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Stelmack, Joan A., D. ’Anna Moran, Deborah Dean, and Robert W. Massof. "Short- and Long-Term Effects of an Intensive Inpatient Vision Rehabilitation Program." Archives of Physical Medicine and Rehabilitation 88, no. 6 (June 2007): 691–95. http://dx.doi.org/10.1016/j.apmr.2007.03.025.
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Høglend, P., H. S. Dahl, A. G. Hersoug, S. Lorentzen, and J. C. Perry. "Long-term effects of transference interpretation in dynamic psychotherapy of personality disorders." European Psychiatry 26, no. 7 (October 2011): 419–24. http://dx.doi.org/10.1016/j.eurpsy.2010.05.006.
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AbstractBackgroundOnly a few treatment studies of personality disorders (PD) patients are on longer-term psychotherapy, general outcome measures are used, and follow-up periods are usually short. More studies of long-term therapies, using outcome measures of core psychopathology, are needed.MethodThis study is a dismantling randomized controlled clinical trial, specifically designed to study long-term effects of transference interpretation. Forty-six patients with mainly cluster C personality disorders were randomly assigned to 1 year of dynamic psychotherapy with or without transference interpretations. The outcome measures were remission from PD, improvement in interpersonal functioning, and use of mental health resources in the 3-year period after treatment termination.ResultsAfter therapy with transference interpretation PD-patients improved significantly more in core psychopathology and interpersonal functioning, the drop-out rate was reduced to zero, and use of health services was reduced to 50%, compared to therapy without this ingredient. Three years after treatment termination, 73% no longer met diagnostic criteria for any PD in the transference group, compared to 44% in the comparison group.ConclusionsPD-patients with co-morbid disorders improved in both treatment arms in this study. However, transference interpretation improved outcome substantially more. Long-term psychotherapy that includes transference interpretation is an effective treatment for cluster C personality disorders and milder cluster B personality disorders.
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Prado, Wagner Luiz do, Alena Siegfried, Ana R. Dâmaso, June Carnier, Aline de Piano, and Wolfgang Siegfried. "Effects of long-term multidisciplinary inpatient therapy on body composition of severely obese adolescents." Jornal de Pediatria 85, no. 3 (June 1, 2009): 243–48. http://dx.doi.org/10.2223/jped.1889.
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Tschuschke, Volker, and Tamara Anbeh. "Early Treatment Effects of Long-Term Outpatient Group Therapies - First Preliminary Results." Group Analysis 33, no. 3 (September 2000): 397–411. http://dx.doi.org/10.1177/0533316400333008.
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The article is based on the preliminary data derived from a larger German outpatient group therapy study. Under the auspices of the German Group Psychotherapy Association (DAGG) the PAGE (Projekt für ambulante Gruppentherapie-Evaluation) got under way in late 1996. It aims at the evaluation of group therapeutic treatments of physicians and psychologists in private practice.
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Lopes, Rodrigo T., Miguel M. Gonçalves, Daniel B. Fassnacht, Paulo P. P. Machado, and Inês Sousa. "Long-term effects of psychotherapy on moderate depression: A comparative study of narrative therapy and cognitive-behavioral therapy." Journal of Affective Disorders 167 (October 2014): 64–73. http://dx.doi.org/10.1016/j.jad.2014.05.042.
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Baldwin, Jeffrey N., and Kathleen A. Kriegler. "Alcoholism Treatment: A Model of Abstinence-Oriented Care." Journal of Pharmacy Practice 4, no. 6 (December 1991): 351–56. http://dx.doi.org/10.1177/089719009100400603.
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Alcohol is the United States' foremost drug of abuse. Although a significant portion of the population continues to identify alcoholism with moral weakness, society embraces treatment as the primary mode of dealing with this disease. Treatment stressing ongoing abstinence from alcohol is the most universally accepted method of therapy. Following initial intervention and referral, treatment of the alcoholic includes detoxification; intensive early treatment, using either outpatient or inpatient treatment settings; and long-term support for recovery. Aftercare programs often require continuing attendance at Alcoholics Anonymous meetings, recovery support groups, and psychotherapy. In addition, recovering individuals may receive continued health care supervision from a physician knowledgeable about alcoholism. Family therapy is stressed as a component of recovery.
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Salzer, Simone, Christel Winkelbach, Frank Leweke, Eric Leibing, and Falk Leichsenring. "Long-Term Effects of Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioural Therapy in Generalized Anxiety Disorder: 12-Month Follow-up." Canadian Journal of Psychiatry 56, no. 8 (August 2011): 503–8. http://dx.doi.org/10.1177/070674371105600809.
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Sills, Jonathan, James A. Mazzone, Flora Ma, Peter Louras, and Erickson Alexander. "TECHNOLOGY-ENHANCED PSYCHOTHERAPY IMPROVES LIFE SATISFACTION AMONG OLDER ADULT VETERANS IN LONG-TERM CARE." Innovation in Aging 3, Supplement_1 (November 2019): S504. http://dx.doi.org/10.1093/geroni/igz038.1863.
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Abstract To buffer the risk of declining life satisfaction among a Veteran cohort residing within a Veteran’s Affairs long term care facility, a new model of care called Individualized Non-Pharmacological Services Integrating Geriatric Health and Technology (INSIGHT) therapy was developed and evaluated. Consistent with the INSIGHT therapy model, traditional psychotherapy interventions including reminiscence, behavioral activation, and relaxation exercises were modified such that they could be delivered on a digital platform. A paired sample T-test was performed to identify the effects INSIGHT Therapy had on Veteran satisfaction with life. Findings indicated that Veteran life satisfaction ratings the month prior (M= 19.6522) to the initiation of INSIGHT intervention and the month following three months of INSIGHT intervention (M=22.4783) show that the satisfaction with life increased among residents (t(22)=-2.334, p=.028). Effect size = 0.489. These results suggest that INSIGHT therapy interventions help to contribute to an increase in life satisfaction among an older adult Veteran cohort residing within a Veteran’s Affairs long term care facility.
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Gräsel, E., R. Schmidt, J. Biehler, and W. Schupp. "Long-term effects of the intensification of the transition between inpatient neurological rehabilitation and home care of stroke patients." Clinical Rehabilitation 20, no. 7 (July 2006): 577–83. http://dx.doi.org/10.1191/0269215506cr978oa.
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Fava, Giovanni A., Maria Zielezny, Gianni Savron, and Silvana Grandi. "Long-Term Effects of Behavioural Treatment for Panic Disorder with Agoraphobia." British Journal of Psychiatry 166, no. 1 (January 1995): 87–92. http://dx.doi.org/10.1192/bjp.166.1.87.
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BackgroundThere are few long-term follow-up studies of panic disorder treatments, particularly when patients have been treated by behavioural methods only and have recovered.Method110 consecutive patients satisfying the DSM–III–R criteria for panic disorder with agoraphobia were treated in an out-patient clinic with behavioural methods based on exposure. After 12 sessions of psychotherapy, 81 patients became panic-free. A 2–9 year follow-up was available. Survival analysis was employed to characterise the clinical course of patients. Regular assessments by a clinical psychologist were based on the Clinical Interview for Depression.ResultsThe estimated cumulative percentage of patients remaining in remission was 96.1% for at least two years, 77.6% for at least five years, and 67.4% for at least seven years. These outcomes greatly improved in the absence of a personality disorder or residual agoraphobia after treatment.ConclusionsThe findings suggest that, even though one patient in four is unable to complete treatment or does not benefit sufficiently from it, exposure treatment can provide lasting relief for the majority of patients. Disappearance of residual and subclinical agoraphobic avoidance, and not simply of panic attacks, should be the aim of exposure therapy.
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Postma, Karin, Janneke A. Haisma, Maria T. E. Hopman, Michael P. Bergen, Henk J. Stam, and Johannes B. Bussmann. "Resistive Inspiratory Muscle Training in People With Spinal Cord Injury During Inpatient Rehabilitation: A Randomized Controlled Trial." Physical Therapy 94, no. 12 (December 1, 2014): 1709–19. http://dx.doi.org/10.2522/ptj.20140079.
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Background People with spinal cord injury (SCI) may benefit from resistive inspiratory muscle training (RIMT). Current evidence is weak, and little is known about the effect on functional outcomes and long-term effects. Objective The purpose of this study was to assess immediate and long-term effects of RIMT in people with SCI. Design This was a single-blinded randomized controlled trial. Setting The study was conducted at 4 specialized SCI units in the Netherlands. Patients The study participants were 40 people with SCI (15 with motor complete tetraplegia, 16 with incomplete tetraplegia, 8 with motor complete paraplegia, and 1 with incomplete paraplegia) who had impaired pulmonary function and were admitted for initial inpatient rehabilitation. Intervention Study participants were randomized to an RIMT group or a control group. All participants received usual rehabilitation care. In addition, participants in the intervention group performed RIMT with a threshold trainer. Measurements Measurements were performed at baseline, after 8 weeks of intervention, 8 weeks later, and 1 year after discharge from inpatient rehabilitation. Primary outcome measures were: respiratory muscle function, lung volumes and flows, and perceived respiratory function. Secondary outcome measures concerned patient functioning, which included health-related quality of life, limitations in daily life due to respiratory problems, and respiratory complications. Results During the intervention period, maximum inspiratory pressure (MIP) improved more in the RIMT group than in the control group (11.7 cm H2O, 95% confidence interval=4.3 to 19.0). At follow-up, this effect was no longer significant. No effect on other primary or secondary outcome measures was found except for an immediate effect on mental health. Limitations The sample size was insufficient to study effects on respiratory complications. Conclusions Resistive inspiratory muscle training has a positive short-term effect on inspiratory muscle function in people with SCI who have impaired pulmonary function during inpatient rehabilitation.
