Sebastian Saur,Kiona K Weisel,Catharina Lang,Lukas M Fuhrmann,Niklas Meurer,Daniela Reichl,Mathias Zink,Peter Heepe,Thomas Hillemacher,Wolf-Dietrich Braunwarth,Peter Falkai,Gabriele Koller,Yaroslav Kiderman,Thomas Kraus,Johannes Kornhuber,Philipp Spitzer,Dominikus Bönsch,Mark Stemmler,Anja Hildebrand,Sabine Steins-Loeber,Matthias Berking
INTRODUCTIONRelapse rates in individuals with alcohol use disorder (AUD) are particularly high following inpatient treatment. Innovative strategies should specifically target the transitional gap between completion of inpatient treatment and uptake of standard continuing care. This study aimed to determine whether Appstinence, a digital approach that combines a smartphone app intervention with adjunct telephone coaching, more markedly reduces the risk of relapse for 6 months after inpatient AUD treatment in comparison to a control group with access to standard continuing care.METHODSIn this multicenter clinical trial, 356 participants were randomized to the intervention (n=175) or control group (n=181). Eligibility criteria included diagnosis of AUD, smartphone access, no acute suicidality, and no language or neurocognitive impairments. The primary outcome was risk of relapse within six months after randomization, as assessed with the Timeline-Follow-Back method. Secondary outcomes included uptake of standard continuing care, hazardous alcohol consumption, craving, depression and anxiety symptom severity, and well-being.RESULTSThe intervention reduced the risk of relapse within six months as indicated by a log-rank test (HR 0.72, 95% CI 0.53-0.98, p=0.04) and Cox regression adjusted for baseline characteristics (HR 0.67, 95% CI 0.48-0.92, p=0.01). This effect increased when participants fully adhered to the intervention protocol (log-rank test: HR 0.61, 95% CI 0.39-0.94, p=0.02). No significant differences were observed in secondary outcomes.CONCLUSIONOur findings provide supportive evidence for digital AUD transition treatment. Specifically, we found that, in comparison with access standard continuing care, the novel intervention more effectively reduced risk of relapse within six months following inpatient treatment.
酒精使用障碍（AUD）患者在住院治疗后复发率特别高。创新策略应专门针对完成住院治疗和接受标准持续治疗之间的过渡差距。本研究旨在确定Appstinence，一种结合智能手机应用程序干预和辅助电话指导的数字方法，与接受标准持续治疗的对照组相比，是否能更显著地降低住院AUD治疗后6个月的复发风险。方法在本多中心临床试验中，356名受试者随机分为干预组（n=175）和对照组（n=181）。入选标准包括AUD诊断、智能手机接入、无急性自杀倾向、无语言或神经认知障碍。主要终点是随机分组后6个月内的复发风险，采用时间线-随访法进行评估。次要结局包括接受标准持续治疗、危险饮酒、渴望、抑郁和焦虑症状严重程度以及幸福感。结果经log-rank检验（HR 0.72, 95% CI 0.53-0.98, p=0.04）和Cox回归校正基线特征（HR 0.67, 95% CI 0.48-0.92, p=0.01），干预降低了6个月内的复发风险。当参与者完全遵守干预方案时，这种效果增加（log-rank检验：HR 0.61, 95% CI 0.39-0.94, p=0.02）。次要结局无显著差异。结论：我们的研究结果为数字化AUD转换治疗提供了支持性证据。具体来说，我们发现，与获得标准的持续治疗相比，新的干预措施更有效地降低了住院治疗后六个月内复发的风险。
{"title":"Evaluation of a Smartphone App Intervention with Telephone Guidance as Transitional Support from Inpatient Treatment to Continuing Care for Individuals with Alcohol Use Disorder: Results from a Randomized Controlled Trial.","authors":"Sebastian Saur,Kiona K Weisel,Catharina Lang,Lukas M Fuhrmann,Niklas Meurer,Daniela Reichl,Mathias Zink,Peter Heepe,Thomas Hillemacher,Wolf-Dietrich Braunwarth,Peter Falkai,Gabriele Koller,Yaroslav Kiderman,Thomas Kraus,Johannes Kornhuber,Philipp Spitzer,Dominikus Bönsch,Mark Stemmler,Anja Hildebrand,Sabine Steins-Loeber,Matthias Berking","doi":"10.1159/000545817","DOIUrl":"https://doi.org/10.1159/000545817","url":null,"abstract":"INTRODUCTIONRelapse rates in individuals with alcohol use disorder (AUD) are particularly high following inpatient treatment. Innovative strategies should