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1.
J Psychiatr Pract ; 27(2): 121-125, 2021 03 05.
Artículo en Inglés | MEDLINE | ID: mdl-33656818

RESUMEN

There have been shifts over time in the value placed on long-term psychotherapeutic modalities even though they can be life-saving. For example, the province of Ontario in Canada has been dealing with a government proposal put forward in 2019 to limit the length of psychotherapy treatment. In response, stakeholders from numerous groups came together to advocate for the importance of continuing unrestricted access to long-term psychotherapy. Approaches to this advocacy then had to unexpectedly adapt to the Coronavirus Disease 2019 (COVID-19) pandemic that came to the forefront in 2020 and will continue to develop in response to this changing landscape.


Asunto(s)
Defensa del Consumidor , Política de Salud/legislación & jurisprudencia , Salud Mental/legislación & jurisprudencia , Psicoterapia/legislación & jurisprudencia , Psicoterapia/métodos , Humanos , Ontario , Pandemias , Factores de Tiempo
2.
Trials ; 22(1): 186, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33673867

RESUMEN

BACKGROUND: Depression and anxiety impact up to 1 in 5 pregnant and postpartum women worldwide. Yet, as few as 20% of these women are treated with frontline interventions such as evidence-based psychological treatments. Major barriers to uptake are the limited number of specialized mental health treatment providers in most settings, and problems with accessing in-person care, such as childcare or transportation. Task sharing of treatment to non-specialist providers with delivery on telemedicine platforms could address such barriers. However, the equivalence of these strategies to specialist and in-person models remains unproven. METHODS: This study protocol outlines the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) randomized trial. SUMMIT is a pragmatic, non-inferiority test of the comparable effectiveness of two types of providers (specialist vs. non-specialist) and delivery modes (telemedicine vs. in-person) of a brief, behavioral activation (BA) treatment for perinatal depressive and anxiety symptoms. Specialists (psychologists, psychiatrists, and social workers with ≥ 5 years of therapy experience) and non-specialists (nurses and midwives with no formal training in mental health care) were trained in the BA protocol, with the latter supervised by a BA expert during treatment delivery. Consenting pregnant and postpartum women with Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 10 (N = 1368) will be randomized to one of four arms (telemedicine specialist, telemedicine non-specialist, in-person specialist, in-person non-specialist), stratified by pregnancy status (antenatal/postnatal) and study site. The primary outcome is participant-reported depressive symptoms (EPDS) at 3 months post-randomization. Secondary outcomes are maternal symptoms of anxiety and trauma symptoms, perceived social support, activation levels and quality of life at 3-, 6-, and 12-month post-randomization, and depressive symptoms at 6- and 12-month post-randomization. Primary analyses are per-protocol and intent-to-treat. The study has successfully continued despite the COVID-19 pandemic, with needed adaptations, including temporary suspension of the in-person arms and ongoing randomization to telemedicine arms. DISCUSSION: The SUMMIT trial is expected to generate evidence on the non-inferiority of BA delivered by a non-specialist provider compared to specialist and telemedicine compared to in-person. If confirmed, results could pave the way to a dramatic increase in access to treatment for perinatal depression and anxiety. TRIAL REGISTRATION: ClinicalTrials.gov NCT04153864 . Registered on November 6, 2019.


Asunto(s)
Ansiedad/terapia , Depresión Posparto/terapia , Depresión/terapia , Accesibilidad a los Servicios de Salud , Complicaciones del Embarazo/terapia , Psicoterapia/métodos , Telemedicina/métodos , Prestación de Atención de Salud/métodos , Estudios de Equivalencia como Asunto , Femenino , Humanos , Servicios de Salud Materna , Servicios de Salud Mental/organización & administración , Partería , Enfermeras y Enfermeros , Ensayos Clínicos Pragmáticos como Asunto , Embarazo , Escalas de Valoración Psiquiátrica , Psiquiatría , Psicología , Trabajadores Sociales , Especialización
3.
Z Psychosom Med Psychother ; 67(1): 5-20, 2021.
Artículo en Alemán | MEDLINE | ID: mdl-33565377

RESUMEN

On the notion of trust in psychotherapy - epistemic and evaluative aspects Objectives: One of the most consistent findings in the psychotherapy research literature is that the quality of the relationship between the patient and the therapist is a major determinant of psychotherapeutic effectiveness. Yet so far a consistent and assured definition of a helping alliance doesn't exist. Recently P. Fonagy and his research group have introduced the notion of "epistemic trust" to open up a new understanding of the effectiveness of the therapeutic relationship. Methods: The paper outlines Fonagy's et al. notion of "epistemic trust" and compares it to notions of trust devised in the humanities and social sciences from a clinical-psychodynamic perspective. Results: Fonagy et al. characterize epistemic trust as "trust in the authenticity and personal relevance of interpersonally transmitted information". Thus it enables an individual to safely learn from others and to orient himself within a primarily unknown and an ever changing social world. By contrast the humanities and social sciences offer a more comprehensive perspective insofar as trust is described as both an affective, cognitive and volitive phenomenon embedded within a specific ethical topography (evaluative trust). Conclusions: Taking trust's multidimensionality into account results in a slightly different clinical understanding of confidence building within psychotherapy and postulates a primacy of recognition over cognition in clinical encounter as well.


