[Summarising the efficiency of psychological interventions in the treatment of endometriosis]. / Az endometriózis pszichológiai ellátásában használatos beavatkozások hatékonyságának összegzése.

Endometriosis is a common gynecological disease affecting 5-10% of women resulting in several psychological impacts. Regarding the high prevalence as well as extensive somatic symptoms, this has become a growing issue of psychological research in recent years. Thanks to its rising importance the negative effect on quality of life, mood, and anxiety symptoms has been proven. Thus we aimed to organize psychological interventions affecting the mentioned constructs and also examine their efficiency and scientific standards. Our inclusion criteria referred to studies based on randomized controlled trials, systematic reviews, and meta-analyses. We selected seven types of interventions, such as psychoeducation, cognitive behavioural therapy, mindfulness-based methods, progressive muscle relaxation, yoga, physical activity, and complex programs. Regarding the quality of life, mood, and anxiety cognitive behavioural therapy and progressive muscle relaxation were the most effective methods, however, other interventions had promising results either. Besides, there is a growing demand for psychological and mind-body interventions, which should get a more important place in the primary care of endometriosis next to medical treatment. We find inevitable further high-quality examinations, and from the point of practice, we consider it crucial to implement current evidence-based methods in the psychological care of endometriosis. Keywords: , , , , , , , , , , , .

"I am now on 'speaking terms' with my migraine monster" - patient experiences in acceptance-based cognitive behavioral therapy delivered via the internet for migraine: a randomized controlled pilot study using a mixed-method approach.

Migraine is a common neurological disorder globally. Migraines, with or without aura, are episodic and recurring with symptom-free periods. Frequent and prolonged attacks can lead to chronic migraine. This pilot randomized controlled trial (RCT) aimed to evaluate feasibility of therapist-guided, acceptance-based internet cognitive behavioral therapy (iCBT) as an adjunct to standard medical care for migraine patients in Swedish primary healthcare settings using a mixed methods approach. Participants (treatment n = 15, control n = 14) underwent qualitative and quantitative assessments to evaluate feasibility, acceptance, and initial treatment effects. Interviews with participants (n = 7) indicate that most participants had struggled with migraines for decades and expressed dissatisfaction with the limited medical care. They found the flexible, digital format particularly helpful, praising its accessibility and structured learning. While they appreciated the comprehensive content, some faced challenges with the psychological language and the program pace. Post-treatment, participants reported emotional and behavioral changes, and better migraine management. Seventy-two percent of the 29 participants completed both baseline and 3-month follow-up measures. On average, participants completed 7.7 modules, with 60% completing all 10 modules. Promising effect size indicated a reduction in migraine days during the three-month follow-up. Both qualitative and quantitative data support the feasibility and acceptability of the intervention in primary care settings.

Videoconference-Delivered Cognitive Behavioral Therapy for Parents of Adolescents With Internet Addiction: Pilot Randomized Controlled Trial.

BACKGROUND: The rise in internet addiction, including web-based gaming and social networking services, is a serious concern. Even with access to medical institutions and counseling services, individuals with internet addiction, particularly adolescents, often refuse medical treatment or counseling. Parent-focused psychological intervention may lead to positive outcomes by improving the parent-adolescent relationship and helping parents identify and modify their adolescent's problematic behaviors, including internet addiction. OBJECTIVE: This study was a pilot randomized controlled trial to test the feasibility of remote cognitive behavioral therapy via videoconferencing for parents of adolescents with internet addiction. METHODS: A total of 13 parents of adolescents aged 12-20 years with internet addiction were recruited and randomly assigned to either 12 sessions of the videoconference-delivered cognitive behavioral therapy (vCBT) group (n=6, 46%) or the waitlist control group (n=7, 54%). The study period was from March 1, 2018, to March 31, 2022. The primary outcome was the scores of the Young Internet Addiction Test reported by the adolescents. The secondary outcomes were adolescents' hours of internet use per day (Internet Addiction Test), reported by the adolescents and by their parents; the Young Diagnostic Questionnaire, completed by the parents; and the quality of life of the adolescents and the parents, measured by the EQ-5D-5L. These were evaluated at weeks 0 and 13. RESULTS: As the primary outcome, the mean total Internet Addiction Test score decreased from 67.7 (SD 18.3; 6/13, 46%) at week 0 to 56.2 (SD 25.1; 5/9, 56%) at week 13 in the vCBT group, compared to an increase from 66.9 (SD 21.9; 7/13, 54%) to 68.0 (SD 18.7; 4/9, 44%) in the control group. For all outcomes, no significant differences were found between the 2 groups (all P>.05). CONCLUSIONS: This study suggested the practical feasibility of vCBT for parents of adolescents with internet addiction. Further large-scale, multicenter randomized controlled trials are necessary to examine the effectiveness. TRIAL REGISTRATION: UMIN Clinical Trials Registry UMIN000032483; https://tinyurl.com/yuhen6c9.

