首页 > 最新文献

Psychotherapy and Psychosomatics最新文献

英文 中文
Psychotherapy for Chronic In- and Outpatients with Common Mental Disorders: The "Choose Change" Effectiveness Trial. 常见病慢性住院和门诊患者的心理治疗:“选择改变”效果试验。
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.1159/000529411
Andrew T Gloster, Elisa Haller, Jeanette Villanueva, Victoria Block, Charles Benoy, Andrea H Meyer, Sandra Brogli, Veronika Kuhweide, Maria Karekla, Klaus Bader, Marc Walter, Undine Lang

Introduction: Treatment non-response occurs regularly, but psychotherapy is seldom examined for such patients. Existing studies targeted single diagnoses, were relatively small, and paid little attention to treatment under real-world conditions.

Objective: The Choose Change trial tested whether psychotherapy was effective in treating chronic patients with treatment non-response in a transdiagnostic sample of common mental disorders across two variants of treatment delivery (inpatient and outpatient).

Methods: The controlled nonrandomized effectiveness trial was conducted between May 2016 and May 2021. The study took place in two psychiatric clinics with N = 200 patients (n = 108 inpatients and n = 92 outpatients). Treatment variants were integrated inpatient care versus outpatient care based on acceptance and commitment therapy (ACT) for approximately 12 weeks. Therapists delivered individualized and non-manualized ACT. Main outcome measures were symptoms (Brief Symptom Checklist [BSCL]); well-being (Mental Health Continuum-Short Form [MHC-SF]), and functioning (WHO Disability Assessment Schedule [WHO-DAS]).

Results: Both inpatients and outpatients showed decreases in symptomatology (i.e., BSCL: d = 0.68) and increases in well-being and functioning (MHC-SF: d = 0.60 and WHO-DAS: d = 0.70), with more improvement in the inpatients during treatment. Both groups maintained gains 1 year following treatment, and the groups did not significantly differ from each other at this timepoint. Psychological flexibility moderated impact of stress on outcomes.

Conclusions: Psychotherapy as practiced under routine conditions is effective for a sample of patients with common mental disorders, a long history of treatment experience and burden of disease, in both inpatient and outpatient settings.

Trial registration: This study was registered in the ISRCTN registry on May 20, 2016, with the registration number ISRCTN11209732.