specifically target the transitional gap between completion of inpatient treatment and uptake of standard continuing care. This study aimed to determine whether Appstinence, a digital approach that combines a smartphone app intervention with adjunct telephone coaching, more markedly reduces the risk of relapse for 6 months after inpatient AUD treatment in comparison to a control group with access to standard continuing care.METHODSIn this multicenter clinical trial, 356 participants were randomized to the intervention (n=175) or control group (n=181). Eligibility criteria included diagnosis of AUD, smartphone access, no acute suicidality, and no language or neurocognitive impairments. The primary outcome was risk of relapse within six months after randomization, as assessed with the Timeline-Follow-Back method. Secondary outcomes included uptake of standard continuing care, hazardous alcohol consumption, craving, depression and anxiety symptom severity, and well-being.RESULTSThe intervention reduced the risk of relapse within six months as indicated by a log-rank test (HR 0.72, 95% CI 0.53-0.98, p=0.04) and Cox regression adjusted for baseline characteristics (HR 0.67, 95% CI 0.48-0.92, p=0.01). This effect increased when participants fully adhered to the intervention protocol (log-rank test: HR 0.61, 95% CI 0.39-0.94, p=0.02). No significant differences were observed in secondary outcomes.CONCLUSIONOur findings provide supportive evidence for digital AUD transition treatment. Specifically, we found that, in comparison with access standard continuing care, the novel intervention more effectively reduced risk of relapse within six months following inpatient treatment.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"22 1","pages":"1-24"},"PeriodicalIF":22.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTIONCoronary heart disease (CHD) has serious implications for patients´ quality of life (QoL). Psychological distress affects 15 to 40% of patients with CHD and is robustly associated with poorer prognosis. Blended collaborative care (BCC), a telephone-delivered intervention involving non-physician care managers that address both psychological and medical factors can be applied for secondary prevention of CHD.METHODSWe conducted the multicenter, randomized controlled TEACH trial that investigated the efficacy of a BCC intervention (TeamCare) in distressed CHD patients. The primary aim was to examine the treatment response rate of TeamCare defined as ≥ 50% improvements in health-related QoL (HRQoL, assessed by HeartQoL) after 12 months compared to usual care (UC). Secondary endpoints were changes in HRQoL, psychological and medical factors, and satisfaction with care.RESULTSIn total, 457 patients (mean age 62.9 ± 9.5 years, 23% females) were randomized to TeamCare (n=230) or UC (n=227). At 12 months, TeamCare patients showed a significantly higher proportion of treatment response on HeartQoL compared to UC (19% vs. 10%, respectively). TeamCare yielded significantly greater improvements in HeartQoL scores: global (d=0.338), physical (d=0.270), and emotional (d=0.382). Further, TeamCare led to a significantly greater decrease in depression (d=-0.329), anxiety (d=-0.300), perceived stress (d=-0.233), and medical risk score (d=-0.235). Finally, BCC patients showed a higher satisfaction with overall treatment and psychosocial care.CONCLUSIONThe TEACH study is the first ever performed BCC trial in distressed CHD patients in Europe. The BCC intervention has the potential to significantly improve secondary prevention in distressed CHD patients.
