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Rasch Analysis and Its Relevance to Psychosomatic Medicine. Rasch 分析及其与心身医学的相关性。
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-01-04 DOI: 10.1159/000535633
Kaj Sparle Christensen, Fiammetta Cosci, Danilo Carrozzino, Tom Sensky
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引用次数: 0
Acceptance and Commitment Therapy, Combined with Bedtime Restriction, versus Cognitive Behavioral Therapy for Insomnia: A Randomized Controlled Pilot Trial. 接受与承诺疗法结合睡前限制与认知行为疗法治疗失眠的比较:随机对照试验》。
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-02-28 DOI: 10.1159/000535834
Elisabeth Hertenstein, Ersilia Trinca, Carlotta L Schneider, Kristoffer D Fehér, Anna F Johann, Christoph Nissen

Introduction: Cognitive behavioral therapy for insomnia (CBT-I) is the current first-line treatment for insomnia. However, rates of nonresponse and nonremission are high and effects on quality of life are only small to moderate, indicating a need for novel treatment developments. We propose that Acceptance and Commitment Therapy (ACT) addresses core pathophysiological pathways of insomnia. ACT therefore has the potential to improve treatment efficacy when combined with bedtime restriction, the most effective component of CBT-I. The aim of this study was to compare the efficacy of ACT for insomnia combined with bedtime restriction (ACT-I) and CBT-I in improving insomnia severity and sleep-related quality of life.

Methods: Sixty-three patients with insomnia disorder (mean age 52 years, 65% female, 35% male) were randomly assigned to receive either ACT-I or CBT-I in a group format. The primary outcomes were insomnia severity (Insomnia Severity Index) and sleep-related quality of life (Glasgow Sleep Impact Index). Outcomes were assessed before randomization (T0), directly after treatment (T1), and at 6-month follow-up (T2).

Results: The results indicated significant, large pre-to-post improvements in both groups, for both primary and secondary outcomes. Improvements were maintained at the 6-month follow-up. However, there was no significant group by time interactions in linear mixed models, indicating an absence of differential efficacy. On a subjective treatment satisfaction scale, patients in the ACT-I group indicated significantly greater satisfaction with their improvement of several aspects of health including their energy level and work productivity.

Conclusions: The results suggest that ACT-I is feasible and effective, but not more effective than CBT-I for the improvement of insomnia severity and sleep-related quality of life. Future studies are needed to assess whether ACT-I is noninferior to CBT-I and to shed light on mechanisms of change in both treatments.

简介失眠认知行为疗法(CBT-I)是目前治疗失眠的一线疗法。然而,无应答率和不缓解率很高,对生活质量的影响也只是小到中等,这表明需要开发新的治疗方法。我们提出,接纳与承诺疗法(ACT)可解决失眠症的核心病理生理途径。因此,当接纳与承诺疗法与 CBT-I 最有效的组成部分--睡前限制相结合时,有可能提高治疗效果。本研究的目的是比较 ACT 治疗失眠结合限制就寝时间(ACT-I)和 CBT-I 在改善失眠严重程度和睡眠相关生活质量方面的疗效:63名失眠症患者(平均年龄52岁,65%为女性,35%为男性)被随机分配接受ACT-I或CBT-I小组治疗。主要结果是失眠严重程度(失眠严重程度指数)和睡眠相关生活质量(格拉斯哥睡眠影响指数)。结果在随机化前(T0)、治疗后(T1)和随访 6 个月(T2)进行评估:结果表明,在主要和次要结果方面,两组患者在治疗前和治疗后都有明显的大幅改善。在 6 个月的随访中,改善效果得以保持。然而,在线性混合模型中,组与组之间没有明显的时间交互作用,这表明疗效没有差异。在主观治疗满意度量表中,ACT-I 组患者对其健康状况改善的满意度明显更高,包括精力水平和工作效率:结果表明,在改善失眠严重程度和与睡眠相关的生活质量方面,ACT-I 是可行和有效的,但并不比 CBT-I 更有效。未来的研究需要评估 ACT-I 是否不逊于 CBT-I,并揭示两种疗法的改变机制。
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引用次数: 0
Oxytocin-Augmented Modular-Based Group Intervention for Loneliness: A Proof-Of-Concept Randomized Controlled Trial. 催产素增强模块化团体孤独干预:概念验证随机对照试验》。
IF 16.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-05-16 DOI: 10.1159/000538752
Ruben Berger, Rene Hurlemann, Simone Shamay-Tsoory, Alisa Kanterman, Maura Brauser, Jessica Gorni, Maike Luhmann, Elisabeth Schramm, Johannes Schultz, Alexandra Philipsen, Jana Lieberz, Dirk Scheele