引言:治疗无反应时有发生,但很少对此类患者进行心理治疗检查。现有的研究针对单一诊断,相对较小,并且很少关注现实世界条件下的治疗。目的:选择改变试验测试了在两种治疗方式(住院和门诊)的常见精神障碍的跨诊断样本中,心理治疗对治疗无反应的慢性患者是否有效。方法:2016年5月- 2021年5月进行对照非随机疗效试验。该研究在两家精神病诊所进行,共有200名患者(108名住院患者和92名门诊患者)。治疗变体是基于接受和承诺治疗(ACT)的住院治疗与门诊治疗的综合治疗,持续约12周。治疗师提供个性化和非手动ACT。主要结局指标为症状(简要症状检查表[BSCL]);健康(精神健康连续简表[MHC-SF])和功能(世卫组织残疾评估表[WHO- das])。结果:住院患者和门诊患者均表现出症状减轻(即BSCL: d = 0.68),幸福感和功能改善(MHC-SF: d = 0.60, WHO-DAS: d = 0.70),住院患者在治疗期间改善较多。两组在治疗后1年均保持获益,在此时间点各组间无显著差异。心理灵活性调节压力对结果的影响。结论:在常规条件下进行心理治疗对住院和门诊有长期治疗经验和疾病负担的常见精神障碍患者样本有效。试验注册:本研究于2016年5月20日在ISRCTN注册中心注册,注册号为ISRCTN11209732。
{"title":"Psychotherapy for Chronic In- and Outpatients with Common Mental Disorders: The \"Choose Change\" Effectiveness Trial.","authors":"Andrew T Gloster,&nbsp;Elisa Haller,&nbsp;Jeanette Villanueva,&nbsp;Victoria Block,&nbsp;Charles Benoy,&nbsp;Andrea H Meyer,&nbsp;Sandra Brogli,&nbsp;Veronika Kuhweide,&nbsp;Maria Karekla,&nbsp;Klaus Bader,&nbsp;Marc Walter,&nbsp;Undine Lang","doi":"10.1159/000529411","DOIUrl":"https://doi.org/10.1159/000529411","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment non-response occurs regularly, but psychotherapy is seldom examined for such patients. Existing studies targeted single diagnoses, were relatively small, and paid little attention to treatment under real-world conditions.</p><p><strong>Objective: </strong>The Choose Change trial tested whether psychotherapy was effective in treating chronic patients with treatment non-response in a transdiagnostic sample of common mental disorders across two variants of treatment delivery (inpatient and outpatient).</p><p><strong>Methods: </strong>The controlled nonrandomized effectiveness trial was conducted between May 2016 and May 2021. The study took place in two psychiatric clinics with N = 200 patients (n = 108 inpatients and n = 92 outpatients). Treatment variants were integrated inpatient care versus outpatient care based on acceptance and commitment therapy (ACT) for approximately 12 weeks. Therapists delivered individualized and non-manualized ACT. Main outcome measures were symptoms (Brief Symptom Checklist [BSCL]); well-being (Mental Health Continuum-Short Form [MHC-SF]), and functioning (WHO Disability Assessment Schedule [WHO-DAS]).</p><p><strong>Results: </strong>Both inpatients and outpatients showed decreases in symptomatology (i.e., BSCL: d = 0.68) and increases in well-being and functioning (MHC-SF: d = 0.60 and WHO-DAS: d = 0.70), with more improvement in the inpatients during treatment. Both groups maintained gains 1 year following treatment, and the groups did not significantly differ from each other at this timepoint. Psychological flexibility moderated impact of stress on outcomes.</p><p><strong>Conclusions: </strong>Psychotherapy as practiced under routine conditions is effective for a sample of patients with common mental disorders, a long history of treatment experience and burden of disease, in both inpatient and outpatient settings.</p><p><strong>Trial registration: </strong>This study was registered in the ISRCTN registry on May 20, 2016, with the registration number ISRCTN11209732.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"92 2","pages":"124-132"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9949312","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}
引用次数: 2
Depression and Anxiety Trajectories in Chronic Disease: A Systematic Review and Meta-Analysis. 慢性病患者的抑郁和焦虑轨迹:系统综述和荟萃分析。
IF 16.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 Epub Date: 2023-08-22 DOI: 10.1159/000533263
Amelia J Scott, Ashleigh B Correa, Madelyne A Bisby, Blake F Dear

Introduction: People living with chronic diseases are at an increased risk of anxiety and depression, which are associated with poorer medical and psychosocial outcomes. Many studies have examined the trajectories of depression and anxiety in people with specific diseases, including the predictors of these trajectories. This is valuable for understanding the process of adjustment to diseases and informing treatment planning. However, no review has yet synthesised this information across chronic diseases.

Methods: Electronic databases were searched for studies reporting trajectories of depression or anxiety in chronic disease samples. Data extracted included sample characteristics, results from trajectory analyses, and predictors of trajectories. Meta-analysis of the overall pooled prevalence of depression and anxiety trajectories was conducted, and qualitative synthesis of disease severity predictors was undertaken.

Results: Following search and screening, 67 studies were included (N = 61,201 participants). Most participants followed a stable nonclinical trajectory for depression (69.0% [95% CI: 65.6, 72.2]) and anxiety (73.4% [95% CI: 66.3, 79.5]). Smaller but meaningful subsamples followed a trajectory of depression and anxiety symptoms consistently in the clinical range (11.8% [95% CI: 9.2, 14.8] and 13.7% [95% CI: 9.3, 19.7], respectively). Several clinical and methodological moderators emerged, and qualitative synthesis suggested that few aspects of disease severity were associated with participants' trajectories.

Conclusion: Most people with chronic disease follow a trajectory of distress that is low and stable, suggesting that most people psychologically adjust to living with chronic disease. Evidence also suggests that the nature and severity of the disease are not meaningful predictors of psychological distress.