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Külz, Anne Katrin, Sarah Landmann, Magdalena Schmidt-Ott, Bartosz Zurowski, Andreas Wahl-Kordon, and Ulrich Voderholzer. "Long-Term Follow-up of Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: Symptom Severity and the Role of Exposure 8–10 Years After Inpatient Treatment." Journal of Cognitive Psychotherapy 34, no. 3 (June 26, 2020): 261–71. http://dx.doi.org/10.1891/jcpsy-d-20-00002.
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Obsessive-compulsive disorder (OCD) can be effectively treated by cognitive behavioral therapy (CBT) with exposure and response prevention (ERP). Yet, little is known about the long-term effects of inpatient CBT up to one decade after treatment. Thirty patients who had been treated with 12 weeks of intensive inpatient CBT with ERP were examined 8–10 years after their stay in hospital with regard to obsessive-compulsive symptoms, secondary outcomes, and use of healthcare services. Significant (p < .001) improvements in OC symptoms with medium and large effects compared to baseline on the Yale-Brown-Obsessive-Compulsive Scale (Y-BOCS) and on the Obsessive-Compulsive Inventory (OCI-R) could still be observed, with 20% of the patients reaching remission status. Continuation of exposure exercises after the inpatient stay was the sole significant factor for improved scores at follow-up. The results suggest that OCD does not necessarily take a chronic course. However, maintenance of exposure training seems to be crucial for sustained improvement.
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O’Shea, Gabrielle, Susan H. Spence, and Caroline L. Donovan. "Group versus Individual Interpersonal Psychotherapy for Depressed Adolescents." Behavioural and Cognitive Psychotherapy 43, no. 1 (May 13, 2014): 1–19. http://dx.doi.org/10.1017/s1352465814000216.
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Background: This study adds to the limited evidence concerning the benefits of Interpersonal Psychotherapy (IPT) with depressed adolescents. It evaluates the long-term effects of group versus individual delivery of this treatment approach. Aims: To conduct a small-scale examination of the long-term efficacy of group versus individual delivery of IPT for depressed adolescents. Method: Thirty-nine adolescents, aged 13–19 years, with a primary diagnosis of Major Depressive Disorder, were randomly assigned in blocks to either group or individual delivery of IPT. Standardized clinical interview and questionnaire assessments were conducted at pre- and posttreatment, and 12-month follow-up. Results: Intent-to-treat (ITT) analyses indicated significant improvements in depression, anxiety, youth-reported internalizing problems, and global functioning from pre- to posttreatment for those receiving IPT, with no significant differences in outcome between group and individual formats of delivery. Improvements were maintained at 12-month follow-up. Completer analyses also revealed significant and sustained improvements on these measures for those receiving IPT, with no differences in outcome between therapy formats for most measures. Individual IPT showed significantly greater improvements than group IPT in parent-reported internalizing problems for the completer but not the ITT analyses. Conclusions: Both individual and group formats of IPT offer promise in producing long-term benefits in the treatment of depression among adolescents.
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Furukawa, Toshi A., Norio Watanabe, and Rachel Churchill. "Psychotherapy plus antidepressant for panic disorder with or without agoraphobia." British Journal of Psychiatry 188, no. 4 (April 2006): 305–12. http://dx.doi.org/10.1192/bjp.188.4.305.
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BackgroundPanic disorder can be treated with psychotherapy, pharmacotherapy or a combination of both.AimsTo summarise the evidence concerning the short- and long-term benefits and adverse effects of a combination of psychotherapy and antidepressant treatment.MethodMeta-analyses and meta-regressions were undertaken using data from all relevant randomised controlled trials identified by a comprehensive literature search. The primary outcome was relative risk (RR) of response.ResultsWe identified 23 randomised comparisons (21 trials involving a total of 1709 patients). In the acute-phase treatment, the combined therapy was superior to antidepressant pharmacotherapy (RR=1.24, 95% CI 1.02–1.52) or psychotherapy (RR=1.16, 95%CI 1.03–1.30). After termination of the acute-phase treatment, the combined therapy was more effective than pharmacotherapy alone (RR=1.61, 95% CI 1.23–2.11) and was as effective as psychotherapy (RR=0.96, 95% CI 0.79–1.16).ConclusionsEither combined therapy or psychotherapy alone may be chosen as first-line treatment for panic disorder with or without agoraphobia, depending on the patient's preferences.
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Geraghty, Keith J., and Charlotte Blease. "Cognitive behavioural therapy in the treatment of chronic fatigue syndrome: A narrative review on efficacy and informed consent." Journal of Health Psychology 23, no. 1 (September 15, 2016): 127–38. http://dx.doi.org/10.1177/1359105316667798.
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Cognitive behavioural therapy is increasingly promoted as a treatment for chronic fatigue syndrome. There is limited research on informed consent using cognitive behavioural therapy in chronic fatigue syndrome. We undertook a narrative review to explore efficacy and to identify the salient information that should be disclosed to patients. We found a complex theoretical model underlying the rationale for psychotherapy in chronic fatigue syndrome. Cognitive behavioural therapy may bring about changes in self-reported fatigue for some patients in the short term, however there is a lack of evidence for long-term benefit or for improving physical function and cognitive behavioural therapy may cause distress if inappropriately prescribed. Therapist effects and placebo effects are important outcome factors.
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De Tullio, Pamela L., Duane M. Kirking, Debra K. Zacardelli, and Paul Kwee. "Evaluation of Long-Term Triazolam Use in an Ambulatory Veterans Administration Medical Center Population." DICP 23, no. 4 (April 1989): 290–93. http://dx.doi.org/10.1177/106002808902300403.
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Triazolam is indicated for the short-term treatment of insomnia. To determine how it was being prescribed and used, we examined triazolam use in patients who had received the drug for greater than six weeks. We reviewed medical charts of 72 adult male patients from an ambulatory Veterans Administration population who had received a 30-day triazolam prescription with at least one refill. Results showed that although prescribed daily doses of triazolam were generally appropriate for the age of the patient being treated, the average length of therapy was 6.2 months. Seventy-five percent of the prescriptions had been written for a one-month supply with five refills. Neither prescriber specialty nor level of training was significantly related to length of therapy. Thirty-nine of the patients (54 percent) were available for a telephone interview to determine how the drug was actually being used and the adverse effects profile. Over 60 percent claimed to be taking the drug every night, 95 percent at the dose prescribed. Sixty-seven percent of the patients taking triazolam nightly reportedly did not sleep as well if they tried a night without the drug. Apart from effects on sleep, dizziness and confusion were the most commonly reported adverse effects. As a result of this study, automatic stop orders on discharge were implemented to limit triazolam therapy to inpatient stays. Physicians must evaluate the need for continued hypnotic therapy so that a longer-acting agent like flurazepam may be used if chronic medication is necessary.
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Sams, Deanna P., Elizabeth D. Handley, and Linda J. Alpert-Gillis. "Mindfulness-based group therapy: Impact on psychiatrically hospitalized adolescents." Clinical Child Psychology and Psychiatry 23, no. 4 (May 20, 2018): 582–91. http://dx.doi.org/10.1177/1359104518775144.
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The practice of mindfulness has long been incorporated into psychotherapy. Research on the therapeutic benefits of mindfulness exists within adult populations, and emerging empirical evidence demonstrates the benefit of such practices in the treatment of adolescents in both clinical and non-clinical settings. However, there are extremely limited data on the practice of mindfulness with adolescents in a psychiatric hospital. The iMatter ( Improve Mindful ATTention, Enhance Relaxation) group is a manualized program developed to provide adolescents on a short-term psychiatric inpatient unit with an opportunity to learn and practice relaxation strategies, mindfulness exercises, and simple yoga poses. Mindfulness skills are taught in the context of the group and include self-observation of thoughts and feelings, breathing exercises, self-validation of one’s experience, loving-kindness toward self, non-judgmental stance toward self, and acceptance and observation of change within self. Participants included 65 adolescents aged 13–17 years ( M = 15.06, standard deviation ( SD) = 1.34) who took part in at least one session of the iMatter intervention. Improvements in self-reported mood were evident following participation in a mindfulness group. Also, participants’ heart rate significantly decreased following participation in two groups. Future directions include improved integration of mindfulness into the milieu and other unit programming. Furthermore, comparing self-reported mood and physiological measures from this sample to findings obtained for other unit groups will further clarify the impact of the iMatter intervention.
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FAVA, G. A., S. GRANDI, C. RAFANELLI, C. RUINI, S. CONTI, and P. BELLUARDO. "Long-term outcome of social phobia treated by exposure." Psychological Medicine 31, no. 5 (July 2001): 899–905. http://dx.doi.org/10.1017/s0033291701004020.
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Background. There is very little information on long-term follow-up of social phobia.Methods. A consecutive series of 70 patients satisfying the DSM-IV criteria for social phobia was treated in an out-patient clinic with behavioural methods based on exposure homework. Forty-five patients were judged to be remitted after eight individual sessions of psychotherapy. A 2 to 12 year (median = 6 years) follow-up was performed. Survival analysis was selected to characterize the clinical course of patients. Assessments were performed before treatment, at the end of therapy, after 1 year, and subsequently on a yearly basis, and utilized selected items of Paykel's Clinical Interview for Depression.Results. Six of the 45 patients (13%) had a relapse of social phobia at some time during follow-up. The estimated cumulative percentage of patients remaining in remission was 98 after 2 years, 85 after 5 years and 85 after 10 years. Such probabilities increased in the absence of a personality disorder, of residual social phobic avoidance after exposure, and of concurrent use of benzodiazepines.Conclusions. The findings suggest that, even though one patient out of three is unable to complete treatment or does not benefit sufficiently from it, exposure treatment can provide lasting effects to the majority of patients with social phobia. Disappearance of residual, subclinical social phobic avoidance appears to be the target of treatment.