Introduction: Loneliness poses a significant health problem and existing psychological interventions have shown only limited positive effects on loneliness. Based on preliminary evidence for impaired oxytocin signaling in trait-like loneliness, the current proof-of-concept study used a randomized, double-blind, placebo-controlled design to probe intranasal oxytocin (OT) as an adjunct to a short-term modular-based group intervention for individuals suffering from high trait-like loneliness (HL, UCLA Loneliness Scale ≥55).

Methods: Seventy-eight healthy HL adults (56 women) received five weekly group psychotherapy sessions. HL participants received OT or placebo before the intervention sessions. Primary outcomes were trait-like loneliness measured at baseline, after the intervention, and again at two follow-up time points (3 weeks and 3 months), and, assessed at each session, state loneliness (visual analog scale), perceived stress (Perceived Stress Scale, PSS-10), quality of life (World Health Organization Five Well-Being Index, WHO-5), and the therapeutic relationship (Group Questionnaire, GQ-D).

Results: The psychological intervention was associated with significantly reduced perceived stress and improved trait-like loneliness across treatment groups, which was still evident at the 3-month follow-up. OT had no significant effect on trait-like loneliness, quality of life, or perceived stress. However, compared to placebo, OT significantly facilitated the decrease in state loneliness within sessions and significantly improved positive bonding between the group members.

Conclusion: Despite significantly improved trait-like loneliness after the intervention, OT did not significantly augment this effect. Further studies are needed to determine optimal intervention designs to translate the observed acute effects of OT into long-term benefits.

引言孤独是一个严重的健康问题,现有的心理干预措施对孤独的积极影响有限。根据特质样孤独感中催产素信号受损的初步证据,目前的概念验证研究采用随机、双盲、安慰剂对照设计,探究鼻内催产素(OT)作为短期模块化团体干预的辅助手段,用于治疗高度特质样孤独感(HL,加州大学洛杉矶分校孤独感量表≥55)患者:78 名健康的 HL 成人(56 名女性)每周接受五次小组心理治疗。HL 参与者在干预课程前接受 OT 或安慰剂治疗。主要结果是在基线、干预后和两个随访时间点(3周和3个月)测量的特质孤独感,以及在每次治疗中评估的状态孤独感(视觉模拟量表)、感知压力(感知压力量表,PSS-10)、生活质量(世界卫生组织五项幸福指数,WHO-5)和治疗关系(团体问卷,GQ-D):结果:在各治疗组中,心理干预明显减轻了感知压力,改善了特质型孤独感,这在 3 个月的随访中仍很明显。心理治疗对特质型孤独感、生活质量或感知压力没有明显影响。然而,与安慰剂相比,加压疗法明显促进了疗程内状态孤独感的降低,并显著改善了小组成员之间的积极联系:结论:尽管干预后特质型孤独感有了明显改善,但加压疗法并没有明显增强这种效果。还需要进一步研究,以确定最佳干预设计,将观察到的加压疗法的急性效应转化为长期益处。
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引用次数: 0
The Role of Neurosciences in Clinical Interviewing. 神经科学在临床访谈中的作用。
IF 16.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-06-14 DOI: 10.1159/000539165
Stefano Pallanti
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引用次数: 0
Prevalence and Rapid Screen Method of Diagnostic Criteria for Psychosomatic Research Syndromes in Human Papillomavirus-Infected Patients. 人类乳头瘤病毒感染患者心身研究综合征诊断标准的流行率和快速筛查方法。
IF 16.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-06-26 DOI: 10.1159/000539471
Xuelian Cui, Lixin Ding, Yongjuan Xu, Xiaosong Yuan, Qiaoli Zhang, Chiara Rafanelli, Sara Gostoli, Zhiwei Liu, Jianxin Cao

