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Johnson E, Ismond K, Hyde A, Ezekowitz J, Wright G, Spiers J, Spence J, Thompson S, McNeely ML, Zheng Y, Round J, Tymchuk S, Lee-Baggley D, Isley S, Corrick S, Minckler H, Tandon P. eMPower: An online Mind-body wellness Program for adults living with chronic health conditions: A three-armed randomized controlled trial protocol. Contemp Clin Trials 2024; 145:107642. [PMID: 39079613 DOI: 10.1016/j.cct.2024.107642] [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: 04/12/2024] [Revised: 07/02/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Symptoms of depression and anxiety are prevalent among adults with chronic health conditions, contributing to reduced quality of life, morbidity, and mortality. Mind-body wellness interventions (i.e. psychology programming, mindful movement, breathwork, meditation) may impact mental health symptoms, with online delivery offering access and scalability. Whether online mind-body wellness interventions are effective in improving patient outcomes across a broad range of chronic conditions remains uncertain. METHODS This three-armed, pragmatic, randomized controlled trial will use a nested mixed methods approach to assess the effectiveness of an online mind-body wellness intervention (eMPower), offered at two levels of personnel support, on symptoms of anxiety and depression in adults with chronic health conditions. Inclusion criteria require a self-reported chronic condition and access to an internet-connected device. Eligible participants will be randomized 1:1:1 to [1] waitlist control; [2] eMPower; [3] eMPower + weekly 1-to-1 check-in. The primary analysis will compare the Hospital and Anxiety Depression Scale (HADS) total score between eMPower + weekly 1-to-1 check-in versus controls, with secondary and exploratory outcomes including HADS subscales, health-related quality of life, fatigue, program engagement, and frailty. CONCLUSION With online intervention delivery, a range of outcomes, mixed method evaluation, and automated intervention tracking, findings are anticipated to enhance our understanding of how individuals living with chronic health conditions engage with and are impacted by online mind-body wellness programming. Six hundred and fifty-six participants have been enrolled as of April 5, 2024, and 598 patients have completed 12-week follow-up.
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Affiliation(s)
- Emily Johnson
- Faculty of Medicine and Dentistry, Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta, Canada.
| | - Kathleen Ismond
- Faculty of Medicine and Dentistry, Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta, Canada.
| | - Ashley Hyde
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - Justin Ezekowitz
- Faculty of Medicine and Dentistry, Division of Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | - Gail Wright
- Canadian Primary Biliary Cholangitis (PBC) Society, 4936 Yonge St, North York, Ontario, Canada.
| | - Jude Spiers
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - John Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada.
| | - Stephanie Thompson
- Faculty of Medicine and Dentistry, Division of Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | - Margaret L McNeely
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | - Yinggan Zheng
- Faculty of Medicine and Dentistry, Division of Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | - Jeff Round
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
| | - Sarah Tymchuk
- Faculty of Medicine and Dentistry, Department of Psychiatry University of Alberta, Edmonton, Alberta, Canada.
| | - Dayna Lee-Baggley
- Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Serena Isley
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta, Canada.
| | - Shaina Corrick
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta, Canada.
| | - Holly Minckler
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta, Canada.
| | - Puneeta Tandon
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta, Canada.
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Chermahini MB, Eadie J, Agarwal A, Stephenson C, Malakouti N, Nikjoo N, Jagayat J, Jarabana V, Shirazi A, Kumar A, Gizzarelli T, Gutierrez G, Khan F, Patel C, Yang M, Omrani M, Alavi N. Comparing the Efficacy of Electronically Delivered Cognitive Behavioral Therapy (e-CBT) to Weekly Online Mental Health Check-Ins for Generalized Anxiety Disorder-A Randomized Controlled Trial: Comparaison de l'efficacité de la thérapie cognitivo-comportementale délivrée par voie électronique (e-TCC) aux contrôles hebdomadaires en ligne de santé mentale pour le trouble d'anxiété généralisée - un essai randomisé contrôlé. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024:7067437241261933. [PMID: 39033431 DOI: 10.1177/07067437241261933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is a prevalent anxiety disorder characterized by uncontrollable worry, trouble sleeping, muscle tension, and irritability. Cognitive behavioural therapy (CBT) is one of the first-line treatments that has demonstrated high efficacy in reducing symptoms of anxiety. Electronically delivered CBT (e-CBT) has been a promising adaptation of in-person treatment, showing comparable efficacy with increased accessibility and scalability. Finding further scalable interventions that can offer benefits to patients requiring less intensive interventions can allow for better resource allocation. Some studies have indicated that weekly check-ins can also lead to improvements in GAD symptoms. However, there is a lack of research exploring the potential benefits of online check-ins for patients with GAD. OBJECTIVE This study aims to investigate the effects of weekly online asynchronous check-ins on patients diagnosed with GAD and compare it with a group receiving e-CBT. METHODS Participants (n e-CBT = 45; n check-in = 51) with GAD were randomized into either an e-CBT or a mental health check-in program for 12 weeks. Participants in the e-CBT program completed pre-designed modules and homework assignments through a secure online delivery platform where they received personalized feedback from a trained care provider. Participants in the mental health check-in condition had weekly asynchronous messaging communication with a care provider where they were asked structured questions with a different weekly theme to encourage conversation. RESULTS Both treatments demonstrated statistically significant reductions in GAD-7-item questionnaire (GAD-7) scores over time, but when comparing the groups there was no significant difference between the treatments. The number of participants who dropped out and baseline scores on all questionnaires were comparable for both groups. CONCLUSIONS The findings support the effectiveness of e-CBT and mental health check-ins for the treatment of GAD.