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Altieri, M., R. Di Giambattista, L. Di Clemente, D. Fagiolo, E. Tarolla, A. Mercurio, E. Vicenzini, et al. "Combined Pharmacological and Short-Term Psychodynamic Psychotherapy for Probable Medication Overuse Headache: A Pilot Study." Cephalalgia 29, no. 3 (March 2009): 293–99. http://dx.doi.org/10.1111/j.1468-2982.2008.01717.x.
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We studied the effects of short-term psychodynamic psychotherapy (STPP) and pharmacological therapy in 26 consecutive patients with probable medication overuse headache (pMOH). Patients underwent a standard in-patient detoxification protocol, lasting a mean of 7 days. Eleven patients overused non-steroidal anti-inflammatory drugs (NSAIDs), five a combination of NSAIDs and triptans, four triptans, four a combination of NSAIDs, and three triptans and ergot derivates. Preventive therapy was initiated during detoxification. The STPP protocol comprised the Brief Psychodynamic Investigation (BPI) and psychoanalysis-inspired psychotherapy. All patients (groups A and B) underwent the BPI and pharmacological therapy. Half of the patients (group B) also not randomly underwent psychoanalysis-inspired psychotherapy. We found a significant interaction between time and group for headache frequency and medication intake. At 12-month follow-up, a statistically greater decrease in headache frequency and medication intake was observed in group B than in group A ( P = 0.0108 and P = 0.0097, respectively). The relapse rate was much lower in group B patients at both 6 and 12 months [15.3%, odds ratio (OR) 0.11, P = 0.016, and 23%, OR 0.18, P = 0.047, respectively] than in group A. The risk of developing chronic migraine (CM) during follow-up was higher in group A than in group B at 6 (OR 2.0, P = 0.047) and 12 months (OR 2.75, P = 0.005). Our study suggests that STPP in conjunction with drug withdrawal and prophylactic pharmacotherapy relieves headache symptoms in pMOH, reducing both long-term relapses and the burden of CM.
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Lieb, K., O. J. Storebø, B. Völlm, J. Mattivi, S. Nielsen, M. Kielsholm, E. Simonsen, and J. Stoffers-Winterling. "Are Treatment Gains Maintained? Long-term Psychological Interventions for Bordeline Personality Disorder." European Psychiatry 41, S1 (April 2017): S47. http://dx.doi.org/10.1016/j.eurpsy.2017.01.202.
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IntroductionMany new approaches have been developed to treat borderline personality disorder (BPD) by means of psychotherapy. Though there is a clear research trend towards short-interventions, the evidence from randomised controlled trials (RCT) on longer-term programmes still accumulates. On the one hand, well-established treatments like Dialectical Behavior Therapy (DBT) or Mentalisation-Based Treatment (MBT) are now subject to real-world effectiveness studies; on the other hand, new dynamic approaches have been studied, lasting longer than 6 months.ObjectivesWe are currently updating the cochrane Collaboration review on psychological interventions for BPD. First findings on the effects of longer-term psychotherapies will be presented.MethodsWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) according to cochrane collaboration standards. Any randomized comparisons of psychological interventions versus unspecific control interventions, waitlist or specific psychotherapeutic interventions in adult BPD patients were eligible. Primary outcomes were BPD core pathology as depicted by DSM criteria. Secondary outcomes included associated pathology, i.e., depression and anxiety, general psychopathology severity and functioning as well as tolerability and safety. Two researchers selected trials, assessed quality and extracted data independently.ResultsThe current evidence of longer-term psychological interventions in general, and the types of interventions for which RCT evidence is available will be evaluated and critically discussed.Disclosure of interestThe authors declare that they have no competing interest.
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Hinsberger, Martina, Leon Holtzhausen, Jessica Sommer, Debra Kaminer, Thomas Elbert, Soraya Seedat, Mareike Augsburger, Maggie Schauer, and Roland Weierstall. "Long-term effects of psychotherapy in a context of continuous community and gang violence: changes in aggressive attitude in high-risk South African adolescents." Behavioural and Cognitive Psychotherapy 48, no. 1 (May 31, 2019): 1–13. http://dx.doi.org/10.1017/s1352465819000365.
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AbstractBackground:Post-traumatic stress but also aggressive attitudes and behaviour can be found in adolescents living in a context of ongoing community and gang violence in the low-income urban areas of Cape Town, South Africa.Aims:We investigated the long-term effects (15–20 months after therapy) of (a) Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET) and (b) the cognitive behavioural intervention ‘Thinking for a Change’ (CBT) on post-traumatic stress disorder (PTSD) and aggression compared with a waiting list.Method:Fifty-four young males participated in the treatment trial, of which 17 completed the FORNET intervention, 11 the CBT intervention, and 26 were on a waiting list. The primary outcome was the change score for the Appetitive Aggression Scale; secondary outcomes were the PTSD Symptom Scale-Interview change scores, and the number of perpetrated violent event types.Results:The reduction in scores for PTSD that had been observed in FORNET completers at the first follow-up were still significant at the second long-term follow-up (Cohen’s d = 0.86). In this treatment arm (FORNET), the scores for appetitive aggression were also significantly reduced (Cohen’s d = 1.00). There were no significant changes observed for CBT or for the waiting list.Conclusions:The study indicates that FORNET can successfully reduce post-traumatic stress as well as the attraction to violence even for individuals living under conditions of continuous traumatic stress.
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Huttunen, Laura. "From individual grief to a shared history of the Bosnian war." Focaal 2014, no. 68 (March 1, 2014): 91–104. http://dx.doi.org/10.3167/fcl.2014.680107.
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This article explores the relationship between psychotherapeutic practices with people with refugee backgrounds and “the political”. The relationship between voice and audience in psychotherapeutic practices is explored; through such an analysis the relationship between psychotherapy, history, and the political is considered. The theoretical questions are approached through a case study, a Bosnian man with refugee background living in Finland and attending psychotherapy there who invited the anthropologist to attend his therapy sessions. The analysis of the single case is situated within long-term ethnographic research on the Bosnian diaspora. Situating the personal in historical and moral plots, as well as seeking larger audiences beyond the confines of the therapeutic relationship, is seen as crucial in producing therapeutic effects. Simultaneously, the case enables a theoretical discussion about the relationships between voice, audience, and the political.
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Hartman, Brenda, Mary Donnelly-VanderLoo, Tiffany Watson, Colleen O’Connor, and Janet Madill. "Proton-pump inhibitor therapy and vitamin B12 status in an inpatient hospital setting." Applied Physiology, Nutrition, and Metabolism 41, no. 10 (October 2016): 1071–76. http://dx.doi.org/10.1139/apnm-2016-0020.
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The risk for impaired vitamin B12 status increases with age, as does the use of proton pump inhibitors (PPI). Long-term use of PPIs is associated with several nutritional deficiencies including B12. Currently, there are no recommendations for B12 screening among patients taking PPIs. Data were abstracted on B12 concentrations, B12-containing supplement use, medications, and select hematological values from a retrospective chart review of 658 adults, 391 with serum B12 concentrations, admitted to 6 different medical units at 2 regional hospitals in Southwestern Ontario between 2010 and 2012. We found no difference between PPI users and nonusers and serum B12 concentrations (404 ± 224 vs 369 ± 213 pmol/L; P = 0.0690). This may be due to use of B12 containing multivitamins in 41% of PPI users. Regression modelling found that aging increases the odds of having an impaired B12 status (<220 pmol/L) by 1.4 times and those using B12 supplements are almost 4 times more likely to have an impaired status. Mean corpuscular volume was not related to B12 status. In this population, older PPI users are more likely to be using multivitamins, which may delay nutritional deficiencies. However, the lower B12 concentrations of PPI users taking only B12 supplements is a concern and requires further research. Finally, physicians need to be aware that mean corpuscular volume is no longer recommended as an effective biomarker for B12 screening and updated screening protocols need to be used to reduce the possibility of adverse neurological effects from impaired B12 status.
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Jatchavala, Chonnakarn Jatchavala, and Stella W. Y. Chan. "Psychological Interventions for Recurrence Prevention in Adolescent Depression: A Systematic Review." Journal of Health Science and Medical Research 36, no. 3 (August 20, 2018): 171. http://dx.doi.org/10.31584/jhsmr.2018.36.3.15.
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Objective: To determine the effectiveness of psychological interventions in depressive adolescents to prevent recurrent depressive episodes.Material and Methods: English databases, including Embase, Medline, Global Health, and PsychINFO, were searched for studies that examined the effectiveness of psychological interventions in preventing recurrent depression. Eight articles were found in the electronic databases and 4 studies were found from a manual search. Methodological quality was assessed using the Cochrane Collaboration’s tool.Results: One quasi-randomized control trial and 11 randomized control trials met the inclusion criteria. A systematic review of the 12 studies was conducted. The studies involved 1,641 participants that represented different effects of recurrence prevention interventions at 6, 9, 12, 24, and 33 months following treatment completion. Cognitive behavioral therapy (CBT) group intervention showed effectiveness in recurrence prevention in depressive adolescents in 6-33 months. Supportive psychotherapy and family therapy also prevented recurrent depression at 24-month follow-up, while psychodynamic/psychoanalytic psychotherapy and interpersonal psychotherapy could prevent recurrence in depressive adolescents for 12 months following completion of the intervention.Conclusion: Among the psychological interventions studied in the included articles, CBT group intervention showed the greatest long-term effect since group CBT could prevent recurrent depression in adolescents up to 33 months.
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Lochtenberg, Jessica, Ari Kirshenbaum, and Matthew Johnson. "Adjunct pharmacotherapy for psychotherapy." BJPsych Open 7, S1 (June 2021): S166—S167. http://dx.doi.org/10.1192/bjo.2021.460.
