Psychotherapy and Psychosomatics最新文献

Introduction: Rapid symptom relief is crucial for individuals with emotional disorders. The current study aimed to determine whether facilitator-supported mindfulness-based self-help (MBSH) intervention as an adjunctive treatment could provide rapid improvement for individuals with emotional disorders.

Methods: A practice-oriented randomized controlled trial was conducted on a sample of 302 patients with emotional disorders from four centers. Participants were randomly assigned to either MBSH+TAU (treatment as usual; n = 152) or TAU-only group (n = 150). Assessments were conducted at baseline, week 3, week 5, immediately after intervention and at a 3-month follow-up. Primary outcomes included self-reported and clinician-reported anxiety and depression symptoms. Secondary outcomes included mindfulness, physical symptoms, perceived stress, sleep quality, and inner peace.

Results: The MBSH+TAU group achieved significantly greater improvements in all primary and secondary outcome measures as compared with TAU-only immediately after intervention (Cohen's d = 0.19-0.51). In addition, relatively greater improvements were observed in self-reported depression, mindfulness, physical symptoms, perceived stress, and inner peace as early as week 3 or 5, which were sustained at the 3-month follow-up (Cohen's d = 0.20-0.34).

Conclusions: Facilitator-supported MBSH offers a scalable and effective adjunctive treatment option for patients with emotional disorders in clinical practice, facilitating rapid improvements.

Introduction: Impairments in social cognition in bipolar disorder (BD) have been extensively described in the last decade but few treatment strategies have been studied to address this issue. This study presents findings from a randomized controlled trial (RCT) investigating the efficacy of metacognitive training for bipolar disorder (MCT-BD) compared to Treatment as Usual (TAU) among individuals with BD in remission. The aim was to determine whether MCT-BD could improve social cognition and overall functioning in this population.

Methods: Participants (N = 56) were recruited via social media and an internal database at the University of São Paulo Medical School. Inclusion criteria included a confirmed BD diagnosis, current state of remission, and the presence of social functioning impairments. Exclusion criteria included any impairments that could hinder neuropsychological testing. Patients were randomly assigned to either MCT-BD or TAU, with assessments conducted at baseline and follow-up. The MCT-BD program consisted of nine sessions.

Results: The overall attendance rate across all MCT-BD intervention sessions was 96.6%. The MCT-BD program demonstrated added value in improving social cognition, specifically in emotion recognition reaction time. However, no significant changes were found in theory of mind, psychosocial functioning, or quality of life.

Conclusion: This RCT provides preliminary evidence for the efficacy of MCT-BD in improving emotion recognition latency, emphasizing the importance of targeted interventions in social cognition outcomes for individuals with BD. The study's strengths include high completion rates and comprehensive cognitive assessments. Future studies should explore long-term effects and personalized treatment approaches aiming to improve social-cognitive deficits in this population.

Introduction: Many studies have demonstrated that social anxiety disorder (SAD) can be effectively treated with psychotherapy, particularly cognitive-behavioral therapy (CBT), including internet-based CBT (ICBT). Despite evidence-based treatments, many individuals do not sufficiently benefit from them. Identifying the active components could help improve the effectiveness of SAD treatment. This study tested the effects of four treatment components (psychoeducation, cognitive restructuring, attention training, and exposure) within ICBT for SAD to investigate its active components.

Methods: This randomized full factorial trial consisted of four factors (i.e., treatment components) and 16 conditions. A total of 464 adults with a diagnosed SAD were recruited from the community. The primary outcome was SAD symptoms at 8 weeks (post-assessment). Secondary outcomes included SAD diagnosis, SAD symptoms at follow-up (4 months after post), depression and anxiety symptoms, quality of life, client satisfaction, and adverse effects.

Results: Conditions including psychoeducation and exposure were significantly more effective in reducing SAD symptoms at post compared to conditions without these components. Conditions including cognitive restructuring and attention training did not show superiority over conditions without them at post. However, all treatment conditions significantly reduced symptoms compared to the condition without a treatment component. At follow-up, the superiority of psychoeducation and exposure was not significant anymore due to the version without the respective components catching up.

Conclusion: The findings suggest that while all treatment components of ICBT for SAD are beneficial compared to no treatment, psychoeducation and exposure include specific active components that significantly improve treatment outcomes more quickly in ICBT for SAD.

Introduction: Communication between medical staff and patients about treatment efficacy elicits expectations of benefit and improves treatment outcomes. While demonstrated in multiple studies via different research methodologies, uniform communication protocols have not been adopted in clinical practice. Here, we summarize the results of two sister studies aimed at bridging this gap.

Methods: Women undergoing C-section (study 1, randomized controlled trial) and patients undergoing general or otolaryngologic surgeries (study 2, control group design) were recruited and assigned to the "regular communication" (RC) or "enhanced communication" (EC) arms. The EC arm received positive information about treatment, while the RC arm received no such information. In both studies, the primary outcome was change in pain intensity; in study 2, an additional outcome was morphine consumption.

Results: Eighty women successfully completed study 1, and 102 patients successfully completed study 2. In both studies, significant time*group interactions were observed (p < 0.001). The analgesic effect was virtually twice as large in the EC arm compared to the RC arm. In study 2, in the last two timepoints of assessment, participants in the EC arm also consumed fewer doses of opioids than participants in the RC arm (p < 0.001). No significant differences were found in vital signs.

Conclusions: We provide ecological evidence that positive information about treatment significantly decreases pain and opioid consumption during routine clinical care. This study and others could encourage healthcare providers to harness the powerful effects of patients' expectations of benefit to improve analgesics outcomes and, potentially, the outcomes of other symptoms.