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Affiliation(s)
- Melinaz Barati Chermahini
- Department of Public Health Sciences, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Jazmin Eadie
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
- Department of Psychology, Faculty of Arts and Sciences, Queen's University, Kingston, Ontario, Canada
| | - Anika Agarwal
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Callum Stephenson
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Niloufar Malakouti
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Niloofar Nikjoo
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Jasleen Jagayat
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Vineeth Jarabana
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | | | - Anchan Kumar
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Tessa Gizzarelli
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Gilmar Gutierrez
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Ferwa Khan
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Charmy Patel
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Megan Yang
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Mohsen Omrani
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
- OPTT Inc., Toronto, Ontario, Canada
| | - Nazanin Alavi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
- OPTT Inc., Toronto, Ontario, Canada
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Li Y, Zhang L. Efficacy of Cognitive Behavioral Therapy Combined with Pharmacotherapy Versus Pharmacotherapy Alone in Adult ADHD: A Systematic Review and Meta-Analysis. J Atten Disord 2024; 28:279-292. [PMID: 38084075 DOI: 10.1177/10870547231214969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND ADHD diagnosis rates are rising; however, currently, no effective treatment method that has been identified. This study compared the efficacy of CBT + M with M for adult ADHD. METHODS PubMed, Embase, WOS, and Cochrane Library databases were searched up to July 29, 2023. Literature screening and data analysis were conducted. RESULTS The six randomized controlled studies included. Meta-analysis showed that CBT + M was more effective than M in improving ADHD symptoms. Subgroup analysis showed developed countries significant in ADHD symptoms improvement. At the 3-month, CBT + M was superior to M, but at the 6 and 9 months, no statistically significant differences were observed. CONCLUSION CBT + M is more effective than M in improving adult ADHD symptoms and maintains an advantage for at least 3 months. It is recommended to intensifying CBT treatment after 3 months. Country and economy may influence results. Combined therapy for ADHD should be prioritized in developed countries.
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Affiliation(s)
- Yanxi Li
- Second School of Clinical Medicine, Baotou Medical College, Inner Mongolia University of Science & Technology, Baotou, Inner Mongolia, China
| | - Lina Zhang
- College of Humanities and International Education, Baotou Medical College, Inner Mongolia University of Science & Technology, Baotou, Inner Mongolia, China
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Rajasree Katta M, Prasad S, Tiwari A, Abdelgawad Abouzid MR, Mitra S. The effectiveness of cognitive-behavioral therapy for heart failure patients: a narrative review. J Int Med Res 2023; 51:3000605231198371. [PMID: 37694958 PMCID: PMC10498714 DOI: 10.1177/03000605231198371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 08/14/2023] [Indexed: 09/12/2023] Open
Abstract
Heart failure (HF) remains a major cause of morbidity, mortality and healthcare costs, despite available treatments. Psychological issues such as depression, anxiety and poor self-care are prevalent in HF patients. Such issues adversely affect patients' daily lives and increase hospitalization and mortality rates; therefore, effective approaches to address these are needed. Cognitive-behavioral therapy (CBT) has been proposed as potentially useful for psychological comorbidities in HF patients, but its efficacy is not well-established. This narrative review aimed to summarize the evidence on the effectiveness of CBT for HF patients. A search was conducted using PubMed and Google Scholar for randomized controlled trials (RCTs) on CBT for HF patients. Ten studies (nine RCTs and one case study) were included in the review. CBT was found to be an effective intervention for managing depression, anxiety, low quality of life, and impaired social and physical functioning in HF patients. The results suggest that CBT can improve psychological well-being and enhance the benefits of rehabilitation programs. Face-to-face CBT appears to be superior to conventional therapy and can be implemented in cardiac rehabilitation settings. Further research is needed to evaluate the efficacy of internet-based CBT for cardiac patients and identify factors that promote treatment adherence.
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Affiliation(s)
| | - Sakshi Prasad
- Faculty of Medicine, Vinnytsia National Medical University, Vinnytsya, Ukraine
| | - Atit Tiwari
- B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | | | - Saloni Mitra
- Bogomolets National Medical University, Kyiv, Ukraine
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Gilbert BJ, Lu C, Yom-Tov E. Tracking Population-Level Anxiety Using Search Engine Data: Ecological Study. JMIR Form Res 2023; 7:e44055. [PMID: 36947130 PMCID: PMC10131769 DOI: 10.2196/44055] [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: 11/04/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Anxiety disorders are the most prevalent mental disorders globally, with a substantial impact on quality of life. The prevalence of anxiety disorders has increased substantially following the COVID-19 pandemic, and it is likely to be further affected by a global economic recession. Understanding anxiety themes and how they change over time and across countries is crucial for preventive and treatment strategies. OBJECTIVE The aim of this study was to track the trends in anxiety themes between 2004 and 2020 in the 50 most populous countries with high volumes of internet search data. This study extends previous research by using a novel search-based methodology and including a longer time span and more countries at different income levels. METHODS We used a crowdsourced questionnaire, alongside Bing search query data and Google Trends search volume data, to identify themes associated with anxiety disorders across 50 countries from 2004 to 2020. We analyzed themes and their mutual interactions and investigated the associations between countries' socioeconomic attributes and anxiety themes using time-series linear models. This study was approved by the Microsoft Research Institutional Review Board. RESULTS Query volume for anxiety themes was highly stable in countries from 2004 to 2019 (Spearman r=0.89) and moderately correlated with geography (r=0.49 in 2019). Anxiety themes were predominantly long-term and personal, with "having kids," "pregnancy," and "job" the most voluminous themes in most countries and years. In 2020, "COVID-19" became a dominant theme in 27 countries. Countries with a constant volume of anxiety themes over time had lower fragile state indexes (P=.007) and higher individualism (P=.003). An increase in the volume of the most searched anxiety themes was associated with a reduction in the volume of the remaining themes in 13 countries and an increase in 17 countries, and these 30 countries had a lower prevalence of mental disorders (P<.001) than the countries where no correlations were found. CONCLUSIONS Internet search data could be a potential source for predicting the country-level prevalence of anxiety disorders, especially in understudied populations or when an in-person survey is not viable.
