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Edinoff AN, Fort JM, Woo JJ, Causey CD, Burroughs CR, Cornett EM, Kaye AM, Kaye AD. Selective Serotonin Reuptake Inhibitors and Clozapine: Clinically Relevant Interactions and Considerations. Neurol Int 2021; 13:445-463. [PMID: 34564289 PMCID: PMC8482107 DOI: 10.3390/neurolint13030044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/29/2021] [Accepted: 08/12/2021] [Indexed: 12/21/2022] Open
Abstract
The monoamine hypothesis of depression attributes the symptoms of major depressive disorders to imbalances of serotonin, noradrenaline, and dopamine in the limbic areas of the brain. The preferential targeting of serotonin receptor (SERT) by selective serotonin reuptake inhibitors (SSRIs) has offered an opportunity to reduce the range of these side effects and improve patient adherence to pharmacotherapy. Clozapine remains an effective drug against treatment-resistant schizophrenia, defined as failing treatment with at least two different antipsychotic medications. Patients with schizophrenia who display a constellation of negative symptoms respond poorly to antipsychotic monotherapy. Negative symptoms include the diminution of motivation, interest, or expression. Conversely to the depressive symptomology of interest presently, supplementation of antipsychotics with SSRIs in schizophrenic patients with negative symptoms lead to synergistic improvements in the function of these patients. Fluvoxamine is one of the most potent inhibitors of CYP1A2 and can lead to an increase in clozapine levels. Similar increases in serum clozapine were detected in two patients taking sertraline. However, studies have been contradictory as well, showing no such increases, which are worrying. Clinicians should be aware that clozapine levels should be monitored with any coadministration with SSRIs.
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Affiliation(s)
- Amber N Edinoff
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Science Center Shreveport, 1501 Kings Hwy, Shreveport, LA 71103, USA
| | - Juliana M Fort
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Science Center Shreveport, 1501 Kings Hwy, Shreveport, LA 71103, USA
| | - Joshua J Woo
- School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA 71103, USA
| | - Christopher D Causey
- School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA 71103, USA
| | - Caroline R Burroughs
- School of Medicine, Louisiana State University Health Shreveport, Shreveport, LA 71103, USA
| | - Elyse M Cornett
- Department of Anesthesiology, Louisiana State University Health Science Center Shreveport, Shreveport, LA 71103, USA
| | - Adam M Kaye
- Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Science Center Shreveport, Shreveport, LA 71103, USA
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De Nadai AS, Etherton JL. Beyond Efficacy and Effectiveness: Clinical Efficiency Is Necessary for Dissemination. J Cogn Psychother 2021; 35:221-231. [PMID: 34362861 DOI: 10.1891/jcpsy-d-20-00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nearly all patients interact with critical gatekeepers-insurance companies or centralized healthcare systems. For mental health dissemination efforts to be successful, these gatekeepers must refer patients to evidence-based care. To make these referral decisions, they require evidence about the amount of resources expended to achieve therapeutic gains. Without this information, a bottleneck to widespread dissemination of evidence-based care will remain. To address this need for information, we introduce a new perspective, clinical efficiency. This approach directly ties resource usage to clinical outcomes. We highlight how cost-effectiveness approaches and other strategies can address clinical efficiency, and we also introduce a related new metric, the incremental time efficiency ratio (ITER). The ITER is particularly useful for quantifying the benefits of low-intensity and concentrated interventions, as well as stepped-care approaches. Given that stakeholders are increasingly requiring information on resource utilization, the ITER is a metric that can be estimated for past and future clinical trials. As a result, the ITER can allow researchers to better communicate desirable aspects of treatment, and an increased focus on clinical efficiency can improve our ability to deliver high-quality treatment to more patients in need.