Asunto(s)
Psicoterapia , Alianza Terapéutica , Confianza , Humanos , Psicoterapia/métodos
4.
Z Psychosom Med Psychother ; 67(1): 36-55, 2021.
Artículo en Alemán | MEDLINE | ID: mdl-33565382

RESUMEN

Functions of language in psychotherapy: A qualitative study of psychotherapists' subjective theories of the "talking cure" Objectives: Psychotherapy is traditionally considered as a "talking cure". The specific functions of verbal activity, however, are disputed. The present study aims at identifying central therapeutic functions of verbal activity. Methods: In qualitative interviews n = 23 psychotherapists with psychodynamic (n = 12) or behavioral (n = 11) background were interviewed regarding their theories of the "talking cure." Based on Consensual Qualitative Research (CQR) a category system of therapeutic functions of verbal activity was constructed. Results: The participants described a wide range of relational, experiential, and behavioral functions of verbal activity in psychotherapy. Psychodynamic therapists emphasized relational and experiential functions of verbal activity, while behavioral therapists emphasized behavioral functions. Conclusions: The findings imply that verbal activity fulfills diverse functions in therapeutic contexts. This suggests a basic verbal materiality of many therapeutic techniques and common factors that needs to be specified in subsequent research.


Asunto(s)
Lenguaje , Psicoterapia/métodos , Investigación Cualitativa , Humanos , Relaciones Profesional-Paciente
5.
J Psychol ; 155(2): 129-139, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33539235

RESUMEN

The Dutch protocol for Eye Movement Desensitization and Reprocessing (EMDR) uses two psychological myths as part of the therapeutic instruction: memory works as a video camera and individuals can have a photographic memory. This study explored how participants experience and evaluate such instructions and if these instructions affect their beliefs on memory. Participants received a video, photo, or a control instruction. Participants indicated on a visual analog scale how vivid and emotional they expected to recall the traumatic memory, how credible the therapeutic instruction was, and how reliable they would consider a therapist providing such an instruction. Next, participants completed a memory belief survey. Participants who received the video instruction were most likely to expect to vividly recall a memory. The credibility of the instructions and the reliability of the therapist providing the instruction were at chance level, which might pose problems for the therapeutic alliance and therapy outcome.


Asunto(s)
Desensibilización y Reprocesamiento del Movimiento Ocular , Trauma Psicológico , Psicoterapia , Humanos , Memoria , Recuerdo Mental , Países Bajos , Trauma Psicológico/psicología , Trauma Psicológico/terapia , Psicoterapia/métodos , Resultado del Tratamiento
6.
Value Health ; 24(2): 216-226, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33518028

RESUMEN

OBJECTIVES: The Depression Care for People with Cancer program (DCPC) is a cost-effective depression care model for UK patients with cancer. However, DCPC's cost-effectiveness in the United States is unknown, particularly for patients with prostate cancer in the United States. This study evaluates the health and economic impact of providing DCPC to patients with prostate cancer. METHODS: DCPC was compared with usual care in a mathematical model that simulates depression and its outcomes in a hypothetical cohort of US patients with prostate cancer. DCPC was modeled as a sequential combination of universal depression screening, post-screening evaluations, and first-line combination therapy. Primary outcomes were lifetime direct costs of depression care, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. Secondary outcomes included life expectancy, number of depression-free months and lifetime depressive episodes, duration of depressive episodes, cumulative incidence of depression, lifetime depression diagnoses/misdiagnoses, and the cumulative incidence of maintenance therapy for depression. Sensitivity analyses were used to examine uncertainty. RESULTS: In the base case, DCPC dominated usual care by offering 0.11 more QALYs for $2500 less per patient (from averted misdiagnoses). DCPC also offered 5 extra depression-free months, shorter depressive episodes, and a lower chance of maintenance therapy. DCPC's trade-offs were a higher cumulative incidence of depression and more lifetime depressive episodes. Life expectancy was identical under usual care and DCPC. Sensitivity analyses indicate that DCPC was almost always preferable to usual care. CONCLUSION: Compared with usual care, DCPC may offer more value to US patients with prostate cancer. DCPC should be considered for inclusion in prostate cancer survivorship care guidelines.


