Evaluation of effect of brief-intensive cognitive behavior therapy on symptoms severity in relation with catastrophic cognition in patients with panic disorder: a randomized controlled trial.

INTRODUCTION: Due to a dearth of evidence, we examined the effectiveness of brief-intensive CBT on symptom severity and catastrophic cognition in patients with panic disorder (PD). MATERIALS AND METHODS: In this randomized controlled trial, 155 patients were assigned to either the experimental group (2 successive days of brief-intensive CBT-3 h per day) or the control group (regular pharmacotherapy only). After excluding ineligible participants, 20 patients in the brief intensive CBT group and 18 patients in the control group completed the study and were included in the final analysis. The primary outcome was symptom severity, and the secondary outcome was catastrophic cognition, assessed by the Panic Disorder Severity Scale (PDSS) for symptoms severity and the Agoraphobic Cognition Scale (ACS) for cognitive assessment, respectively. RESULTS: The study showed that after one month of treatment, the PDSS (1.70 vs. 4.78; p = 0.0172) in the brief-intensive CBT group was significantly lower compared to the control group in contrast with the ACS (5.10 vs. 5.44; p = 0.8533). The mean score of PDSS and ACS significantly decreased from 21.60 to 1.7 (p < 0.0001) and from 22.55 to 5.10 (p < 0.0001) in the brief CBT group and from 19.44 to 4.78 (p < 0.0001) and 20.00 to 5.44 (p < 0.0001) in the control group, respectively. After treatment, the mean scores of PDSS and ACS significantly decreased in the brief intensive CBT and control groups. Both higher ACS and lower education levels contributed to higher PDSS in the brief intensive CBT group. However, only the PDSS correlated to the ACS in the control group. CONCLUSIONS: The study showed that brief-intensive CBT is an effective technique for reducing the severity of symptoms among PD patients. But, it was not effective to improve the cognitive level in PD patients at one month.

The lived experience of hospitalized and non-hospitalized health care providers of COVID-19 pandemic: a qualitative study.

This paper explores the lived experience and any mental health issues of COVID-19 survivors throughout the disease crisis using a qualitative method. The semi-structured interviewing method was conducted with COVID-19 patients who were admitted and non-admitted to hospitals in Kurdistan, Iraq. The patients had positive and negative perceptions of the COVID-19 pandemic and disease, including beliefs and thoughts about COVID-19, conspiracy thinking, and concerns toward the family and their children. The patients were affected by the disease in different ways including physical consequences of COVID-19 infection, social isolation, life changes, and mental wellbeing. But they had some coping strategies to overcome the disease, such as seeking help, preventive measures, and coping techniques. The patients had some concerns about health settings and therapeutic procedures, including lack of sufficient care, receptiveness, hospital environment, and infection guidelines. This study showed that the COVID-19 disease had devastating effects on patients either physically or psychologically.

Sleep severity and fatigue manifestations in relation to the doctor-patient relationship.

OBJECTIVES: The doctor-patient relationship has an important role in the delivery of high-quality healthcare. The aim of the present study was to explore and evaluate the impact of sleep severity and fatigue manifestations on doctor-patient relationships. METHODS: The present study was an analysis of a cross-sectional sample of a total of 123 physicians with different specialties and work in various shifts in Iraq. Sleep severity difficulty was measured by Athens Insomnia Scale (AIS) in accordance with the International Classification of Diseases (ICD-10) and the multidimensional nature of fatigue was assessed by the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Moreover, the doctor-patient relationship was measured by Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10). RESULTS: In this study, nearly half of the physicians (45.5%) were insomniacs. The total fatigue score was 9.46; general fatigue (Mean (M): 5.84 of 24); physical fatigue (M: 5.15 of 24); emotional fatigue (M: 6.04 of 24); mental fatigue (M: 5.45 of 24); and vigor (M: 12.98 of 24). The doctors felt slight irritation in their communications with patients (M: 2.33); had moderate dysphoria (M: 3.37); had slight compliance in their communications (M: 1.71), and slightly considered patients to be self-destructive (M: 1.97). In addition, the study showed that general and physical fatigue, night shift-work, and increased working hours in the public sector were predictors for doctors finding their patient irritating. Similarly, increased working hours by clinicians in the public sector was a predictor for having less compliance in their relationships with patients. CONCLUSION: The present investigation suggests that insomnia has an indirect association with negative categories of the doctor-patient relationship.

Sleep disorders as primary and secondary factors in relation with daily functioning in medical students.

BACKGROUND: College students experience various types of sleep disorders that impact daily functioning. Previous studies have focused on the effect of one sleep disorder. OBJECTIVE: Examine factors that might relate to several sleep disorders and the impacts of sleep disorders on the daily functioning in medical students. DESIGN: Cross-sectional study. SETTING: Medical college. SUBJECTS AND METHODS: A random sample of medical students from a public university was invited to participate in a cross-sectional study using the structured SLEEP-50 self-reported questionnaire. The sleep disorders covered by the questionnaire were insomnia, sleep apnea, restless legs syndrome, sleep walking, circadian rhythm sleep disorder, nightmares, narcolepsy, and factors impacting sleep, effects of sleep complaints on daily functioning, and sleeping duration. MAIN OUTCOME MEASURE: Sleep duration, sleep disorders. RESULTS: Of 317 participants, 165 (50.2%) reported having less than 7 hours sleep and apart from hyper-somnia, had various kinds of sleep disorders. Various factors such as having no pleasure and entertainment, feeling sadness, alcohol drinking, amount of sleeping hours, smoking, age, a noisy or light bedroom, and substance abuse were related to different sleep disorders. Moreover, students with sleep disorders felt tired arising, felt sleepy during the day, were easily irritated, had difficulty in concentration, had concerns about amount of sleep, and slept badly at college. CONCLUSIONS: Insufficient sleep is a common issue in medical students and a number of sleep disorders were found. The results suggest that sleep disorders could have negative impacts on the daily functioning of students. LIMITATIONS: The study findings may not be generalizable because sociocultural characteristics of the sample may differ from the general population.