引言:患有慢性病的人患焦虑和抑郁的风险增加,这与较差的医疗和心理社会结果有关。许多研究已经检查了患有特定疾病的人的抑郁和焦虑的轨迹,包括这些轨迹的预测因素。这对于理解疾病的适应过程和为治疗计划提供信息是很有价值的。然而,还没有任何综述综合了慢性病的这些信息。方法:在电子数据库中搜索报告慢性病样本中抑郁或焦虑轨迹的研究。提取的数据包括样本特征、轨迹分析结果和轨迹预测因素。对抑郁和焦虑轨迹的总体合并患病率进行了荟萃分析,并对疾病严重程度预测因素进行了定性综合。结果:经过搜索和筛选,纳入了67项研究(N=61201名参与者)。大多数参与者在抑郁(69.0%[95%CI:65.6,72.2])和焦虑(73.4%[95%CI=66.3,79.5])方面遵循稳定的非临床轨迹。较小但有意义的子样本在临床范围内始终遵循抑郁和焦虑症状的轨迹(分别为11.8%[95%CI:9.2,14.8]和13.7%[95%CI:9.3,19.7])。出现了几个临床和方法论调节因子,定性综合表明,疾病严重程度的几个方面与参与者的轨迹有关。结论:大多数慢性病患者的痛苦轨迹是低而稳定的,这表明大多数人在心理上适应了慢性病的生活。证据还表明,疾病的性质和严重程度并不是心理困扰的有意义的预测因素。
{"title":"Depression and Anxiety Trajectories in Chronic Disease: A Systematic Review and Meta-Analysis.","authors":"Amelia J Scott, Ashleigh B Correa, Madelyne A Bisby, Blake F Dear","doi":"10.1159/000533263","DOIUrl":"10.1159/000533263","url":null,"abstract":"<p><strong>Introduction: </strong>People living with chronic diseases are at an increased risk of anxiety and depression, which are associated with poorer medical and psychosocial outcomes. Many studies have examined the trajectories of depression and anxiety in people with specific diseases, including the predictors of these trajectories. This is valuable for understanding the process of adjustment to diseases and informing treatment planning. However, no review has yet synthesised this information across chronic diseases.</p><p><strong>Methods: </strong>Electronic databases were searched for studies reporting trajectories of depression or anxiety in chronic disease samples. Data extracted included sample characteristics, results from trajectory analyses, and predictors of trajectories. Meta-analysis of the overall pooled prevalence of depression and anxiety trajectories was conducted, and qualitative synthesis of disease severity predictors was undertaken.</p><p><strong>Results: </strong>Following search and screening, 67 studies were included (N = 61,201 participants). Most participants followed a stable nonclinical trajectory for depression (69.0% [95% CI: 65.6, 72.2]) and anxiety (73.4% [95% CI: 66.3, 79.5]). Smaller but meaningful subsamples followed a trajectory of depression and anxiety symptoms consistently in the clinical range (11.8% [95% CI: 9.2, 14.8] and 13.7% [95% CI: 9.3, 19.7], respectively). Several clinical and methodological moderators emerged, and qualitative synthesis suggested that few aspects of disease severity were associated with participants' trajectories.</p><p><strong>Conclusion: </strong>Most people with chronic disease follow a trajectory of distress that is low and stable, suggesting that most people psychologically adjust to living with chronic disease. Evidence also suggests that the nature and severity of the disease are not meaningful predictors of psychological distress.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"227-242"},"PeriodicalIF":16.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10048190","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}
引用次数: 0
Front & Back Matter 正面和背面事项
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.1159/000529257
J. Guidi, G. Fava, J. Leon
{"title":"Front & Back Matter","authors":"J. Guidi, G. Fava, J. Leon","doi":"10.1159/000529257","DOIUrl":"https://doi.org/10.1159/000529257","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":""},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43922595","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}
引用次数: 0
Real-Time fMRI Functional Connectivity Neurofeedback Reducing Repetitive Negative Thinking in Depression: A Double-Blind, Randomized, Sham-Controlled Proof-of-Concept Trial. 实时fMRI功能连接神经反馈减少抑郁症的重复性消极思维:一项双盲,随机,假对照的概念验证试验。
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.1159/000528377
Aki Tsuchiyagaito, Masaya Misaki, Namik Kirlic, Xiaoqian Yu, Stella M Sánchez, Gabe Cochran, Jennifer L Stewart, Ryan Smith, Kate D Fitzgerald, Michael L Rohan, Martin P Paulus, Salvador M Guinjoan

Introduction: Repetitive negative thinking (RNT) is a cognitive process focusing on self-relevant and negative experiences, leading to a poor prognosis of major depressive disorder (MDD). We previously identified that connectivity between the precuneus/posterior cingulate cortex (PCC) and right temporoparietal junction (rTPJ) was positively correlated with levels of RNT.

