Efficacy of cognitive behavioural therapy for bipolar disorder: A systematic review.

INTRODUCTION: Bipolar disorder (BD) is a serious mental illness with a chronic course and significant morbidity and mortality. BD has a lifetime prevalence rate of 1%-1.5% and is characterised by recurrent episodes of mania and depression, or a mixture of both phases. Although it has harmacological and psychotherapeutic treatment, cognitive behavioural therapy (CBT) has shown beneficial effects, but there is not enough clinical information in the current literature. METHODS: The main aim was to determine the efficacy of CBT alone or as an adjunct to pharmacological treatment for BD. A systematic review of 17 articles was carried out. The inclusion criteria were: quantitative or qualitative research aimed at examining the efficacy of CBT in BD patients with/without medication; publications in English language; and) being 18-65 years of age. The exclusion criteria were: review and meta-analysis articles; articles that included patients with other diagnoses in addition to BD and that did not separate the results based on such diagnoses; and studies with patients who did not meet the DSM or ICD criteria for BD. The PubMed, PsycINFO and Web of Science databases were searched up to 5 January 2020. The search strategy was: "Bipolar Disorder" AND "Cognitive Behavioral Therapy". RESULTS: A total of 1531 patients both sexes were included. The weighted mean age was 40.703 years. The number of sessions ranged from 8 to 30, with a total duration of 45-120 min. All the studies show variable results in improving the level of depression and the severity of mania, improving functionality, reducing relapses and recurrences, and reducing anxiety levels and the severity of insomnia. CONCLUSIONS: The use of CBT alone or adjunctive therapy in BD patients is considered to show promising results after treatment and during follow-up. Benefits include reduced levels of depression and mania, fewer relapses and recurrences, and higher levels of psychosocial functioning. More studies are needed.

Eficácia de la Terapia Cognitiva Conductual Para el Trastorno Bipolar: una Revisión Sistemática

Introducción: El trastorno bipolar (TB) es una enfermedad mental grave con un curso crónico y una morbimortalidad importante. El TB tiene una tasa de prevalencia a lo largo de la vida del 1 al 1,5% y se caracteriza por episodios recurrentes de manía, depresión o una mezcla de ambas fases. Aunque tiene tratamiento farmacológico y psicoterapéutico, la terapia cognitiva conductual (TCC) ha mostrado efectos beneficiosos, pero no se cuenta con suficiente información clínica en la literatura actual. Métodos: El objetivo principal es determinar la eficacia de la TCC sola o como complemento del tratamiento farmacológico para el TB. Se realizó una revisión sistemática de 17 artículos. Los criterios de inclusión fueron: investigación cuantitativa o cualitativa dirigida a examinar la eficacia de la TCC en pacientes con TB con/sin medicación, publicaciones en idioma inglés y tener 18-65 anos de edad. Los criterios de exclusión fueron: artículos de revisión y metanálisis, artículos que incluían a pacientes con otros diagnósticos además de TB y no separaban los resultados basados en dichos diagnósticos y estudios con pacientes que no cumplían los criterios de TB del DSM o ICD. Se realizaron búsquedas en las bases de datos PubMed, PsycINFO y Web of Science hasta el 5 de enero de 2020. La estrategia de búsqueda fue: "Bipolar Disorder" AND "Cognitive Behavioral Therapy". Resultados: Se incluyó en total a 1.531 pacientes de ambos sexos. La media de edad ponderada fue 40,703 arios. El número de sesiones varió de 8 a 30, con una duración total de 45-120 min. Todos los estudios muestran resultados variables en la mejora del nivel de depresión y la gravedad de la manía, mejora de la funcionalidad, disminución de recaídas y recurrencias, reducción de los niveles de ansiedad y reducción de la gravedad del insomnio. Conclusiones: Se considera que la TCC sola o complementaria para pacientes con TB muestra resultados prometedores después del tratamiento y durante el seguimiento. Los beneficios incluyen niveles reducidos de depresión y manía, menos recaídas y recurrencias y niveles más altos de funcionamiento psicosocial. Se necesitan más estudios.

Introduction: Bipolar disorder (BD) is a serious mental illness with a chronic course and significant morbidity and mortality. BD has a lifetime prevalence rate of 1% to 1.5% and is characterised by recurrent episodes of mania and depression, or a mixture of both phases. Although it has harmacological and psychotherapeutic treatment, cognitive behaviouraltherapy (CBT) has shown beneficial effects, but there is not enough clinical information in the current literature. Methods: The main aim was to determine the efficacy of CBT alone or as an adjunct to pharmacological treatment for BD. A systematic review of 17 articles was carried out. The inclusion criteria were: quantitative or qualitative research aimed at examining the efficacy of CBT in BD patients with/without medication; publications in English language; and) being 18-65 years of age. The exclusion criteria were: review and meta-analysis articles; articles that included patients with other diagnoses in addition to BD and that did not separate the results based on such diagnoses; and studies with patients who did not meet the DSM or ICD criteria for BD. The PubMed, PsycINFO and Web of Science databases were searched up to 5 January 2020. The search strategy was: "Bipolar Disorder" AND "Cognitive Behavioral Therapy". Results: A total of 1,531 patients both sexes were included. The weighted mean age was 40.703 years. The number of sessions ranged from 8-30, with a total duration of 45120 minutes. All the studies show variable results in improving the level of depression and the severity of mania, improving functionality, reducing relapses and recurrences, and reducing anxiety levels and the severity of insomnia. Conclusions: The use of CBT alone or adjunctive therapy in BD patients is considered to show promising results after treatment and during follow-up. Benefits include reduced levels of depression and mania, fewer relapses and recurrences, and higher levels of psychosocial functioning. More studies are needed.

Effectiveness of abbreviated trauma-focused cognitive behavioural therapy for South African adolescents: a randomized controlled trial.