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Affiliation(s)
| | - Chunling Lu
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, MA, United States
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Galffy M, Bichler C, Mohr T, Egeter J, Neu L, Oberhammer M, Högl B, Deisenhammer EA, Sperner-Unterweger B, Hüfner K. Adhoc Setup of an Online Mental Health Self-Help Program During the COVID-19 Pandemic: Description of the Development and Implementation Processes and Analysis of Its Users’ and Usage Profiles. Front Psychol 2022; 13:853371. [PMID: 35936283 PMCID: PMC9350598 DOI: 10.3389/fpsyg.2022.853371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/24/2022] [Indexed: 12/20/2022] Open
Abstract
BackgroundThe COVID-19 pandemic hit Austria in March 2020. This led to a considerable reduction in outpatient psychiatric therapies. People with mental disorders as well as with newly emerging mental health issues found themselves with very limited treatment options. Within only a few days our hospital set up an online mental health self-help program which went online in its first version on the first day of the lockdown in Austria. The process of this development and implementation process alongside with the user’s and usage data for the program are presented here.MethodsA small core team initiated the development of the program on a low-budget basis and using mostly freely available digital resources. The program had to be free of costs for its users and easy to navigate. Each self-help module contains a text description of the topic, a self-rating questionnaire and several psychoeducational 2–5 min videos. These videos explain, e.g., interactions of mental stress and the immune system or the vicious circle of anxiety. Additional videos provide easy to learn techniques like breathing and relaxation exercises.ResultsWe illustrate the implementation of this program following the replicating effective program (REP) model. We provide a detailed description of the implementation process starting from a simple website to a smartphone-based application with registered user area and instantaneous reporting of self-rating questionnaire results to users. The described process could be used as a model for the setup of similar programs in a very short time. As an indicator of acceptance, we report 46,100 unique video views and 3,937 completed questionnaires in the first year of use. The most accessed videos were those on anxiety, relaxation and resilience. Analysis of the sociodemographic user data indicate that they were mostly young (< 45 years; 59.7%), females (77.5%) and previously mentally healthy individuals (74.5%). An example of the collected psychometric questionnaire data over time is given.ConclusionWe show that it is possible to set up an online mental health self-help program ad hoc and without extensive prior planning, which enabled us to dynamically respond to a new situation. We are now planning on keeping the program active for a longer period of time to supplement and expand traditional treatment settings also outside the COVID-19 pandemic.
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Affiliation(s)
- Matyas Galffy
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Carina Bichler
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Thomas Mohr
- Center for Cancer Research, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Jonas Egeter
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Leonie Neu
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Maria Oberhammer
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry I, Innsbruck Medical University, Innsbruck, Austria
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Eberhard A. Deisenhammer
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
- *Correspondence: Katharina Hüfner,
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Ahrens J, Shao R, Blackport D, Macaluso S, Viana R, Teasell R, Mehta S. Cognitive -behavioral therapy for managing depressive and anxiety symptoms after stroke: a systematic review and meta-analysis. Top Stroke Rehabil 2022; 30:368-383. [PMID: 35352629 DOI: 10.1080/10749357.2022.2049505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Post-stroke anxiety and depression can be disabling and result in impaired recovery. Cognitive-behavioral therapy (CBT) has been demonstrated to be effective for anxiety and depression; however, determining its efficacy among those with stroke is warranted. Our objectives to evaluate CBT for anxiety and depression post-stroke . METHODS This review was registered with PROSPERO (REG# CRD42020186324). Medline, PsycInfo, and EMBR Cochrane were used to locate studies published before May 2020, using keywords such as stroke and CBT. A study was included if: (1) interventions were CBT-based, targeting anxiety and/or depression; (2) participants experienced a stroke at least 3 months previous; (3) participants were at least 18 years old. Standardized mean differences ± standard errors and 95% confidence intervals were calculated, and heterogeneity was determined. The Cochrane Risk of Bias tool was used. RESULTS The search yielded 563 articles, of which 10 (N = 672) were included;6 were randomized controlled trials. Primary reasons for exclusion included: (1) wrong population (2) insufficient data provided for a meta-analysis; (3) wrongoutcomes. CBT showed large effects on reducing overall anxiety (SMD ± SE: 1.01 ± 0.32, p < .001) and depression (SMD ± SE: 0.95 ± 0.22, p < .000) symptoms at the end of the studies. CBT moderately maintained anxiety (SDM ± SE: 0.779 ± 0.348, p ˂.025) and depression (SDM ± SE: 0.622 ± 0.285, p ˂ .029) scores after 3-months. Limitations included small sample size, limited comparators, and lack of follow-up data. CONCLUSION The results of this meta-analysis provide substantial evidence for the use of CBTto manage post-stroke anxiety and depression.
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Affiliation(s)
- Jessica Ahrens
- Lawson Health Research Institute, Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
| | - Richard Shao
- Lawson Health Research Institute, Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
| | - Daymon Blackport
- Lawson Health Research Institute, Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
| | - Steven Macaluso
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, Canada
| | - Ricardo Viana
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, Canada
| | - Robert Teasell
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, Canada
| | - Swati Mehta
- Lawson Health Research Institute, Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, Canada
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Dificultades en la regulación emocional de pacientes con trastorno límite de personalidad atendidos en un centro de terapia dialéctico conductual de Medellín, Colombia. REVISTA IBEROAMERICANA DE PSICOLOGÍA 2022. [DOI: 10.33881/2027-1786.rip.15102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
La desregulación emocional puede expresarse de distinta manera en el trastorno límite de personalidad (TLP), posiblemente por la influencia del contexto cultural. El objetivo de este estudio fue caracterizar las dificultades en la regulación emocional en pacientes con TLP que consultan a un centro especializado en Terapia Dialéctico Conductual (DBT) en la ciudad de Medellín, Colombia. Se realizó un estudio de corte transversal con 54 pacientes, principalmente mujeres jóvenes, solteras y de estrato socioeconómico alto con TLP que ingresaron a tratamiento y se les aplicó la “Escala de Dificultades en la Regulación Emocional” (DERS). Se calcularon la mediana (M) y rango intercuartílico (RIQ) y valor de p con la U de Mann-Whitney y el tamaño del efecto (valor r). El puntaje total en la DERS fue alto (M=134; RIQ=117-142). Se encontraron diferencias entre hombres y mujeres, con un tamaño de efecto intermedio (Mmujer=135,5 versus Mhombre=119; p=0,047; r=-0,26). No se encontraron diferencias entre grupos etarios, pero las dificultades en la regulación emocional sí fueron diferentes en los pacientes que cursaban además con TDAH, ansiedad, depresión y ansiedad combinados, y trastorno bipolar. Esto indicaría que en pacientes de una ciudad de Colombia en tratamiento con DBT, las dificultades en la regulación emocional son altas y parecen ser mayores en las mujeres. La presencia de ansiedad, depresión, TDAH y trastorno bipolar podría influir en la intensidad de la desregulación emocional y en las facetas en la que se manifiesta, lo que sugiere alta variabilidad dentro del diagnóstico.