Objective: In this double-blind, randomized, sham-controlled, proof-of-concept trial, we employed real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) to delineate the neural processes that may be causally linked to RNT and could potentially become treatment targets for MDD.

Methods: MDD-affected individuals were assigned to either active (n = 20) or sham feedback group (n = 19). RNT was measured by the Ruminative Response Scale-brooding subscale (RRS-B) before and 1 week after the intervention.

Results: Individuals in the active but not in the sham group showed a significant reduction in the RRS-B; however, a greater reduction in the PCC-rTPJ connectivity was unrelated to a greater reduction in the RRS-B. Exploratory analyses revealed that a greater reduction in the retrosplenial cortex (RSC)-rTPJ connectivity yielded a more pronounced reduction in the RRS-B in the active but not in the sham group.

Conclusions: RtfMRI-nf was effective in reducing RNT. Considering the underlying mechanism of rtfMIR-nf, the RSC and rTPJ could be part of a network (i.e., default mode network) that might collectively affect the intensity of RNT. Understanding the relationship between the functional organization of targeted neural changes and clinical metrics, such as RNT, has the potential to guide the development of mechanism-based treatment of MDD.

重复性消极思维(RNT)是一种专注于自我相关和消极体验的认知过程,导致重度抑郁症(MDD)预后不良。我们之前发现楔前叶/后扣带皮层(PCC)和右颞顶交界处(rTPJ)之间的连通性与RNT水平呈正相关。目的:在这项双盲、随机、假对照、概念验证的试验中,我们采用实时功能磁共振成像神经反馈(rtfMRI-nf)来描绘可能与RNT有因果关系的神经过程,并可能成为重度抑郁症的治疗靶点。方法:将受mdd影响的个体分为主动反馈组(n = 20)和虚假反馈组(n = 19)。干预前和干预后1周采用反刍反应量表-沉思子量表(RRS-B)测量RNT。结果:运动组个体RRS-B明显降低,而假手术组个体RRS-B明显降低;然而,PCC-rTPJ连通性的较大降低与RRS-B的较大降低无关。探索性分析显示,活跃组脾后皮质(RSC)-rTPJ连通性的更大减少导致RRS-B的更明显减少,而假手术组则没有。结论:RtfMRI-nf可有效降低RNT。考虑到rtfMIR-nf的潜在机制,RSC和rTPJ可能是一个网络(即默认模式网络)的一部分,可能共同影响RNT的强度。了解靶向神经变化的功能组织与临床指标(如RNT)之间的关系,有可能指导基于机制的重度抑郁症治疗的发展。
{"title":"Real-Time fMRI Functional Connectivity Neurofeedback Reducing Repetitive Negative Thinking in Depression: A Double-Blind, Randomized, Sham-Controlled Proof-of-Concept Trial.","authors":"Aki Tsuchiyagaito,&nbsp;Masaya Misaki,&nbsp;Namik Kirlic,&nbsp;Xiaoqian Yu,&nbsp;Stella M Sánchez,&nbsp;Gabe Cochran,&nbsp;Jennifer L Stewart,&nbsp;Ryan Smith,&nbsp;Kate D Fitzgerald,&nbsp;Michael L Rohan,&nbsp;Martin P Paulus,&nbsp;Salvador M Guinjoan","doi":"10.1159/000528377","DOIUrl":"https://doi.org/10.1159/000528377","url":null,"abstract":"<p><strong>Introduction: </strong>Repetitive negative thinking (RNT) is a cognitive process focusing on self-relevant and negative experiences, leading to a poor prognosis of major depressive disorder (MDD). We previously identified that connectivity between the precuneus/posterior cingulate cortex (PCC) and right temporoparietal junction (rTPJ) was positively correlated with levels of RNT.</p><p><strong>Objective: </strong>In this double-blind, randomized, sham-controlled, proof-of-concept trial, we employed real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) to delineate the neural processes that may be causally linked to RNT and could potentially become treatment targets for MDD.</p><p><strong>Methods: </strong>MDD-affected individuals were assigned to either active (n = 20) or sham feedback group (n = 19). RNT was measured by the Ruminative Response Scale-brooding subscale (RRS-B) before and 1 week after the intervention.</p><p><strong>Results: </strong>Individuals in the active but not in the sham group showed a significant reduction in the RRS-B; however, a greater reduction in the PCC-rTPJ connectivity was unrelated to a greater reduction in the RRS-B. Exploratory analyses revealed that a greater reduction in the retrosplenial cortex (RSC)-rTPJ connectivity yielded a more pronounced reduction in the RRS-B in the active but not in the sham group.</p><p><strong>Conclusions: </strong>RtfMRI-nf was effective in reducing RNT. Considering the underlying mechanism of rtfMIR-nf, the RSC and rTPJ could be part of a network (i.e., default mode network) that might collectively affect the intensity of RNT. Understanding the relationship between the functional organization of targeted neural changes and clinical metrics, such as RNT, has the potential to guide the development of mechanism-based treatment of MDD.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"92 2","pages":"87-100"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10238612/pdf/nihms-1875510.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9593764","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}