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AimsA variety of pharmacotherapies have been used to assist the psychotherapy process as “adjunctive therapies.” These drugs are used in an acute, targeted fashion, such that they are explicitly delivered in the context of psychotherapy for anxiety, mood and substance-dependence disorders (SUDs). Our narrative review highlights the potential of medically-assisted psychotherapy by outlining the current state of research on few of these medications and describing the basic science that supports their use.MethodFirstly, we researched an assortment of medications that have been used off-label to enhance psychotherapy, and selected a few that have received the most empirical attention in preclinical and clinical-trial settings. Our review of clinical trials focused on three of the most common psychiatric ailments. For all studies reviewed, we identify the strengths and weaknesses of the data supporting the use of the medications for the three aforementioned disorders.ResultD-cycloserine: accelerates the process of associative emotional learning, enhancing exposure therapy in the treatment of various anxiety disorders, including obsessive-compulsive disorder and posttraumatic stress disorder. Limited studies are available on efficacy in treating SUDs.Intranasal oxytocin: accelerates memory retrieval-extinction procedures used in posttraumatic stress disorder, and promotes prosocial cognition and behaviour, facilitating a therapeutic alliance. Sufficiently powered studies and safety studies are required before strong conclusions can be made.Propranolol: interrupts the reconsolidation of memories (leading to maladaptive learned responses) involved in posttraumatic stress disorder during memory-reactivation therapy sessions, but there is little evidence that this drug can be used for depression or SUDs.Psychedelics: may effect the brain's default mode network, engendering a transformative experience that is often followed by a reduction in psychiatric symptoms. 3,4-methylenedioxymethamphetamine may additionally modulate the amygdala response in a way that allows for reprocessing of traumatic memories, and improves the therapeutic alliance. Anxiety, mood, and SUDs appear to be positively influence by traditional and non-traditional (ketamine) psychedelics.ConclusionAlthough the efficacy of the medically-assisted psychotherapies reviewed is still under investigation, we propose that these novel treatment approaches may be preferred over traditional psychopharmacological treatments due to the presence of fewer chronic side effects, as well less toxicity and abuse potential. Furthermore, these adjunctive pharmacotherapies may help to reinforce the psychotherapeutic alliance and may ultimately yield better long-term treatment outcomes. If at least some of the adjunctive pharmacotherapies outlined in this review are found to be clinically efficacious and safe, patients will benefit from having more treatment options available to them in the future.
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Lemmens, Lotte H. J. M., Suzanne C. van Bronswijk, Frenk Peeters, Arnoud Arntz, Steven D. Hollon, and Marcus J. H. Huibers. "Long-term outcomes of acute treatment with cognitive therapy v. interpersonal psychotherapy for adult depression: follow-up of a randomized controlled trial." Psychological Medicine 49, no. 3 (May 24, 2018): 465–73. http://dx.doi.org/10.1017/s0033291718001083.
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AbstractBackgroundAlthough equally efficacious in the acute phase, it is not known how cognitive therapy (CT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) compare in the long run. This study examined the long-term outcomes of CT v. IPT for MDD.MethodsOne hundred thirty-four adult (18–65) depressed outpatients who were treated with CT (n = 69) or IPT (n = 65) in a large open-label randomized controlled trial (parallel group design; computer-generated block randomization) were monitored across a 17-month follow-up phase. Mixed regression was used to determine the course of self-reported depressive symptom severity (Beck Depression Inventory II; BDI-II) after treatment termination, and to test whether CT and IPT differed throughout the follow-up phase. Analyses were conducted for the total sample (n = 134) and for the subsample of treatment responders (n = 85). Furthermore, for treatment responders, rates of relapse and sustained response were examined for self-reported (BDI-II) and clinician-rated (Longitudinal Interval Follow-up Evaluation; LIFE) depression using Cox regression.ResultsOn average, the symptom reduction achieved during the 7-month treatment phase was maintained across follow-up (7–24 months) for CT and IPT, both in the total sample and in the responder sample. Two-thirds (67%) of the treatment responders did not relapse across the follow-up period on the BDI-II. Relapse rates assessed with the LIFE were somewhat lower. No differential effects between conditions were found.ConclusionsPatients who responded to IPT were no more likely to relapse following treatment termination than patients who responded to CT. Given that CT appears to have a prophylactic effect following successful treatment, our findings suggest that IPT might have a prophylactic effect as well.
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Vos, S. P. F., M. J. H. Huibers, L. Diels, and A. Arntz. "A randomized clinical trial of cognitive behavioral therapy and interpersonal psychotherapy for panic disorder with agoraphobia." Psychological Medicine 42, no. 12 (April 30, 2012): 2661–72. http://dx.doi.org/10.1017/s0033291712000876.
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BackgroundInterpersonal psychotherapy (IPT) seems to be as effective as cognitive behavioral therapy (CBT) in the treatment of major depression. Because the onset of panic attacks is often related to increased interpersonal life stress, IPT has the potential to also treat panic disorder. To date, a preliminary open trial yielded promising results but there have been no randomized controlled trials directly comparing CBT and IPT for panic disorder.MethodThis study aimed to directly compare the effects of CBT versus IPT for the treatment of panic disorder with agoraphobia. Ninety-one adult patients with a primary diagnosis of DSM-III or DSM-IV panic disorder with agoraphobia were randomized. Primary outcomes were panic attack frequency and an idiosyncratic behavioral test. Secondary outcomes were panic and agoraphobia severity, panic-related cognitions, interpersonal functioning and general psychopathology. Measures were taken at 0, 3 and 4 months (baseline, end of treatment and follow-up).ResultsIntention-to-treat (ITT) analyses on the primary outcomes indicated superior effects for CBT in treating panic disorder with agoraphobia. Per-protocol analyses emphasized the differences between treatments and yielded larger effect sizes. Reductions in the secondary outcomes were equal for both treatments, except for agoraphobic complaints and behavior and the credibility ratings of negative interpretations of bodily sensations, all of which decreased more in CBT.ConclusionsCBT is the preferred treatment for panic disorder with agoraphobia compared to IPT. Mechanisms of change should be investigated further, along with long-term outcomes.
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Jasiak, Karalea D., Ellen A. Middleton, James M. Camamo, Brian L. Erstad, Linda S. Snyder, and Yvonne C. Huckleberry. "Evaluation of Discontinuation of Atypical Antipsychotics Prescribed for ICU Delirium." Journal of Pharmacy Practice 26, no. 3 (November 26, 2012): 253–56. http://dx.doi.org/10.1177/0897190012465987.
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A number of trials suggest that short-term use of atypical antipsychotics may be useful in the treatment of delirium associated with critical illness. However, long-term use of such agents for this indication has not been studied and may be associated with risks of adverse effects as well as unnecessary health care costs. A retrospective study of prescribing patterns of atypical antipsychotics initiated for the treatment of intensive care unit (ICU) delirium was performed to identify whether these agents were being discontinued prior to or upon hospital discharge. Of the 59 patients who met inclusion criteria and survived to hospital discharge, 28 (47%) were continued on the atypical antipsychotic upon discharge from the medical ICU. For those continued on the agent, 20 patients (71.4%) were prescribed continued therapy as an outpatient. Inpatient costs for atypical antipsychotics during the 9-month study period were increased by approximately $888. Annual cost of the medication as outpatient therapy is assessed at approximately $45 107. Although short-term trials of atypical antipsychotics may be useful for ICU delirium, caution is advised regarding potential adverse effects and added health care costs when use is prolonged.
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Leuzinger-Bohleber, Marianne, Martin Hautzinger, Georg Fiedler, Wolfram Keller, Ulrich Bahrke, Lisa Kallenbach, Johannes Kaufhold, et al. "Outcome of Psychoanalytic and Cognitive-Behavioural Long-Term Therapy with Chronically Depressed Patients: A Controlled Trial with Preferential and Randomized Allocation." Canadian Journal of Psychiatry 64, no. 1 (November 1, 2018): 47–58. http://dx.doi.org/10.1177/0706743718780340.
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Objective: For chronic depression, the effectiveness of brief psychotherapy has been limited. This study is the first comparing the effectiveness of long-term cognitive-behavioural therapy (CBT) and long-term psychoanalytic therapy (PAT) of chronically depressed patients and the effects of preferential or randomized allocation. Methods: A total of 252 adults met the inclusion criteria (aged 21-60 years, major depression, dysthymia, double depression for at least 24 months, Quick Inventory of Depressive Symptoms [QIDS] >9, Beck Depression Inventory II [BDI] >17, informed consent, not meeting exclusion criteria). Main outcome measures were depression self-rating (BDI) and rating (clinician-rated QIDS [QIDS-C]) by independent, treatment-blinded clinicians. Full remission rates (BDI ≤12, QIDS-C ≤5) were calculated. An independent center for data management and biostatistics analyzed the treatment effects and differences using linear mixed models (multilevel models and hierarchical models). Results: The average BDI declined from 32.1 points by 12.1 points over the first year and 17.2 points over 3 years. BDI overall mean effect sizes increased from d = 1.17 after 1 year to d = 1.83 after 3 years. BDI remission rates increased from 34% after 1 year to 45% after 3 years. QIDS-C overall effect sizes increased from d = 1.56 to d = 2.08, and remission rates rose from 39% after 1 year to 61% after 3 years. We found no significant differences between PAT and CBT or between preferential and randomized allocation. Conclusions: Psychoanalytic as well as cognitive-behavioural long-term treatments lead to significant and sustained improvements of depressive symptoms of chronically depressed patients exceeding effect sizes of other international outcome studies.