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Mourad G, Eriksson-Liebon M, Karlström P, Johansson P. The Effect of Internet-Delivered Cognitive Behavioral Therapy Versus Psychoeducation Only on Psychological Distress in Patients With Noncardiac Chest Pain: Randomized Controlled Trial. J Med Internet Res 2022; 24:e31674. [PMID: 35089153 PMCID: PMC8838599 DOI: 10.2196/31674] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/09/2021] [Accepted: 12/08/2021] [Indexed: 01/19/2023] Open
Abstract
Background Patients with recurrent episodes of noncardiac chest pain (NCCP) experience cardiac anxiety as they misinterpret the pain to be cardiac related and avoid physical activity that they think could threaten their lives. Psychological interventions, such as internet-delivered cognitive behavioral therapy (iCBT), targeting anxiety can be a feasible solution by supporting patients to learn how to perceive and handle their chest pain. Objective This study aims to evaluate the effects of a nurse-led iCBT program on cardiac anxiety and other patient-reported outcomes in patients with NCCP. Methods Patients with at least two health care consultations because of NCCP during the past 6 months, and who were experiencing cardiac anxiety (Cardiac Anxiety Questionnaire score ≥24), were randomized into 5 weeks of iCBT (n=54) or psychoeducation (n=55). Patients were aged 54 (SD 17) years versus 57 (SD 16) years and were mainly women (32/54, 59% vs 35/55, 64%). The iCBT program comprised psychoeducation, mindfulness, and exposure to physical activity, with weekly homework assignments. The primary outcome was cardiac anxiety. The secondary outcomes were fear of bodily sensations, depressive symptoms, health-related quality of life, and chest pain frequency. Intention-to-treat analysis was applied, and the patients were followed up for 3 months. Mixed model analysis was used to determine between-group differences in primary and secondary outcomes. Results No significant differences were found between the iCBT and psychoeducation groups regarding cardiac anxiety or any of the secondary outcomes in terms of the interaction effect of time and group over the 3-month follow-up. iCBT demonstrated a small effect size on cardiac anxiety (Cohen d=0.31). In the iCBT group, 36% (16/44) of patients reported a positive reliable change score (≥11 points on the Cardiac Anxiety Questionnaire), and thus an improvement in cardiac anxiety, compared with 27% of (13/48) patients in the psychoeducation group. Within-group analysis showed further significant improvement in cardiac anxiety (P=.04) at the 3-month follow-up compared with the 5-week follow-up in the iCBT group but not in the psychoeducation group. Conclusions iCBT was not superior to psychoeducation in decreasing cardiac anxiety in patients with NCCP. However, iCBT tends to have better long-term effects on psychological distress, including cardiac anxiety, health-related quality of life, and NCCP frequency than psychoeducation. The effects need to be followed up to draw more reliable conclusions. Trial Registration ClinicalTrials.gov NCT03336112; https://www.clinicaltrials.gov/ct2/show/NCT03336112
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Affiliation(s)
- Ghassan Mourad
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Magda Eriksson-Liebon
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Emergency Medicine in Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Patric Karlström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Internal Medicine, Ryhov County Hospital, Region Jönköping County, Jönköping, Sweden
| | - Peter Johansson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Internal Medicine in Norrköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Zhang W, Du Y, Yang X, Wang E, Fang J, Liu Z, Wu S, Liu Q, Hu Y. Comparative efficacy of face-to-face and internet-based cognitive behavior therapy for generalized anxiety disorder: A meta-analysis of randomized controlled trial. Front Psychiatry 2022; 13:832167. [PMID: 35966496 PMCID: PMC9366007 DOI: 10.3389/fpsyt.2022.832167] [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: 12/09/2021] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The study aimed to ascertain the comparative efficacy of these two forms on reducing anxiety scores of scales in patients with a generalized anxiety disorder (GAD) by examining the available evidence for face-to-face cognitive behavior therapy (CBT) and internet-based cognitive behavior therapy (ICBT). Moreover, this study attempted to determine whether ICBT can obtain similar benefits as CBT for GAD patients during coronavirus disease 2019 (COVID-19) due to the quarantine policy and the requirement of social distance. METHODS This meta-analysis was registered with the International Prospective Register of Systematic Reviews (PROSPERO) according to the guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement (registration number CRD42021241938). Therefore, a meta-analysis of randomized controlled trials (RCTs) examining CBT or ICBT was conducted in this study to treat GAD patients diagnosed with DMS-IV. The researchers searched PubMed, MEDLINE, Embase, PsycINFO, and the Cochrane Database of Systematic Reviews for relevant studies published from 2000 to July 5, 2022. Evidence from RCTs was synthesized by Review Manager 5.4 as mean difference (MD) for change in scores of scales through a random-effects meta-analysis. RESULTS A total of 26 trials representing 1,687 participants were pooled. The results demonstrated that ICBT and CBT were very close in the effect size of treating GAD (MD = -2.35 vs. MD = -2.79). Moreover, they still exhibited a similar response (MD = -3.45 vs. MD = -2.91) after studies with active control were removed. CONCLUSION Regarding the treatment of GAD, ICBT can achieve a similar therapeutic effect as CBT and could be CBT's candidate substitute, especially in the COVID-19 pandemic era, since the internet plays a crucial role in handling social space constraints. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=241938, identifier CRD42021241938.