Effect of psychological nursing intervention on anxiety level and quality of life in patients with gastrointestinal peptic ulcer.

BACKGROUND: Peptic ulcer is a common gastrointestinal disease, and psychological intervention has an important influence on its occurrence and development. AIM: To investigate the effect of psychological nursing intervention on the anxiety level and quality of life of patients with gastrointestinal peptic ulcers. METHODS: Two groups of patients with peptic ulcer were selected from January to December 2012, with 60 cases in each group, and psychological nursing intervention and routine treatment were respectively performed. Psychological nursing interventions include cognitive behavioral therapy, psychological support and relaxation training. Self-rating anxiety scale (SAS) and quality of life questionnaire were used to evaluate the anxiety level and quality of life of patients before, during and after treatment. RESULTS: The SAS scores of the experimental group significantly decreased over the course of treatment, from 52.3 before treatment to 30.5 after treatment, while SAS scores of the control group did not change significantly. Meanwhile, the experimental group's quality of life score (SF-36) significantly improved over the course of treatment, from 65.2 to 85.2, while the control group remained stable. Further analysis showed that sex and age had no significant influence on the effect of psychotherapy. Both men and women, young and old, showed similar trends in anxiety relief and improved quality of life after treatment. CONCLUSION: Psychological nursing-based intervention program has a positive effect on the anxiety level and quality of life of patients with gastrointestinal peptic ulcer.

Clinical Considerations for Integrating Ethical Principles of Beneficence in the Development of Evidence-Based Interventions: The case of Pediatric Misophonia.

Misophonia is a condition involving decreased tolerance and intense responses to specific sounds, often those that are human-generated and repetitive in nature. Misophonia frequently onsets during childhood and is associated with significant distress, impairment, and diminished quality of life. While misophonia research remains nascent and no definitive practice guidelines exist at present, extant studies offer several promising potential avenues in intervention development for adults with misophonia. However, such research is comparatively limited for youth. Before widespread adoption of promising treatments, it is important to consider the potential for harm or non-beneficence that may arise from the mis-informed application of such treatments. In this article, we identify several potential pitfalls within intervention development for pediatric misophonia and provide recommendations to circumvent them. To that end, we focus on the following three topic areas: (a) challenges arising when psychological mechanisms are not considered in intervention development, (b) importation of a cognitive-behavior therapy (CBT) framework for obsessive-compulsive spectrum disorders without nuanced tailoring to misophonia, and (c) neglecting to include individuals with lived experience in the process of intervention development research. Considering these key areas within misophonia intervention development will be critical for upholding beneficence and minimizing harm in treatment of misophonia across the lifespan.

Lisdexamfetamine maintenance treatment for binge-eating disorder following successful treatments: randomized double-blind placebo-controlled trial.