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Khaiyom JHA, Mukhtar F, Po OT. Treatments for Anxiety Disorders in Malaysia. Malays J Med Sci 2019; 26:24-36. [PMID: 31303848 PMCID: PMC6613468 DOI: 10.21315/mjms2019.26.3.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 09/15/2018] [Indexed: 12/18/2022] Open
Abstract
This current study aims to systematically review the treatments for anxiety disorders in Malaysia. PsycINFO, MEDLINE databases, and 28 local journals were used to search published papers in this area. Eight articles were subjected to review after excluding 273 papers that did not meet the inclusion criteria. A total of 598 participants with various types of anxiety disorders were included in the review. Based on the findings, the combination of pharmacotherapy and psychotherapy provided better treatment outcomes if compared to psychotherapy or pharmacotherapy alone. The combination of selective serotonin reuptake inhibitors and cognitive behaviour therapy was considered as one of the most effective treatment to treat patients with anxiety disorders in Malaysia. This is in line with the clinical practice guidelines from the Ministry of Health Singapore and Canada. Even though there were some limitations in the methodology and reporting of the results, it can be concluded that efforts have been taken to conduct studies related to treatments for patients with anxiety disorders in Malaysia. Future studies are suggested to make conscious efforts to overcome these limitations.
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Affiliation(s)
| | - Firdaus Mukhtar
- Department of Psychiatry, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Oei Tian Po
- School of Psychology and CBT Unit, Toowong Hospital, University of Queensland, Brisbane, St Lucia QLD, Australia.,Department of Psychology, James Cook University, 149 Sims Drive, Singapore
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van Vliet NI, Huntjens RJC, van Dijk MK, de Jongh A. Phase-based treatment versus immediate trauma-focused treatment in patients with childhood trauma-related posttraumatic stress disorder: study protocol for a randomized controlled trial. Trials 2018; 19:138. [PMID: 29471855 PMCID: PMC5824601 DOI: 10.1186/s13063-018-2508-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 01/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The treatment of posttraumatic stress disorder (PTSD) related to a history of sexual and/or physical abuse in childhood is the subject of international debate, with some favouring a phase-based approach as their preferred treatment, while others argue for immediate trauma-focused treatment. A history of (chronic) traumatisation during childhood has been linked to the development of distinct symptoms that are often labelled as symptoms of complex PTSD. Many therapists associate the presence of symptoms of complex PTSD with a less favourable treatment prognosis. The purpose of this study is to determine whether a phase-based approach is more effective than stand-alone trauma-focused therapy in individuals with PTSD and possible symptoms of complex PTSD resulting from a history of repeated sexual and/or physical abuse in childhood. An additional aim is to investigate moderators, predictors of treatment (non) response and drop-out. METHOD The sample consists of patients between 18 and 65 years old with a diagnosis of PTSD who report a history of repeated sexual and/or physical abuse in childhood (N = 122). Patients will be blindly allocated to either 16 sessions of eye movement desensitization and reprocessing (EMDR) therapy preceded by a stabilization phase (eight sessions of Skills Training in Affect and Interpersonal Regulation (STAIR)) or only 16 sessions of EMDR therapy. Assessments are carried out pre-treatment, after every eighth session, post-treatment, and at 3 and 6 months follow up. The main parameter will be the severity of PTSD symptoms (PTSD Symptoms Scale-Self Report). Secondary outcome variables are the presence of a PTSD diagnosis (Clinician-Administered PTSD Scale for DSM-5), severity of complex PTSD symptoms (Structured Interview for Disorders of Extreme Stress-Revised and symptoms-specific questionnaires), changes in symptoms of general psychopathology (Brief Symptom Inventory), and quality of life (Euroqol-5D). Health care consumption and productivity loss in patients will also be indexed. DISCUSSION The study results may help to inform the ongoing debate about whether a phase-based approach has added value over immediate trauma-focused therapy in patients suffering from PTSD due to childhood abuse. Furthermore, the results will contribute to knowledge about the safety, efficacy, and cost-effectiveness of treatments in this target group. TRIAL REGISTRATION Nederlands Trialregister, NTR5991 . Registered on 23 august 2016. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5991.
