Franziska Mosler,Aikaterini Christogianni,Sam Singleton,Tim G Hales,Janine Rennie,Lesley A Colvin,Line Caes
Children exposed to adverse experiences (ACEs) are more likely to experience mental health problems in adulthood. However, ACE assessment is highly heterogeneous, hampering widespread screening and trauma-informed care provision. We aimed to systematically identify and critically evaluate all validated, self-report ACE questionnaires, working with people with lived experience (PWLE). The review followed PRISMA guidelines to systematically search databases for validated self-report measures, completed by adults, assessing at least two ACEs. Articles were excluded if they were not written in English, were not original articles, assessed poor childhood health or adverse experiences happening in adulthood, and/or only assessed one ACE. Psychometric properties were evaluated using Cohen's criteria for evidence-based assessments, the COSMIN checklist, and a content validity form co-designed with PWLE. We identified 112 eligible studies covering 31 ACE questionnaires. Cohen's criteria classified 9 questionnaires as "well-established" and 2 as "approaching well-established". No questionnaire was rated as "sufficient" quality across all the COSMIN measurement properties. The ACE Study-questionnaire, Childhood Experiences Survey (CES) and the ACE-International Questionnaire had the highest number of properties rated as sufficient. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) was most frequently evaluated but received "insufficient" ratings across all measurement properties. PWLE scored content validity highest for the CES. Consequently, no ACE questionnaires received good psychometric ratings, with the most widely used questionnaire (CTQ-SF) not performing well, which has implications for selecting an appropriate instrument. With increasing emphasis on trauma-informed health care, there is an urgent need to co-develop ACE questionnaires with PWLE to balance content validity with usability.
{"title":"Assessing exposure to childhood adversity in adults: A systematic review of validated self-report childhood adversity questionnaires.","authors":"Franziska Mosler,Aikaterini Christogianni,Sam Singleton,Tim G Hales,Janine Rennie,Lesley A Colvin,Line Caes","doi":"10.1159/000547529","DOIUrl":"https://doi.org/10.1159/000547529","url":null,"abstract":"Children exposed to adverse experiences (ACEs) are more likely to experience mental health problems in adulthood. However, ACE assessment is highly heterogeneous, hampering widespread screening and trauma-informed care provision. We aimed to systematically identify and critically evaluate all validated, self-report ACE questionnaires, working with people with lived experience (PWLE). The review followed PRISMA guidelines to systematically search databases for validated self-report measures, completed by adults, assessing at least two ACEs. Articles were excluded if they were not written in English, were not original articles, assessed poor childhood health or adverse experiences happening in adulthood, and/or only assessed one ACE. Psychometric properties were evaluated using Cohen's criteria for evidence-based assessments, the COSMIN checklist, and a content validity form co-designed with PWLE. We identified 112 eligible studies covering 31 ACE questionnaires. Cohen's criteria classified 9 questionnaires as \"well-established\" and 2 as \"approaching well-established\". No questionnaire was rated as \"sufficient\" quality across all the COSMIN measurement properties. The ACE Study-questionnaire, Childhood Experiences Survey (CES) and the ACE-International Questionnaire had the highest number of properties rated as sufficient. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) was most frequently evaluated but received \"insufficient\" ratings across all measurement properties. PWLE scored content validity highest for the CES. Consequently, no ACE questionnaires received good psychometric ratings, with the most widely used questionnaire (CTQ-SF) not performing well, which has implications for selecting an appropriate instrument. With increasing emphasis on trauma-informed health care, there is an urgent need to co-develop ACE questionnaires with PWLE to balance content validity with usability.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"15 1","pages":""},"PeriodicalIF":22.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684205","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}
Jennifer Schuffelen,Leonie F Maurer,Annika Gieselmann
INTRODUCTIONManaging chronic pain is a significant healthcare challenge requiring a multimodal approach. The frequent presence of comorbid insomnia and its bidirectional relationship with pain complicates treatment. This study tested whether adding digital cognitive behavioral therapy for insomnia (dCBT-I) to standard chronic pain treatment improves symptoms compared to a waitlist control (WLC).METHODSParticipants with chronic pain and insomnia were randomized (1:1) to dCBT-I or WLC. Assessments occurred at baseline, eight, and 24 weeks post-randomization. The primary outcome was insomnia severity (Insomnia Severity Index; ISI). Secondary outcomes included sleep- and pain-related symptoms, well-being, and dreams. Linear mixed models assessed between-group differences.RESULTSA total of 207 participants (182 women, mean age=51.96±12.97 years) were randomized to dCBT-I (n=103) or WLC (n=104). The dCBT-I group showed large improvements in insomnia severity versus WLC at both eight (-4.36, p<.001; d=-1.18) and 24 weeks (-4.88, p<.001; d=-1.32). Pain-related impairments and life control also improved, favoring dCBT-I (ds=0.22-0.35). Moderate-to-large effects were observed for secondary outcomes, including daytime sleepiness, fatigue, and dysfunctional sleep beliefs (ds=0.47-1.12).CONCLUSIONdCBT-I effectively reduces insomnia severity in individuals with chronic pain and insomnia. Improvements in chronic pain symptoms highlight its potential as a scalable, evidence-based intervention for multimodal pain management.