BACKGROUND: Controlled research examining maintenance treatments for responders to acute interventions for binge-eating disorder (BED) is limited. This study tested efficacy of lisdexamfetamine (LDX) maintenance treatment amongst acute responders. METHODS: This prospective randomized double-blind placebo-controlled single-site trial, conducted March 2019 to September 2023, tested LDX as maintenance treatment for responders to acute treatments with LDX-alone or with cognitive-behavioral therapy (CBT + LDX) for BED with obesity. Sixty-one (83.6% women, mean age 44.3, mean BMI 36.1 kg/m2) acute responders were randomized to LDX (N = 32) or placebo (N = 29) for 12 weeks; 95.1% completed posttreatment assessments. Mixed-models and generalized-estimating equations comparing maintenance LDX v. placebo included main/interactive effects of acute (LDX or CBT + LDX) treatments to examine their predictive/moderating effects. RESULTS: Relapse rates (to diagnosis-level binge-eating frequency) following maintenance treatments were 10.0% (N = 3/30) for LDX and 17.9% (N = 5/28) for placebo; intention-to-treat binge-eating remission rates were 59.4% (N = 19/32) and 65.5% (N = 19/29), respectively. Maintenance LDX and placebo did not differ significantly in binge-eating but differed in weight-loss and eating-disorder psychopathology. Maintenance LDX was associated with significant weight-loss (-2.3%) whereas placebo had significant weight-gain (+2.2%); LDX and placebo differed significantly in weight-change throughout treatment and at posttreatment. Eating-disorder psychopathology remained unchanged with LDX but increased significantly with placebo. Acute treatments did not significantly predict/moderate maintenance-treatment outcomes. CONCLUSIONS: Adults with BED/obesity who respond to acute lisdexamfetamine treatment (regardless of additionally receiving CBT) had good maintenance during subsequent 12-weeks. Maintenance lisdexamfetamine, relative to placebo, did not provide further benefit for binge-eating but was associated with significantly better eating-disorder psychopathology outcomes and greater weight-loss.

Cognitive Behavioral Therapy and Mindfulness-Based Cognitive Therapy for Depressive Disorders: Enhancing Access and Tailoring Interventions in Diverse Settings.

Depressive disorders are an enormous societal burden given their high prevalence and impact on all facets of being human (e.g., relationships, emotions, motivation). There is a variety of evidence-based psychological treatments, with cognitive behavioral therapy (CBT) being the gold standard for major depression. Research has shown that mindfulness-based interventions (MBIs) such as mindfulness-based cognitive therapy (MBCT) are an effective relapse prevention and treatment for depression and that MBIs can be integrated in individual therapy. Furthermore, various delivery modes (e.g., digital-delivered therapy) and settings are offered to best meet different needs and improve accessibility: Evidence suggests that therapist-guided digital CBT, blended therapy, and, to some degree, digitalized MBIs may be an efficacious supplement to traditional face-to-face therapy. This chapter provides an overview of the principles and evidence base for CBT and MBCT as well as different delivery modes for depressive disorders in adults. Finally, chances and challenges of integration are discussed as implications for practice, as well as recommendations and ideas for future research.

Acceptance and Commitment Therapy for Major Depressive Disorder: Navigating Depression Treatment in Traditional and Digital Settings with Insights from Current Research.

Given the shortcomings of a mechanistic assumption of traditional cognitive behavioral therapy (CBT), a newer generation of CBT-grounded interventions focusing on process-orientated emotional and motivational aspects has emerged. These so-called third-wave CBTs emphasize function and context of inner experience over form and content, and have become evidence-based practice in the past four decades. Among these approaches, acceptance and commitment therapy (ACT) has both a large body of research for various (mental) health conditions, including major depressive disorder (MDD) in particular. ACT is a transdiagnostic approach that intends to increase psychological flexibility (PF) of clients as a universal mechanism of behavior change and a value-driven orientation in life. By focusing on present-moment awareness, acceptance, defusion, establishing a stable sense of self, clarifying personal valued life directions, and committing to behaviors consistent to these values, ACT targets the core processes of PF. Meta-analyses have indicated the efficacy and effectiveness of ACT in reducing depressive symptoms and increasing well-being, with mainly moderate effect sizes in clinical trials. ACT for MDD has been shown to be effective across different delivery modes (e.g., individual, group, digital). ACT can also be applied using self-help formats (e.g., mobile apps) and combined with features from compatible approaches like behavioral activation. There is also evidence for a high acceptability of ACT and adherence rates comparable to classic CBT. Moreover, process research has shown that ACT works specifically through the mediator of PF and by addressing its suggested core therapeutic processes. Given the essential role of offering a personalized therapeutic strategy in treatment outcomes and adherence, it is central to provide more effective options that match clients' needs and preferences. This chapter illustrates different applications of ACT for adults with MDD and the current evidence base to promote informed decisions on using ACT as additional or stand-alone therapeutic approach.