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Affiliation(s)
- Noortje I. van Vliet
- Department for Anxiety and Mood Disorders, Dimence Mental Health Group, Deventer, the Netherlands
| | - Rafaele J. C. Huntjens
- Department of Experimental Psychotherapy and Psychopathology, University of Groningen, Groningen, the Netherlands
| | - Maarten K. van Dijk
- Department for Anxiety and Mood Disorders, Dimence Mental Health Group, Deventer, the Netherlands
| | - Ad de Jongh
- Department of Social Dentistry and Behavioral Sciences, University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
- School of Health Sciences, Salford University, Manchester, UK
- Institute of Health and Society, University of Worcester, Worcester, UK
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CONCEPTUALIZATIONS OF THE SOCIETAL PERSPECTIVE WITHIN ECONOMIC EVALUATIONS: A SYSTEMATIC REVIEW. Int J Technol Assess Health Care 2017. [PMID: 28641592 DOI: 10.1017/s0266462317000526] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The aim of this study was to investigate how the societal perspective is conceptualized in economic evaluations and to assess how intersectoral costs and benefits (ICBs), that is, the costs and benefits pertaining to sectors outside the healthcare sector, impact their results. METHODS Based on a search in July 2015 using PubMed, Embase, CINAHL, and PsychINFO, a systematic literature review was performed for economic evaluations which were conducted from a societal perspective. Conceptualizations were assessed in NVivo version 11 using conventional and directed content analysis. Trial-based evaluations in the fields of musculoskeletal and mental disorders were analyzed further, focusing on the way ICBs impact the results of economic evaluations. RESULTS A total of 107 studies were assessed, of which 74 (69.1 percent) provided conceptualizations of the societal perspective. These varied in types of costs included and in descriptions of cost bearers. Labor productivity costs were included in seventy-two studies (67.3 percent), while only thirty-eight studies (35.5 percent) included other ICBs, most of which entailed informal care and/or social care costs. ICBs within the educational and criminal justice sectors were each included five times. Most of the trial-based evaluations analyzed further (n = 21 of 28) reported productivity costs. In nine, these took up more than 50 percent of total costs. In several studies, criminal justice and informal care costs were also important. CONCLUSIONS There is great variety in the way the societal perspective is conceptualized and interpreted within economic evaluations. Use of the term "societal perspective" is often related to including merely productivity costs, while other ICBs could be relevant as well.
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Ophuis RH, Lokkerbol J, Heemskerk SCM, van Balkom AJLM, Hiligsmann M, Evers SMAA. Cost-effectiveness of interventions for treating anxiety disorders: A systematic review. J Affect Disord 2017; 210:1-13. [PMID: 27988373 DOI: 10.1016/j.jad.2016.12.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 10/17/2016] [Accepted: 12/12/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Anxiety disorders are highly prevalent mental disorders that constitute a major burden on patients and society. As a consequence, economic evaluations of the interventions have become increasingly important. However, no recent overview of these economic evaluations is currently available and the quality of the published economic evaluations has not yet been assessed. Therefore, the current study has two aims: to provide an overview of the evidence regarding the cost-effectiveness of interventions for anxiety disorders, and to assess the quality of the studies identified. METHODS A systematic review was conducted using PubMed, PsycINFO, NHS-EED, and the CEA registry. We included full economic evaluations on interventions for all anxiety disorders published before April 2016, with no restrictions on study populations and comparators. Preventive interventions were excluded. Study characteristics and cost-effectiveness data were collected. The quality of the studies was appraised using the Consensus on Health Economic Criteria. RESULTS Forty-two out of 826 identified studies met the inclusion criteria. The studies were heterogeneous and the quality was variable. Internet-delivered cognitive behavioural therapy (iCBT) appeared to be cost-effective in comparison with the control conditions. Four out of five studies comparing psychological interventions with pharmacological interventions showed that psychological interventions were more cost-effective than pharmacotherapy. LIMITATIONS Comparability was limited by heterogeneity in terms of interventions, study design, outcome and study quality. CONCLUSIONS Forty-two studies reporting cost-effectiveness of interventions for anxiety disorders were identified. iCBT was cost-effective in comparison with the control conditions. Psychological interventions for anxiety disorders might be more cost-effective than pharmacological interventions.