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Sesti, Francesco, Talia Capozzolo, Adalgisa Pietropolli, Marco Collalti, Maria Rosa Bollea, and Emilio Piccione. "Dietary therapy: a new strategy for management of chronic pelvic pain." Nutrition Research Reviews 24, no. 1 (October 25, 2010): 31–38. http://dx.doi.org/10.1017/s0954422410000272.
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Chronic pelvic pain (CPP) can be identified as a chronic nociceptive, inflammatory and neuropathic pain characterised by spontaneous pain and an exaggerated response to painful and/or innocuous stimuli. This pain condition is extremely debilitating and usually difficult to treat. Currently, the main approaches to treatment include counselling supported by reassuring ultrasound scanning or psychotherapy, attempting to provide reassurance using laparoscopy to exclude serious pelvic pathology, hormonal therapy and neuroablative treatment to interrupt nerve pathways. Dietary supplementation has been suggested as a means to treat chronic medical illnesses that are poorly responsive to prescription drugs or in which therapeutic options are limited, costly or carry a high side-effect profile. A comprehensive search of the PubMed database was performed using the search terms ‘chronic pelvic pain’, ‘oxidative stress’, ‘antioxidants’ and ‘dietary therapy’. The systematic review focuses on both randomised and non-randomised controlled trials from 2005 onwards, in which CPP was the end point. Given the complexity and not well-understood aetiology of CPP, its treatment is often unsatisfactory and limited to partial symptom relief. Dietary therapy with antioxidants improves function of the immune system and in fighting free radical damage. Agents with antioxidant activity are able to improve CPP without undesired effects and any important metabolic changes associated with hormonal suppression therapy. In conclusion, dietary therapy with antioxidants could be considered as a new effective strategy in the long term for CPP, and may be better accepted by patients. Further randomised trials with larger series and long-term follow-up to confirm these observations are needed.
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Hovland, Anders, Inger Hilde Nordhus, Trond Sjøbø, Bente A. Gjestad, Birthe Birknes, Egil W. Martinsen, Torbjørn Torsheim, and Ståle Pallesen. "Comparing Physical Exercise in Groups to Group Cognitive Behaviour Therapy for the Treatment of Panic Disorder in a Randomized Controlled Trial." Behavioural and Cognitive Psychotherapy 41, no. 4 (July 5, 2012): 408–32. http://dx.doi.org/10.1017/s1352465812000446.
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Background: Previous studies have suggested that physical exercise can reduce symptoms for subjects suffering from panic disorder (PD). The efficacy of this intervention has so far not been compared to an established psychotherapy, such as cognitive behaviour therapy (CBT). Assessment of controlled long-term effects and the clinical significance of the treatment are also lacking. Aim: To compare physical exercise to CBT as treatment for PD, and assess controlled long-term and clinically significant effects. Method: PD-patients were randomized to either three weekly sessions of physical exercise (n = 17), or one weekly session of CBT (n = 19). Both treatments ran for 12 weeks, were manualized and administered in groups. Patients were assessed twice before the start of treatment, at post-treatment and at 6 and 12 months thereafter. Primary outcome-measures consisted of the Mobility Inventory (MI), the Agoraphobia Cognitions Questionnaire (ACQ) and the Body Sensations Questionnaire (BSQ). Results: A two-way repeated measures MANOVA of these measures demonstrated a significant effect of time, F(16, 544) = 7.28, p < .01, as well as a significant interaction effect, F(16, 544) = 1.71, p < .05, in favour of CBT. This finding was supported by the assessment of clinically significant changes of avoidant behaviour and of treatment-seeking one year later. Conclusion: Group CBT is more effective than group physical exercise as treatment of panic disorder, both immediately following treatment and at follow-up assessments.
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Zucchetti, Giulia, Filippo Candela, Cristina Bottigelli, Gabriela Campione, Annalisa Parrinello, Paola Piu, Elena Vassallo, and Franca Fagioli. "The Power of Reiki: Feasibility and Efficacy of Reducing Pain in Children With Cancer Undergoing Hematopoietic Stem Cell Transplantation." Journal of Pediatric Oncology Nursing 36, no. 5 (May 3, 2019): 361–68. http://dx.doi.org/10.1177/1043454219845879.
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Purpose: Reiki is a growing complementary therapy in pediatric oncology that needs evidence to become more credible among the health community. A within-subject design experiment was conducted to pilot testing the feasibility and efficacy of Reiki to provide pain relief among pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Method: Pediatric patients undergoing HSCT during the inpatient phase in the Stem Cell Transplantation Unit were eligible to participate to the pilot study. Short and medium effects were assessed investigating the increase or decrease of patient’s pain during three specific time periods (“delta”) of the day: morning of the Reiki session versus assessment before Reiki session (within subjects control period), assessment before Reiki session versus assessment after Reiki session (within subjects experimental period) and assessment after Reiki session versus morning the day after Reiki session (within subject follow-up period). The long-term effects were verified comparing the pain evolution in the day of the Reiki session with the following rest day. Results: The effect of 88 Reiki therapy sessions in nine patients (Mage = 12; Female = 61%) was analyzed following a short, medium, and long-term perspective. Repeated-measures analysis of variance revealed a significant difference among the three periods ( F = 17,17 p < .0001): A decrease of the pain occurred in the experimental period in short and medium term, while in the follow-up period, the pain level remained stable. Conclusions: This study demonstrates the feasibility of using Reiki therapy in pediatric cancer patients undergoing HSCT. Furthermore, these findings evidence that trained pediatric oncology nurses can insert Reiki into their clinical practice as a valid instrument for diminishing suffering from cancer in childhood.
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Martinek, Martin, Helmut Pürerfellner, Hermann Blessberger, and Gerald Pruckner. "Impact of catheter ablation therapy for atrial fibrillation on healthcare expenditures in a middle European cohort." EP Europace 22, no. 4 (January 27, 2020): 576–83. http://dx.doi.org/10.1093/europace/euz362.
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Abstract Aims Atrial fibrillation (AF) is the most prevalent arrhythmia in western countries. It is associated with increased mortality and morbidity and responsible for hospitalization rates of 10–40% per patient per year. Studies from the UK and the USA have shown that AF is responsible for ∼1% of the total healthcare expenditures in these countries. The only potentially curative treatment is pulmonary vein isolation (PVI). Published health economic data on the impact of PVI mainly consist of simulations of expenditures with assumed efficacy taken from ablation studies. Real expenditure data are missing as well as pre-ablation period data and long-term data. Methods and results We analyse true healthcare expenditures based on inpatient and outpatient data from the Upper Austrian Health Insurance Fund social security system of patients undergoing PVI during 2005 to 2015. We identified 1135 patients undergoing PVI with 268 having multiple procedures. Days of hospitalization and days of sick leave started to rise in the year before ablation. PVI was able to lower both parameters to the level of 1 year before ablation. Comparing four quarters before and after a single-index ablation, a highly significant reduction in inpatient healthcare expenditures was documented. There was a significant, but numerically small increase in outpatient expenditures, resulting in a significant reduction in overall healthcare expenditures. Conclusion Analysing a cohort of the Upper Austrian Health Insurance Fund undergoing PVI, we found significant cost-saving effects on post-interventional healthcare expenditures and a reduction in days of sick leave.
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Batrak, G. A., A. N. Brodovskaya, and S. E. Myasoedova. "EXPERIENCE OF LONG-TERM TERIPARATIDE USE FOR THE TREATMENT OF POSTOPERATIVE HYPOPARATHYROIDISM ASSOCIATED WITH OSTEOPOROSIS IN ELDERLY PATIENT." Clinician 12, no. 2 (November 30, 2018): 51–55. http://dx.doi.org/10.17650/1818-8338-2018-2-51-55.
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The aim of studyis to reflect the possibilities and effectiveness of teriparatide for the treatment of postoperative hypoparathyroidism associated with severe systemic osteoporosis, based on the data of the clinical case.Materials and methods.Patient N., aged 69, having a history of resection of 2/3 of the stomach according by Bilrot-2, urolithiasis, hypertension; since 2011 has been repeatedly hospitalized in National Medical Research Centre of Endocrinology, Ministry of Health of Russia, for secondary hyperparathyroidism and severe systemic osteoporosis. In 2016 thyroidectomy was performed in connection with papillary thyroid cancer and removal of left parathyroid gland adenoma, after which the patient developed postoperative hypoparathyroidism with severe uncontrolled hypocalcemia. As a replacement therapy, a synthetic analogue of parathyroid hormone, teriparatide, was used. For this work we used epicrisis of 2011–2016, as well as the results of the patient’s examination performed during the inpatient treatment in the Endocrinology Department of City Clinical Hospital № 4 (Ivanovo) from 2016 to 2018.Results.As a result of treatment with teriparatide in this patient, according to the results of a three-year follow-up, there is a positive clinical effect in the form of absence of convulsive syndrome, normalization of total and ionized calcium levels, absence of new compression fractures of vertebral bodies. Since the recovery of parathyroid gland function after surgery has not occurred, the use of this drug to the patient is recommended for the life term.Conclusion.The study describes a clinical case involving teriparatide as a therapy for postoperative hypoparathyroidism in combination with severe systemic osteoporosis and impaired calcium absorption in an elderly patient. The clinical effect of this type of treatment over a period of 3 years was proved in the form of normalization of phosphorus-calcium metabolism and the processes of bone remodeling in the absence of any side effects.
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Seppala, J., J. Miettunen, E. Jääskeläinen, M. Isohanni, A. Seppälä, and H. Koponen. "Definition, Epidemiology, Clinical Course and Outcomes in Treatment-resistant Schizophrenia." European Psychiatry 41, S1 (April 2017): S67. http://dx.doi.org/10.1016/j.eurpsy.2017.01.070.