Twelve-month results for a randomized sham-controlled effectiveness trial of an in-home skills-based virtual reality program for chronic low back pain.

Introduction: Low-risk, accessible, and long-term effective nonpharmacologic behavioral interventions for chronic low back pain (cLBP) are needed. Pain education and cognitive behavioral therapy (CBT) are recommended first-line treatments, but access is poor, treatment effectiveness is variable, and long-term effectiveness is inconsistent. In-home virtual reality (VR)-delivered therapies might address these shortcomings because therapeutic content can be delivered in a consistent and quality-controlled manner. Objective: To determine whether a 56-session, self-administered in-home, Skills-Based VR program for cLBP (RelieVRx) yields long-term reductions in pain intensity and pain interference 12 months posttreatment in a large demographically diverse and clinically severe real-world sample. Methods: Participants were 1,093 demographically diverse individuals with self-reported nonmalignant cLBP >3 months duration and average pain intensity and interference scores >4/10. Participants were randomized to Skills-Based VR or active Sham, and data were collected from January 31, 2022 to October 31, 2023. Pretreatment to 12-month posttreatment analyses were conducted. Results: From baseline to 12 months posttreatment, Skills-Based VR reductions for average pain intensity (1.7 ± 2.1) and pain interference (1.9 ± 2.3) were robust and significantly greater than those found for Sham. More than half of Skills-Based VR participants reported at least a 2-point reduction in pain intensity, pain interference, or both at 12 months posttreatment. Conclusions: A standardized, in-home Skills-Based VR therapy is effective for reducing pain intensity and pain interference, and these effects are maintained to 12 months posttreatment.

Naturalistic use of a digital mental health intervention for depression and anxiety: A randomized clinical trial.

BACKGROUND: Digital mental health interventions (DMHI) may offer scalable treatment for common mental health conditions. However, many commercially available apps have not been subjected to rigorous evaluation of effectiveness, particularly among users experiencing clinically significant symptomatology. We examined depression and anxiety symptom outcomes associated with a top-rated, commercially available self-guided DMHI based on cognitive behavioral therapy ("Sanvello") relative to waitlist control. METHODS: This preregistered web-based, 2-arm, parallel-group randomized trial enrolled U.S. adults with self-reported elevated symptoms of depression and/or anxiety. Those assigned to the treatment condition were provided 8 weeks of access to Sanvello. Co-primary outcomes of depression (Patient Health Questionnaire [PHQ-9]) and anxiety (Generalized Anxiety Disorder 7-item scale [GAD-7]) severity were assessed at baseline and 2, 4, 6, and 8 weeks. RESULTS: Intention-to-treat analyses included 280 participants (mean age 32.47 ± 9.32 years; 86.1 % women). Generalized linear mixed models showed a significant improvement in depression (F(4,779) = 6.51, p < .001) and anxiety (F(4,907) = 3.28, p = .01) associated with the DMHI over time. The intervention was also associated with a greater proportion of participants exhibiting depression response (25 [45.5 %] vs 26 [16.9 %]) and remission (10 [18.2 %] vs 7 [4.5 %]) on the PHQ-9, and anxiety response (31 [44.9 %] vs 39 [22.8 %]) and remission (20 [29.0 %] vs 27 [15.8 %]) on the GAD-7, relative to waitlist. LIMITATIONS: Findings may not represent people with serious mental illness, suicidality, or the broader population of DMHI users. CONCLUSIONS: A commercially available, self-guided DMHI was effective at improving symptoms in individuals experiencing depression or anxiety. TRIAL REGISTRATION: ClinicalTrials.gov [NCT05373329].