{"title":"Efficacy of team‑based collaborative care for distressed patients in secondary prevention of chronic coronary heart disease: Results from the multicenter, randomized controlled TEACH trial.","authors":"Monika Sadlonova,Birgit Herbeck Belnap,Ingrid Becker,Kristina Bersch,Franziska Geiser,Viktoria Adenauer,Martin Hellmich,Ingrid Kindermann,Angela Zimmer,Matthias Michal,Jasmin Ghaemi Kerahrodi,Mariel Nöhre,Martina de Zwaan,Astrid Petersmann,Irina Müller-Kozarez,Maja Ehlers,Rolf Wachter,Christian Albus,Christoph Herrmann-Lingen,","doi":"10.1159/000545865","DOIUrl":"https://doi.org/10.1159/000545865","url":null,"abstract":"INTRODUCTIONCoronary heart disease (CHD) has serious implications for patients´ quality of life (QoL). Psychological distress affects 15 to 40% of patients with CHD and is robustly associated with poorer prognosis. Blended collaborative care (BCC), a telephone-delivered intervention involving non-physician care managers that address both psychological and medical factors can be applied for secondary prevention of CHD.METHODSWe conducted the multicenter, randomized controlled TEACH trial that investigated the efficacy of a BCC intervention (TeamCare) in distressed CHD patients. The primary aim was to examine the treatment response rate of TeamCare defined as ≥ 50% improvements in health-related QoL (HRQoL, assessed by HeartQoL) after 12 months compared to usual care (UC). Secondary endpoints were changes in HRQoL, psychological and medical factors, and satisfaction with care.RESULTSIn total, 457 patients (mean age 62.9 ± 9.5 years, 23% females) were randomized to TeamCare (n=230) or UC (n=227). At 12 months, TeamCare patients showed a significantly higher proportion of treatment response on HeartQoL compared to UC (19% vs. 10%, respectively). TeamCare yielded significantly greater improvements in HeartQoL scores: global (d=0.338), physical (d=0.270), and emotional (d=0.382). Further, TeamCare led to a significantly greater decrease in depression (d=-0.329), anxiety (d=-0.300), perceived stress (d=-0.233), and medical risk score (d=-0.235). Finally, BCC patients showed a higher satisfaction with overall treatment and psychosocial care.CONCLUSIONThe TEACH study is the first ever performed BCC trial in distressed CHD patients in Europe. The BCC intervention has the potential to significantly improve secondary prevention in distressed CHD patients.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"19 1","pages":"1-32"},"PeriodicalIF":22.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christoph Flückiger,Madita Böhme,Ann-Marie Schweizer,Juan-Martín Gómez Penedo,Bruce E Wampold
{"title":"In psychedelic-assisted therapy, the alliance in the psychotherapy component is as important as the drug.","authors":"Christoph Flückiger,Madita Böhme,Ann-Marie Schweizer,Juan-Martín Gómez Penedo,Bruce E Wampold","doi":"10.1159/000546270","DOIUrl":"https://doi.org/10.1159/000546270","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"37 1","pages":"1-5"},"PeriodicalIF":22.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophie Juul,Janus Christian Jakobsen,Emilie Hestbaek,Caroline Barkholt Kamp,Markus Harboe Olsen,Marie Rishede,Frederik Weischer Frandsen,Sune Bo,Stig Poulsen,Per Sørensen,Anthony Bateman,Sebastian Simonsen
Introduction Borderline personality disorder (BPD) is a severe and prevalent psychiatric disorder. Mentalization-based therapy (MBT) is an evidence-based intervention for BPD, which is often delivered as a long-term psychotherapy program for BPD. We previously published a randomized clinical trial assessing short-term versus long-term MBT for BPD 16 months after randomization as the primary follow-up time-point. Objectives To assess the long-term (24 months) results of short-term versus long-term MBT for outpatients with BPD. Methods Adult outpatients (≥18 years) with subthreshold or diagnosed BPD were randomly assigned (1:1) to short-term MBT (5 months) or long-term MBT (14 months). The primary outcome was BPD symptoms assessed with the Zanarini Rating Scale for Borderline Personality Disorder. Secondary outcomes were level of functioning (assessed using the Work and Social Adjustment Scale), quality of life (assessed using Short Form Health Survey, SF-36), global functioning (assessed using the Global Assessment of Functionins scale, GAF), and severe self-harm. All outcomes were assessed at 24 months after randomization. Results Between October 4, 2018, and December 3, 2020, we randomly assigned 166 participants to short-term MBT (n=84) or long-term MBT (n=82). After 24 months, regression analyses showed no evidence of a difference when assessing the primary outcome, BPD symptoms (ZAN-BPD MD -0.56; 95% CI -2.67 to 1.54; p = 0.598), level of functioning (WSAS MD -1.42% CI -5.04 to 2.21; p = 0.440), global functioning (GAF MD 2.51 95% CI: -1.65 to 6.67; p = 0.234), or severe self-harm (RR 1.38; 95% CI 0.88 to 2.21; p = 0.149). Regression analyses showed evidence of a beneficial effect of long-term MBT when assessing.