引用次数: 5
Management of Depression in Medical Patients: The Role of Clinical Evaluation. 医疗病人抑郁症的治疗:临床评估的作用。
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 Epub Date: 2023-10-20 DOI: 10.1159/000533954
Giovanni A Fava, Jenny Guidi
{"title":"Management of Depression in Medical Patients: The Role of Clinical Evaluation.","authors":"Giovanni A Fava, Jenny Guidi","doi":"10.1159/000533954","DOIUrl":"10.1159/000533954","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"287-291"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692035","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}
引用次数: 0
ICPM News Section. ICPM新闻部分。
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 Epub Date: 2023-11-20 DOI: 10.1159/000534795
{"title":"ICPM News Section.","authors":"","doi":"10.1159/000534795","DOIUrl":"10.1159/000534795","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"92 5","pages":"347-348"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138177166","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}
引用次数: 0
Discontinuation of Antidepressant Medications: A Significant Healthcare Problem Insufficiently Addressed by the NICE Guidelines. 抗抑郁药物的停药:NICE指南未充分解决的一个重要的医疗保健问题。
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.1159/000530692
Fiammetta Cosci, Virginie-Anne Chouinard, Guy Chouinard
aDepartment of Health Sciences, University of Florence, Florence, Italy; bDepartment of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands; cInternational Lab of Clinical Measurements, University of Florence, Florence, Italy; dPsychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, MA, USA; eClinical Pharmacology and Toxicology Residency Program, McGill University, Montréal, QC, Canada; fUniversity Mental Health Institute of Montreal, Research Center Fernand Seguin, University of Montréal, Montréal, QC, Canada
{"title":"Discontinuation of Antidepressant Medications: A Significant Healthcare Problem Insufficiently Addressed by the NICE Guidelines.","authors":"Fiammetta Cosci,&nbsp;Virginie-Anne Chouinard,&nbsp;Guy Chouinard","doi":"10.1159/000530692","DOIUrl":"https://doi.org/10.1159/000530692","url":null,"abstract":"aDepartment of Health Sciences, University of Florence, Florence, Italy; bDepartment of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands; cInternational Lab of Clinical Measurements, University of Florence, Florence, Italy; dPsychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, MA, USA; eClinical Pharmacology and Toxicology Residency Program, McGill University, Montréal, QC, Canada; fUniversity Mental Health Institute of Montreal, Research Center Fernand Seguin, University of Montréal, Montréal, QC, Canada","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"92 3","pages":"148-151"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9694460","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}
引用次数: 0
Behavioural Activation versus Treatment as Usual for Depressed Older Adults in Primary Care: A Pragmatic Cluster-Randomised Controlled Trial. 初级保健中抑郁老年人的行为激活与常规治疗:一项实用的聚类随机对照试验。
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 Epub Date: 2023-06-29 DOI: 10.1159/000531201
Noortje P Janssen, Peter Lucassen, Marcus J H Huibers, David Ekers, Theo Broekman, Judith E Bosmans, Harm Van Marwijk, Jan Spijker, Richard Oude Voshaar, Gert-Jan Hendriks

Introduction: Effective non-pharmacological treatment options for depression in older adults are lacking.

Objective: The effectiveness of behavioural activation (BA) by mental health nurses (MHNs) for depressed older adults in primary care compared with treatment as usual (TAU) was evaluated.

