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}
Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that frequently persists into adulthood. Pharmacotherapies are effective but have side effects and dropout risks. Videoconference-based cognitive behavioral therapy (vCBT) has emerged as a promising intervention, particularly for improving treatment accessibility. This study aimed to evaluate the efficacy of vCBT in adults with ADHD compared to treatment-as-usual (TAU) using a randomized, assessor-blinded, controlled trial design.
Methods: Thirty participants (aged 18-65 years) with ADHD were randomly assigned to either the 12-session individual vCBT intervention as an adjunct to TAU or TAU group. The primary outcome was the change in the total score on the ADHD Rating Scale-IV (ADHD-RS-IV) with adult prompts by a blinded assessor at 12 weeks from baseline. Secondary outcomes included self-reported measures of ADHD symptoms using the Conners' Adult ADHD Rating-Self-Report, quality of life (QOL) using the Euro QOL 5 Dimension-5 Level, functional impairment using the Sheehan Disability Scale, depression, anxiety, and self-esteem.
Results: All of the participants received pharmacotherapy. Participants in the vCBT group (n = 15) demonstrated a significantly greater reduction in ADHD-RS-IV total score than those in the TAU group (vCBT -9.02 vs. TAU 0.84, p = 0.0007, effect size -1.46). Significant improvements in self-reported inattention, hyperactivity, impulsivity, QOL, and work/school performance were observed in favor of vCBT.
Conclusion: This study highlights the efficacy of vCBT as a viable and accessible intervention for adults with ADHD, particularly in reducing core symptoms and enhancing QOL and functional outcomes. vCBT is an important alternative treatment, especially for patients who remain symptomatic after pharmacotherapy.
注意力缺陷/多动障碍（ADHD）是一种神经发育障碍，经常持续到成年。药物治疗是有效的，但有副作用和退出风险。基于视频会议的认知行为疗法（vCBT）已经成为一种很有前途的干预手段，特别是在提高治疗可及性方面。本研究旨在采用随机、评估盲、对照试验设计，评估vCBT与常规治疗（TAU）相比对成年ADHD患者的疗效。方法：30名患有ADHD的参与者（年龄在18-65岁）被随机分配到12个阶段的vCBT干预作为TAU的辅助或TAU组。主要结果是ADHD评定量表- iv （ADHD- rs - iv）总分的变化，由盲法评估者在基线后12周进行成人提示。次要结果包括使用Conners'成人ADHD评定自我报告的ADHD症状自我报告，使用Euro QOL 5维度5水平的生活质量（QOL），使用Sheehan残疾量表的功能损害，抑郁，焦虑和自尊。结果：所有患者均接受药物治疗。vCBT组（n=15）比TAU组（vCBT -9.02 vs. TAU 0.84, p = 0.0007，效应值-1.46）的参与者在ADHD-RS-IV总分上的降低显著更大。在自我报告的注意力不集中、多动、冲动、生活质量和工作/学习表现方面，观察到vCBT的显著改善。结论：本研究强调了vCBT作为一种可行且可获得的成人ADHD干预措施的有效性，特别是在减少核心症状和提高生活质量和功能结局方面。vCBT是一种重要的替代疗法，特别是对于药物治疗后仍有症状的患者。
{"title":"Videoconference-Based Cognitive Behavioral Therapy in Medication-Treated Adults with Attention-Deficit/Hyperactivity Disorder: A Randomized, Assessor-Blinded, Controlled Trial.","authors":"Aiko Eto, Ayumu Endo, Tokiko Yoshida, Yoichi Seki, Kayoko Taguchi, Minako Hongo, Kohei Takahashi, Yuki Shiko, Yoshiyuki Hirano, Eiji Shimizu","doi":"10.1159/000546539","DOIUrl":"10.1159/000546539","url":null,"abstract":"<p><strong>Introduction: </strong>Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that frequently persists into adulthood. Pharmacotherapies are effective but have side effects and dropout risks. Videoconference-based cognitive behavioral therapy (vCBT) has emerged as a promising intervention, particularly for improving treatment accessibility. This study aimed to evaluate the efficacy of vCBT in adults with ADHD compared to treatment-as-usual (TAU) using a randomized, assessor-blinded, controlled trial design.</p><p><strong>Methods: </strong>Thirty participants (aged 18-65 years) with ADHD were randomly assigned to either the 12-session individual vCBT intervention as an adjunct to TAU or TAU group. The primary outcome was the change in the total score on the ADHD Rating Scale-IV (ADHD-RS-IV) with adult prompts by a blinded assessor at 12 weeks from baseline. Secondary outcomes included self-reported measures of ADHD symptoms using the Conners' Adult ADHD Rating-Self-Report, quality of life (QOL) using the Euro QOL 5 Dimension-5 Level, functional impairment using the Sheehan Disability Scale, depression, anxiety, and self-esteem.</p><p><strong>Results: </strong>All of the participants received pharmacotherapy. Participants in the vCBT group (n = 15) demonstrated a significantly greater reduction in ADHD-RS-IV total score than those in the TAU group (vCBT -9.02 vs. TAU 0.84, p = 0.0007, effect size -1.46). Significant improvements in self-reported inattention, hyperactivity, impulsivity, QOL, and work/school performance were observed in favor of vCBT.</p><p><strong>Conclusion: </strong>This study highlights the efficacy of vCBT as a viable and accessible intervention for adults with ADHD, particularly in reducing core symptoms and enhancing QOL and functional outcomes. vCBT is an important alternative treatment, especially for patients who remain symptomatic after pharmacotherapy.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"343-357"},"PeriodicalIF":17.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234949","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}
Pub Date : 2025-01-01Epub Date: 2024-11-04DOI: 10.1159/000541810
Roi Treister, Vered Cohen, Limor Issa, Karine Beiruti Wiegler, Alexander Izakson, Mariana Agostinho
<p><strong>Introduction: </strong>Communication between medical staff and patients about treatment efficacy elicits expectations of benefit and improves treatment outcomes. While demonstrated in multiple studies via different research methodologies, uniform communication protocols have not been adopted in clinical practice. Here, we summarize the results of two sister studies aimed at bridging this gap.</p><p><strong>Methods: </strong>Women undergoing C-section (study 1, randomized controlled trial) and patients undergoing general or otolaryngologic surgeries (study 2, control group design) were recruited and assigned to the "regular communication" (RC) or "enhanced communication" (EC) arms. The EC arm received positive information about treatment, while the RC arm received no such information. In both studies, the primary outcome was change in pain intensity; in study 2, an additional outcome was morphine consumption.