{"title":"Short-term versus long-term mentalization-based therapy for borderline personality disorder (MBT-RCT): 24 months follow-up of a randomized clinical trial.","authors":"Sophie Juul,Janus Christian Jakobsen,Emilie Hestbaek,Caroline Barkholt Kamp,Markus Harboe Olsen,Marie Rishede,Frederik Weischer Frandsen,Sune Bo,Stig Poulsen,Per Sørensen,Anthony Bateman,Sebastian Simonsen","doi":"10.1159/000544934","DOIUrl":"https://doi.org/10.1159/000544934","url":null,"abstract":"Introduction Borderline personality disorder (BPD) is a severe and prevalent psychiatric disorder. Mentalization-based therapy (MBT) is an evidence-based intervention for BPD, which is often delivered as a long-term psychotherapy program for BPD. We previously published a randomized clinical trial assessing short-term versus long-term MBT for BPD 16 months after randomization as the primary follow-up time-point. Objectives To assess the long-term (24 months) results of short-term versus long-term MBT for outpatients with BPD. Methods Adult outpatients (≥18 years) with subthreshold or diagnosed BPD were randomly assigned (1:1) to short-term MBT (5 months) or long-term MBT (14 months). The primary outcome was BPD symptoms assessed with the Zanarini Rating Scale for Borderline Personality Disorder. Secondary outcomes were level of functioning (assessed using the Work and Social Adjustment Scale), quality of life (assessed using Short Form Health Survey, SF-36), global functioning (assessed using the Global Assessment of Functionins scale, GAF), and severe self-harm. All outcomes were assessed at 24 months after randomization. Results Between October 4, 2018, and December 3, 2020, we randomly assigned 166 participants to short-term MBT (n=84) or long-term MBT (n=82). After 24 months, regression analyses showed no evidence of a difference when assessing the primary outcome, BPD symptoms (ZAN-BPD MD -0.56; 95% CI -2.67 to 1.54; p = 0.598), level of functioning (WSAS MD -1.42% CI -5.04 to 2.21; p = 0.440), global functioning (GAF MD 2.51 95% CI: -1.65 to 6.67; p = 0.234), or severe self-harm (RR 1.38; 95% CI 0.88 to 2.21; p = 0.149). Regression analyses showed evidence of a beneficial effect of long-term MBT when assessing.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"69 1","pages":"1-14"},"PeriodicalIF":22.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Victoria Sennerstam,Ludwig Franke Föyen,Evelina Kontio,Frank Svärdman,Mats Lekander,Elin Lindsäter,Erik Hedman-Lagerlöf
BACKGROUNDStress-related disorders such as adjustment disorder (AD) and exhaustion disorder (ED) are associated with substantial suffering and high societal costs. Cognitive behavioral therapy (CBT) is a promising treatment for symptom reduction but has not been rigorously compared with other active treatments. This study aimed to investigate the efficacy of CBT compared to an active control treatment (General Health Promotion; GHP) treatment for individuals diagnosed with AD or ED.METHODSA total of 300 adults diagnosed with AD or ED were randomly assigned to a 12-week CBT (n=151) or GHP (n=149), both delivered as therapist-supported online treatments. Primary outcome was post-treatment scores on the 10-item Perceived Stress Scale. Secondary outcomes included several mental health symptom domains and functional impairment. All outcomes were assessed at baseline, post-treatment, and at 1-year follow-up. The trial was pre-registered on Clinicaltrials.gov (NCT04797273).RESULTSThe CBT intervention was not superior to GHP in reducing symptoms of perceived stress and secondary symptoms. Both treatments generated large within-group effect sizes pre- to post-treatment (Cohen's d= 1.19 and 1.06, respectively) and results were maintained to the 1-year follow-up. Diagnostic group moderated the treatment effect pre- to post-treatment and indicated that CBT was superior to GHP for individuals diagnosed with AD but not for those diagnosed with ED.CONCLUSIONSCommon factors likely play an important role in symptom reduction for individuals with stress-related disorders. A refined understanding of the conceptualization of stress-related disorders and which specific mechanisms to target in the respective patient groups is needed to improve treatment outcomes.