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Affiliation(s)
- Wenle Zhang
- Department of Psychological Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,Department of Clinical Psychology, Capital Medical University, Beijing, China
| | - Yun Du
- Department of Psychological Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,Department of Clinical Psychology, Capital Medical University, Beijing, China
| | - Xiangyun Yang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Encong Wang
- Department of Psychological Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jiexin Fang
- Department of Psychological Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ziqi Liu
- School of Foreign Languages, Shanghai University, Shanghai, China
| | - Shanqian Wu
- Beijing Anding Hospital, Capital Medical University, Beijing, China.,Department of Psychiatry, Capital Medical University, Beijing, China
| | - Qinqin Liu
- Department of Clinical Psychology, Capital Medical University, Beijing, China.,Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yongdong Hu
- Department of Psychological Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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11
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Mercer Lindsay N, Chen C, Gilam G, Mackey S, Scherrer G. Brain circuits for pain and its treatment. Sci Transl Med 2021; 13:eabj7360. [PMID: 34757810 DOI: 10.1126/scitranslmed.abj7360] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Nicole Mercer Lindsay
- Department of Cell Biology and Physiology, UNC Neuroscience Center, Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.,Department of Biology, CNC Program, Department of Applied Physics, Stanford University, Stanford, CA 94305, USA
| | - Chong Chen
- Department of Cell Biology and Physiology, UNC Neuroscience Center, Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Gadi Gilam
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Sean Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Grégory Scherrer
- Department of Cell Biology and Physiology, UNC Neuroscience Center, Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.,New York Stem Cell Foundation-Robertson Investigator, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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12
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GENÇ M, TOLAN Ö. Okul Öncesi Dönemde Sık Görülen Psikolojik ve Gelişimsel Bozukluklarda Oyun Terapisi Uygulamaları. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2021. [DOI: 10.18863/pgy.757366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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13
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Khodarahimi S, Mirderikvand F, Amraei K. The Effect of a Psychotherapy Protocol on Dream Awareness in Adults With Generalized Anxiety Disorder. J Nerv Ment Dis 2021; 209:291-296. [PMID: 33476107 DOI: 10.1097/nmd.0000000000001292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT This study aimed to examine the effect of an Affective and Sensory Psychotherapy Protocol (ASPP) on dream awareness in adults with generalized anxiety disorder (GAD). For this purpose, 60 self-referred male and female adults were studied within a randomized clinical trial. The Generalized Anxiety Disorder 7-Item Scale and the Mannheim Dream Questionnaire were used at baseline, posttreatment, and 3-month follow-up. No significant difference was observed between patients in the experimental and control groups at baseline. Findings showed that patients in the experimental group had a significant increase in dream recall, attitude toward dreams, and the total dream score than individuals in the control group. However, no sex difference was observed in the results for within-subject and between-group effects in the current study. The present research supported the influence of an ASPP on dream awareness in adults with GAD.
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Affiliation(s)
- Siamak Khodarahimi
- Psychology Department, School of Literature and Humanities Sciences, Lorestan University, Khorramabad, Iran
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14
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Zhao MC, Yang K, Yang BH, Guo S, Wang YP, Zhang XW, Li HP. Prognosis of C4 dislocation with spinal cord injury following psychological intervention. J Int Med Res 2021; 49:3000605211004520. [PMID: 33823641 PMCID: PMC8033484 DOI: 10.1177/03000605211004520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/03/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate the effect of psychological intervention on the prognosis of patients with C4 dislocation and spinal cord injury. METHODS We investigated target patients admitted between 2010 and 2018. Patients' mental state, quality of life and neurological function at different time points were evaluated to examine the relationship between psychological intervention and recovery and prognosis of acute and critical spinal cord injury. RESULTS All patients showed improvements in clinical symptoms, neurological function and quality of life. Psychological intervention significantly improved Zung Self-Rating Anxiety Scale score, Zung Self-Rating Depression Scale score and SF-36 Mental Component Summary score within 3 months. Japanese Orthopaedic Association neurological function score and SF-36 Physical Component Summary score were significantly improved after 1-year follow-up. Psychological intervention did not improve 2-year survival. CONCLUSION Timely and professional psychological intervention can eliminate the psychological disorders of C4 dislocation patients with spinal cord injury. This has a positive effect on their quality of life and prognosis.