Background: In low- and middle- income countries (LMICs) trauma exposure among youth is high, but mental health services are critically under-resourced. In such contexts, abbreviated trauma treatments are needed.Objective: To evaluate the efficacy of an abbreviated eight-session version of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) for improving posttraumatic stress disorder (PTSD) and depression symptoms in a sample of South African adolescents.Method: 75 trauma-exposed adolescents (21 males, 54 females; mean age = 14.92, range = 11-19) with posttraumatic stress disorder (PTSD) symptoms were randomly assigned to eight sessions of TF-CBT or to usual services. At baseline, post-treatment and three-month follow-up, participants completed the Child PTSD Symptom Scale for DSM 5 (CPSS-5) and the Beck Depression Inventory II (BDI-II). The trial is registered on the Pan African Trial Registry (PACTR202011506380839).6.Results: 95% of TF-CBT participants completed treatment while only 47% of TAU participants accessed treatment. Intention-to-treat analyses found that the TF-CBT group had a significantly greater reduction in CPSS-5 PTSD symptom severity at post-treatment (Cohen's d = 0. 60, p < .01) and three-month follow-up (Cohen's d = 0.62, p < . 01), and a greater reduction in the proportion of participants meeting the CPSS-5 clinical cut-off for PTSD at both time points (p = .02 and p = .03, respectively). There was also a significantly greater reduction in depression symptom severity in the TF-CBT group at post-treatment (Cohen's d = 0.51, p = .03) and three-month follow-up (Cohen's d = 0.41, p = .05), and a greater reduction in the proportion of TF-CBT participants meeting the BDI clinical cut-off for depression at both time points (p = .02 and p = .03, respectively).Conclusion: The findings provide preliminary evidence of the efficacy of an abbreviated eight-session version of TF-CBT for reducing PTSD and depression symptoms in a LMIC sample of adolescents with multiple trauma exposure.

Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) is one of the leading evidence-based treatments for child and adolescent posttraumatic stress, but an abbreviated version has not been evaluated in low- and middle-income countries (LMICs).At post-treatment and three-month follow-up, eight sessions of TF-CBT were more effective than treatment-as-usual in reducing posttraumatic stress and depression symptoms in an LMIC sample of South African adolescents exposed to multiple traumas.Effect sizes were similar to those reported for standard length TF-CBT, indicating that abbreviated TF-CBT may be a suitable option for resource-constrained child and adolescent mental health services in LMICs.

Trastorno de Acumulación: A propósito de un caso / Hoarding Disorder: A case report

El trastorno de acumulación se caracteriza por una extrema dificultad para deshacerse o descartar artículos, independientemente de su valor real, originando con ello múltiples síntomas y problemas cotidianos de todo tipo. Aunque la severidad es más marcada en adultos mayores, el cuadro es de instalación progresiva a lo largo de varias décadas. Se presenta el caso de un paciente varón de 49 años, con inicio de la enfermedad desde los 15 años, guardando libros y cuadernos usados con la idea de que podrían ser útiles en el futuro; además de manifestaciones significativas de ansiedad. La acumulación de otros objetos como herramientas, ropa y utensilios de cocina se fue intensificando junto con el incremento de la ansiedad tras varias pérdidas familiares. El paciente buscó atención médica en diferentes centros sin encontrar alivio. Finalmente, el diagnóstico, el tratamiento psicofarmacológico y psicoterapéutico fueron replanteados con resultados favorables.

SUMMARY Hoarding Disorder is characterized by an extreme difficulty to get rid of or discard objects, regardless of their real value and originating multiple symptoms and everyday life problems. The severity is major in old adults although the condition progresses throughout several decades of life. The case of a 49 years old man is presented: the illness started at age 15, keeping used books and notebooks with idea that they would be necessary in the future. This was associated with significant anxiety in some social situations; later, other objects such as tools, clothes and cookware beside were added with intensified anxiety relate to emotional and family losses. The patient sought medical attention in several centers without relief. Finally, his diagnosis, psychopharmacological and psychotherapeutic treatment were re-framed with favorable results.

Implicações neurológicas da meditação do tipo terapia cognitiva baseada em mindfulness em pacientes com transtorno de ansiedade ou transtorno depressivo: uma revisão integrativa / Neurological implications of mindfulness-based cognitive therapy in patients with anxiety or depressive disorders: an integrative review / Implicaciones neurológicas de la meditación de la terapia cognitiva basada en mindfulness en pacientes con trastorno de ansiedad o trastorno depresivo: una revisión integradora

A Terapia Cognitiva Baseada em Mindfulness (MBCT, do inglês Mindfulness-Based Cognitive Therapy) é uma técnica baseada na combinação da Terapia Cognitiva-Comportamental e da meditação mindfulness, na busca pela melhoria de sintomas psiquiátricos. O presente trabalho tem como objetivo a busca por publicações que discutam as implicações neurológicas de pacientes diagnosticados com transtorno depressivo e transtorno de ansiedade e que buscaram nessa técnica a melhoria de sua condição clínica ou qualidade de vida. Nossos resultados preliminares mostraram que os benefícios dessa prática foram colhidos na totalidade dos estudos encontrados, elucidando as áreas cerebrais modificadas e o motivo pelo qual elas foram ativadas. Procuramos abordar ainda a diferença entre essa técnica e o uso de medicamentos e tratamento usual. PALAVRAS-CHAVE: Terapia Cognitiva-Comportamental; Cérebro; Transtornos Psiquiátricos; Antidepressivos.

Mindfulness-Based Cognitive Therapy (MBCT) is a technique based on the combination of Cognitive-Behavioral Therapy and mindfulness meditation, in the search of improving psychiatric symptoms. This present work aims to search for studies and articles that discuss the neurological implications of patients diagnosed with anxiety and major depressive disorders who sought improvement in their clinical condition or life quality through this technique. The preliminary results showed that the benefits of this practice were observed in all of the studies found, elucidating the modified brain areas and the reason why they were activated. The differences between this technique and the use of medication and treatment-as-usual was also addressed.

La Terapia Cognitiva Basada en Mindfulness (MBCT) es una técnica basada en la combinación de la Terapia Cognitivo-Conductual y la meditación mindfulness, en la búsqueda de la mejora de los síntomas psiquiátricos. El presente trabajo tiene como objetivo buscar publicaciones que discutan las implicaciones neurológicas de pacientes diagnosticados con trastorno depresivo y trastorno de ansiedad y que busquen en esta técnica mejorar su condición clínica o calidad de vida. Nuestros resultados preliminares mostraron que los beneficios de esta práctica se cosecharon en todos los estudios encontrados, dilucidando las áreas cerebrales modificadas y la razón por la cual se activaron. También tratamos de abordar la diferencia entre esta técnica y el uso de medicación y tratamiento habitual.