{"title":"Internet-Delivered Treatment for Stress-Related Disorders: A Randomized Controlled Superiority Trial of Cognitive Behavioral Therapy versus General Health Promotion.","authors":"Victoria Sennerstam,Ludwig Franke Föyen,Evelina Kontio,Frank Svärdman,Mats Lekander,Elin Lindsäter,Erik Hedman-Lagerlöf","doi":"10.1159/000546221","DOIUrl":"https://doi.org/10.1159/000546221","url":null,"abstract":"BACKGROUNDStress-related disorders such as adjustment disorder (AD) and exhaustion disorder (ED) are associated with substantial suffering and high societal costs. Cognitive behavioral therapy (CBT) is a promising treatment for symptom reduction but has not been rigorously compared with other active treatments. This study aimed to investigate the efficacy of CBT compared to an active control treatment (General Health Promotion; GHP) treatment for individuals diagnosed with AD or ED.METHODSA total of 300 adults diagnosed with AD or ED were randomly assigned to a 12-week CBT (n=151) or GHP (n=149), both delivered as therapist-supported online treatments. Primary outcome was post-treatment scores on the 10-item Perceived Stress Scale. Secondary outcomes included several mental health symptom domains and functional impairment. All outcomes were assessed at baseline, post-treatment, and at 1-year follow-up. The trial was pre-registered on Clinicaltrials.gov (NCT04797273).RESULTSThe CBT intervention was not superior to GHP in reducing symptoms of perceived stress and secondary symptoms. Both treatments generated large within-group effect sizes pre- to post-treatment (Cohen's d= 1.19 and 1.06, respectively) and results were maintained to the 1-year follow-up. Diagnostic group moderated the treatment effect pre- to post-treatment and indicated that CBT was superior to GHP for individuals diagnosed with AD but not for those diagnosed with ED.CONCLUSIONSCommon factors likely play an important role in symptom reduction for individuals with stress-related disorders. A refined understanding of the conceptualization of stress-related disorders and which specific mechanisms to target in the respective patient groups is needed to improve treatment outcomes.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"68 1","pages":"1-20"},"PeriodicalIF":22.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Naomi Takemura,Krista Ching-Wai Chung,Jojo Yan-Yan Kwok,Daniel Yee Tak Fong
INTRODUCTIONPsycho-spiritual distress remains one of the most prevalent and pressing concerns throughout the cancer survivorship journey, impacting their existential integrity. Various yoga interventions have been examined for their potential to alleviate this distress, but their effects in cancer patients varied.METHODSWe searched seven databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, SportDiscus, and Web of Science) and two clinical trial registries from their inception to October 2024, without language restriction. The randomized control trials (RCTs) that compared the effects of yoga interventions with controls on psychological, spiritual, and emotional well-being among adults with cancer were included. The random effects pooled estimates (Hedges' g) and 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using I2. Moderators were identified through meta-regression.RESULTSFifty-five RCTs involving 3,608 participants (2,935 [81.3%] female; mean age range, 46-69 years) were included. Meta-analysis revealed that yoga interventions largely reduced anxiety (Hedges' g, -0.82; 95% CI, -1.33 to -0.31; I2=88%), moderately-to-largely reduced depression (g, -0.62; 95% CI, -1.06 to -0.19; I2=85%), as well as mildly-to-moderately improved spiritual well-being (g, 0.31; 95% CI, 0.17 to 0.46; I2=0%) and emotional well-being (g, 0.23; 95% CI, 0.02 to 0.45; I2=47%).CONCLUSIONYoga effectively reduces anxiety and depression, and improves spiritual well-being and emotional well-being in cancer, underscoring their potential to improve the psychological and spiritual health of this population. More rigorously designed trials are needed to understand the optimal intervention parameters to maximize the effects of yoga on psychological outcomes.