Introduction: The early and rapid identification of psychosomatic symptoms is crucial to prevent harmful outcomes in patients with human papillomavirus (HPV) infection in busy comprehensive clinics. This study aimed to explore the prevalence and rapid screening method of the Diagnostic Criteria for Psychosomatic Research-revised (DCPR) syndromes in patients with HPV infection.

Methods: A total of 504 participants underwent a clinical assessment that included DCPR, Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), the Social Support Rating Scale (SSRS), the Simplified Coping Style Questionnaire (SCSQ), fear of disease, sociodemographic and clinical characteristics. The prevalence of DCPR syndromes and DSM-5 diagnoses were compared between the HPV-positive and negative patients using χ2 tests. We explored the rapid screen indicator through multiple logistic regression analyses of the participants' psychosocial factors, sociodemographic and clinical characteristics.

Results: The incidence of DCPR syndromes in HPV-positive patients (56.6%) was significantly greater than that in HPV-negative patients (17.3%) and DSM-5 diagnoses (8.5%) in the HPV-positive group. Health anxiety, irritable mood, type A behavior, and demoralization were the most common psychosomatic syndromes in HPV-positive patients. As the degree of fear increased from 0 to 5 to 10, the risk of DCPR increased from 1.27 (95% CI: 0.21-7.63) to 3.24 (score range: 1-5, 95% CI: 1.01-10.39) to 9.91 (score range: 6-10, 95% CI: 3.21-30.62) in the HPV-positive group.

Conclusion: The degree of fear, as an independent risk factor, could be used to quickly screen outpatients with a high risk of DCPR syndrome among women with HPV infection.

导言:在繁忙的综合门诊中,早期快速识别心身症状对于防止人类乳头瘤病毒(HPV)感染患者出现有害后果至关重要。本研究旨在探讨心身医学研究诊断标准修订版(DCPR)综合征在人乳头瘤病毒感染患者中的患病率和快速筛查方法:共有 504 名参与者接受了临床评估,评估内容包括 DCPR、《精神疾病诊断与统计手册》第五版(DSM-5)、社会支持评定量表(SSRS)、简化应对方式问卷(SCSQ)、疾病恐惧、社会人口学和临床特征。我们使用χ2检验比较了HPV阳性和阴性患者之间DCPR综合征和DSM-5诊断的患病率。我们通过对参与者的社会心理因素、社会人口学和临床特征进行多元逻辑回归分析,探讨了快速筛查指标:HPV阳性患者中DCPR综合征的发生率(56.6%)明显高于HPV阴性患者(17.3%),HPV阳性组中DSM-5诊断的发生率(8.5%)也明显高于HPV阴性组。健康焦虑、烦躁情绪、A 型行为和士气低落是 HPV 阳性患者最常见的心身综合征。随着恐惧程度从 0 到 5 到 10 的增加,HPV 阳性组的 DCPR 风险从 1.27(95% CI:0.21-7.63)增加到 3.24(评分范围:1-5,95% CI:1.01-10.39)到 9.91(评分范围:6-10,95% CI:3.21-30.62):恐惧程度作为一个独立的风险因素,可用于在感染 HPV 的妇女中快速筛查出 DCPR 综合征的高风险门诊患者。
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引用次数: 0
The Clinical Importance of Life Setting: A Tribute to Eugene S. Paykel, MD (1934-2023). 生活环境的临床重要性:向尤金-佩克尔医学博士(1934-2023)致敬。
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-01-19 DOI: 10.1159/000535668
Giovanni A Fava
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引用次数: 0
Neuropsychological Assessments of Cognitive Impairment in Major Depressive Disorder: A Systematic Review and Meta-Analysis with Meta-Regression. 重度抑郁症认知功能障碍的神经心理学评估:系统性回顾和元回归分析》(A Systematic Review and Meta-Analysis with Meta-Regression.
IF 16.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.1159/000535665
Taeho Greg Rhee, Sung Ryul Shim, Kevin J Manning, Howard A Tennen, Tyler S Kaster, Giacomo d'Andrea, Brent P Forester, Andrew A Nierenberg, Roger S McIntyre, David C Steffens