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Affiliation(s)
- Robbin H Ophuis
- Centre of Economic Evaluation, Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, The Netherlands; Department of Health Services Research, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands; Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Joran Lokkerbol
- Centre of Economic Evaluation, Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, The Netherlands; Rob Giel Research Center, University Medical Center Groningen, Groningen, The Netherlands.
| | - Stella C M Heemskerk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Anton J L M van Balkom
- Department of Psychiatry and EMGO+ Institute, VU University Medical Centre, GGZ inGeest, Amsterdam, The Netherlands.
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| | - Silvia M A A Evers
- Centre of Economic Evaluation, Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, The Netherlands; Department of Health Services Research, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
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Seki Y, Nagata S, Shibuya T, Yoshinaga N, Yokoo M, Ibuki H, Minamitani N, Kusunoki M, Inada Y, Kawasoe N, Adachi S, Yoshimura K, Nakazato M, Iyo M, Nakagawa A, Shimizu E. A feasibility study of the clinical effectiveness and cost-effectiveness of individual cognitive behavioral therapy for panic disorder in a Japanese clinical setting: an uncontrolled pilot study. BMC Res Notes 2016; 9:458. [PMID: 27717407 PMCID: PMC5055685 DOI: 10.1186/s13104-016-2262-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 09/29/2016] [Indexed: 01/27/2023] Open
Abstract
Background In Japan, cognitive behavioral therapy (CBT) for panic disorder (PD) is not well established. Therefore, a feasibility study of the clinical effectiveness and cost-effectiveness of CBT for PD in a Japanese clinical setting is urgently required. This was a pilot uncontrolled trial and the intervention consisted of a 16-week CBT program. The primary outcome was Panic Disorder Severity Scale (PDSS) scores. Quality of life was assessed using the EuroQol’s EQ-5D questionnaire. Assessments were conducted at baseline, 8 weeks, and at the end of the study. Fifteen subjects completed outcome measures at all assessment points. Results At post-CBT, the mean reduction in PDSS scores from baseline was −6.6 (95 % CI 3.80 to −9.40, p < 0.001) with a Cohen’s d = 1.77 (95 % CI 0.88–2.55). Ten (66.7 %) participants achieved a 40 % or greater reduction in PDSS. By calculating areas under the curve for EQ-5D index changes, we estimated that patients gained a minimum of 0.102 QALYs per 1 year due to the CBT. Conclusions This study demonstrated that individual CBT for PD may be useful in Japanese clinical settings but further randomized control trials are needed. Trial registration: UMIN-CTR UMIN000022693 (retrospectively registered)
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Affiliation(s)
- Yoichi Seki
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan. .,Research Center for Child Mental Development, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan.
| | - Shinobu Nagata
- Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takayuki Shibuya
- Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Naoki Yoshinaga
- Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan.,Organization for Promotion of Tenure Track, University of Miyazaki, Miyazaki, Japan
| | - Mizue Yokoo
- Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hanae Ibuki
- Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Noriko Minamitani
- Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | | | | | | | - Kensuke Yoshimura
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michiko Nakazato
- Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan.,Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan
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Inoue K, Kaiya H, Hara N, Okazaki Y. A discussion of various aspects of panic disorder depending on presence or absence of agoraphobia. Compr Psychiatry 2016; 69:132-5. [PMID: 27423353 DOI: 10.1016/j.comppsych.2016.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 05/20/2016] [Accepted: 05/21/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The quality of life of individuals with panic disorder and agoraphobia can be improved by the alleviation of agoraphobia. In other words, examining panic disorder in terms of whether agoraphobia is present is crucial. The current study examined panic disorder from this perspective. METHODS Subjects were 253 patients who met the diagnostic criteria for panic disorder (lifetime) according to the Mini International Neuropsychiatric Interview (MINI). Of those patients, 179 had agoraphobia and 74 did not. Statistical analysis was used to examine gender differences in the presence (or absence) of agoraphobia, comorbidities, and the effects of the presence of agoraphobia (severity, assessment of depression, assessment of anxiety, and personality) in these patients. RESULTS Results indicated gender differences in the presence (or absence) of agoraphobia. Compared to patients without agoraphobia, significantly more patients with agoraphobia were female (p<.001), and had a higher prevalence of comorbidities. Patients with agoraphobia had a higher suicide risk (p<.05), more hypomanic episodes (current) (p<.05), and more frequent episodes of social phobia (p<.05). In addition, patients with agoraphobia had more severe panic disorder and a higher level of neuroticism, sensitivity to anxiety, and trait anxiety [PDSS-J, P&A, NEO-N: p<.01, ASI, STAI (Trait Anxiety): p<.05]. CONCLUSIONS The current findings suggest that when treating a panic disorder, diagnosing the presence of agoraphobia is extremely important.