Treatment of insomnia associated with alcohol and opioid use: a narrative review.

Substance use disorders (SUDs) are associated with profound sleep disturbances, including insomnia, sleep fragmentation, and circadian rhythm dysfunction resulting in serious mental and physical consequences. This minireview presents an overview of the neurocircuitry underlying sleep disturbances in SUDs and elaborates on treatment options with emphasis on alcohol use disorder (AUD) and opioid use disorder (OUD). A PubMed, Embase, CINAHL Plus, Cochrane, and Scopus search were conducted using sleep- and AUD/OUD related keywords from January 1st, 2000, to January 31st, 2023, with preferences for recent publications and randomized-controlled trials. A bidirectional relationship exists between insomnia and addiction with the status of each condition impacting the other in dictating clinical outcome. Existing evidence points to a resurgence of insomnia during detoxification, and unless treated satisfactorily, insomnia may lead to relapse. The discussion summarizes the strengths and limitations of cognitive behavioral therapy and pharmacological treatment for insomnia in SUDs covering evidence from both animal and clinical studies. The assumption of reestablishing normal sleep patterns by attaining and maintaining sobriety is misguided. Comorbid insomnia in patients with SUDs should be approached as an independent condition that requires its own treatment. Future clinical trials are needed with the aim of providing a resource for guiding clinical management of the many patients with insomnia and SUD.

Cognitive behavioral therapy approaches to the improvement of mental health in Parkinson's disease patients: a systematic review and meta-analysis.

BACKGROUND: Non-motor symptoms (NMS) such as impaired cognition, anxiety, and depression can have a strong adverse effect on the quality of life (QoL) of Parkinson's disease (PD) patients. The clinical application of cognitive behavioral therapy (CBT) offers an opportunity to improve cognitive function, mental health, and overall QoL for these patients. OBJECTIVE: CBT is frequently applied as a treatment option aimed at benefiting the mental health of PD patients, but the relative utility of CBT in this patient population has yet to be rigorously assessed. The present review was thus conducted with the goal of examining the relative safety and efficacy of CBT as a treatment option for PD patients suffering from cognitive impairment, anxiety, and depression, with a particular focus on the impact of CBT on PD patient QoL. METHODS: The PubMed, Embase, Medline, and Cochrane Library databases were searched for all studies published from their inception to present using keywords including "cognitive behavioral therapy" and "Parkinson's disease". Two reviewers independently screened these published studies and extracted relevant data from studies that met with defined inclusion/exclusion criteria, in addition to assessing the risk of bias. Those randomized controlled trials (RCTs) assessing the impact of CBT on older PD patients were eligible for study inclusion. In total, 22 articles incorporating 1,053 patients were included in this meta-analysis. Study quality was examined as per the Cochrane risk of bias framework. Heterogeneity and associated outcomes were assessed based on mean difference (MD), I2, and 95% confidence interval (95%CI) values. RESULTS: In total, 22 RCTs were ultimately found to be eligible for inclusion in the present meta-analysis. The results of this meta-analysis indicated that CBT significantly impacted cognition as compared to other treatment options (including placebo treatment, clinical monitoring, clinic-based treatment, psychoeducation, physical activity training, health enhancement) (I2 = 49%, MD = 0.23, 95%CI: 0.03-0.44, P = 0.03). CBT was also associated with significant improvements in PD patient QoL (I2 = 0%, MD = 3.45, 95%CI: 1.13-5.57, P = 0.04), anxiety symptoms (I2 = 57%, MD = -2.01, 95%CI: -4.01-0.01, P = 0.05), and depression symptoms (I2 = 74%, MD = -3.94, 95%CI: -6.47 to -1.42, P = 0.04). CONCLUSIONS: These results reveal that CBT can have beneficial effects on PD patient cognitive status and QoL. Notably, CBT represents an effective option for treating NMS such as anxiety and depression in PD patients. These results offer strong evidence in favor of applying CBT as a means of enhancing the mental health, cognition, and QoL of individuals with PD. However, additional high-quality large-scale studies will be essential to confirm and expand upon these results.