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Affiliation(s)
- Min-Chao Zhao
- Department of Orthopaedics, Second Affiliated Hospital of Xi’an
Jiaotong University, Xi’an, China
| | - Kai Yang
- Department of Orthopaedics, Second Affiliated Hospital of Xi’an
Jiaotong University, Xi’an, China
| | - Bao-Hui Yang
- Department of Orthopaedics, Second Affiliated Hospital of Xi’an
Jiaotong University, Xi’an, China
| | - Shuai Guo
- Department of Orthopaedics, Second Affiliated Hospital of Xi’an
Jiaotong University, Xi’an, China
| | - Ya-Ping Wang
- Department of Psychology and Psychiatry, Second Affiliated
Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiao-Wei Zhang
- Department of Orthopaedics, First Affiliated Hospital of Xi’an
Jiaotong University, Xi’an, China
| | - Hao-Peng Li
- Department of Orthopaedics, Second Affiliated Hospital of Xi’an
Jiaotong University, Xi’an, China
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15
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Effects of a psychological nursing intervention on prevention of anxiety and depression in the postpartum period: a randomized controlled trial. Ann Gen Psychiatry 2021; 20:2. [PMID: 33397393 PMCID: PMC7783989 DOI: 10.1186/s12991-020-00320-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/27/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Anxiety and postpartum depression are the most common psychological problems in women after delivery. Cognitive behavior intervention has been reported to have an effect in the therapy of postpartum depression. This research aimed to investigate whether cognitive behavior intervention could prevent the pathogenesis of postpartum depression in primiparous women. METHODS In this randomized controlled trial, primiparous women who were prone to postpartum depression were recruited. Participates in the control group received routine postpartum care and those in the intervention group received both routine postpartum care and cognitive behavior intervention. Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Edinburgh Postpartum Depression Scale (EPDS) and Pittsburgh Sleep Quality Index (PSQI) were evaluated before and after the intervention. RESULTS In the intervention group, the post-intervention scores of HAMA, HAMD, EPDS and PSQI were all significantly lower than the baseline scores (p = 0.034, p = 0.038, p = 0.004, p = 0.014, respectively). The proportion of participants with postpartum depression in the intervention group (11.5%) was significantly lower than the control group (24.3%) after the 6-week intervention. Participants in the intervention group were significantly more satisfied with the care than those in the control group (p = 0.032). CONCLUSION This research provided evidence that cognitive behavioral intervention in postpartum period could alleviate anxiety and depression in primiparous women, and inhibit the pathogenesis of postpartum depression. Trial registry This clinical trial was registered in the Chinese Clinical Trial Registry (ChiCTR2000040076).
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16
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Szejko N, Lombroso A, Bloch MH, Landeros-Weisenberger A, Leckman JF. Refractory Gilles de la Tourette Syndrome-Many Pieces That Define the Puzzle. Front Neurol 2020; 11:589511. [PMID: 33391155 PMCID: PMC7775596 DOI: 10.3389/fneur.2020.589511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/20/2020] [Indexed: 12/27/2022] Open
Abstract
Gilles de la Tourette syndrome (GTS) is a childhood onset neuropsychiatric disorder characterized by the presence of motor and vocal tics. The clinical spectrum of GTS is heterogeneous and varies from mild cases that do not require any medical attention to cases that are refractory to standard treatments. One of the unresolved issues is the definition of what constitutes treatment-refractory GTS. While for some other neuropsychiatric disorders, such as obsessive-compulsive disorder (OCD), a clear definition has been established, there is still no consensus with regard to GTS. One important issue is that many individuals with GTS also meet criteria for one or more other neurodevelopmental and neuropsychiatric disorders. In many individuals, the severity of these comorbid conditions contributes to the degree to which GTS is treatment refractory. The scope of this paper is to present the current state-of-the-art regarding refractory GTS and indicate possible approaches to define it. In closing, we discuss promising approaches to the treatment of individuals with refractory GTS.
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Affiliation(s)
- Natalia Szejko
- Division of Neurocritical Care & Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT, United States.,Department of Neurology, Medical University of Warsaw, Warsaw, Poland.,Department of Bioethics, Medical University of Warsaw, Warsaw, Poland
| | - Adam Lombroso
- Child Study Center, Departments of Psychiatry, Pediatrics and Psychology, Yale University, New Haven, CT, United States
| | - Michael H Bloch
- Child Study Center, Departments of Psychiatry, Pediatrics and Psychology, Yale University, New Haven, CT, United States
| | - Angeli Landeros-Weisenberger
- Child Study Center, Departments of Psychiatry, Pediatrics and Psychology, Yale University, New Haven, CT, United States
| | - James F Leckman
- Child Study Center, Departments of Psychiatry, Pediatrics and Psychology, Yale University, New Haven, CT, United States
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17
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Khodarahimi S, Mirderikvand F, Amraei K. The efficacy of affective and sensory psychotherapy module for sleep disturbances in generalized anxiety disorder. Explore (NY) 2020; 18:17-24. [PMID: 33309467 DOI: 10.1016/j.explore.2020.11.011] [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: 05/28/2020] [Revised: 11/27/2020] [Accepted: 11/29/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study was aimed to examine the effectiveness of a newly developed therapeutic method focusing on affective and sensory processes in the treatment of sleep problems in outpatients with Generalized Anxiety Disorder (GAD), called the 'Affective and Sensory Psychotherapy Module' (ASPM). METHOD A randomised controlled trial was conducted, there were 60 outpatient participants. The Generalized Anxiety Disorder 7-Item Scale (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI) were used at baseline, post-treatment, and 3 month follow-up. RESULTS There were no significant differences between the therapeutic and control groups at baseline. The therapeutic group showed a significant improvement in sleep quality and anxiety decrease compared to the control group. Sex differences did not occur in the results for within-subjects and between-group effects in this study. CONCLUSIONS The present study supported the efficacy of ASPM in the treatment of sleep problems in adult outpatients with GAD.
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Affiliation(s)
- Siamak Khodarahimi
- Psychology Department, School of Literature and Humanities Sciences, Lorestan University; Khorramabad, Iran
| | - Fazlolah Mirderikvand
- Psychology Department, School of Literature and Humanities Sciences, Lorestan University; Khorramabad, Iran.
| | - Kourosh Amraei
- Psychology Department, School of Literature and Humanities Sciences, Lorestan University; Khorramabad, Iran
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18
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da Silva ML, Rocha RSB, Buheji M, Jahrami H, Cunha KDC. A systematic review of the prevalence of anxiety symptoms during coronavirus epidemics. J Health Psychol 2020; 26:115-125. [PMID: 32830577 DOI: 10.1177/1359105320951620] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Coronavirus pandemics causes systemic and mainly pulmonary changes. We assessed the prevalence of generalized anxiety disorder (GAD) in pandemic survivors and the general population. Papers indexed by MEDLINE/PubMed, The Cochrane, Embase, Lilacs, Scielo, Psycoinfo, and Pepsic databases were searched to April 2020, using GAD and Coronavirus (CoV) infection as keywords. Sixteen studies with 25,779 participants in eight countries were included. A 46% pooled prevalence of anxiety symptoms (95% CI 33.9-58.2%) was found with significant evidence of between-study heterogeneity (Q = 154953, I2 = 99.99%, p < 0.001). Age and sex were not found to be significant moderators for anxiety symptoms. Intervention programs for anxiety symptoms are highly recommended.