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Based on a systematic review on TRS 285 studies were included regarding definitions of TRS (n = 11), genetics (18), brain structure and functioning (18), cognition (8), other neurobiological studies (16), medication (158), psychotherapy and cognitive rehabilitation (12), electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) (15), prognosis (21), and other miscellaneous studies (8). Definitions of TRS varied notably. TRS was associated with 3 to 11-fold higher healthcare costs than schizophrenia in general. One-fifth to one-third of all patients with schizophrenia were considered to be resistant to treatment. Based on limited evidence of genetics, brain structure and functioning and cognition, TRS may present as a different disorder with different etiology compared to non-TRS. Clozapine, olanzapine, risperidone, ECT and cognitive-behavioral therapy have shown effectiveness, although the number of studies and quality of research on interventions is limited. About 40% to 70% of TRS patients had an unfavorable prognosis. Younger age, living in a rural or less urban area, primary education level, more psychiatric hospital treatment days in the year before first schizophrenia diagnosis, inpatient at first schizophrenia diagnosis, paranoid subtype, comorbid personality disorder and previous suicide attempt may be risk factors associated with TRS.TRS is a poorly defined, studied and understood condition. To create a framework of knowledge for TRS, as a basis to develop innovative studies on treatment, there is a need for a consensus on the definition of TRS. Prospective long-term prognostic and novel treatment intervention studies are needed [1].Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Bartova, L., A. Weidenauer, M. Dold, A. Naderi-Heiden, S. Kasper, M. Willeit, and N. Praschak-Rieder. "Alternating intravenous racemic ketamine and electroconvulsive therapy in treatment resistant depression: A case report." European Psychiatry 41, S1 (April 2017): S522. http://dx.doi.org/10.1016/j.eurpsy.2017.01.693.
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IntroductionTreatment resistant depression (TRD) affecting approximately 10–30% of all depressed patients often remains misdiagnosed and undertreated, leading to a higher risk of relapse and suicide. Electroconvulsive therapy (ECT) and sub-anesthetic ketamine have repeatedly shown to be effective in the TRD population. Administering ketamine as an anesthetic component to augment antidepressant efficacy of ECT has been proven inconclusive, while a combination of alternating ECT and ketamine has not been investigated yet.Case reportWe present a severely depressed and chronically suicidal female inpatient who failed multiple antidepressant treatment attempts, requiring frequent psychiatric admissions. Since available conventional as well as non-conventional antidepressant treatment strategies were nearly exhausted, we employed a combination of ECT (bilateral stimulation up to 150%) 2–3 times/week, while intravenous racemic ketamine (up to 75 mg per infusion) was administered on ECT free days 2–3 times/week. Consequently, robust anti-suicidal and antidepressant effects could be observed already during the first treatment week. The temporarily occurring subjective forgetfulness disappeared after the last ECT. Summarizing, we employed 9 ECT treatments and 7 ketamine infusions leading to a stable psychopathological state even after discharge from psychiatric inpatient care. In order to prevent relapse a maintenance-therapy comprising ECT once monthly and 2 ketamine infusions (up to 100 mg per infusion) administered on the day before and after ECT was established.ConclusionsIn our patient alternating ECT and intravenous racemic ketamine were proven safe and long-term effective after numerous failed antidepressant trials including ECT and ketamine alone. We may hence encourage clinicians to widen their therapeutic armamentarium in severe TRD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Ponomareva, Elena Y. "Antibacterial therapy at different stages of treatment of infectious endocarditis. Do we act correctly?" Clinical Medicine (Russian Journal) 94, no. 9 (November 2, 2016): 662–68. http://dx.doi.org/10.18821/0023-2149-2016-94-9-662-668.
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Objective. To study characteristics of antibacterial therapy (ABT) at different stages of treatment of patients with infective endocarditis (IE) in clinical practice. Materials and methods. In retrospective (2001 to 2008) and prospective (2008 to 2014) studies lasting 14-years, 302 hospitalized patients with confirmed native valve IE were given antibiotic therapy at outpatient and inpatient stages of treatment. The choice of antibacterial drugs, duration and side effects ofprolonged use of antibiotics (AB) were analyzed in comparison with the results of hospital treatment of patients with IE. Results. It was shown that outpatients with IE due to fever without a specific diagnosis, were frequently prescribed short courses of antibiotics with the prevalence of ceftriaxone monotherapy and its combination with aminoglycosides as the starting treatment under hospital conditions. The cases of incompliance with the recommended duration of antimicrobial therapy were documented. The most common side effects of AB included diarrheal disorders, but the most serious problem was nephrotoxicity resulting in total or partial withdrawal of ABT. Conclusions. The potential of antibiotic treatment of IE is employed but incompletely, the main obstacles to the implementation of adequate antibiotic therapy of IE being the low rate of early diagnosis of the disease including etiological one and the unacceptable level of long-term safety of ABT for the patients.
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Ghaderi, Ata, Jenny Odeberg, Sanna Gustafsson, Maria Råstam, Agneta Brolund, Agneta Pettersson, and Thomas Parling. "Psychological, pharmacological, and combined treatments for binge eating disorder: a systematic review and meta-analysis." PeerJ 6 (June 21, 2018): e5113. http://dx.doi.org/10.7717/peerj.5113.
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Objective To systematically review the efficacy of psychological, pharmacological, and combined treatments for binge eating disorder (BED). Method Systematic search and meta-analysis. Results We found 45 unique studies with low/medium risk of bias, and moderate support for the efficacy of cognitive behavior therapy (CBT) and CBT guided self-help (with moderate quality of evidence), and modest support for interpersonal psychotherapy (IPT), selective serotonin reuptake inhibitors (SSRI), and lisdexamfetamine (with low quality of evidence) in the treatment of adults with BED in terms of cessation of or reduction in the frequency of binge eating. The results on weight loss were disappointing. Only lisdexamfetamine showed a very modest effect on weight loss (low quality of evidence). While there is limited support for the long-term effect of psychological treatments, we have currently no data to ascertain the long-term effect of drug treatments. Some undesired side effects are more common in drug treatment compared to placebo, while the side effects of psychological treatments are unknown. Direct comparisons between pharmaceutical and psychological treatments are lacking as well as data to generalize these results to adolescents. Conclusion We found moderate support for the efficacy of CBT and guided self-help for the treatment of BED. However, IPT, SSRI, and lisdexamfetamine received only modest support in terms of cessation of or reduction in the frequency of binge eating. The lack of long-term follow-ups is alarming, especially with regard to medication. Long-term follow-ups, standardized assessments including measures of quality of life, and the study of underrepresented populations should be a priority for future research.
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Takeuchi, Tsutomu, Naoko Wakasugi, Satoshi Uno, and Hirofumi Makino. "Long-term Safety and Effectiveness of Tacrolimus in Patients With Lupus Nephritis: 5-year Interim Postmarketing Surveillance Study in Japan (TRUST)." Journal of Rheumatology 48, no. 1 (April 1, 2020): 74–81. http://dx.doi.org/10.3899/jrheum.191008.
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Objective.To assess the long-term safety and effectiveness of tacrolimus for treating lupus nephritis (LN) in the real-world clinical setting.Methods.This is an ongoing, open-label, noncomparative, observational, postmarketing surveillance study conducted across 275 sites in Japan. Registered patients with LN were followed for 10 years. Here we report data relating to 5 years of tacrolimus maintenance therapy at the interim data cutoff in August 2016.Results.Of 1395 registered patients, 1355 received tacrolimus maintenance therapy for LN and provided safety data. The most common serious adverse drug reactions (ADR) included pneumonia (1.1%), herpes zoster (1.0%), cellulitis (1.0%), and diabetes mellitus (1.0%). ADR occurred mainly within the first 28 weeks of tacrolimus treatment, and no marked increase was observed during the follow-up period. Subgroup analyses suggested that risk factors for commonly observed ADR associated with tacrolimus included inpatient management, LN disease severity, increasing age, abnormal renal or hepatic function, and comorbid or previous disease. The cumulative rate of progression to renal failure (based on the attending physician’s assessment) was 0.8% at Year 1 and 6.6% at Year 5. Cumulative relapse rates were 7.8% and 30.6%, respectively. Urine protein:creatinine ratio, serum anti-dsDNA antibody levels, complement C3 levels, and steroid-sparing effects were all significantly improved from 4 weeks after tacrolimus treatment initiation (P < 0.001) and were sustained over 5 years.Conclusion.Long-term tacrolimus maintenance treatment over 5 years in the real-world clinical setting was well tolerated and effective in a large population of patients with LN (www.ClinicalTrials.gov: NCT01410747).
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Thaker, V. V., A. M. Leung, L. E. Braverman, R. S. Brown, and B. Levine. "Iodine-Induced Hypothyroidism in Full-term Infants With Congenital Heart Disease: More Common Than Currently Appreciated?" Journal of Clinical Endocrinology & Metabolism 99, no. 10 (October 1, 2014): 3521–26. http://dx.doi.org/10.1210/jc.2014-1956.
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Abstract Context: Iodine is a micronutrient essential for thyroid hormone synthesis. Thyroid hormone is critical for normal neurocognitive development in young infants, and even transient hypothyroidism can cause adverse neurodevelopmental outcomes. Both iodine deficiency and excess can cause hypothyroidism. Although iodine-induced hypothyroidism is well recognized in premature infants, full-term neonates have received less attention. Infants with congenital heart disease (CHD) are commonly exposed to excess iodine from administration of iodinated contrast agents during cardiac catheterization as well as topical application of iodine-containing antiseptics and dressings; hence, this is a vulnerable population. Objective: We report three cases of iodine-induced hypothyroidism in full-term neonates with CHD after cardiac angiography and topical application of iodine-containing antiseptics and dressings in the operative setting. Results: Three neonates with CHD and normal thyroid function at birth developed hypothyroidism after exposure to excess iodine. Two of these infants had transient hypothyroidism, and one had severe hypothyroidism requiring ongoing thyroid replacement therapy. All infants were asymptomatic, with hypothyroidism detected incidentally in the inpatient setting due to repeat newborn screening mandated by the long duration of hospitalization in these infants. Conclusions: Iodine-induced hypothyroidism may be under-recognized in infants with CHD exposed to excess iodine. Systematic monitoring of thyroid function should be considered to avoid potential long-term adverse neurodevelopmental effects of even transient thyroid dysfunction in this susceptible population.