{"title":"The Effects of Digital Cognitive Behavioral Therapy for Insomnia in Chronic Pain: A Randomized Controlled Trial.","authors":"Jennifer Schuffelen,Leonie F Maurer,Annika Gieselmann","doi":"10.1159/000547436","DOIUrl":"https://doi.org/10.1159/000547436","url":null,"abstract":"INTRODUCTIONManaging chronic pain is a significant healthcare challenge requiring a multimodal approach. The frequent presence of comorbid insomnia and its bidirectional relationship with pain complicates treatment. This study tested whether adding digital cognitive behavioral therapy for insomnia (dCBT-I) to standard chronic pain treatment improves symptoms compared to a waitlist control (WLC).METHODSParticipants with chronic pain and insomnia were randomized (1:1) to dCBT-I or WLC. Assessments occurred at baseline, eight, and 24 weeks post-randomization. The primary outcome was insomnia severity (Insomnia Severity Index; ISI). Secondary outcomes included sleep- and pain-related symptoms, well-being, and dreams. Linear mixed models assessed between-group differences.RESULTSA total of 207 participants (182 women, mean age=51.96±12.97 years) were randomized to dCBT-I (n=103) or WLC (n=104). The dCBT-I group showed large improvements in insomnia severity versus WLC at both eight (-4.36, p<.001; d=-1.18) and 24 weeks (-4.88, p<.001; d=-1.32). Pain-related impairments and life control also improved, favoring dCBT-I (ds=0.22-0.35). Moderate-to-large effects were observed for secondary outcomes, including daytime sleepiness, fatigue, and dysfunctional sleep beliefs (ds=0.47-1.12).CONCLUSIONdCBT-I effectively reduces insomnia severity in individuals with chronic pain and insomnia. Improvements in chronic pain symptoms highlight its potential as a scalable, evidence-based intervention for multimodal pain management.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"3 1","pages":"1-35"},"PeriodicalIF":22.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640206","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}
Ludwig Franke Föyen,Victoria Sennerstam,Evelina Kontio,Mats Lekander,Erik Hedman-Lagerlöf,Elin Lindsäter
Introduction Stress-related disorders, including adjustment disorder and exhaustion disorder, are associated with cognitive complaints and prolonged sickness absence (SA). This study evaluated the effects of cognitive behavioral therapy (CBT) compared with an active control treatment (entitled General Health Promotion; GHP) on these outcomes and examined the association between cognitive impairment and SA. Methods In this randomized clinical trial, 300 participants were randomized to CBT or GHP. SA data from the Swedish Social Insurance register were collected from one year before to one year after treatment. Cognitive functioning, assessed via a validated test battery, was measured at baseline, posttreatment, and one-year follow-up (1YFU). Hurdle negative binomial models evaluated SA and linear mixed-effects models analyzed cognitive outcomes. Results CBT and GHP had comparable effects on SA and cognitive functioning with no significant between-group effects (all p > .05). Analyzing effects across the entire sample, the number of SA days among those with any SA did not significantly change (p = .946) but the likelihood of having any SA decreased significantly by the 1YFU (OR = .92, 95% CI [.87, .96], p < .001). Independent of treatment group, overall cognitive functioning improved both posttreatment (d = -.42, 95% CI [-.6, -.25], p < .001) and at 1YFU (d = -.72, 95% CI [-.91, -.54], p < .001). Improvements in cognitive functioning pre to posttreatment were associated with fewer SA days at the 1YFU (IRR = .54, 95% CI [.33, .87], p = .01). Conclusion This study found no specific effect of CBT on SA or cognitive functioning for individuals with stress-related disorders. Cognitive functioning improved regardless of treatment. Early support before SA initiation is likely important to prevent long-term SA.