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Affiliation(s)
- Ken Inoue
- Department of Public Health, Gunma University Graduate School of Medicine, Gunma, Japan.
| | - Hisanobu Kaiya
- Warakukai Incorporated Medical Institution Nagoya Mental Clinic, Aichi, Japan
| | - Naomi Hara
- Department of Child Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yuji Okazaki
- Michinoo Hospital, Nagasaki, Japan; Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
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Nielsen SKK, Vangkilde S, Wolitzky-Taylor KB, Daniel SIF, Hageman I. An investigation of general predictors for cognitive-behavioural therapy outcome for anxiety disorders in a routine clinical setting. BMJ Open 2016; 6:e010898. [PMID: 27016248 PMCID: PMC4809100 DOI: 10.1136/bmjopen-2015-010898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Cognitive-behavioural therapy (CBT) is effective for treating anxiety disorders and is offered in most mental health services around the world. However, a relatively large number of patients with anxiety disorders do not benefit from CBT, experience relapses or drop out. Reliable predictors of treatment effects are lacking. The aim of this study is to investigate the predictive value of emotion regulation and attentional control for CBT outcome in a routine setting. METHODS AND ANALYSIS In this prospective and practice-based study, 112 patients with anxiety disorders referred for manual-based group CBT at two psychiatric outpatient clinics will be recruited. Emotion regulation, severity of anxiety and attentional control will be assessed with self-report measures and with an experimental computer-based attentional control task at baseline, post-treatment and at a 6-month follow-up. Emotion regulation will be measured with Difficulties in Emotion Regulation Questionnaire, severity of anxiety will be assessed with Beck Anxiety Inventory and attentional control will be measured with the self-report questionnaire, Attention Control Scale, and with an experimental computer-based attentional control task based on theory of visual attention. Data will be analysed using multilevel mixed-effects modelling. ETHICS AND DISSEMINATION The study is approved by the Danish National Ethical Board, the Department of Psychology Ethical Board, University of Copenhagen and by the Danish Data Protection Agency. Study findings will be disseminated through peer-reviewed journal publications and conference presentations. The Danish Committee System on Health Research Ethics has been notified about the project. TRIAL REGISTRATION NUMBER NCT02638363.
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Affiliation(s)
| | - Signe Vangkilde
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Kate B Wolitzky-Taylor
- Department of Psychiatry and Biobehavioral Sciences Semel Institute, University of California, California, USA
| | | | - Ida Hageman
- Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
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EMDR in the Treatment of Panic Disorder With Agoraphobia: A Case Description. JOURNAL OF EMDR PRACTICE AND RESEARCH 2016. [DOI: 10.1891/1933-3196.10.4.256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The results of preliminary research investigating the application of eye movement desensitization and reprocessing (EMDR) treatment in panic disorder and panic disorder with agoraphobia suggests that reprocessing of past traumas produces significant reduction of anxiety and consequently, remission from panic attacks and avoidance behavior. This article describes the case study of a 30-year-old working professional where EMDR treatment, used to target early childhood traumas, led to reduction in symptoms of panic disorder with agoraphobia. Panic attacks diminished after 17 sessions of EMDR treatment, which followed Leeds’s treatment model. Treatment gains were maintained 5 years after termination. The study shows the value of solid preparation work, and of addressing the current triggers and recent events, before targeting historical traumas. EMDR worked as a first-line treatment to resolving the roots of the panic attacks, suggesting that the resolution of traumatic childhood memories can make a significant difference to current symptoms of panic disorder with agoraphobia.
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