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Sheridan Rains, Luke, Thomas Steare, Oliver Mason, and Sonia Johnson. "Improving substance misuse outcomes in contingency management treatment with adjunctive formal psychotherapy: a systematic review and meta-analysis." BMJ Open 10, no. 10 (October 2020): e034735. http://dx.doi.org/10.1136/bmjopen-2019-034735.
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ObjectivesContingency management (CM) is a treatment for substance misuse that involves the provision of incentives. This review examines the hypothesis that adding another formal psychotherapy, such as cognitive–behavioural therapy (CBT) or motivational enhancement therapy (MET), to CM improves substance use outcomes at both treatment end and at post-treatment follow-up compared with CM only.Data sourcesSearches were performed in December 2017 and July 2019 of seven electronic bibliographic databases (MEDLINE, PsycINFO, EMBASE, Scopus, Web of Science, CINAHL, PsycEXTRA), as well as online trial registries and EThoS, and were followed by reference list screening.Eligibility criteriaIncluded studies were randomised controlled trials of adults (18–65) who were using illicit substances, alcohol or tobacco. Studies featured an experimental arm delivering CM combined with a structured evidence-based psychotherapeutic intervention and a CM-only arm. Studies published up to July 2019 were included.Data extraction and synthesisThe primary outcome was biometrically verified point prevalent abstinence (PPA) at treatment end. Secondary outcomes included biometrically verified PPA at post-treatment follow-up and self-reported days of use at treatment end and post-treatment follow-up. Pooled risk ratios for PPA outcomes and standardised mean differences for days of use were calculated using random effects models. Risk of bias was assessed using the Grading of Recommendations Assessment, Development and Evaluation.Results12 studies (n=1654) were included. The primary analysis found no evidence of a synergistic effect in PPA at treatment end (relative risk (RR) 0.97, 95% CI 0.85 to 1.09; p=0.57). Sensitivity analysis of studies featuring CBT/MET also found no evidence of an effect (RR 0.92; 95% CI 0.79 to 1.08; p=0.32). None of the secondary outcomes showed any evidence of benefit.ConclusionThe results of the meta-analyses found no evidence that combining CM with another intervention improves the short-term or long-term effects of CM treatment.
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Mikhail, Christine, Khaled Elgaaly, Ahmed Abd El Latif Abd El Hamid, Olfat Shaker, and Shereen Ali. "Gustatory Dysfunction among a Sample of Depressed Egyptian Adults under Antidepressants Therapy: A Retrospective Cohort Study." International Journal of Dentistry 2021 (March 4, 2021): 1–10. http://dx.doi.org/10.1155/2021/5543840.
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It is quite clear that the ability to perceive taste sensations significantly affects food choice, which consequently affects health status in the long term. Gustatory dysfunction is a neglected symptom among the depressed patients and those under antidepressants therapy, although these patients are suspectable to oral problems, due to general self-negligence related to mental disease, fear of dental treatment, and side effects of varied medications utilized in psychiatry. This study is aimed at assessing gustatory thresholds (detection and recognition thresholds) among a sample of 30 depressed Egyptian adults under antidepressants therapy for at least 3 months or psychotherapy with age ranging from 20 to 50 years old, seeking the Psychiatric Clinic at the Faculty of Medicine, Cairo University, Egypt. These patients were distributed into three equal groups (tricyclic antidepressants (TCA), selective serotonin reuptake inhibitors (SSRIs), and psychotherapy) and were assessed for gustatory detection and recognition thresholds using the filter paper disc method through a scoring system. The participants were also divided into normal taste group in which both the detection and recognition scores were 1, while the scores from 2 till 5 were considered as hypogeusia group and the score of 6 was considered as dysgeusia group. The TCA group was statistically significant from the other 2 groups in sweet detection thresholds ( p = 0.043) and sweet recognition thresholds ( p = 0.007). Hypogeusia for sweet was statistically significant ( p = 0.041), where it was more common among TCA (70%) than both SSRIs and the psychotherapy group (20%). Gustatory dysfunction was found to be mostly associated with TCA followed by SSRIs particularly for sweet taste thresholds. More attention has to be given to taste changes among these patients as oral health affects general health by causing considerable pain and by changing what people eat, their speech, and their quality of life and wellbeing. Proper awareness and evaluation of this problem will improve the quality of life for the depressed patients and avoid unnecessary treatment. This trial is registered with ClinicalTrials.gov ID: NCT03599011.
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Corrigan, Amber Elyse, Ella Burchill, Lucy Pelton, Alessia Marrocu, Adele Mazzoleni, and Lydia Shackshaft. "Psilocybin: the magic medicine for depression?" BJPsych Open 7, S1 (June 2021): S165. http://dx.doi.org/10.1192/bjo.2021.456.
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AimsDepression is the single largest contributor to global disability. However, effective treatments are currently lacking, resulting in a significant burden of treatment-resistant depression (TRD). Psilocybin, a serotonergic psychedelic, found as the active compound in 'magic mushrooms', has been proposed as a novel therapeutic avenue for TRD. We aimed to evaluate the future feasibility and implications of psilocybin as a new antidepressant therapy.MethodWe reviewed and critically analysed the available literature on the efficacy and safety of psilocybin as a treatment for depression, and the potential pharmacological and psychological mechanisms of the therapeutic benefit. We discussed the relative contributions to this therapeutic effect of the pharmacological drug treatment, placebo effects, and the context and parameters of the psychotherapeutic experience. We reviewed legal, social, and economic barriers to primary research and clinical implementation.ResultPsilocybin in combination with psychotherapy has been shown to be safe and effective in TRD. Its mechanism of action in TRD has not been fully elucidated, however reviewing functional neuroimaging studies demonstrated disparate short and long-term modifications of default mode network connectivity, suggested to represent a ‘reset’ mechanism of acute modular disintegration and subsequent reintegration which restores normal function, reviving emotional responsiveness.Research suggests psychedelic treatment induces lasting personality, belief and attitude changes. The psychedelic drug itself, the context of the psychotherapeutic experience, and the post-drug integration therapy all appear to have a significant role. Preparation prior to treatment, the environment, context and support during the psychedelic experience itself, and the following long-term integration and support process must be considered.Despite novel findings Psilocybin is a Schedule I drug; this imposes a persisting ethical barrier to clinical use. Prohibition of psilocybin results in high costs of drug supply, and potential for harmful drug-seeking behaviours. Therefore, complex socio-political factors currently limit wider implementation.ConclusionPsilocybin in combination with psychotherapy is safe and effective in TRD. The interacting and elusive therapeutic mechanisms have implications for clinical implementation. Preparation prior to treatment, the physical and social environment in which the psychedelic experience takes place, and long-term integration and support are considered to play a significant role. Optimisation of these parameters and cost-benefit analyses are required prior to this being feasible as a widely available therapy. Systemic legislative, political and social change will also be key to enable widespread clinical use. The promise of this therapy on a background of inadequate current antidepressant treatments indicates these must be a priority.
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Spanier, C., E. Frank, A. B. McEachran, V. J. Grochocinski, and D. J. Kupfer. "The prophylaxis of depressive episodes in recurrent depression following discontinuation of drug therapy: integrating psychological and biological factors." Psychological Medicine 26, no. 3 (May 1996): 461–75. http://dx.doi.org/10.1017/s0033291700035546.
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SynopsisModels of long-term treatment in recurrent unipolar illness ideally should integrate both psychological and biological factors. In earlier reports we noted that high treatment specificity (i.e. good-quality maintenance interpersonal psychotherapy) and high delta sleep ratio were each associated with significantly increased wellness intervals in the absence of pharmacotherapy among patients with recurrent unipolar depression. To determine how these specific factors when taken together are related to length of survival time, we examined the concurrent effects of treatment specificity and delta sleep ratio on wellness intervals using survival analysis. We found significant effects of both treatment specificity and delta ratio on survival time. Seventy-three per cent of the patients in the high treatment specificity/high delta ratio group survived the 3-year trial, while 44% of the patients in the low delta ratio but high treatment specificity group survived. None of those rated low on both variables survived. We also found an effect for individual clinicians on treatment specificity and survival time and noted that the prophylactic effect of treatment specificity was maintained even within subsets of therapists grouped by their patients' survival times. Secondary analyses revealed an effect of patient attitudes on treatment specificity and survival time, although, when taken together, treatment specificity was the only variable remaining significantly associated with outcome. We conclude that patients remain well the longest when pre-treatment delta sleep parameters more closely approximate those of non-depressed individuals and when monthly psychotherapy is of higher quality. The key finding is that high specificity is of significant prophylactic benefit even for patients with a biological vulnerability for recurrence. We also conclude that in addition to therapists, patient expectancies contribute to treatment specificity, and high treatment specificity is, in turn, reflected in longer times to recurrence.
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Opaas, Marianne, Tore Wentzel-Larsen, and Sverre Varvin. "The 10-year course of mental health, quality of life, and exile life functioning in traumatized refugees from treatment start." PLOS ONE 15, no. 12 (December 31, 2020): e0244730. http://dx.doi.org/10.1371/journal.pone.0244730.
