| | - Siofra Peeren
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL UK
- Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL UK
| | - Dawn Rogers
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL UK
- Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL UK
| | - Leona Rose
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YT UK
| | - Zara Skitt
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL UK
- Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL UK
| | - Rachael Theed
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YT UK
| | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YT UK
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Dindo LN, Recober A, Calarge CA, Zimmerman BM, Weinrib A, Marchman JN, Turvey C. One-Day Acceptance and Commitment Therapy Compared to Support for Depressed Migraine Patients: a Randomized Clinical Trial. Neurotherapeutics 2020; 17:743-753. [PMID: 31863406 PMCID: PMC7283406 DOI: 10.1007/s13311-019-00818-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
In patients with migraine, depression is associated with poorer medical prognosis, decreased quality of life, and increased risk of suicidality and disability; yet, behavioral interventions have rarely been investigated. The current study compared the efficacy of two 1-day (5- to 6-h) interventions for co-occurring migraine and depression: (1) acceptance and commitment therapy plus migraine education (ACT-ED), and (2) support plus migraine education (S-ED). One hundred and thirty-six patients with comorbid depression and migraine were randomized to a treatment. One hundred and three (76%) completed the ACT-ED (N = 56) or S-ED (N = 47) workshop. Primary outcomes were depression diagnosis and symptoms. Secondary outcomes were anxiety symptoms, headache-related disability and general functioning, and quality of life. Assessments were completed at baseline and 3 and 6 months following the workshop. At the 6-month follow-up, on categorical outcomes, a significantly greater number of people in the ACT-ED condition no longer met criteria for a major depressive episode and exhibited a > 50% drop in symptoms on the Hamilton Rating Scale of Depression. Similarly, though, weaker results were found when examining depressive symptoms dimensionally. On secondary outcomes, people in the ACT-ED condition exhibited significantly greater improvements in anxiety, headache-related disability, and quality of social relationships, compared to S-ED, No differences between groups were observed in general functioning. A 1-day (5- to 6-h) ACT workshop can deliver substantial and lasting benefits to depressed migraineurs, over and above those provided by group support and education. This approach is an attractive alternative to weekly psychotherapy. Clinicaltrials.gov # NCT02108678.
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Affiliation(s)
- Lilian N Dindo
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Holcombe, Houston, TX, 77030, USA.
- Department of Internal Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA.
| | - Ana Recober
- University of Pennsylvania & the Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Chadi A Calarge
- Department of Internal Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | | | - Aliza Weinrib
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - James N Marchman
- Department of Psychology, University of Iowa, Iowa City, IA, USA
| | - Carolyn Turvey
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
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Barkowski S, Schwartze D, Strauss B, Burlingame GM, Rosendahl J. Efficacy of group psychotherapy for anxiety disorders: A systematic review and meta-analysis. Psychother Res 2020; 30:965-982. [DOI: 10.1080/10503307.2020.1729440] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Sarah Barkowski
- Institute of Psychosocial Medicine and Psychotherapy, Friedrich-Schiller University, Jena University Hospital, Jena, Germany
| | - Dominique Schwartze
- Institute of Psychosocial Medicine and Psychotherapy, Friedrich-Schiller University, Jena University Hospital, Jena, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine and Psychotherapy, Friedrich-Schiller University, Jena University Hospital, Jena, Germany
| | | | - Jenny Rosendahl
- Institute of Psychosocial Medicine and Psychotherapy, Friedrich-Schiller University, Jena University Hospital, Jena, Germany
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Osma J, Suso-Ribera C, Peris-Baquero Ó, Gil-Lacruz M, Pérez-Ayerra L, Ferreres-Galan V, Torres-Alfosea MÁ, López-Escriche M, Domínguez O. What format of treatment do patients with emotional disorders prefer and why? Implications for public mental health settings and policies. PLoS One 2019; 14:e0218117. [PMID: 31181100 PMCID: PMC6557569 DOI: 10.1371/journal.pone.0218117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/25/2019] [Indexed: 11/30/2022] Open
Abstract
Objective We analyzed the preference of three psychological intervention formats—individual, group, and online—in a sample of 267 patients with a primary diagnosis of emotional disorder in Spanish public mental health settings. Method We studied patients’ preferences considering sociodemographic characteristics, diagnoses, history of psychological treatments, number of sessions, and satisfaction with past interventions. Results Most participants (85.4%) preferred psychological treatment in an individual format, 14.2% in group, and 0.4% online. When comparing the people who chose individual and group treatment, no demographic or clinical differences were found. The arguments against group format were the lack of privacy and expression difficulties. Regarding online format, these included being considered impersonal and ineffective. Conclusion The rejection of group and online psychotherapy formats allows us to define the actions we should carry out in public mental health settings to improve the acceptance of more cost-effective therapy formats.
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Affiliation(s)
- Jorge Osma
- Departamento de psicología y sociología, Universidad de Zaragoza, Teruel, Spain
- Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain
- * E-mail:
| | - Carlos Suso-Ribera
- Departamento de psicología básica, clínica y psicobiología, Universitat Jaume I, Castellón, Spain
| | | | - Marta Gil-Lacruz
- Departamento de psicología y sociología, Universidad de Zaragoza, Teruel, Spain
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Shechtman Z, Vogel DL, Strass HA, Heath PJ. Stigma in help-seeking: the case of adolescents. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2016. [DOI: 10.1080/03069885.2016.1255717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Zipora Shechtman
- Department of Counseling and Human Development, Haifa University, Haifa, Israel
| | - David L. Vogel
- Department of Psychology, Iowa State University, Ames, IA, USA
| | - Haley A. Strass
- Department of Psychology, Iowa State University, Ames, IA, USA
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