A hospital and community-based violence intervention program for Black & Latino youth and their caregivers.

BACKGROUND: Black and Latino youth are disproportionately affected by trauma from community violence, but to date, few data support the benefit of evidence-based treatments for these youth or of including peer support to engage these youth in mental health services. OBJECTIVE: From 2018 until 2020, a hospital and community-based violence intervention program in Philadelphia pilot tested the integration of home and community-based Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) with peer services and case management for youth impacted by community violence. This study describes the implementation of this intervention. METHOD: Data was gathered by querying the program's database. The Child Post Traumatic Stress Symptom Severity Scale (CPSS-SR-5) and the Short Mood and Feelings Questionnaire (SMFQ) were utilized to evaluate the participants' pre- and post-intervention assessment of PTSD and depression. The sample (N = 50) consisted of Black and Latino youth, mean age 14. RESULTS: Twenty-nine (58%) completed TF-CBT, and 82% met peer and case management goals. Youth who completed therapy showed significant improvement in both PTSD and depression symptoms at post-test. CONCLUSION: To our knowledge, this is the first study describing the implementation of home and community-based TF-CBT with peer support and case management. The study's limitations and need for further research are discussed.

Black and Latino youth are disproportionally affected by violence across US cities. Mental health research is needed to evaluate how to engage these youth in mental health services and provide effective and culturally relevant trauma treatment. This research describes the experiences of 50 children and adolescents (ages 8­18) who participated in this pilot tested health services intervention using their electronic health records to access de-identified information and present youths' demographics, services received, and clinical outcomes. Specifically, we describe ways in which the intervention was culturally relevant to the participants' lived experiences. Services delivered consisted of the integration of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) with peer services and case management for youth impacted by community violence. Services were provided by licensed social workers and certified peer specialists at a hospital and community-based (i.e., youth's home, school) violence intervention program (HVIP). Our results indicate that this intervention shows preliminary efficacy for decreasing post-traumatic stress disorder (PTSD) and depression symptoms for Black & Latino youth impacted by ongoing violence. This real-world study lays out a blueprint for implementing similar programs. The study has several limitations, and we discuss the need for additional research.

Development and Management of Avoidant/Restrictive Food Intake Disorder and Food Neophobia in Pediatric Patients with Food Allergy: A Comprehensive Review.

Avoidant/Restrictive Food Intake Disorder (ARFID) and food neophobia present significant challenges in pediatric healthcare, particularly among children with food allergies (FAs). These eating disorders, characterized by the persistent avoidance or restriction of food, can lead to severe nutritional deficiencies and psychosocial impairments. The presence of FAs further complicates these eating behaviors, as the fear of allergic reactions exacerbates avoidance and restrictive patterns. This comprehensive review synthesizes current knowledge on ARFID and food neophobia, focusing on their definitions, characteristics, and the unique challenges they present in the context of FAs. The review explores the critical role of healthcare professionals, especially nurses, in integrating psychological and clinical care to improve outcomes for affected children. A multidisciplinary approach, including Cognitive Behavioral Therapy (CBT) and Family-Based Therapy (FBT), is emphasized as essential in addressing the complex needs of these patients. The review also highlights the need for standardized treatment protocols and further research on the long-term outcomes of these disorders, aiming to enhance therapeutic strategies and family support systems. Effective management of ARFID and food neophobia in the context of FAs requires a holistic and integrated approach to mitigate the profound impacts on a child's growth, development, and overall well-being.

Introducing and Evaluating the Effectiveness of Online Cognitive Behavior Therapy for Gambling Disorder in Routine Addiction Care: Comparative Cohort Study.