Preliminary results of a Cognitive-Behavioral Life Skills Program for Adolescents / Resultados preliminares do Programa Cognitivo-Comportamental de Habilidades para Vida em Adolescentes / Resultados preliminares de Programa Cognitivo-Conductual de Habilidades para la Vida en Adolescentes

The aim of this study was to evaluate the effect of the Life Skills Promotion Program in Adolescents (PRHAVIDA-Adolescents) on the development of a repertoire of life skills based on the cognitive-behavioral approach. A study was carried out with 78 adolescents (M = 12.47 years; SD = 0.69) to compare the results of the Social Skills Inventory for Adolescents (IHSA-Del-Prette) before and after the intervention. Differences were found between pre- and post-test considering the frequency of emission of skills for girls in the subscales self-control, assertiveness, affective approach, and social development; boys showed differences in the subscales empathy, self-control, assertiveness, affective approach, and social development. Thus, it is considered that PRHAVIDA-Adolescents is an effective program that has demonstrated that it is capable of developing several relevant skills for both sexes at a satisfactory level. Its contents proved to be comprehensive, consisting of a viable alternative for health promotion for adolescents within the cognitive-behavioral approach. (AU)

O objetivo deste estudo foi a avaliação do efeito do Programa de Promoção de Habilidades para a Vida em Adolescentes (PRHAVIDA-Adolescentes) no desenvolvimento de um repertório de habilidades para a vida com base na abordagem cognitivo-comportamental. Foi realizado um estudo com 78 adolescentes (M = 12,47 anos; DP = 0,69) para comparar resultados do Inventário de Habilidades Sociais para Adolescentes (IHSA-Del-Prette) antes e depois da intervenção. Foram encontradas diferenças entre pré e pós-teste considerando a frequência de emissão das habilidades para meninas nas subescalas autocontrole, assertividade, abordagem afetiva e desenvolvimento social; já os meninos apresentaram diferença nas subescalas empatia, autocontrole, assertividade, abordagem afetiva e desenvolvimento social. Dessa forma, considera-se que o PRHAVIDA-Adolescentes é um programa efetivo que demonstrou ser capaz de desenvolver diversas habilidades relevantes para ambos os sexos em nível satisfatório. Seus conteúdos se mostraram abrangentes, consistindo em alternativa viável para a promoção de saúde para adolescentes dentro da abordagem cognitivo-comportamental. (AU)

El objetivo de este estudio fue evaluar el efecto del Programa de Promoción de Habilidades para la Vida en Adolescentes (PRHAVIDA-Adolescentes) en el desarrollo de un repertorio de habilidades para la vida basado en el enfoque cognitivo-conductual. Se realizó un estudio con 78 adolescentes (M = 12,47 años; DS = 0,69) para comparar los resultados del Inventario de Habilidades Sociales para Adolescentes (IHSA-Del-Prette) antes y después de la intervención. Se encontraron diferencias entre el pre y postest considerando la frecuencia de emisión de habilidades para las niñas en las subescalas de autocontrol, asertividad, afectividad y desarrollo social; los niños, por su parte, mostraron diferencias en las subescalas de empatía, autocontrol, asertividad, afectividad y desarrollo social. Así, se considera que PRHAVIDA-Adolescentes es un programa efectivo que ha demostrado que es capaz de desarrollar varias habilidades relevantes para ambos sexos a un nivel satisfactorio. Su contenido resultó ser integral, constituyendo una alternativa viable para la promoción de la salud de los adolescentes dentro del enfoque cognitivo-conductual. (AU)

Representações sociais de estudantes de Psicologia sobre Terapia Cognitivo-Comportamental / Social representations of Psychology students on Cognitive Behavioral Therapy / Representaciones sociales de estudiantes de Psicología sobre la Terapia Cognitiva Conductual

O estudo investigou as representações sociais de estudantes de Psicologia acerca da Terapia Cognitivo-Comportamental (TCC). Os 196 estudantes indicaram de três a cinco palavras que lhes vinham à mente ao pensarem sobre a TCC. Os resultados foram tratados no Software Evoc e distribuídos em quatro quadrantes em ordem de expressividade: 1) comportamentos, crenças e reforço; 2) pensamentos; 3) emoção, objetiva, cognição, curto-prazo, científica e testes; 4) técnica, tarefas e mudanças. O pensamento social dos estudantes é consonante com a estrutura base da teoria e os resultados contribuem para o entendimento da TCC na formação em Psicologia.

The study investigated the social representations of Psychology students on Cognitive-Behavioral Therapy (CBT). The 196 students indicated three to five words that came to their minds when thinking about CBT. The results were treated on the Evoc Software and distributed in four quadrants in order of expressiveness: 1) behaviors, beliefs and reinforcement; 2) thoughts; 3) emotion, objective, cognition, short-term, scientific and tests; 4) techniques, tasks and changes. The students' social thinking is in line with the basic structure of the theory and the results contribute to the understanding of CBT in Psychology training.

El estudio investigó las representaciones sociales de estudiantes de Psicología respecto de la Terapia Cognitiva Conductual (TCC). Los 196 estudiantes indicaron de tres a cinco palabras que le venían a la mente al pensar sobre la TCC. Los resultados fueron sistematizados en el Software Evoc y se distribuyeron en cuatro cuadrantes en orden de expresividad: 1) comportamientos, creencias y refuerzo; 2) pensamientos; 3) emoción, objetiva, cognición a corto plazo, científico y pruebas; 4) técnicas, tareas y cambios. El pensamiento social de los estudiantes está en línea con la estructura teórica básica y los resultados contribuyen a la comprensión de la TCC en la formación en Psicología.

