Is it safe enough? A pilot feasibility study of an 8-day intensive treatment for severe PTSD.

Intensive treatments for posttraumatic stress disorder (PTSD) are gaining increased research support. Treatment models targeting Complex PTSD and previously treatment-resistant PTSD have shown a good effect. A pilot study was performed to assess the feasibility of an 8-day intensive treatment program for severe PTSD in a Swedish public healthcare setting. Eleven participants completed treatment, and overall, the reduction in PTSD symptoms was considerable. Also, loss of diagnosis at 3-month follow-up was 100%. No adverse events occurred, and no elevation of suicidal intentions was reported. Symptom exacerbation could not be observed in the data and dropout due to the intensity of the treatment format did not occur. Based on these positive results, it is recommended that further research with larger samples is conducted. If found safe and effective, the 8-day treatment program could be an important addition to psychiatric healthcare.

The importance of personal documentation for patients living with long-term illness symptoms after pituitary surgery: A Constructivist Grounded Theory study.

INTRODUCTION: Despite surgical treatment, pituitary adenomas often cause long-term illness symptoms, that profoundly impact patients' quality of life physically, psychologically and socially. Healthcare professionals often fail to recognize and discuss the ensuing problems. Personal documentation, such as symptom monitoring, reflective writing or even posts on social media, may help this patient group to manage their daily life and support communication of their care needs. Documentation strategies and the role of documentation for people with long-term symptoms after pituitary adenoma surgery are currently unknown. AIM: To examine the effects and strategies of documenting symptoms, activities and physical and emotional well-being among people living with long-term pituitary adenoma. METHODS: In this Constructivist Grounded Theory study, 12 individuals living with long-term illness symptoms after pituitary adenoma surgery described their documentation strategies in in-depth interviews using teleconferencing and photo-elicitation between August and October 2020. RESULTS: Strategies for documentation included analogue and digital media. One core category (Exercising autonomy) and three categories describing processes (Gaining insight, Striving for control and Sharing) emerged from the analysis. These three interrelated processes become an expression of autonomy to manage life and make sense of chronic illness. Personal documentation is a flexible tool that is used more extensively in times of ill health and less in times of relative well-being. Sharing documentation with healthcare professionals facilitated care planning and sharing with friends and family fostered emotional well-being. CONCLUSION: Personal documentation is a valuable resource for managing life after pituitary adenoma surgery. The current findings may be relevant to other chronic illnesses. Further research exploring potential tools for personal documentation is needed. PATIENT OR PUBLIC CONTRIBUTION: We deliberately chose a Constructivist Grounded Theory approach for this interview study. Using Constructivist Grounded Theory, we gave people living with long-term symptoms a voice, allowing them to freely speak about managing their illness in connection with personal documentation. The theoretical sampling approach enabled us to invite participants that could provide a broad overview of the landscape of personal documentation.

To tape or not to tape: annular ligament (pulley) injuries in rock climbers-a systematic review.

BACKGROUND: Popularity of rock climbing is steadily increasing. With its inclusion in the Olympic Games this will likely continue. Injuries from rock climbing are also increasing. The most common injury is to the flexor pulley system, consisting of the finger flexors and five annular ligaments (pulleys). Treatment of this injury includes taping of affected fingers, but evaluation of this treatment was previously lacking. The aim of this review was therefore to assess whether taping is associated with better outcomes than non-taping. A secondary aim was to present treatment recommendations or areas for future research. METHODS: Systematic searches of PubMed, Scopus, SPORTDiscus, Cochrane Library, PEDro and CINAHL. Free text searches of Google Scholar. Citation searching. No restrictions to language, date of publication or study design. Included studies were assessed using Cochrane scale for clinical relevance, by two independent authors. Results were presented in narrative synthesis. Certainty of evidence (GRADE) was assessed by three authors. Review was done according to PICO-protocol and reported according to PRISMA-guidelines. RESULTS: After removing duplicates, 595 records were identified. Eight studies and one case report (in nine articles, one poster) were included, consisting of 206 rock climbers, four non-climbers, 23 pairs of cadaver hands. Clinical relevance ranged from 0 to 5 (median 2). Evidence of low to moderate certainty suggests that taping might reduce bowstringing of the finger flexor tendons by 15-22%. Evidence regarding pain, time for return to sports, shearing forces against pulleys, pulley ruptures and maximum voluntary contraction (MVC) were all regarded as "very low", "very low to low" or "low", and were not considered reliable. Evidence of moderate certainty suggests that taping has no effect on MVC or muscle activation in uninjured rock climbers. No adverse effects of taping were reported. CONCLUSION: Low to moderate evidence suggests that taping might reduce bowstringing of the finger flexor tendons. Moderate evidence suggests that taping has no effect on MVC or muscle activation in uninjured climbers. For other outcomes more studies evaluating the effects of taping are needed. TRIAL REGISTRATION: PROSPERO CRD42021241271, date of registration: 18-04-2021.

A manual-based phenomenological art therapy for individuals diagnosed with moderate to severe depression (PATd): A randomized controlled study.

OBJECTIVE: This study investigated the effects of manual-based Phenomenological Art Therapy for individuals living with depression in addition to treatment as usual (PATd/TAU) compared with only treatment as usual (TAU) for individuals diagnosed with moderate to severe depression. METHOD: 79 adults (men = 29.1%) were included in this randomized-controlled-trial (RCT), multicenter study in Sweden with an intention-to-treat design. Participants were randomized into either the PATd/TAU-group (n = 43) or TAU-group (n = 36). Data were collected at baseline and at end of treatment. The main outcomes were depression levels and self-esteem. Secondary outcomes were suicide ideation and sickness absence. RESULTS: The PATd/TAU-group showed a significant decrease of depression levels. The PATd/TAU-group returned to work to a higher degree than the TAU-group. Self-esteem significantly improved in both groups. Suicide ideation was unaffected. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Manual-based PATd works as expected, being an effective treatment, and contributes to recovery for individuals with moderate to severe depression. This outcome needs to be confirmed and its long-term effects examined in further studies. (PsycINFO Database Record

Art therapy for patients with depression: expert opinions on its main aspects for clinical practice.

BACKGROUND: Art therapy is based mainly on clinical experience and is rarely described and evaluated scientifically. There is a need for further exploration of its use in patients with depression. AIM: The aim of this study was to explore what experts consider to be the main aspects of art therapy in clinical practice for patients with depression. METHOD: Eighteen occupational therapists experienced and educated in art therapy participated. The experts answered three rounds of Delphi questionnaires and ranked their agreement with 74 assertions. Consensus was defined as 70% or higher. RESULTS: The experts agreed more on assertions about theoretical frames of reference than about clinical practice. The main aspects of art therapy were agreed to be the patients' opportunity to express themselves verbally and through making art. It was equally important that art tasks provided an opportunity to address depressive thoughts, feelings, life experiences, and physical symptoms. CONCLUSIONS: Experts in the field of art therapy considered that the main aspect of clinical practice in art therapy for patients with depression is that art themes should promote expression related to both to depression and personal history.