Introduction: Cognitive dysfunction or deficits are common in patients with major depressive disorder (MDD). The current study systematically reviews and meta-analyzes multiple domains of cognitive impairment in patients with MDD.

Methods: PubMed/MEDLINE, PsycINFO, Cochrane Library, Embase, Web of Science, and Google Scholar were searched from inception through May 17, 2023, with no language limits. Studies with the following inclusion criteria were included: (1) patients with a diagnosis of MDD using standardized diagnostic criteria; (2) healthy controls (i.e., those without MDD); (3) neuropsychological assessments of cognitive impairment using Cambridge Neuropsychological Test Automated Battery (CANTAB); and (4) reports of sufficient data to quantify standardized effect sizes. Hedges' g standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were used to quantify effect sizes of cognitive impairments in MDD. SMDs were estimated using a fixed- or random-effects models.

Results: Overall, 33 studies consisting of 2,596 subjects (n = 1,337 for patients with MDD and n = 1,259 for healthy controls) were included. Patients with MDD, when compared to healthy controls, had moderate cognitive deficits (SMD, -0.39 [95% CI, -0.47 to -0.31]). In our subgroup analyses, patients with treatment-resistant depression (SMD, -0.56 [95% CI, -0.78 to -0.34]) and older adults with MDD (SMD, -0.51 [95% CI, -0.66 to -0.36]) had greater cognitive deficits than healthy controls. The effect size was small among unmedicated patients with MDD (SMD, -0.19 [95% CI, -0.37 to -0.00]), and we did not find any statistical difference among children. Cognitive deficits were consistently found in all domains, except the reaction time. No publication bias was reported.

Conclusion: Because cognitive impairment in MDD can persist in remission or increase the risk of major neurodegenerative disorders, remediation of cognitive impairment in addition to alleviation of depressive symptoms should be an important goal when treating patients with MDD.

简介认知功能障碍或缺陷在重度抑郁障碍(MDD)患者中很常见。本研究对重度抑郁症患者认知功能障碍的多个领域进行了系统回顾和荟萃分析:方法:对 PubMed/MEDLINE、PsycINFO、Cochrane Library、Embase、Web of Science 和 Google Scholar 进行了检索,检索时间从开始到 2023 年 5 月 17 日,没有语言限制。符合以下纳入标准的研究均被纳入:(1) 使用标准化诊断标准确诊为 MDD 的患者;(2) 健康对照组(即无 MDD 的对照组);(3) 使用剑桥神经心理学测试自动化电池(CANTAB)对认知障碍进行神经心理学评估;(4) 有足够数据可量化标准化效应大小的报告。赫奇斯 g 标准化平均差 (SMD) 及相应的 95% 置信区间 (CI) 用于量化 MDD 认知障碍的效应大小。SMD采用固定效应或随机效应模型进行估算:共有 33 项研究纳入了 2,596 名受试者(MDD 患者为 1,337 人,健康对照组为 1,259 人)。与健康对照组相比,MDD 患者存在中度认知缺陷(SMD,-0.39 [95% CI,-0.47 至 -0.31])。在亚组分析中,与健康对照组相比,耐药抑郁症患者(SMD,-0.56 [95% CI,-0.78 至 -0.34])和老年多发性抑郁症患者(SMD,-0.51 [95% CI,-0.66 至 -0.36])的认知缺陷更大。在未服药的 MDD 患者中,效应大小较小(SMD,-0.19 [95% CI,-0.37 至 -0.00]),我们在儿童中未发现任何统计学差异。除反应时间外,我们在所有领域都发现了认知缺陷。未发现发表偏倚:由于 MDD 患者的认知障碍可能会在缓解期持续存在,或增加主要神经退行性疾病的风险,因此在治疗 MDD 患者时,除了缓解抑郁症状外,还应将缓解认知障碍作为一个重要目标。
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引用次数: 0
Abstracts ICPM World Congress 2024. 2024 年国际移徙大会世界大会摘要。
IF 16.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-08-26 DOI: 10.1159/000540400