Estado cognitivo y funcional a largo plazo en supervivientes de una hemorragia subaracnoidea aneurismática: análisis de una cohorte retrospectiva / Long-term cognitive and functional status in survivors of an aneurysmal subarachnoid hemorrhage: Analysis of a retrospective cohort

Objetivo: Existe poca información sobre los resultados funcionales y cognitivos a largo plazo en pacientes con hemorragia subaracnoidea aneurismática (HSA). El objetivo principal fue evaluar la situación cognitiva, funcional, anímica y la calidad de vida en personas con HSA a largo plazo. Pacientes y método: Estudio de corte transversal de una cohorte de 40 pacientes (edad media 58,2 [DE 9,9] años) con HSA ingresados en la unidad de Rehabilitación neurológica entre enero del 2010 a julio del 2017. Variables de resultado: estado cognitivo (cuestionario de Pfeiffer), nivel funcional (índice de Barthel), depresión (escala de Hamilton) y calidad de vida (European Quality of Life-5 Dimensions [EQ-5D]), así como las terapias de rehabilitación realizadas en un seguimiento mínimo de seis meses post-HSA. Resultados: De 35 pacientes con alteraciones cognitivas en fase aguda, solo 12 realizaron terapia cognitiva tras el alta hospitalaria. En el seguimiento a largo plazo, los déficits cognitivos persistían en 22 casos, y en comparación con el resto, presentaban peores puntuaciones en el índice de Barthel (15,5 [IC 95% 1,2 a 29,7]), la escala de Hamilton (-0,8 [IC 95% -1,27 a -0,37]), y la EQ-5D (27,6 [IC 95% 12,4 a 19]). Conclusión: La prevalencia de déficits cognitivos a largo plazo en supervivientes de una HSA es alta y su presencia se relaciona con un peor estado funcional, más depresión y peor calidad de vida. El bajo porcentaje de individuos que realizan terapia cognitiva en su proceso de rehabilitación junto con las repercusiones clínicas observadas apoyan la necesidad de incluir las terapias neurocognitivas en los programas de rehabilitación de las HSA.(AU)

Objective: Little data is available on long-term functional and cognitive outcomes in patients with aneurysmal subarachnoid hemorrhage (ASH). The main objective of this study was to assess cognition, functional state, mood disorders, and quality of life in patients with SAH at least six months following the ASH. Patients and methods: Cross-sectional study of 40 patients (aged 58.2 [SD 9.9] years) with ASH, discharged from a Neurologic Rehabilitation unit between January 2010 and July 2017. Main outcome variables: functional status (Barthel index), cognition (Pfeiffer questionnaire), depression (Hamilton scale), and health-related quality of life (European Quality of Life-5 Dimensions [EQ-5D]), as well as type and duration of therapeutic rehabilitation procedures after discharge. Results: From 35 patients with cognitive disorders, only 12 received cognitive therapy at hospital discharge. In the long-term follow-up, cognitive impairment persisted in 22 patients. When compared with those without cognitive impairment, they presented significantly worse mean differences in the Barthel index (15.5 [95% CI: 1.2-29.7]), Hamilton scale (-0.8 [95% CI: -1.27 to -0.37]), and EQ-5D (27.6 [95% CI: 12.4-19]). Conclusion: The prevalence of long-term cognitive impairments in survivors of a SAH episode is high, and their presence is associated with worse functional status, more depression and worse quality of life. The low percentage of subjects who received cognitive therapies through their recovery process and the clinical implications observed, support the need of including neuropsychological therapies in the rehabilitation programs after an SAH event.(AU)

[Long-term cognitive and functional status in survivors of an aneurysmal subarachnoid hemorrhage: Analysis of a retrospective cohort]. / Estado cognitivo y funcional a largo plazo en supervivientes de una hemorragia subaracnoidea aneurismática: análisis de una cohorte retrospectiva.

OBJECTIVE: Little data is available on long-term functional and cognitive outcomes in patients with aneurysmal subarachnoid hemorrhage (ASH). The main objective of this study was to assess cognition, functional state, mood disorders, and quality of life in patients with SAH at least six months following the ASH. PATIENTS AND METHODS: Cross-sectional study of 40 patients (aged 58.2 [SD 9.9] years) with ASH, discharged from a Neurologic Rehabilitation unit between January 2010 and July 2017. MAIN OUTCOME VARIABLES: functional status (Barthel index), cognition (Pfeiffer questionnaire), depression (Hamilton scale), and health-related quality of life (European Quality of Life-5 Dimensions [EQ-5D]), as well as type and duration of therapeutic rehabilitation procedures after discharge. RESULTS: From 35 patients with cognitive disorders, only 12 received cognitive therapy at hospital discharge. In the long-term follow-up, cognitive impairment persisted in 22 patients. When compared with those without cognitive impairment, they presented significantly worse mean differences in the Barthel index (15.5 [95% CI: 1.2-29.7]), Hamilton scale (-0.8 [95% CI: -1.27 to -0.37]), and EQ-5D (27.6 [95% CI: 12.4-19]). CONCLUSION: The prevalence of long-term cognitive impairments in survivors of a SAH episode is high, and their presence is associated with worse functional status, more depression and worse quality of life. The low percentage of subjects who received cognitive therapies through their recovery process and the clinical implications observed, support the need of including neuropsychological therapies in the rehabilitation programs after an SAH event.

Inserção das estratégias cognitivo-comportamentais no CAPS álcool e drogas / Insertion of cognitive-behavioral strategies in CAPS for alcohol and drugs / inserción de estrategias cognitivo-conductuales en CAPS alcohol y drogas

Este estudo teve como objetivo conhecer a percepção de psicólogos que trabalham em Centros de Atenção Psicossocial para Álcool e Drogas sobre a inserção de estratégias das terapias cognitivo-comportamentais para o tratamento de dependência de álcool e outras drogas em sua prática. Foi realizado um estudo qualitativo de caráter exploratório, por meio de entrevistas com 16 psicólogos que atuam no Rio de Janeiro e em Minas Gerais. Os dados coletados foram analisados por meio da análise de conteúdo temática de Bardin. Os resultados apontam que, na percepção dos psicólogos, essas estratégias são passíveis de serem adotadas por esses centros e conferem bons resultados ao tratamento, embora haja limitações na formação especializada em terapia cognitivo-comportamental para lidar com a dependência de drogas entre os participantes. São discutidas a contribuição dessas terapias para a prática baseada em evidências no serviço público no que se refere ao monitoramento e avaliação de resultados, bem como sua relação compatível com a estratégia de redução de danos e com a lógica do tratamento psicossocial. Apesar das terapias cognitivo-comportamentais serem reconhecidas em outros países como intervenções bem embasadas cientificamente e apresentarem características importantes para a saúde pública, persistem obstáculos para a adoção destas ferramentas no tratamento da dependência de álcool e outras drogas nos serviços de saúde mental no Brasil.(AU)