</p><p><strong>Results: </strong>Eighty women successfully completed study 1, and 102 patients successfully completed study 2. In both studies, significant time*group interactions were observed (p < 0.001). The analgesic effect was virtually twice as large in the EC arm compared to the RC arm. In study 2, in the last two timepoints of assessment, participants in the EC arm also consumed fewer doses of opioids than participants in the RC arm (p < 0.001). No significant differences were found in vital signs.</p><p><strong>Conclusions: </strong>We provide ecological evidence that positive information about treatment significantly decreases pain and opioid consumption during routine clinical care. This study and others could encourage healthcare providers to harness the powerful effects of patients' expectations of benefit to improve analgesics outcomes and, potentially, the outcomes of other symptoms.</p><p><strong>Introduction: </strong>Communication between medical staff and patients about treatment efficacy elicits expectations of benefit and improves treatment outcomes. While demonstrated in multiple studies via different research methodologies, uniform communication protocols have not been adopted in clinical practice. Here, we summarize the results of two sister studies aimed at bridging this gap.</p><p><strong>Methods: </strong>Women undergoing C-section (study 1, randomized controlled trial) and patients undergoing general or otolaryngologic surgeries (study 2, control group design) were recruited and assigned to the "regular communication" (RC) or "enhanced communication" (EC) arms. The EC arm received positive information about treatment, while the RC arm received no such information. In both studies, the primary outcome was change in pain intensity; in study 2, an additional outcome was morphine consumption.</p><p><strong>Results: </strong>Eighty women successfully completed study 1, and 102 patients successfully completed study 2. In both studies, significant time*group interactions were observed (p < 0.001). The analgesic
{"title":"The Power of a Good Word: Enhancing the Efficacy of Analgesics in Clinical Settings.","authors":"Roi Treister, Vered Cohen, Limor Issa, Karine Beiruti Wiegler, Alexander Izakson, Mariana Agostinho","doi":"10.1159/000541810","DOIUrl":"10.1159/000541810","url":null,"abstract":"<p><strong>Introduction: </strong>Communication between medical staff and patients about treatment efficacy elicits expectations of benefit and improves treatment outcomes. While demonstrated in multiple studies via different research methodologies, uniform communication protocols have not been adopted in clinical practice. Here, we summarize the results of two sister studies aimed at bridging this gap.</p><p><strong>Methods: </strong>Women undergoing C-section (study 1, randomized controlled trial) and patients undergoing general or otolaryngologic surgeries (study 2, control group design) were recruited and assigned to the \"regular communication\" (RC) or \"enhanced communication\" (EC) arms. The EC arm received positive information about treatment, while the RC arm received no such information. In both studies, the primary outcome was change in pain intensity; in study 2, an additional outcome was morphine consumption.</p><p><strong>Results: </strong>Eighty women successfully completed study 1, and 102 patients successfully completed study 2. In both studies, significant time*group interactions were observed (p < 0.001). The analgesic effect was virtually twice as large in the EC arm compared to the RC arm. In study 2, in the last two timepoints of assessment, participants in the EC arm also consumed fewer doses of opioids than participants in the RC arm (p < 0.001). No significant differences were found in vital signs.</p><p><strong>Conclusions: </strong>We provide ecological evidence that positive information about treatment significantly decreases pain and opioid consumption during routine clinical care. This study and others could encourage healthcare providers to harness the powerful effects of patients' expectations of benefit to improve analgesics outcomes and, potentially, the outcomes of other symptoms.</p><p><strong>Introduction: </strong>Communication between medical staff and patients about treatment efficacy elicits expectations of benefit and improves treatment outcomes. While demonstrated in multiple studies via different research methodologies, uniform communication protocols have not been adopted in clinical practice. Here, we summarize the results of two sister studies aimed at bridging this gap.</p><p><strong>Methods: </strong>Women undergoing C-section (study 1, randomized controlled trial) and patients undergoing general or otolaryngologic surgeries (study 2, control group design) were recruited and assigned to the \"regular communication\" (RC) or \"enhanced communication\" (EC) arms. The EC arm received positive information about treatment, while the RC arm received no such information. In both studies, the primary outcome was change in pain intensity; in study 2, an additional outcome was morphine consumption.</p><p><strong>Results: </strong>Eighty women successfully completed study 1, and 102 patients successfully completed study 2. In both studies, significant time*group interactions were observed (p < 0.001). The analgesic ","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"60-67"},"PeriodicalIF":17.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11797921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576769","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}
Pub Date : 2025-01-01Epub Date: 2024-11-29DOI: 10.1159/000542424
Peter Henningsen, Bernd Löwe
{"title":"Bodily Distress and International Classification of Diseases-11: Advances, Loose Ends, and Some Confusion.","authors":"Peter Henningsen, Bernd Löwe","doi":"10.1159/000542424","DOIUrl":"10.1159/000542424","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"15-19"},"PeriodicalIF":16.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771746","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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