BACKGROUND: Several treatment-related challenges exist for gambling disorder, in particular at-scale dissemination in health care settings. OBJECTIVE: This study describes the introduction of a newly developed internet-delivered cognitive behavioral therapy (iCBT) program for gambling disorder (GD), provided with therapist support in routine addiction care, in a nationally recruited sample in Sweden. The study details the introduction of the iCBT program, evaluates its effectiveness and acceptability, and compares registry outcomes among iCBT patients with other patients with GD at the clinic who received face-to-face psychological treatment as usual. METHODS: The study site was the Stockholm Addiction eClinic, which offers digital interventions for addictive disorders in routine care. The iCBT program was introduced nationally for treatment-seeking patients through the Swedish eHealth platform. After approximately 2 years of routine treatment provision, we conducted a registry study, including ordinary patients in routine digital care (n=218), and a reference sample receiving face-to-face psychological treatment for GD (n=216). RESULTS: A statistically significant reduction in the Gambling Symptom Assessment Scale scores during the treatment was observed (B=-1.33, SE=0.17, P<.001), corresponding to a large within-group Cohen d effect size of d=1.39. The iCBT program was rated high for satisfaction. A registry-based survival analysis, controlling for psychiatric comorbidity, showed that patients receiving iCBT exhibited posttreatment outcomes (re-engagement in outpatient addiction care, receiving new psychiatric prescriptions, enrollment in psychiatric inpatient care, and care events indicative of contact with social services) similar to comparable patients who underwent face-to-face treatment-as-usual. CONCLUSIONS: A lack of randomized allocation notwithstanding, the iCBT program for GD evaluated in this study was well-received by patients in routine addiction care, was associated with the expected symptom decrease during treatment, and appears to result in posttreatment registry outcomes similar to face-to-face treatment. Future studies on treatment mechanisms and moderators are warranted. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s40814-020-00647-5.

[Fatigue and sensorimotor instability : Neurologically controlled conversion of post-COVID-19 patients]. / Fatigue und sensomotorische Instabilität : Neurologisch kontrollierte Konversion von Post-COVID-19-Patienten.

BACKGROUND: For the treatment of the symptoms of post-COVID-19 syndrome, no causal therapy is currently widely recommended according to evidence-based criteria. The overarching goal of the intervention study over a 3-year period (Q1-2021-Q4-2023) was to evaluate the changes in the key symptoms of fatigue and sensorimotor instability through individualized stress-controlled training therapy and through intensified cognitive behavioral therapy. MATERIAL AND METHODS: In the 3­year period 407 vaccinated nucleocapsid positive patients were treated at the Post-COVID-19 Center Lausitz (Senftenberg). In 78 (around 19%) fatigue/immunometabolic depression and sensorimotor instability were identified as the leading syndromes. The evaluation of the individualized stress-controlled training therapy was based on the specific post-COVID-19 syndrome and motor fatigue parameters. The secondary psychosomatic syndrome was assessed using cognitive fatigue parameters and cognitive behavioral therapy instruments. The investigation of -parameters influencing behavior took place in Q2-2023-Q4-2023 with a guide-supported qualitative interview among the participants. RESULTS: The post-COVID-19 key symptoms "fatigue," "sensorimotor instability," "neuropsychiatric symptoms," "cardiac/autonomic dysfunction," and "pain" improved significantly in the overall cohort and in the gender-specific analysis. A deterioration occurred in "secondary psychosomatic symptoms". A therapeutic effect was demonstrated for all motor fatigue parameters for the entire cohort using the Cohen's d value. An intensification of cognitive behavioral therapy achieved positive effects through an increasing development of the patients' own activity and their self-control using persuasion and gamification.

From guidelines to bedside - insomnia treatment practices in South Korea: a nationwide cohort study.