This study aimed to understand the perception of psychologists who work in Psychosocial Care Centers for Alcohol and Drugs about the inclusion of cognitive-behavioral therapies for treating addiction to alcohol and other drugs in their practice. A qualitative exploratory study was carried out, by interviewing 16 psychologists who work in the states of Rio de Janeiro and Minas Gerais. The collected data were analyzed with Bardin's thematic content analysis. The results show that, in the psychologists' perception, these strategies are likely to be adopted in the centers and provide good results to the treatment, despite limitations in the specialized training in cognitive-behavioral therapies for dealing with drug addiction among the participants. The contribution of these therapies to evidence-based practice in the public service concerning monitoring and evaluation of results, and their compatible relationship with the harm reduction strategy and with the logic of psychosocial treatment are discussed. Although cognitive-behavioral therapies are recognized in other countries as well-founded scientific processes and provide essential characteristics for public health, challenges persist for adopting these tools in the treatment of addiction to alcohol and other drug in mental health services in Brazil.(AU)

Este estudio tiene como objetivo comprender la percepción de los psicólogos que trabajan en Centros de Atención Psicosocial de Alcohol y Drogas sobre la inserción de estrategias de terapia cognitivo-conductual para el tratamiento de la adicción al alcohol y otras drogas en su práctica. Se realizó un estudio exploratorio cualitativo, a través de entrevistas con dieciséis psicólogos que trabajan en los estados de Rio de Janeiro y Minas Gerais. Los datos recopilados se analizaron mediante el análisis de contenido temático de Bardin. Los resultados muestran que, en la percepción de los psicólogos, es probable que estas estrategias se adopten en el estos centros y proporcionen buenos resultados en el tratamiento, aunque existen limitaciones en la formación especializada en terapia cognitivo-conductual para la adicción a las drogas entre los participantes. Se discute la contribución de esas terapias a la práctica basada en la evidencia en el servicio público con respecto al seguimiento y evaluación de resultados, así como su relación compatible con la estrategia de Reducción de Daños y con la lógica del tratamiento psicosocial. Aunque las terapias cognitivo-conductuales sean reconocidas en otros países como intervenciones científicamente bien fundamentadas y brinden características importantes para la salud pública, persisten obstáculos para la adopción de estas herramientas en el tratamiento de la adicción al alcohol y otras drogas en los servicios de salud mental en Brasil.(AU)

Associações entre autocompaixão e esquemas iniciais desadaptativos / Associations between self-compassion and early maladaptive schemas / Asociaciones entre autocompasión y esquemas desadaptativos tempranos

Apesar das repetidas relações entre autocompaixão e saúde mental e a relevância dos esquemas iniciais desadaptativos (EID's) para compreensão do funcionamento da personalidade, ainda é internacionalmente escasso o número de estudos que relacionam tais construtos. O objetivo deste estudo foi investigar as relações entre os componentes da autocompaixão e os EID's. A amostra foi composta por 328 estudantes universitários, com idade média de 25,39 (DP=6,99). Como instrumentos, foram utilizados a Escala de Autocompaixão de Neff (SCS) e o Questionário de Esquemas de Young (YSQ-S3). Os resultados mostraram correlações negativas e significativas entre os EID's e os componentes da autocompaixão, sugerindo que quanto maior a intensidade do esquema, menores os níveis de autocompaixão. Compreender a forma como as características individuais se relacionam com os componentes da autocompaixão pode nortear o desenvolvimento de intervenções mais apuradas para a promoção dos benefícios da autocompaixão.

Despite the repeated relationships between self-compassion and mental health and the relevance of the early maladaptive schemas (EMS) to understand personality, the number of studies relating these constructs is still internationally scarce. The aim of this study was to investigate the relationships between the components of self-compassion and EMS. The sample consisted of 209 university students (medium age of 25.55; SD = 6.96). Measures used were Self-Compassion Scale (SCS) and Young Schema Questionnaire (YSQ-S3). The results showed negative and significant correlations between the EMS and the components of self-compassion, suggesting that the greater the intensity of the schema, the lower the levels of self-compassion. Understanding how individual characteristics relate to the components of self-compassion can guide the development of more refined interventions to promote the benefits of self-compassion.

A pesar de las repetidas relaciones entre autocompasión y salud mental y la relevancia de los esquemas desadaptativos tempranos (EDTs) para comprender el funcionamiento de la personalidad, el número de estudios que relacionan estos constructos aún es internacionalmente escaso. El objetivo de este estudio fue investigar las relaciones entre los componentes de la autocompasión y los EDTs. Respondieron medidas de autocompasión e de EDTs 328 estudiantes universitarios (edad media: 25,39). Se realizaron análisis descriptivos y correlacionales de Pearson (p <0.05). Los resultados mostraron correlaciones negativas y significativas entre los EDTs y los componentes de la autocompasión, lo que sugiere que cuanto mayor es la intensidad del esquema, menores son los niveles de autocompasión. Comprender cómo se relacionan las características individuales con los componentes de la autocompasión puede guiar el desarrollo de intervenciones más refinadas para promover los beneficios de la autocompasión.

Uma intervenção cognitivo-comportamental em grupo com indivíduos com obesidade: resultados preliminares / A cognitive behavioral group intervention with obese patients: preliminary results / Uma intervenciión cognitiva conductual em grupo com individuos obesos: resultados preliminares

A obesidade tem causas multifatoriais e a Terapia Cognitivo-Comportamental apresenta resultados positivos sobre os aspetos cognitivos, emocionais e comportamentais relativos à perda de peso. Este estudo apresenta uma avaliação preliminar do Programa Cognitivo Comportamental de Educação Alimentar em Grupo (PROMETA). Foi realizado um estudo quantitativo, pré-experimental com avaliação pré e pós-teste. Sessenta e sete participantes adultos com sobrepeso ou obesidade realizaram as 12 sessões da intervenção em grupos. Foram utilizados os inventários Beck de depressão, de ansiedade, e de desesperança, a escala de compulsão alimentar periódica, e a escala de figuras de silhuetas. Os resultados indicaram que o PROMETA contribuiu para redução de sintomas de depressão, ansiedade, desesperança, e compulsão alimentar. Portanto, o programa apresenta resultados satisfatórios para esta amostra.