Abstracts of the 27th ICPM World Congress in Tübingen September 2024.

2024 年 9 月在图宾根举行的第 27 届国际理论数学和应用数学中心世界大会摘要。
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引用次数: 0
Emerging Perspectives on Neuroprotection. 神经保护的新视角
IF 16.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-08-16 DOI: 10.1159/000540032
Gregor Hasler, Dragos Inta

Neuroprotection aims to safeguard neurons from damage caused by various factors like stress, potentially leading to the rescue, recovery, or regeneration of the nervous system and its functions [J Clin Neurosci. 2002;9(1):4-8]. Conversely, neuroplasticity refers to the brain's ability to adapt and change throughout life, involving structural and functional alterations in cells and synaptic transmission [Neural Plast. 2014;2014:541870]. Neuroprotection is a broad and multidisciplinary field encompassing various approaches and strategies aimed at preserving and promoting neuronal health. It is a critical area of research in neuroscience and neurology, with the potential to lead to new therapies for a wide range of neurological disorders and conditions. Neuroprotection can take various forms and may involve pharmacological agents, lifestyle modifications, or behavioral interventions. Accordingly, also the perspective and the meaning of neuroprotection differs due to different angles of interpretation. The primary interpretation is from the pharmacological point of view since the most consistent data come from this field. In addition, we will discuss also alternative, yet less considered, perspectives on neuroprotection, focusing on specific neuroprotective targets, interactions with surrounding microglia, different levels of neuroprotective effects, the reversive/adaptative dimension, and its use as anticipatory/prophylactic intervention.

神经保护的目的是保护神经元免受压力等各种因素的损害,从而可能导致神经系统及其功能的挽救、恢复或再生[J Clin Neurosci. 2002;9(1):4-8]。相反,神经可塑性指的是大脑在整个生命过程中的适应和变化能力,涉及细胞和突触传递的结构和功能改变[Neural Plast.2014;2014:541870]。神经保护是一个广泛的多学科领域,包括旨在保护和促进神经元健康的各种方法和策略。它是神经科学和神经病学的一个重要研究领域,有可能为多种神经系统疾病和病症带来新疗法。神经保护的形式多种多样,可能涉及药物、生活方式调整或行为干预。因此,神经保护的视角和含义也因解释角度的不同而不同。我们主要从药理学的角度进行解释,因为这一领域的数据最为一致。此外,我们还将讨论神经保护的其他视角(但考虑较少),重点关注特定的神经保护靶点、与周围小胶质细胞的相互作用、不同程度的神经保护效应、逆转/适应维度,以及其作为预期/预防性干预的用途。
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引用次数: 0
Nocebo and Placebo Effects and Their Implications in Psychotherapy. 安慰剂效应及其对心理治疗的影响。
IF 16.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-08-30 DOI: 10.1159/000540791
Winfried Rief, Marcel Wilhelm
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引用次数: 0
期刊
Psychotherapy and Psychosomatics
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