Background: Insomnia is a prevalent disorder that impacts quality of life and leads to significant economic costs. Treatment includes both non-medication and pharmacological interventions, with international guidelines recommending cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment. Objective: To describe current insomnia treatment practices in South Korea, focusing on pharmacological and non-medication treatments, and to identify gaps in guideline implementation. Methods: This cohort study used data from the Korea National Health Insurance Service-National Sample Cohort (NHIS-NSC) from 2002 to 2019 and identified 18,003 patients newly diagnosed with insomnia between 2015 and 2019. This study analyzed treatment patterns and utilization rates. Results: Of the 18,003 patients, 16,181 (89.9%) received pharmacological treatment, resulting in 35,638 prescriptions. Zolpidem (60%) and benzodiazepines (30-40%) were the most prescribed medications. Most patients were treated in clinics, with consistent dosages and increasing treatment lengths. Psychotherapy claims rose from 3.20% in 2015 to 9.14% in 2019, particularly in general hospitals (22.06% to 48.37%), but remained low in clinics (1.26% to 2.08%). Conclusion: Pharmacological treatments dominate insomnia management in South Korea, with CBT-I being underutilized. Future efforts should focus on integrating non-pharmacological treatment into routine practice and exploring treatment risks and effectiveness based on patient demographics.

Abu Zayd Ahmed ibn Sahl Al-Balkhi (850-934): A Pioneer in the Field of Psychotherapy and Mental Health.

Abu Zayd Ahmed ibn Sahl Al-Balkhi (850-934) was a versatile scholar during the Islamic Golden Age, who made significant contributions in mental health, psychology, medicine, geography, and philosophy. Al-Balkhi delved into the intricate connection between psychological and physical health, contributing to the early understanding of psychosomatic medicine. His innovative understanding of mental health conditions such as anxiety and depression established the foundation for the subsequent development of cognitive-behavioral therapy (CBT). Al-Balkhi's multidisciplinary approach, shaped by the guidance of his instructor Al-Kindi and the intellectually vibrant atmosphere of Baghdad, enabled him to assimilate knowledge from other traditions. His enduring legacy is acknowledged for its tremendous influence on historical and contemporary scientific thinking, establishing his position as a trailblazing figure in mental health and psychology. This narrative review combines historical and contemporary views to assess Al-Balkhi's lasting legacy in the field of psychotherapy and mental health.

Inadequate Evidence for Acupuncture as an Alternative or Adjunct to Antidepressants/Psychotherapy for Postpartum Depression: A Bayesian Systematic Review and Network Meta-Analysis.

Background: Acupuncture is popular in the treatment of mental illness. This study determined its feasibility and role in managing postpartum depression (PPD) using a network meta-analysis. Methods: We systematically searched seven databases up to May 2024 for randomized controlled trials (RCTs) appraising acupuncture's efficacy and safety against waitlist-control, placebo, standard control, or as an add-on treatment. Cochrane criteria were followed. Results: Thirteen studies encompassing 872 participants underwent analysis. Both pairwise and network meta-analysis indicated that acupuncture, psychotherapy, and antidepressants were comparable in clinical efficacy rate and in reducing Hamilton Depression Scale and Edinburgh Postnatal Depression Scale scores. Acupuncture and psychotherapy also effectively mitigated concurrent anxiety symptoms. Combining acupuncture with antidepressants augmented therapeutic efficacy and reduced reported gastrointestinal adverse effects associated with antidepressant use. Acupuncture combined with psychotherapy offered similar benefits with superior safety profile. However, the quality of evidence ranged from very low to low due to significant risks of bias and limited sample sizes. The efficacy of psychotherapy and the combination of acupuncture and psychotherapy might be underestimated, as most RCTs used supportive therapy or individual counseling as positive controls instead of recommended approaches like interpersonal psychotherapy (IPT) or cognitive behavioral therapy (CBT) per PPD guidelines. Conclusion: Current evidence precludes strong recommendations of administering acupuncture in PPD. Rigorous RCTs are essential to validate promising outcomes observed in comparisons between acupuncture, antidepressants, and their combined application. It remains inconclusive whether acupuncture's antidepressive effect is specific or non-specific. Given that psychotherapy is a recommended first-line treatment, investigating the potential efficacy enhancement of combining acupuncture with IPT/CBT is paramount to ascertain the preferred therapeutic approach for PPD.