Obesity has multifactorial causes and Cognitive-Behavioral Therapy has positive results on cognitive, emotional, and behavioral aspects related to weight loss. This study presents a preliminary assessment of the Cognitive Behavioral Program for Group Food Education (PROMETA). A quantitative, pre-experimental study was carried out with pre- and post-test evaluation. Sixty-seven adults who were overweight or obese participated of 12 intervention sessions in groups. Instruments included the Beck inventories of depression, anxiety, and hopelessness, a periodic binge eating scale, and a body satisfaction scale. Results indicated that PROMETA contributed to the reduction of symptoms of depression, anxiety, hopelessness, and binge eating. Therefore, the program shows satisfactory results for this sample.

La obesidad tiene causas multifactoriales y la terapia cognitivo-conductual tiene resultados positivos en los aspectos cognitivos, emocionales y conductuales relacionados con la pérdida de peso. Este estudio demuestra una evaluación preliminar del Programa de comportamiento cognitivo para la educación alimentaria grupal - PROMETA. Se llevó a cabo un estudio cuantitativo pre-experimental con evaluación previa y posterior a la prueba. Se realizaron 67 participantes adultos con sobrepeso u obesidad como 12 intervenciones de intervención en grupos. Se utilizó el inventivo Beck de depresión, ansiedad y desesperanza, una escala periódica de atracones y una escala de figuras de personajes. Los resultados indicaron que PROMETA contribuyó a la reducción de los síntomas de depresión, ansiedad, desesperanza y atracones. Por tanto, el programa muestra resultados satisfactorios para esta muestra.

Caso clínico de un adulto con trastorno de personalidad obsesivo-compulsiva según clasificación del DSM-V / Clinical Case of an Adult with Obsessive-Compulsive Personality Disorder According to the DSM-V Classification

Resumen Esta investigación presenta el caso clínico de un adulto que padece un trastorno de la personalidad obsesivo-compulsiva. El objetivo es presentar en detalle el procedimiento seguido en los consultorios de psicología de la Universidad de Ibagué mediante la integración de técnicas cognitivas y humanistas mostrando la eficacia y viabilidad de este tratamiento y su aplicación. Los resultados obtenidos, muestran mejorías relevantes como: mayor flexibilidad cognitiva, disminución de la activación fisiológica producto de la alteración emocional y ansiedad ante la falta de control, adquisición de habilidades para la solución de problemas, autocontrol emocional y de los pensamientos acerca de la percepción de sí mismo y de los demás. Se concluye que la formulación clínica cognitivo-humanista y el tratamiento ofrecido resultó pertinente y efectivo respecto a los objetivos terapéuticos perseguidos.

Abstract This research presents the clinical case of an adult with obsessive-compulsive personality disorder. The objective is to present in detail the procedure followed in the psychology offices of the University of Ibague by integrating cognitive and humanistic techniques to demonstrate the effectiveness and feasibility of this treatment and its application. The results obtained show relevant improvements, such as greater cognitive flexibility, a decrease of physiological activation as a result of emotional alteration and anxiety in the face of lack of control, acquisition of problem-solving skills, emotional self-control, and control of thoughts about the perception of oneself and others. It is concluded that the cognitive-humanistic intervention and the treatment given were pertinent and effective for the therapeutic objectives pursued.

Brief online behavioral cognitive intervention for anxiety symptoms: what was learned during and for after the pandemic period?

Cognitive therapies comprise a widely recognized group of psychological interventions with considerable empirical support for different mental health conditions. These interventions can be used both in a traditional clinical setting and in crisis situations, especially those involving self-perception of overestimated risk, high vulnerability, and low coping capacity. The world is currently under a crisis, specifically, the COVID-19 pandemic, which can bring substantial impact on people's routine and cause significant psychological distress. In this context, telehealth interventions are becoming a standard practice and, thus, cognitive therapists could also support patients and people in the general population using this tool for the emerging issues. This text provides a brief overview of the main issues that may arise in the current pandemic situation as possible targets for the practice of cognitive therapists and the main evidence-based strategies that could be used in this context.(AU)

As terapias cognitivas compreendem um grupo amplamente reconhecido de intervenções psicológicas, com considerável suporte empírico para diferentes condições de saúde mental. Essas intervenções podem ser utilizadas tanto em ambiente clínico tradicional quanto em situações de crise, principalmente aquelas envolvendo autopercepção de risco superestimado, alta vulnerabilidade e baixa capacidade de enfrentamento. O mundo vive atualmente uma situação de crise, especificamente, a pandemia de COVID-19, que pode trazer um impacto substancial na rotina das pessoas e causar sofrimento psicológico significativo. Nesse contexto, as intervenções de cuidado online estão se tornando uma prática padrão e, assim, os terapeutas cognitivos também poderiam apoiar seus pacientes e pessoas da população em geral usando esta ferramenta para as questões emergentes. Este texto fornece uma breve visão geral das principais questões que podem surgir na atual situação de pandemia como possíveis alvos para a prática de terapeutas cognitivos e as principais estratégias baseadas em evidências que podem ser utilizadas por eles neste contexto.(AU)

Las terapias cognitivas comprenden un grupo ampliamente reconocido de intervenciones psicológicas, con considerable apoyo empírico para diferentes condiciones de salud mental. Estas intervenciones pueden utilizarse tanto en un entorno clínico tradicional como en situaciones de crisis, especialmente aquellas que implican un riesgo auto percibido sobrestimado, alta vulnerabilidad y baja capacidad de afrontamiento. El mundo atraviesa actualmente una situación de crisis, específicamente la pandemia de COVID-19, que puede tener un impacto sustancial en la rutina de las personas y causar una angustia psicológica significativa. En este contexto, las intervenciones de atención en línea se están convirtiendo en una práctica estándar y, por lo tanto, los terapeutas cognitivos también podrían ayudar a sus pacientes y personas en la población general utilizando esta herramienta para problemas emergentes. Este texto ofrece una breve descripción de los principales problemas que pueden surgir en la situación pandémica actual como posibles objetivos para la práctica de los terapeutas cognitivos y las principales estrategias basadas en la evidencia que pueden ser utilizadas por ellos en este contexto.(AU)

Efficacy of Cognitive Behavioural Therapy for Bipolar Disorder: a Systematic Review. / Eficacia de la Terapia Cognitiva Conductual Para el Trastorno Bipolar: una Revisión Sistemática.