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Affiliation(s)
| | | | - Mohamed Buheji
- International Institutes of Inspiration Economy, Riffa, Bahrain
| | - Haitham Jahrami
- Ministry of Health, Kingdom of Bahrain, Manama, Bahrain.,College of Medicine and Medical Sciences, Arabian Gulf University, Kingdom of Bahrain, Manama, Bahrain
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19
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Li Z, Liu Y, Wang J, Liu J, Zhang C, Liu Y. Effectiveness of cognitive behavioural therapy for perinatal depression: A systematic review and meta-analysis. J Clin Nurs 2020; 29:3170-3182. [PMID: 32563204 DOI: 10.1111/jocn.15378] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/24/2020] [Accepted: 06/05/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To systematically review the efficacy of cognitive behavioural therapy for improving mood in perinatal depression. BACKGROUND The impact of cognitive behavioural therapy on perinatal depression has been evaluated in various studies, but there is uncertainty about their impact. DESIGN Systematic review and meta-analysis. METHODS Nine electronic literature databases were searched to retrieve eligible randomised controlled trials: CNKI, VIP digital database, Chinese Wanfang database, the Cochrane library, PubMed, Web of science, EMBASE, PsycINFO, CINAHL from the inception of the databases up to 15 November 2019. The eligible studies were screened and extracted, and then, the methodological quality was evaluated independently by two researchers. The meta-analyst software (Rev Man 5.3) was used to conduct the meta-analysis. Checklist of Preferred Reporting Items for Systematic Reviews and Meta-analyses has been followed. RESULTS Thirteen RCTs with 966 participants were included. The results showed that the CBT group was superior to the usual care group in reducing depression symptoms of pregnant women after treatment immediately, and the difference was statistically significant. Similarly, at postpartum (<4 months), the results showed that the CBT group was superior to the usual care group in improving depression symptoms of pregnant women. However, there was no statistical difference at postpartum (>4 months). CONCLUSIONS Cognitive behavioural therapy can effectively relieve the symptoms of depression at short-term effect. However, its long-term effect need to be verified by further clinical studies. RELEVANCE TO CLINICAL PRACTICE This meta-analysis suggested that cognitive behavioural therapy should be considered as a complementary programme for patients with perinatal depression. Medical workers could apply cognitive behavioural therapy into daily routine cares for perinatal depression.
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Affiliation(s)
- Zimeng Li
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ying Liu
- Department of Cardiology, Wuxi people's Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Jiayao Wang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jia Liu
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chunmei Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yanhui Liu
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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20
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Orvati Aziz M, Mehrinejad SA, Hashemian K, Paivastegar M. Integrative therapy (short-term psychodynamic psychotherapy & cognitive-behavioral therapy) and cognitive-behavioral therapy in the treatment of generalized anxiety disorder: A randomized controlled trial. Complement Ther Clin Pract 2020; 39:101122. [PMID: 32379661 DOI: 10.1016/j.ctcp.2020.101122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 01/26/2020] [Accepted: 02/20/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND and purpose: Cognitive-behavioral therapy and psychodynamic psychotherapy are common psychotherapies used for mental disorders. The purpose of the present article was to achieve an integration of cognitive-behavioral therapy and short-term psychodynamic psychotherapy that enjoys simultaneously the effects of cognitive-behavioral therapies and the stability of short-term psychodynamic psychotherapies. MATERIALS AND METHODS It was a pre-test/post-test experimental study. Selected based on a purposive non-probabilistic sampling method, the sample studied here consisted of 36 people diagnosed with generalized anxiety according to Clinical Diagnostic Interview, psychiatrist diagnosis and Hamilton Rating Scale for Anxiety (HRSA). They were divided randomly into three 12 person groups: two treated groups by integrative therapy and cognitive-behavioral therapy, and one control group. Only pre-test and post-test were employed for the control group without any kind of treatment. To select patients and evaluate the effects of each type of treatments, the "Hamilton Rating Scale for Anxiety" and "Beck Depression Inventory" were applied for the pre-test/post-test and the differential diagnosis, respectively. The results obtained were analyzed by covariance and ANOVA analyses using SPSS software. RESULTS The results of the study indicate the efficacy of both cognitive-behavioral therapy and integrative therapy in the treatment of generalized anxiety and integrative therapy was more effective in the treatment of generalized anxiety compared to cognitive-behavioral therapy. CONCLUSION Integrative treatment not only to be effective in the treatment of generalized anxiety disorder and the reduction of its symptoms, but also to be more effective than cognitive-behavioral therapy.
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Affiliation(s)
- Marzieh Orvati Aziz
- Faculty of Psychology and Educational Sciences, Alzahra University, Tehran, Iran.