{"title":"Effect of Yoga on Psychological and Spiritual Outcomes in Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with Meta-Regression.","authors":"Naomi Takemura,Krista Ching-Wai Chung,Jojo Yan-Yan Kwok,Daniel Yee Tak Fong","doi":"10.1159/000545697","DOIUrl":"https://doi.org/10.1159/000545697","url":null,"abstract":"INTRODUCTIONPsycho-spiritual distress remains one of the most prevalent and pressing concerns throughout the cancer survivorship journey, impacting their existential integrity. Various yoga interventions have been examined for their potential to alleviate this distress, but their effects in cancer patients varied.METHODSWe searched seven databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, SportDiscus, and Web of Science) and two clinical trial registries from their inception to October 2024, without language restriction. The randomized control trials (RCTs) that compared the effects of yoga interventions with controls on psychological, spiritual, and emotional well-being among adults with cancer were included. The random effects pooled estimates (Hedges' g) and 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using I2. Moderators were identified through meta-regression.RESULTSFifty-five RCTs involving 3,608 participants (2,935 [81.3%] female; mean age range, 46-69 years) were included. Meta-analysis revealed that yoga interventions largely reduced anxiety (Hedges' g, -0.82; 95% CI, -1.33 to -0.31; I2=88%), moderately-to-largely reduced depression (g, -0.62; 95% CI, -1.06 to -0.19; I2=85%), as well as mildly-to-moderately improved spiritual well-being (g, 0.31; 95% CI, 0.17 to 0.46; I2=0%) and emotional well-being (g, 0.23; 95% CI, 0.02 to 0.45; I2=47%).CONCLUSIONYoga effectively reduces anxiety and depression, and improves spiritual well-being and emotional well-being in cancer, underscoring their potential to improve the psychological and spiritual health of this population. More rigorously designed trials are needed to understand the optimal intervention parameters to maximize the effects of yoga on psychological outcomes.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"42 1","pages":"1-22"},"PeriodicalIF":22.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Persistency in Somatic Symptoms: A Sign of Stagnation in Stimulus- Response Process.","authors":"Vedat Şar,Görkem Ayas","doi":"10.1159/000545768","DOIUrl":"https://doi.org/10.1159/000545768","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"37 1","pages":"1-3"},"PeriodicalIF":22.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTIONEmotion dysregulation is prevalent in autistic adults without intellectual disability whereby it has been associated with heightened non-suicidal self-injury and suicidal behaviours. Dialectical behaviour therapy (DBT) has shown to be feasible and preliminary findings suggest that it might reduce emotion dysregulation in this population. Yet studies evaluating the efficacy of DBT in this context are lacking.METHODSSixty-three autistic adults presenting with emotion dysregulation as well as self-harm and/or suicidal behaviours were randomised either to the DBT condition (18-week treatment) or to the waiting list condition. Participants completed self-report scales, including emotion dysregulation, alexithymia, depression and quality of life, at 4 time points (pre-, mid-, post-therapy, six-month follow-up).RESULTSEmotion dysregulation improved in the DBT condition relative to the waiting list condition mid-therapy (β01 = -18.59 [-27.67 to -9.44], Pr (β01 < 0) = 1.000), post- therapy (β02 = -31.91 [-41.67 to -22.30], Pr (β02 < 0) = 1.000), with lasting improvements at follow-up. Alexithymia improvement mediated the therapy effects on emotion dysregulation. Moreover, depressive symptoms and quality of life improved in the DBT condition relative to the waiting list condition post-therapy, with improvements lasting at follow-up.CONCLUSIONDBT was found to be effective to reduce emotion dysregulation in autistic adults presenting with self-harm and/or suicidal behaviour. Additionally, improvements on depression and quality-of-life were observed post-therapy. Interestingly, the improvements on emotion dysregulation were mediated by a decrease in alexithymia, consistent with research showing that alexithymia is a central mechanism of emotion dysregulation in autistic adults.
{"title":"Dialectical Behaviour Therapy to Treat Emotion Dysregulation in Autistic adults without Intellectual Disability: A Randomised Controlled Trial.","authors":"Doha Bemmouna,Emmett Rabot,Romain Coutelle,François Lefebvre,Sébastien Weibel,Luisa Weiner","doi":"10.1159/000544717","DOIUrl":"https://doi.org/10.1159/000544717","url":null,"abstract":"INTRODUCTIONEmotion dysregulation is prevalent in autistic adults without intellectual disability whereby it has been associated with heightened non-suicidal self-injury and suicidal behaviours. Dialectical behaviour therapy (DBT) has shown to be feasible and preliminary findings suggest that it might reduce emotion dysregulation in this population. Yet studies evaluating the efficacy of DBT in this context are lacking.METHODSSixty-three