Methods: In this multicentre cluster-randomised controlled trial, 59 primary care centres (PCCs) were randomised to BA and TAU. Consenting older (≥65 years) adults (n = 161) with clinically relevant symptoms of depression (PHQ-9 ≥ 10) participated. Interventions were an 8-week individual MHN-led BA programme and unrestricted TAU in which general practitioners followed national guidelines. The primary outcome was self-reported depression (QIDS-SR16) at 9 weeks and 3, 6, 9, and 12-month follow-up.

Results: Data of 96 participants from 21 PCCs in BA and 65 participants from 16 PCCs in TAU, recruited between July 4, 2016, and September 21, 2020, were included in the intention-to-treat analyses. At post-treatment, BA participants reported significantly lower severity of depressive symptoms than TAU participants (QIDS-SR16 difference = -2.77, 95% CI = -4.19 to -1.35), p < 0.001; between-group effect size = 0.90; 95% CI = 0.42-1.38). This difference persisted up to the 3-month follow-up (QIDS-SR16 difference = -1.53, 95% CI = -2.81 to -0.26, p = 0.02; between-group effect size = 0.50; 95% CI = 0.07-0.92) but not up to the 12-month follow-up [QIDS-SR16 difference = -0.89 (-2.49 to 0.71)], p = 0.28; between-group effect size = 0.29 (95% CI = -0.82 to 0.24).

Conclusions: BA led to a greater symptom reduction of depressive symptoms in older adults, compared to TAU in primary care, at post-treatment and 3-month follow-up, but not at 6- to 12-month follow-up.