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21
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Arndt A, Rubel J, Berger T, Lutz W. Outpatient and self-referred participants: Adherence to treatment components and outcome in an internet intervention targeting anxiety disorders. Internet Interv 2020; 20:100319. [PMID: 32346518 PMCID: PMC7178477 DOI: 10.1016/j.invent.2020.100319] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/14/2020] [Accepted: 04/02/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE While adherence is an important factor influencing the effectiveness of internet interventions, many studies operationalize adherence only by the number of sessions and do not report adherence to specific treatment components. The goal of this study was to investigate adherence to treatment components as well as outcome in outpatients and self-referred participants who participated in an internet intervention targeting anxiety. METHOD Outpatients (N = 50) were compared to self-referred (N = 37) participants and a matched outpatient waitlist sample (based on nearest neighbor matching): Using t-test and χ2 tests adherence to treatment components based on the number of completed exercises was compared between participant groups. A 2 × 2 repeated measures ANOVA was used to compare pre-to post symptom change between participant groups. Primary measures included the Generalized Anxiety Disorder Scale-7 (GAD-7) and the Mini Social Phobia Inventory (Mini-SPIN). Using nonparametric bootstrap analyses number of sessions and adherence to treatment components were investigated as potential mediators of the relationship between participant group and outcome. Finally, predictors of adherence to treatment components in outpatient participants were investigated using LASSO and logistic regression. RESULTS Self-referred participants were more adherent than outpatient participants, however the groups did not differ significantly in outcome. Outpatient participants who adhered to relaxation showed greater improvement during the waiting period than the matched outpatient waitlist sample. The effect of participant group on outcome was mediated via adherence to exposure and number of sessions. CONCLUSIONS In internet interventions adherence to treatment components differs between participant groups and has a mediating effect on treatment outcome. Therefore, it should be fostered, especially when participants are not self-referred. In line with these findings more studies should investigate relevant participant characteristics in more depth.
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Affiliation(s)
- Alice Arndt
- Department of Clinical Psychology and Psychotherapy, University of Trier, Germany
| | - Julian Rubel
- Department of Psychotherapy Research, Justus-Liebig-University, Giessen, Germany
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Switzerland
| | - Wolfgang Lutz
- Department of Clinical Psychology and Psychotherapy, University of Trier, Germany,Corresponding author at: Department of Clinical Psychology and Psychotherapy, University of Trier, Am Wissenschaftspark 25+27, D-54286 Trier, Germany.
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Ma RC, Yin YY, Wang YQ, Liu X, Xie J. Effectiveness of cognitive behavioural therapy for chronic obstructive pulmonary disease patients: A systematic review and meta-analysis. Complement Ther Clin Pract 2019; 38:101071. [PMID: 31743870 DOI: 10.1016/j.ctcp.2019.101071] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 11/11/2019] [Accepted: 11/11/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND and purpose: Cognitive behavioural therapy (CBT) has gained increasing attention for the treatment of psychological disorders. This study aims to establish the effectiveness of CBT on psychological and physical outcomes in patients with chronic obstructive pulmonary disease (COPD). METHODS Two waves of electronic searches of the PubMed, Cochrane library, EMBASE, Web of Science and China National Knowledge Infrastructure databases were conducted. Statistical analyses were performed using Revman Manager 5.3 and Stata 12.0 software. RESULTS Sixteen randomized controlled trials were eligible. There were significant improvements in anxiety (SMD = -0.23; 95% CI: -0.42 to -0.04; P = 0.02), depression (SMD = -0.29, 95% CI: -0.40 to -0.19, P < 0.01), quality of life (MD = -5.21; 95% CI: -10.25 to -0.17; P = 0.04), and mean visits to emergency departments in the CBT groups. No statistically significant differences were observed in fatigue (SMD = 0.88, 95% CI: -0.58 to 2.35, P = 0.24), exercise capacity (MD = 28.75, 95% CI: -28.30 to 85.80, P = 0.32), self-efficacy (SMD = 0.15, 95% CI: -0.05 to 0.34, P = 0.14), or sleep quality (MD = 1.21, 95% CI: -0.65 to 3.06, P = 0.20). CONCLUSION This meta-analysis suggests that CBT can serve as a complementary therapy to improve anxiety, depression, and quality of life in COPD patients and deserves more widespread application in clinical practice.
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Affiliation(s)
- Rui-Chen Ma
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China
| | - Ying-Ying Yin
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China
| | - Ya-Qing Wang
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China
| | - Xin Liu
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China
| | - Jiao Xie
- School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China.
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Abstract
Six randomized controlled trials (RCTs) investigated the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for adults with anxiety disorders over a span of 20 years (1997–2017). Three RCTs focused on panic disorder, with or without agoraphobia (PDA); two studies targeted specific phobias, whereas the dependent variable of another RCT was “self-esteem,” considered as a mediator factor for anxiety disorders. In four RCTs, EMDR therapy demonstrated a positive effect on panic and phobic symptoms, whereas one RCT on PDA was partly negative and one study failed in improving self-esteem in patients with anxiety disorders. Considered as a whole, these preliminary data suggest EMDR therapy may be effective not only for PD but also for specific phobias. Further controlled studies are needed to corroborate these findings and also to systematically evaluate the efficacy of EMDR therapy for generalized anxiety disorder, social anxiety, and agoraphobia. Because cognitive behavioral therapy (CBT) is presently considered a first-line treatment for anxiety disorders, controlled comparisons between EMDR therapy and CBT would be especially useful in future investigations of EMDR treatment of anxiety disorders.
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Fernandes MA, Ribeiro HKP, Santos JDM, Monteiro CFDS, Costa RDS, Soares RFS. Prevalence of anxiety disorders as a cause of workers' absence. Rev Bras Enferm 2018; 71:2213-2220. [PMID: 30365786 DOI: 10.1590/0034-7167-2017-0953] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/21/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze the prevalence of various anxiety disorders among mental and behavioral disorders as a cause for the leave of absence of workers in the state of Piauí. METHOD transversal census-based study performed with data from the National Social Security Institute. Four-hundred twelve leaves of absence of workers due to anxiety disorders in the 2015-2016 biennium were included. RESULTS higher prevalence was found for mixed anxiety-depressed disorder (31.2%), followed by other anxious disorders (20.6%) and generalized anxiety (14.1%). Ages from 22 to 45 years old prevailed in the group of individuals with duration of absence greater than or equal to 41 days, with statistically significant difference (p < 0.001). There was no statistically significant association (p = 0.004) between rural activity and increased time of absence. CONCLUSION the study draws attention to the prevalence of "other anxiety disorders" as the cause of leave of absence, with emphasis on mixed anxiety-depressed disorder.
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