autistic adults presenting with emotion dysregulation as well as self-harm and/or suicidal behaviours were randomised either to the DBT condition (18-week treatment) or to the waiting list condition. Participants completed self-report scales, including emotion dysregulation, alexithymia, depression and quality of life, at 4 time points (pre-, mid-, post-therapy, six-month follow-up).RESULTSEmotion dysregulation improved in the DBT condition relative to the waiting list condition mid-therapy (β01 = -18.59 [-27.67 to -9.44], Pr (β01 < 0) = 1.000), post- therapy (β02 = -31.91 [-41.67 to -22.30], Pr (β02 < 0) = 1.000), with lasting improvements at follow-up. Alexithymia improvement mediated the therapy effects on emotion dysregulation. Moreover, depressive symptoms and quality of life improved in the DBT condition relative to the waiting list condition post-therapy, with improvements lasting at follow-up.CONCLUSIONDBT was found to be effective to reduce emotion dysregulation in autistic adults presenting with self-harm and/or suicidal behaviour. Additionally, improvements on depression and quality-of-life were observed post-therapy. Interestingly, the improvements on emotion dysregulation were mediated by a decrease in alexithymia, consistent with research showing that alexithymia is a central mechanism of emotion dysregulation in autistic adults.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"75 1","pages":"1-18"},"PeriodicalIF":22.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luke J Hearne,Lachlan Webb,Robin Cash,Conor Robinson,Philip E Mosley,Joanna Ng,Simon T Thwaites,Simon Issa,Jessica Miller,Nga Yan Tse,Andrew Zalesky,Bjorn Burgher,Luca Cocchi
INTRODUCTIONRepetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) is an established treatment for refractory major depressive disorder (MDD), but treatment outcomes vary substantially from person to person. Recent evidence suggests that incorporating neuroimaging-based targeting may help improve clinical outcomes. Here, we report the initial clinical outcomes of our open-label fMRI-personalized treatment protocol from the Queensland Neurostimulation Centre (QNC).METHODSThis open-label, nonrandomized study was conducted between November 2021 and September 2024. Participants were a referred sample aged between 19 and 84, meeting the criteria for treatment-resistant MDD (N=61). They received 20 or 30-weekday sessions of DLPFC rTMS. The stimulation site was personalized using each individual's fMRI brain connectivity data.RESULTSThe primary outcome was change in the Montgomery-Åsberg Depression Rating Scale (MADRS). MADRS was lower post-treatment (d=1.78, p<.001), with 52% and 33% response and remission rates observed. Likewise, anxiety scores (Hamilton Anxiety Rating Scale) were lower post-treatment (d=1.27, p<.001), with 46% and 28% response and remission rates observed. The treatment was most effective in patients who qualified for randomized controlled trials (RCTs; N=19, MADRS response=74%, remission=53%) and least effective in patients with bipolar or neurological disorders (N=8, MADRS response=37%, remission=25%). Neurophysiologically, functional brain connectivity in the personalized DLPFC-SGC pathway was less anti-correlated post-treatment (d=0.63, p<.001).CONCLUSIONOur findings provide new clinical and neurophysiological evidence supporting the high effectiveness of fMRI-connectivity-guided personalized rTMS for MDD, especially in individuals without complex comorbidities. The results encourage future RCTs to assess the superiority of personalized targeting over standard TMS.
{"title":"Clinical and Neurophysiological Effects of Robotically-Delivered fMRI-Guided Personalized Transcranial Magnetic Stimulation Therapy for Depression.","authors":"Luke J Hearne,Lachlan Webb,Robin Cash,Conor Robinson,Philip E Mosley,Joanna Ng,Simon T Thwaites,Simon Issa,Jessica Miller,Nga Yan Tse,Andrew Zalesky,Bjorn Burgher,Luca Cocchi","doi":"10.1159/000545692","DOIUrl":"https://doi.org/10.1159/000545692","url":null,"abstract":"INTRODUCTIONRepetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) is an established treatment for refractory major depressive disorder (MDD), but treatment outcomes vary substantially from person to person. Recent evidence suggests that incorporating neuroimaging-based targeting may help improve clinical outcomes. Here, we report the initial clinical outcomes of our open-label fMRI-personalized treatment protocol from the Queensland Neurostimulation Centre (QNC).METHODSThis open-label, nonrandomized study was conducted between November 2021 and September 2024. Participants were a referred sample aged between 19 and 84, meeting the criteria for treatment-resistant MDD (N=61). They received 20 or 30-weekday sessions of DLPFC rTMS. The stimulation site was personalized using each individual's fMRI brain connectivity data.RESULTSThe primary outcome was change in the Montgomery-Åsberg Depression Rating Scale (MADRS). MADRS was lower post-treatment (d=1.78, p<.001), with 52% and 33% response and remission rates observed. Likewise, anxiety scores (Hamilton Anxiety Rating Scale) were lower post-treatment (d=1.27, p<.001), with 46% and 28% response and remission rates observed. The treatment was most effective in patients who qualified for randomized controlled trials (RCTs; N=19, MADRS response=74%, remission=53%) and least effective in patients with bipolar or neurological disorders (N=8, MADRS response=37%, remission=25%). Neurophysiologically, functional brain connectivity in the personalized DLPFC-SGC pathway was less anti-correlated post-treatment (d=0.63, p<.001).CONCLUSIONOur findings provide new clinical and neurophysiological evidence supporting the high effectiveness of fMRI-connectivity-guided personalized rTMS for MDD, especially in individuals without complex comorbidities. The results encourage future RCTs to assess the superiority of personalized targeting over standard TMS.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"25 5 1","pages":"1-12"},"PeriodicalIF":22.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Louise Sharpe,Madelyne A Bisby,Rachel E Menzies,Jack Benjamin Boyse,Bethany Richmond,Jemma Todd,Amy-Lee Sesel,Blake F Dear
INTRODUCTIONThis study aimed to determine the relative efficacy of mindfulness-based stress reduction (MBSR) or cognitive behaviour therapy (CBT) in comparison to a waitlist control (WLC) for people with rheumatoid arthritis (RA). Participants completed assessments before and after treatment and at 6-month follow-up.METHODSTwo hundred and sixty-nine participants with RA were recruited and randomised in a 2:2:1 ratio to MBSR:CBT:WLC. Participants completed a semi-structured clinical interview for depression and were stratified for history of recurrent depression. We measured the primary outcome of pain interference, as well as pain severity, depression, anxiety, functional ability, and fear of progression. We predicted that MBSR and CBT would result in improvements compared to WLC. We also predicted that those with a history of recurrent depression would benefit more from MBSR than CBT for depression.RESULTSMBSR and CBT were equally efficacious in reducing pain interference compared to WLC. Similar results were found for depression. MBSR demonstrated superior outcomes to CBT for fear of progression at post-treatment and functional ability at 6-month follow-up. CBT only was better than WLC for pain severity at 6-month follow-up. Depressive status did not moderate the efficacy of treatment.CONCLUSIONSMBSR and CBT resulted in statistically and clinically significant changes in pain interference compared to WLC. MBSR was more efficacious than CBT for functional ability and fear of progression, while CBT showed superiority for pain severity. The effect sizes were comparable to those achieved with face-to-face interventions, confirming both online treatments are effective for people with RA.
{"title":"A Tale of Two Treatments: A Randomised Controlled Trial of Mindfulness or Cognitive Behaviour Therapy Delivered Online for People with Rheumatoid Arthritis.","authors":"Louise Sharpe,Madelyne A Bisby,Rachel E Menzies,Jack Benjamin Boyse,Bethany Richmond,Jemma Todd,Amy-Lee Sesel,Blake F Dear","doi":"10.1159/000542489","DOIUrl":"https://doi.org/10.1159/000542489","url":null,"abstract":"INTRODUCTIONThis study aimed to determine the relative efficacy of mindfulness-based stress reduction (MBSR) or cognitive behaviour therapy (CBT) in comparison to a waitlist control (WLC) for people with rheumatoid arthritis (RA). Participants completed assessments before and after treatment and at 6-month follow-up.METHODSTwo hundred and sixty-nine participants with RA were recruited and randomised in a 2:2:1 ratio to MBSR:CBT:WLC. Participants completed a semi-structured clinical interview for depression and were stratified for history of recurrent depression. We measured the primary outcome of pain interference, as well as pain severity, depression, anxiety, functional ability, and fear of progression. We predicted that MBSR and CBT would result in improvements compared to WLC. We also predicted that those with a history of recurrent depression would benefit more from MBSR than CBT for depression.RESULTSMBSR and CBT were equally efficacious in reducing pain interference compared to WLC. Similar results were found for depression. MBSR demonstrated superior outcomes to CBT for fear of progression at post-treatment and functional ability at 6-month follow-up. CBT only was better than WLC for pain severity at 6-month follow-up. Depressive status did not moderate the efficacy of treatment.CONCLUSIONSMBSR and CBT resulted in statistically and clinically significant changes in pain interference compared to WLC. MBSR was more efficacious than CBT for functional ability and fear of progression, while CBT showed superiority for pain severity. The effect sizes were comparable to those achieved with face-to-face interventions, confirming both online treatments are effective for people with RA.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"60 1","pages":"1-12"},"PeriodicalIF":22.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142991740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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