INTRODUCTION: Bipolar disorder (BD) is a serious mental illness with a chronic course and significant morbidity and mortality. BD has a lifetime prevalence rate of 1% to 1.5% and is characterised by recurrent episodes of mania and depression, or a mixture of both phases. Although it has harmacological and psychotherapeutic treatment, cognitive behavioural therapy (CBT) has shown beneficial effects, but there is not enough clinical information in the current literature. METHODS: The main aim was to determine the efficacy of CBT alone or as an adjunct to pharmacological treatment for BD. A systematic review of 17 articles was carried out. The inclusion criteria were: quantitative or qualitative research aimed at examining the efficacy of CBT in BD patients with/without medication; publications in English language; and) being 18-65 years of age. The exclusion criteria were: review and meta-analysis articles; articles that included patients with other diagnoses in addition to BD and that did not separate the results based on such diagnoses; and studies with patients who did not meet the DSM or ICD criteria for BD. The PubMed, PsycINFO and Web of Science databases were searched up to 5 January 2020. The search strategy was: "Bipolar Disorder" AND "Cognitive Behavioral Therapy". RESULTS: A total of 1,531 patients both sexes were included. The weighted mean age was 40.703 years. The number of sessions ranged from 8-30, with a total duration of 45-120minutes. All the studies show variable results in improving the level of depression and the severity of mania, improving functionality, reducing relapses and recurrences, and reducing anxiety levels and the severity of insomnia. CONCLUSIONS: The use of CBT alone or adjunctive therapy in BD patients is considered to show promising results after treatment and during follow-up. Benefits include reduced levels of depression and mania, fewer relapses and recurrences, and higher levels of psychosocial functioning. More studies are needed.

A Terapia Cognitivo-Comportamental Aplicada ao CAPS ad: Uma Revisão de Escopo / The Cognitive-Behavioral Therapy Applied to CAPS ad: A Scope Review / La Terapia Cognitivo-Conductual Aplicada al CAPS ad: Una Revisión del Alcance

Este estudo tem como objetivo realizar uma revisão de escopo sobre estratégias cognitivas e/ou comportamentais empregadas no tratamento de dependência de álcool e outras drogas no mundo, assim como levantar estudos sobre o uso destas abordagens em CAPS ad no Brasil. Foram levantados artigos de revisão sobre "estratégias cognitivas ou comportamentais para tratamento de dependência de álcool e outras drogas" e publicações com o tema "uso de terapias cognitivas e/ou comportamentais em CAPS ad". Foram encontradas apenas cinco publicações relatando emprego de terapias cognitivas e comportamentais em CAPS ad. Estes estudos descreveram intervenções em grupos coordenados por psicólogos, enfermeiros ou outros profissionais de nível superior. Foram incluídos ainda 23 artigos de revisão sobre resultados de tratamentos de base cognitivo-comportamental para tratamento de dependência de álcool e outras drogas. Conclui-se que as estratégias cognitivo-comportamentais apresentam várias características vantajosas à saúde pública, como a possibilidade de sistematização em protocolos, o que facilita sua aplicação e avaliação de resultados terapêuticos. No entanto, persistem obstáculos para adoção desta abordagem nos serviços de saúde mental no Brasil, sendo então necessário avançar no desenvolvimento de instrumentos de políticas públicas que permitam a difusão de boas práticas de intervenções comprovadamente custo-efetivas e acessíveis à população. (AU)

This study aims to conduct an escope review on the use of cognitive-behavioral approaches to treatment of alcohol and other drug addiction in CAPS ad, as well as find studies on the use of this approach in CAPS ad in Brazil. We conducted searches with the theme "use of cognitive and / or behavioral therapies in CAPS ad" and review articles on "cognitive or behavioral strategies for treatment of alcohol and other drug dependence". Only five publications were found reporting the use of cognitive and behavioral therapies in CAPS ad. These studies described interventions in groups coordinated by psychologists, nurses or other graduated professionals. Twenty-three review articles on outcomes of cognitive-behavioral treatments for addiction treatment of alcohol and other drugs were also included. We concluded that cognitive-behavioral strategies showcase several advantageous characteristics to public health, such as the possibility of systematization in protocols, which facilitates their application and evaluation of therapeutic results. However, obstacles to the adoption of this approach in mental health services in Brazil persist, so it is necessary to advance in developing public policy instruments that allow the dissemination of good practices in interventions that are proven to be cost-effective and accessible to the population. (AU)

Este estudio tiene como objetivo realizar una revisión del alcance sobre el empleo de abordajes cognitivo-conductuales para tratamiento de dependencia de alcohol y otras drogas en los CAPS ad en Brasil. Se levantaron publicaciones con el tema "uso de terapias cognitivas y/o conductuales en CAPS ad" y artículos de revisión sobre "estrategias cognitivas o conductuales para el tratamiento de la dependencia del alcohol y otras drogas". Se encontraron sólo cinco publicaciones que relatan empleo de terapias cognitivas y conductuales en CAPS ad. Estos estudios describieron intervenciones en grupos coordinados por psicólogos, enfermeros u otros profesionales de nivel superior. Se incluyeron 23 artículos de revisión sobre resultados de tratamientos de base cognitivo-conductual para tratamiento de dependencia de alcohol y otras drogas. Se concluye que las estrategias cognitivo-conductuales presentan varias características ventajosas para la salud pública, como la posibilidad de sistematización en protocolos, lo que facilita su aplicación y evaluación de resultados terapéuticos. Sin embargo, persisten obstáculos para la adopción de este enfoque en los servicios de salud mental en Brasil, por lo que es necesario avanzar en el desarrollo de instrumentos de política pública que permitan la difusión de buenas prácticas de intervenciones que demuestren ser costo-efectivas y accesibles a la población. (AU)

Abordagem cognitivo-comportamental na escola: possibilidades de intervenção / Cognitive behavioral approach at school: possibilities for intervention

RESUMO O objetivo deste artigo é descrever técnicas grupais desenvolvidas nas turmas do 3º e 6º ano do ensino fundamental de uma escola municipal situada em uma cidade do interior do estado do Rio Grande do Sul. As técnicas tiveram o intuito de intervir em demandas escolares associadas a relações interpessoais e comportamentos desafiadores e opositores tendo como base os pressupostos teóricos e práticos da abordagem cognitivo-comportamental. Os grupos foram homogêneos, com média de 10 estudantes, com objetivo de psicoeducação e de orientação/ treinamento, visando a promoção de saúde na escola. A experiência relatada colabora com a práxis metodológica da área a qual pertence, oferecendo relatos de práticas singulares que podem ser adaptadas a outros contextos e demandas escolares similares.