压力相关障碍，包括适应障碍和疲劳障碍，与认知疾病和长期缺勤（SA）有关。本研究评估了认知行为疗法（CBT）与积极对照治疗(一般健康促进；GHP)对这些结果进行了研究，并研究了认知障碍与SA之间的关系。方法在这项随机临床试验中，300名参与者被随机分为CBT组和GHP组。来自瑞典社会保险登记的SA数据从治疗前一年到治疗后一年收集。在基线、治疗后和1年随访（1YFU）时，通过一组有效的测试来评估认知功能。障碍负二项模型评估SA，线性混合效应模型分析认知结果。结果CBT和GHP对SA和认知功能的影响相当，组间无显著差异（p < 0.05）。分析整个样本的影响，有任何SA的人的SA天数没有显着变化（p = 0.946），但有任何SA的可能性显着降低了1YFU （OR = 0.92, 95% CI）。87, .96], p < .001)。与治疗组独立，治疗后整体认知功能改善(d = -。42, 95% ci[-]。6日-。[25], p < .001)和1YFU (d = -。72, 95% ci[-]。91年-。[54], p < 0.001)。治疗前后认知功能的改善与1YFU时SA天数的减少相关（IRR = 0.54, 95% CI）。33, .87], p = .01)。结论：本研究未发现CBT对应激相关障碍患者的SA或认知功能有特异性影响。无论治疗方式如何，认知功能都有所改善。SA开始前的早期支持可能对预防长期SA很重要。
{"title":"Long-Term Effects of Cognitive Behavioral Therapy on Sickness Absence and Cognitive Functioning in Patients with Stress-Related Disorders: Secondary Results from a Randomized Clinical Trial.","authors":"Ludwig Franke Föyen,Victoria Sennerstam,Evelina Kontio,Mats Lekander,Erik Hedman-Lagerlöf,Elin Lindsäter","doi":"10.1159/000547266","DOIUrl":"https://doi.org/10.1159/000547266","url":null,"abstract":"Introduction Stress-related disorders, including adjustment disorder and exhaustion disorder, are associated with cognitive complaints and prolonged sickness absence (SA). This study evaluated the effects of cognitive behavioral therapy (CBT) compared with an active control treatment (entitled General Health Promotion; GHP) on these outcomes and examined the association between cognitive impairment and SA. Methods In this randomized clinical trial, 300 participants were randomized to CBT or GHP. SA data from the Swedish Social Insurance register were collected from one year before to one year after treatment. Cognitive functioning, assessed via a validated test battery, was measured at baseline, posttreatment, and one-year follow-up (1YFU). Hurdle negative binomial models evaluated SA and linear mixed-effects models analyzed cognitive outcomes. Results CBT and GHP had comparable effects on SA and cognitive functioning with no significant between-group effects (all p > .05). Analyzing effects across the entire sample, the number of SA days among those with any SA did not significantly change (p = .946) but the likelihood of having any SA decreased significantly by the 1YFU (OR = .92, 95% CI [.87, .96], p < .001). Independent of treatment group, overall cognitive functioning improved both posttreatment (d = -.42, 95% CI [-.6, -.25], p < .001) and at 1YFU (d = -.72, 95% CI [-.91, -.54], p < .001). Improvements in cognitive functioning pre to posttreatment were associated with fewer SA days at the 1YFU (IRR = .54, 95% CI [.33, .87], p = .01). Conclusion This study found no specific effect of CBT on SA or cognitive functioning for individuals with stress-related disorders. Cognitive functioning improved regardless of treatment. Early support before SA initiation is likely important to prevent long-term SA.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"65 1","pages":"1-24"},"PeriodicalIF":22.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586626","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":"Research, Relevance and Responsibility - for Psychotherapy and Psychosomatics.","authors":"Stephan Zipfel","doi":"10.1159/000547206","DOIUrl":"https://doi.org/10.1159/000547206","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"27 1","pages":"1-7"},"PeriodicalIF":22.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578598","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}
Psychomotor disturbances (PmD) emerge as common symptoms in many psychiatric diseases. However, currently it lacks a systematic description of PmD among different mental disorders, largely due to the heterogeneity of PmD manifestations. Here we conducted a systematic review and meta-analysis to investigate this question. The initial literature search covered the period from the emergence of the concept of "Psychomotor" (1937) to June 27, 2024, which identified 5,701 relevant articles, then purified into 35 cross-sectional studies encompassing five types of mental disorders with 1,828 participants for further analyses. Our results suggest that patients with various mental disorders may commonly exhibit psychomotor retardation (PmR), with subgroup analyses showing effect sizes ranging from -0.32 to -2.31 across five mental disorder types. Moreover, there is preliminary evidence that patients exhibiting PmR may also experience cognitive impairments compared to healthy controls. In sum, our results indicated that PmD may involve in clinical manifestations of different mental disorders.