引言:老年人抑郁症缺乏有效的非药物治疗方案。目的:与常规治疗(TAU)相比,评估心理健康护士(MHN)在初级保健中对抑郁的老年人进行行为激活(BA)的有效性。方法:在这项多中心集群随机对照试验中,59个初级保健中心(PCCs)被随机分为BA和TAU。有临床相关抑郁症状(PHQ-9≥10)的同意老年(≥65岁)成年人(n=161)参与了研究。干预措施是由MHN领导的为期8周的个人BA计划和不受限制的TAU,全科医生遵循国家指导方针。主要结果是9周和3、6、9和12个月随访时的自我报告抑郁(QIDS-SR16)。结果:2016年7月4日至2020年9月21日期间招募的来自BA 21个PCC的96名参与者和来自TAU 16个PCC的65名参与者的数据被纳入意向治疗分析。在治疗后,BA参与者报告的抑郁症状严重程度显著低于TAU参与者(QIDS-SR16差异=-2.77,95%CI=-4.19至-1.35),p<;0.001;组间效应大小=0.90;95%可信区间=0.42-1.38)。这种差异持续到3个月随访(QIDS-SR16差异=1.53,95%可信区间-2.81至-0.26,p=0.02;组间效应大小=0.50;95%可信区间0.07-0.92),但没有持续到12个月随访[QIDS-SR16=-0.89(-2.49至0.71)],p=0.28;组间效应大小=0.29(95%CI=0.82-0.24)。结论:与初级保健、治疗后和3个月随访中的TAU相比,BA能更大程度地减轻老年人的抑郁症状,但在6至12个月随访时没有。
{"title":"Behavioural Activation versus Treatment as Usual for Depressed Older Adults in Primary Care: A Pragmatic Cluster-Randomised Controlled Trial.","authors":"Noortje P Janssen,&nbsp;Peter Lucassen,&nbsp;Marcus J H Huibers,&nbsp;David Ekers,&nbsp;Theo Broekman,&nbsp;Judith E Bosmans,&nbsp;Harm Van Marwijk,&nbsp;Jan Spijker,&nbsp;Richard Oude Voshaar,&nbsp;Gert-Jan Hendriks","doi":"10.1159/000531201","DOIUrl":"10.1159/000531201","url":null,"abstract":"<p><strong>Introduction: </strong>Effective non-pharmacological treatment options for depression in older adults are lacking.</p><p><strong>Objective: </strong>The effectiveness of behavioural activation (BA) by mental health nurses (MHNs) for depressed older adults in primary care compared with treatment as usual (TAU) was evaluated.</p><p><strong>Methods: </strong>In this multicentre cluster-randomised controlled trial, 59 primary care centres (PCCs) were randomised to BA and TAU. Consenting older (≥65 years) adults (n = 161) with clinically relevant symptoms of depression (PHQ-9 ≥ 10) participated. Interventions were an 8-week individual MHN-led BA programme and unrestricted TAU in which general practitioners followed national guidelines. The primary outcome was self-reported depression (QIDS-SR16) at 9 weeks and 3, 6, 9, and 12-month follow-up.</p><p><strong>Results: </strong>Data of 96 participants from 21 PCCs in BA and 65 participants from 16 PCCs in TAU, recruited between July 4, 2016, and September 21, 2020, were included in the intention-to-treat analyses. At post-treatment, BA participants reported significantly lower severity of depressive symptoms than TAU participants (QIDS-SR16 difference = -2.77, 95% CI = -4.19 to -1.35), p &lt; 0.001; between-group effect size = 0.90; 95% CI = 0.42-1.38). This difference persisted up to the 3-month follow-up (QIDS-SR16 difference = -1.53, 95% CI = -2.81 to -0.26, p = 0.02; between-group effect size = 0.50; 95% CI = 0.07-0.92) but not up to the 12-month follow-up [QIDS-SR16 difference = -0.89 (-2.49 to 0.71)], p = 0.28; between-group effect size = 0.29 (95% CI = -0.82 to 0.24).</p><p><strong>Conclusions: </strong>BA led to a greater symptom reduction of depressive symptoms in older adults, compared to TAU in primary care, at post-treatment and 3-month follow-up, but not at 6- to 12-month follow-up.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"255-266"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9699118","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}
引用次数: 1
Allostatic Load and Allostatic Overload: Preventive and Clinical Implications. 异速负荷和异速负荷:预防和临床意义。
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 Epub Date: 2023-11-06 DOI: 10.1159/000534340
Monique C Pfaltz, Ulrich Schnyder
{"title":"Allostatic Load and Allostatic Overload: Preventive and Clinical Implications.","authors":"Monique C Pfaltz, Ulrich Schnyder","doi":"10.1159/000534340","DOIUrl":"10.1159/000534340","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"279-282"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71485307","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}
引用次数: 0
Screening Second Victims for Emotional Distress: Assessment of the Clinimetric Properties of the WITHSTAND-PSY Questionnaire. 筛查第二受害者的情绪困扰:评估 WITHSTAND-PSY 问卷的临床测量特性。
IF 22.8 1区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 Epub Date: 2023-12-20 DOI: 10.1159/000535006
Isolde Martina Busch, Maria Angela Mazzi, Loretta Berti, Albert W Wu, Fiammetta Cosci, Veronica Marinelli, Francesca Moretti, Michela Rimondini

Introduction: Adverse events (AEs) are a leading cause of patient morbidity and mortality, greatly impacting healthcare providers' well-being (second victim (SV) phenomenon). Since it is not accurately captured by existing psychometric instruments, we developed a clinimetric instrument for assessing SVs' emotional distress before and after an AE.

Methods: Content validity and clinical utility of the WITHSTAND-PSY Questionnaire (WS-PSY-Q) were examined using cognitive interviews. Rasch analysis (n = 284) was applied for clinimetric assessment (i.e., construct, concurrent, and clinical validity, internal consistency), considering two crucial psychological facets of the SV phenomenon (1st: emotional impact of the AE, 2nd: current emotional state).

Results: The Rasch partial credit model was used. The 1st facet demonstrated overall acceptable clinimetric properties with the subscale anxiety meeting clinimetric threshold values (e.g., all items with ordered thresholds, Loevinger's coefficient h ≥ 0.40; Person Separation Reliability Index (PSI) = 0.7). The 2nd facet showed overall better clinimetric properties for both subscales (e.g., h ≥ 0.40, PSI = 0.82 and 0.79, respectively; receiver operating characteristic area of 0.80 and 0.86, respectively). For both datasets, item fit statistics, except those for item 19, were within the critical range (z-score < ±2.5), and meaningful differential functioning analysis was observed for only 4 (out of 24) items. Local dependency was not observed, except for two item couples in the depression subscales.

Conclusions: The WS-PSY-Q is the first clinimetric tool assessing SVs' emotional distress. It should be regarded as part of the armamentarium used by clinicians to assess in-depth healthcare providers' psychological reactions in the aftermath of an AE to mitigate burnout and allostatic overload.