ABSTRACT The objective of this article is to describe group techniques that have developed in the 3rd and 6th grade classes of a municipal school located in a city in the state of Rio Grande do Sul. These techniques, based on the theoretical and practical assumptions of cognitive behavioral theory, have intended to intervene in school demands related to interpersonal relationships and challenging behavior and opposing behaviors. The groups have been homogeneous, with an average of 10 students, aiming at psychoeducation and orientation / training, with the objective at to promote health at school. The reported experience collaborates with the methodological praxis of the area to which it belongs, offering reports of singular practices that can be adapted to other similar contexts and school demands.

Valoración de la eficacia de la Terapia Basada en Mindfulness para el trastorno obsesivo compulsivo. Una revisión sistemática / Mindfulness Based Therapy efficacy assessment for Obsessive Compulsive Disorder. A Systematic Review

Antecedentes y objetivos: Las intervenciones basadas en Mindfulness podrían ser tan útiles para el Trastorno Obsesivo Compulsivo (TOC), con igual o mejores resultados que los tratamientos actuales. El objetivo es revisar la investigación reciente sobre la eficacia y aplicabilidad de una Intervención Basada en Mindfulness (IBM) para el tratamiento del TOC. Material y Métodos: Se seleccionaron 13 estudios (2008-2020), de las bases PsycINFO, Scopus, EBSCO, Web of Knowledge, CINAHL y PSICODOC. Resultados: Siete estudios obtuvieron una mejora de síntomas en comparación con el grupo control, pero tan solo en 3 dicho cambio se relacionaba con diferencias en Mindfulness. Se hace un análisis de los problemas metodológicos y del estado de la investigación sobre los procesos activados por Mindfulness. Conclusiones: Los resultados no indican superioridad de una IBM. No obstante, existen multitud de razones metodológicas y teóricas por las que estos hallazgos deben ser tomados con cautela y se necesita más investigación.(AU)

Introduction and Objectives: Mindfulness-based interventions might be equally helpful for obsessive compulsive disorder (OCD), with equal or better results than standard treatments. A systematic review is conducted to assess the efficacy and applicability of a Mindfulness Intervention for OCD symptoms. Materials and Method: Thirteen studies (2008-2020) were selected, from the bases PsycINFO, Scopus, EBSCO, Web of Knowledge, CINAHL and PSICODOC. Results: Seven studies obtained an improvement in symptoms compared to the control group, but only in 3 was this change related to differences in Mindfulness. Conclusions: The amount of methodological problems and the Mindfulness research premature state makes the exhibited results as inconclusive. Better methodological and clinical standards are necessary for future research, which include better methodological and clinical standards, is necessary.(AU)

Relações familiares e cognições disfuncionais de adolescentes: uma revisão sistemática / Family relations and adolescents dysfunctional cognitions: a systematic review / Relaciones familiares y cogniciones disfuncionales de los adolescentes: una revisión sistemática

O bom funcionamento familiar é fundamental para o desenvolvimento saudável e cognitivo de crianças e adolescentes. Neste sentido, o objetivo do presente estudo foi reunir, sistematizar e analisar pesquisas que tratassem da associação entre relações familiares e cognições disfuncionais dos filhos entre 2008 e 2019. A partir da busca em cinco bases de dados, utilizando como referência o PRISMA, foram selecionados 13 artigos. A análise dos artigos indicou uma grande variedade de termos utilizados para descrever tanto as relações familiares (por exemplo, parentalidade, conflitos) quanto as cognições (cognições mal adaptativas, distorções cognitivas, crenças metacognitivas). Em termos das associações, foi encontrado um padrão entre relações familiares disfuncionais e cognições relacionadas à ansiedade. Diante dos achados, sugere-se que terapias infantojuvenis visem também o aprimoramento da capacidade parental de resolver problemas, com o objetivo de reduzir conflitos intrafamiliares.

A functional family environment is vital to the healthy and cognitive development of children and adolescents. In this sense, the aim of this study was to gather, systematize and analyze researches that addressed the connections between family relations and children's dysfunctional cognitions between 2008 and 2019. From the search in five databases, using PRISMA as a reference, 13 articles were selected. The analysis of the articles indicated a wide variety of terms used to describe both family relations (for example, parenting, conflicts) and cognitions (maladaptive cognitions, cognitive distortions, metacognitive beliefs). In terms of associations, a pattern was found between dysfunctional family relations and anxiety-related cognitions. Given the findings, it is suggested that children and adolescent therapies also aim at improving parental capacity to solve problems, with the objective of reducing intra-family conflicts.

El buen funcionamiento familiar es fundamental para el desarrollo saludable y cognitivo de niños y adolescentes. En este sentido, el objetivo de este estudio fue reunir, sistematizar y analizar investigaciones que abordaron las asociaciones entre las relaciones familiares y las cogniciones disfuncionales de los niños entre 2008 y 2019. De la búsqueda en cinco bases de datos, utilizando PRISMA como referencia, se seleccionaron 13 artículos. El análisis de los artículos indicó una amplia variedad de términos utilizados para describir tanto las relaciones familiares (por ejemplo, la paternidad, los conflictos) como las cogniciones (cogniciones desadaptativas, distorsiones cognitivas, creencias metacognitivas). En términos de asociaciones, se encontró un patrón entre las relaciones familiares disfuncionales y las cogniciones relacionadas con la ansiedad. Dados los hallazgos, se sugiere que las terapias infanto-juveniles tengan como objetivo mejorar la capacidad de los padres para resolver problemas, con el objetivo de reducir los conflictos intrafamiliares.