{"title":"Assessing psychomotor disturbances among mental disorders: A systematic review and meta-analysis.","authors":"Liang-Yuan Song,Zhen Lyu,Ji-Yu Xie,Yi Zhang,Di Zhao,Antao Chen,Taicheng Huang,Ti-Fei Yuan","doi":"10.1159/000546909","DOIUrl":"https://doi.org/10.1159/000546909","url":null,"abstract":"Psychomotor disturbances (PmD) emerge as common symptoms in many psychiatric diseases. However, currently it lacks a systematic description of PmD among different mental disorders, largely due to the heterogeneity of PmD manifestations. Here we conducted a systematic review and meta-analysis to investigate this question. The initial literature search covered the period from the emergence of the concept of \"Psychomotor\" (1937) to June 27, 2024, which identified 5,701 relevant articles, then purified into 35 cross-sectional studies encompassing five types of mental disorders with 1,828 participants for further analyses. Our results suggest that patients with various mental disorders may commonly exhibit psychomotor retardation (PmR), with subgroup analyses showing effect sizes ranging from -0.32 to -2.31 across five mental disorder types. Moreover, there is preliminary evidence that patients exhibiting PmR may also experience cognitive impairments compared to healthy controls. In sum, our results indicated that PmD may involve in clinical manifestations of different mental disorders.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"19 1","pages":"1-21"},"PeriodicalIF":22.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144521030","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}
Michal Tanzer, Marina Bobou, Athanasios Koukoutsakis, Alkistis Saramandi, Paul M Jenkinson, Sam Norton, Caroline Selai, Katerina Fotopoulou
Introduction: Interoception, the sensing, awareness, and regulation of physiological states, is crucial for wellbeing and mental health. Behavioural interventions targeting interoception exist, but randomised controlled trials (RCTs) testing efficacy remain limited. The present, preregistered (ISRCTN16762367) RCT tested the novel Interoceptive iNsight and Metacognitive Efficacy beliefs (InMe) intervention. InMe uses slow breathing and cardiac biofeedback during stress to train interoceptive self-efficacy beliefs and improve self-reported interoception.
Methods: Healthy participants aged 18-30 years with low self-reported interoception were randomly assigned (1:1) to the InMe intervention (n = 50) or an active control (guided imagery; n = 52). Participants blinded to allocation were stratified by gender and disordered eating. Assessments included baseline (T0), post-intervention (T1), and 7-8 weeks post-intervention (T2). The primary outcome was the "adaptive interoception" factor of the Multidimensional Assessment of Interoceptive Awareness questionnaire.
Results: Both arms improved in the primary outcome at T1 (InMe: adjusted M difference = 5.76; 95% CI [-0.03; 11.56], p = 0.05; control: adjusted M difference = 7.90; 95% CI [1.92; 13.87], p = 0.002; marginal R2 = 0.09). However, only InMe sustained this improvement at T2 (InMe: adjusted M difference = 9.25, 95% CI [3.37; 15.13], p < 0.001; control: adjusted M difference = 2.94, 95% CI [-3.07; 8.96], p = 0.72), as indicated by a significant time*arm interaction (b = 6.31; SE = 2.92, 95% CI [0.56; 12.05], p < 0.03; marginal R2 = 0.12). Secondary outcomes showed a reduction in disordered eating scores across both arms at both time points (T1: b = -1.44, SE = 0.37, 95% CI [-2.17; -0.71], p < 0.001; T2: b = -1.05, SE = 0.37, 95% CI [-1.79; -0.32], p = 0.005).