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Refugee patients with severe traumatic experiences may need mental health treatment, but treatment results vary, and there is scarcity of studies demonstrating refugees’ long-term health and well-being after treatment. In a 10-year naturalistic and longitudinal study, 54 multi-origin traumatized adult refugee patients, with a background of war and persecution, and with a mean stay in Norway of 10.5 years, were recruited as they entered psychological treatment in mental health specialist services. The participants were interviewed face-to-face with multiple methods at admittance, and at varying points in time during and after psychotherapy. The aim was to study the participants’ trajectories of symptoms of post-traumatic stress, anxiety and depression, four aspects of quality of life, and two aspects of exile life functioning. Linear mixed effects analyses included all symptoms and quality of life measures obtained at different times and intervals for the participants. Changes in exile life functioning was investigated by exact McNemar tests. Participants responded to the quantitative assessments up to eight times. Length of therapy varied, with a mean of 61.3 sessions (SD = 74.5). The participants improved significantly in symptoms, quality of life, and exile life functioning. Improvement in symptoms of posttraumatic stress, anxiety, and depression yielded small effect sizes (r = .05 to .13), while improvement in quality of psychological and physical health yielded medium effect sizes (r = .38 and .32). Thus, long-time improvement after psychological therapy in these severely traumatized and mostly chronified refugee patients, was more notable in quality of life and exile life functioning than in symptom reduction. The results imply that major symptom reduction may not be attainable, and may not be the most important indication of long-term improvement among refugees with long-standing trauma-related suffering. Other indications of beneficial effects should be applied as well.
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Jaworska-Andryszewska, Paulina, and Janusz Rybakowski. "Pharmacotherapy and psychotherapy for bipolar disorder in the context of early childhood trauma." Pharmacotherapy in Psychiatry and Neurology 35, no. 1 (March 29, 2019): 37–50. http://dx.doi.org/10.33450/fpn.2019.04.001.
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The current pathogenic paradigm of mood disorders proposes a model of gene-environment interaction, linking genetic predisposition, epigenetic regulation and effects of the environment. Among multiple environmental factors, the experience of childhood trauma can be connected with the pathogenesis and course of bipolar disorder (BD) as well as play a role in its pharmacological and psychotherapeutic treatment. Genetic predisposition and epigenetic factors are significant factors that shape the mechanisms of the influence of childhood trauma on the occurrence and course of BD in adulthood. By examining the influence of a number of genes on genetic predisposition, evidence was obtained that the most important genes in this respect are the serotonin transporter gene and the FKBP5 gene. Neurobiological effects can also involve epigenetic mechanisms such as DNA methylation, which can exert an effect on brain function over long-term periods. Moreover, the paper discusses the significance of early childhood trauma in therapeutic management of bipolar disorder. Negative childhood experiences can be connected with difficulties in pharmacological treatment, such as resistance to treatment with antidepressants and mood-stabilisers. Psychotherapeutic methods that directly or indirectly address early childhood trauma play an important role in the treatment of patients suffering from bipolar disorder, who have experienced such events. Among these methods, the most promising data were obtained for psychoeducation and cognitive-behavioural therapy. It appears that psychotherapy should be considered in every patient with the experience of early childhood trauma. Psychotherapeutic management combined with pharmacotherapy significantly improves the results of pharmacological treatment.
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Taube, Christian, Peter Bramlage, Annette Hofer, and Dörte Anderson. "Prevalence of oral corticosteroid use in the German severe asthma population." ERJ Open Research 5, no. 4 (October 2019): 00092–2019. http://dx.doi.org/10.1183/23120541.00092-2019.
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AimsWe investigated the prevalence of severe asthma, its comorbidities, and especially the use of oral corticosteroid (OCS) therapy in patients with severe asthma.MethodsPooled data from 3 961 429 patients insured (with statutory health insurance) during the year 2015 were analysed. Prevalence rates of severe asthma and its OCS-associated comorbidities in patients on high-dosage (HD) inhaled corticosteroid (ICS) in combination with a long-acting β agonist (LABA) therapy were compared with those of patients who were also treated with OCSs.ResultsThe asthma prevalence was 7.3%, of which 8.7% (0.6% absolute) were treated with HD-ICS/LABAs. Of these, 33.6% received additional OCSs with calculated dosages between 0.9 and 9.1 mg·day−1. More than 80% of patients on HD-ICS/LABAs had at least one comorbidity. Disorders of the heart (67.5%), metabolism/ nutrition (51.4%), psychiatric disorders (36.0%), skeletal muscle/connective tissue and bone disorders (20.3%), and eye disorders (20.0%) were predominant. The prevalence of these disorders increased for patients also receiving OCS therapy, depending on the length of treatment. Mean therapy costs ranged from €4266 per patient without OCS therapy to €11 253 per patient on long-term OCS treatment. The largest share of costs was attributable to inpatient care.ConclusionThe analyses show that OCSs are frequently prescribed in patients receiving HD-ICS/LABAs because of severe asthma and are they are frequently associated with adverse effects commonly reported with steroid usage. These data support a necessary change in severe asthma treatment, which is reflected in current treatment guidelines.
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El-Jawahri, Areej, Lara Traeger, Harry VanDusen, Joseph A. Greer, Vicki A. Jackson, William F. Pirl, Jason Telles, et al. "Effect of inpatient palliative care during hematopoietic stem cell transplantation (HCT) hospitalization on psychological distress at six months post-HCT." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 10005. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.10005.
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10005 Background: Patients’ experience during HCT hospitalization leads to significant psychological distress post-HCT. Inpatient palliative care integrated with transplant care improves patient-reported QOL and symptom burden during hospitalization for HCT. We assessed the impact of the inpatient palliative care intervention on patients’ QOL, mood, and post-traumatic stress disorder (PTSD) at 6 months post-HCT. Methods: We randomized 160 patients with hematologic malignancies admitted for autologous or allogeneic HCT to an inpatient palliative care intervention (n=81) integrated with transplant care compared to transplant care alone (n=79). At baseline and 6 months post-HCT, we assessed QOL, mood, and PTSD symptoms using the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT), the Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire (PHQ-9), and the PTSD checklist, respectively. To assess symptom burden during HCT hospitalization, we used the Edmonton Symptom Assessment Scale. We utilized linear regression models controlling for baseline values to analyze the intervention effects on outcomes at 6 months. We conducted causal mediation analyses to examine whether symptom burden during HCT mediated the effect of the intervention on o utcomes at 6 months. Results: Between 8/14 and 1/16, we enrolled 160/186 (86%) of potentially eligible patients. At 6 months post-HCT, the intervention led to improvements in depression and PTSD symptoms, but not QOL or anxiety [Table]. Improvement in symptom burden during HCT hospitalization partially mediated the effect of the intervention on patient-reported outcomes at six months post-HCT. Conclusions: Inpatient palliative care integrated with transplant care leads to improvements in depression and PTSD symptoms at 6 months post-HCT. Addressing symptom burden during HCT hospitalization partially accounts for the effect of the intervention on these long-term outcomes. Clinical trial information: NCT02207322. [Table: see text]
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Zimmermann, Peter, Karl Heinz Biesold, Klaus Barre, and Mario Lanczik. "Long-Term Course of Post-Traumatic Stress Disorder (PTSD) in German Soldiers: Effects of Inpatient Eye Movement Desensitization and Reprocessing Therapy and Specific Trauma Characteristics in Patients with Non-Combat-Related PTSD." Military Medicine 172, no. 5 (May 2007): 456–60. http://dx.doi.org/10.7205/milmed.172.5.456.
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Savenkova, Iryna, and Natalia Tsumarieva. "PSYCHOTHERAPEUTIC METHODS APPLICATION IN FOLLOW-UP OF EMOTIONALLY DEPRIVED ELEMENTARY SCHOOL CHILDREN." Science and Education 2021, no. 2 (June 2021): 5–15. http://dx.doi.org/10.24195/2414-4665-2021-2-1.
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Hardships experienced many times in the family and outside it in the past, have a negative impact on formation of children’s personality. Emotional deprivation is one of such factors. Long-term stay of elementary school children under emotional deprivation conditions results in a whole number of adverse effects. Being directly dependent on environment adverse changes and impacts emotional sphere is most vulnerable in this respect. The range of emotional deprivation adverse effects on elementary school children is quite wide: from mild emotional disorders that can be corrected with the help of correctional and developmental activities to severe mental disorders and diseases that require long-term treatment. Thus, the situation of emotional deprivation requires the use of prophylactic, corrective and rehabilitative actions. The purpose of the article is to reveal the features of psychotherapeutic methods application in arranging psychological follow-up of emotionally deprived elementary school children. To achieve the determined purpose we’ve applied a mix of speculative (analysis, synthesis, comparison and generalization) and empiric (observation, survey, talk, expert evaluations, testing, quantitative and qualitative evaluation of the results obtained) research methods. The results of the literature sources analysis let us sum up by saying that such methods as adaptation, socialization, learning, development, correction, counseling, psychotherapy, follow-up and rehabilitation may be applied to cope with children’s emotional deprivation. We consider follow-up to be the most effective and comprehensive method. The psychological follow-up model developed and tested by us includes support provided to foster families in the course of coping with children’s emotional deprivation adverse effects and is based on the system of working with foster children and parents, as well as on conducting joint classes involving parents and children. We’ve applied various psychological correction and development methods (talk, games, exercises, drawing, fantasizing and relaxation) in combination with psychotherapeutic methods (symbol drama, art therapy and positive psychotherapy) to conduct psychological follow-up of children. Effectiveness and efficiency of the emotionally deprived elementary school children psychological follow-up model developed by us has been tested on the ground of repetitive psychodiagnostic testing and comparing its results of control and experimental groups. The application of remedial methods in combination with psychotherapeutic methods has made it possible to obtain constant and long-lasting results in emotional deprivation evidences reducing and elementary school children emotional intelligence level raising.