导言:不良事件(AEs)是导致患者发病和死亡的主要原因之一,对医护人员的身心健康造成了极大的影响(第二受害者(SV)现象)。由于现有的心理测量工具无法准确捕捉这一现象,我们开发了一种临床测量工具,用于评估 AE 发生前后 SV 的情绪困扰:方法:通过认知访谈对WITHSTAND-PSY问卷(WS-PSY-Q)的内容有效性和临床实用性进行了研究。考虑到 SV 现象的两个关键心理层面(第一:AE 对情绪的影响;第二:当前的情绪状态),采用 Rasch 分析法(n = 284)进行临床评估(即建构效度、并发效度和临床效度、内部一致性):结果:采用了 Rasch 部分信用模型。第 1 个侧面显示出总体上可接受的临床属性,子量表焦虑达到了临床阈值(例如,所有项目都达到了有序阈值,Loevinger 系数 h ≥ 0.40;人员分离可靠性指数(PSI)= 0.7)。对于两个分量表而言,第二分量表显示出更好的临床属性(例如,h ≥ 0.40,PSI = 0.82 和 0.79,接收者操作特征区域分别为 0.80 和 0.86)。在两个数据集中,除第 19 个项目外,其他项目的拟合统计量均在临界范围内(z-score < ±2.5),仅对 4 个项目(共 24 个)进行了有意义的功能差异分析。除了抑郁分量表中的两个项目对偶外,没有观察到局部依赖性:结论:WS-PSY-Q 是首个评估 SV 情绪困扰的临床工具。结论:WS-PSY-Q 是首个评估 SV 人员情绪困扰的临床测量工具,临床医生应将其作为评估 AE 发生后医护人员心理反应的工具之一,以减轻职业倦怠和超负荷负重。
{"title":"Screening Second Victims for Emotional Distress: Assessment of the Clinimetric Properties of the WITHSTAND-PSY Questionnaire.","authors":"Isolde Martina Busch, Maria Angela Mazzi, Loretta Berti, Albert W Wu, Fiammetta Cosci, Veronica Marinelli, Francesca Moretti, Michela Rimondini","doi":"10.1159/000535006","DOIUrl":"10.1159/000535006","url":null,"abstract":"<p><strong>Introduction: </strong>Adverse events (AEs) are a leading cause of patient morbidity and mortality, greatly impacting healthcare providers' well-being (second victim (SV) phenomenon). Since it is not accurately captured by existing psychometric instruments, we developed a clinimetric instrument for assessing SVs' emotional distress before and after an AE.</p><p><strong>Methods: </strong>Content validity and clinical utility of the WITHSTAND-PSY Questionnaire (WS-PSY-Q) were examined using cognitive interviews. Rasch analysis (n = 284) was applied for clinimetric assessment (i.e., construct, concurrent, and clinical validity, internal consistency), considering two crucial psychological facets of the SV phenomenon (1st: emotional impact of the AE, 2nd: current emotional state).</p><p><strong>Results: </strong>The Rasch partial credit model was used. The 1st facet demonstrated overall acceptable clinimetric properties with the subscale anxiety meeting clinimetric threshold values (e.g., all items with ordered thresholds, Loevinger's coefficient h ≥ 0.40; Person Separation Reliability Index (PSI) = 0.7). The 2nd facet showed overall better clinimetric properties for both subscales (e.g., h ≥ 0.40, PSI = 0.82 and 0.79, respectively; receiver operating characteristic area of 0.80 and 0.86, respectively). For both datasets, item fit statistics, except those for item 19, were within the critical range (z-score &lt; ±2.5), and meaningful differential functioning analysis was observed for only 4 (out of 24) items. Local dependency was not observed, except for two item couples in the depression subscales.</p><p><strong>Conclusions: </strong>The WS-PSY-Q is the first clinimetric tool assessing SVs' emotional distress. It should be regarded as part of the armamentarium used by clinicians to assess in-depth healthcare providers' psychological reactions in the aftermath of an AE to mitigate burnout and allostatic overload.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"399-409"},"PeriodicalIF":22.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10794969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138831191","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}
引用次数: 0
期刊
Psychotherapy and Psychosomatics
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1