Conclusion: The InMe intervention selectively improved self-reported interoception at follow-up but did not outperform the control for secondary outcomes. Future research should explore its efficacy in clinical populations alongside complementary therapies.
内感受是对生理状态的感知、意识和调节，对身心健康至关重要。针对内感受的行为干预措施是存在的，但随机对照试验（RCTs）测试效果仍然有限。目前，预注册的（ISRCTN16762367）随机对照试验测试了新的内感受性洞察力和元认知效能信念（InMe）干预。InMe在压力下使用慢呼吸和心脏生物反馈来训练内感受性自我效能感信念并改善自我报告的内感受。方法将年龄在18-30岁、自我报告内感受较低的健康参与者随机（1:1）分配到InMe干预组（n=50）或主动对照组(引导图像；n = 52)。对分配不知情的参与者按性别和饮食紊乱进行分层。评估包括基线（T0）、干预后（T1）和干预后7-8周（T2）。主要结果为内感受意识多维度评估问卷中的“适应性内感受”因子。结果：T1时，两组患者的主要转归均有改善(InMe：调整后M差=5.76；95%可信区间[-0.03,11.56],p = 0.05;对照：调整M差=7.90；95%可信区间[1.92,13.87],p = 0.002;边际R2 = 0.09)。然而，只有InMe在T2时维持了这种改善(InMe：调整后的M差=9.25,95%CI[3.37;15.13], p
{"title":"Biofeedback and Training of Interoceptive Insight and Metacognitive Efficacy Beliefs to Improve Adaptive Interoception: A Subclinical Randomised Controlled Trial.","authors":"Michal Tanzer, Marina Bobou, Athanasios Koukoutsakis, Alkistis Saramandi, Paul M Jenkinson, Sam Norton, Caroline Selai, Katerina Fotopoulou","doi":"10.1159/000546298","DOIUrl":"10.1159/000546298","url":null,"abstract":"<p><strong>Introduction: </strong>Interoception, the sensing, awareness, and regulation of physiological states, is crucial for wellbeing and mental health. Behavioural interventions targeting interoception exist, but randomised controlled trials (RCTs) testing efficacy remain limited. The present, preregistered (ISRCTN16762367) RCT tested the novel Interoceptive iNsight and Metacognitive Efficacy beliefs (InMe) intervention. InMe uses slow breathing and cardiac biofeedback during stress to train interoceptive self-efficacy beliefs and improve self-reported interoception.</p><p><strong>Methods: </strong>Healthy participants aged 18-30 years with low self-reported interoception were randomly assigned (1:1) to the InMe intervention (n = 50) or an active control (guided imagery; n = 52). Participants blinded to allocation were stratified by gender and disordered eating. Assessments included baseline (T0), post-intervention (T1), and 7-8 weeks post-intervention (T2). The primary outcome was the \"adaptive interoception\" factor of the Multidimensional Assessment of Interoceptive Awareness questionnaire.</p><p><strong>Results: </strong>Both arms improved in the primary outcome at T1 (InMe: adjusted M difference = 5.76; 95% CI [-0.03; 11.56], p = 0.05; control: adjusted M difference = 7.90; 95% CI [1.92; 13.87], p = 0.002; marginal R2 = 0.09). However, only InMe sustained this improvement at T2 (InMe: adjusted M difference = 9.25, 95% CI [3.37; 15.13], p < 0.001; control: adjusted M difference = 2.94, 95% CI [-3.07; 8.96], p = 0.72), as indicated by a significant time*arm interaction (b = 6.31; SE = 2.92, 95% CI [0.56; 12.05], p < 0.03; marginal R2 = 0.12). Secondary outcomes showed a reduction in disordered eating scores across both arms at both time points (T1: b = -1.44, SE = 0.37, 95% CI [-2.17; -0.71], p < 0.001; T2: b = -1.05, SE = 0.37, 95% CI [-1.79; -0.32], p = 0.005).</p><p><strong>Conclusion: </strong>The InMe intervention selectively improved self-reported interoception at follow-up but did not outperform the control for secondary outcomes. Future research should explore its efficacy in clinical populations alongside complementary therapies.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-23"},"PeriodicalIF":17.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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}
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