Asunto(s)
Depresión/etiología , Depresión/terapia , Neoplasias de la Próstata/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Antidepresivos/economía , Antidepresivos/uso terapéutico , Análisis Costo-Beneficio , Depresión/economía , Gastos en Salud , Humanos , Esperanza de Vida , Masculino , Persona de Mediana Edad , Modelos Teóricos , Psicoterapia/economía , Psicoterapia/métodos , Calidad de Vida , Años de Vida Ajustados por Calidad de Vida , Estados Unidos
8.
Pap. psicol ; 41(3): 191-195, sept.-dic. 2020. tab
Artículo en Español | IBECS | ID: ibc-197406

RESUMEN

El efecto placebo es poderoso y ha demostrado su eficacia en múltiples estudios, compitiendo incluso con tratamientos bien establecidos. Esto pone de manifiesto un efecto en absoluto inerte o inespecífico. Tiene una naturaleza ubicua y da razón de todo tipo de tratamientos, si bien es la psicología el ámbito que le hace comprensible. Desgranar y conocer qué le hace tan eficaz es una tarea útil e ilustrativa de cómo operan los tratamientos al uso. En este sentido hay que destacar que para que opere debe ser construido en términos contextuales, no requiere de engaños y sí de una persona con problemas, en desequilibrio homeostático. El estudio de las condiciones en que el efecto placebo ocurre ha sido útil para delinear qué aspectos son importantes en los tratamientos, a saber: la facilitación de información y el sentido de ésta, las experiencias previas y las creencias del paciente, la aplicación del tratamiento en condiciones favorables y el uso de tratamientos bien reconocidos y aceptados en sus fundamentos y procedimiento


The placebo effect is powerful and has been proved effective in multiple studies, competing even with well-established treatments. It is not an unspecific or inert effect. It has a ubiquitous nature and accounts for all types of treatments, although psychology is the area that makes it comprehensible. Discussing and discovering what makes it so effective is a useful and illustrative task regarding how treatments work. In this sense, it must be emphasized that in order for the placebo effect to operate, it must be considered from contextual view, it does not require deception, and it does require a person with problems, in homeostatic imbalance. The study of the conditions in which the placebo effect occurs has been useful in delineating which aspects are important in treatments. These are as follows: the provision of information and its meaning, the patient's previous experiences and beliefs, the application of the treatment under favorable conditions, and the use of well-recognized and accepted treatments in their foundations and procedure


Asunto(s)
Humanos , Placebos/normas , Efecto Placebo , Psicoterapia/métodos , Resultado del Tratamiento , Consenso , Psicoterapia/normas , Psicología Clínica/normas , Manejo del Dolor , Síndrome del Colon Irritable/psicología , Hipersensibilidad/psicología , Enfermedades de la Piel/psicología , Ansiedad/psicología , Depresión/psicología
9.
BMC Med ; 18(1): 400, 2020 12 23.
Artículo en Inglés | MEDLINE | ID: mdl-33353539

RESUMEN

BACKGROUND: Major depressive disorder (MDD) shows large heterogeneity of symptoms between patients, but within patients, particular symptom clusters may show similar trajectories. While symptom clusters and networks have mostly been studied using cross-sectional designs, temporal dynamics of symptoms within patients may yield information that facilitates personalized medicine. Here, we aim to cluster depressive symptom dynamics through dynamic time warping (DTW) analysis. METHODS: The 17-item Hamilton Rating Scale for Depression (HRSD-17) was administered every 2 weeks for a median of 11 weeks in 255 depressed inpatients. The DTW analysis modeled the temporal dynamics of each pair of individual HRSD-17 items within each patient (i.e., 69,360 calculated "DTW distances"). Subsequently, hierarchical clustering and network models were estimated based on similarities in symptom dynamics both within each patient and at the group level. RESULTS: The sample had a mean age of 51 (SD 15.4), and 64.7% were female. Clusters and networks based on symptom dynamics markedly differed across patients. At the group level, five dynamic symptom clusters emerged, which differed from a previously published cross-sectional network. Patients who showed treatment response or remission had the shortest average DTW distance, indicating denser networks with more synchronous symptom trajectories. CONCLUSIONS: Symptom dynamics over time can be clustered and visualized using DTW. DTW represents a promising new approach for studying symptom dynamics with the potential to facilitate personalized psychiatric care.


Asunto(s)
Técnicas de Apoyo para la Decisión , Trastorno Depresivo Mayor/epidemiología , Trastorno Depresivo Mayor/terapia , Individualidad , Medicina de Precisión/métodos , Adulto , Anciano , Análisis por Conglomerados , Estudios Transversales , Trastorno Depresivo Mayor/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Medicina de Precisión/normas , Medicina de Precisión/estadística & datos numéricos , Psicoterapia/métodos , Psicoterapia/normas , Factores de Tiempo , Resultado del Tratamiento
10.
J Cogn Psychother ; 34(4): 275-279, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-33372123

RESUMEN

This invited commentary is the personal experience of a psychiatrist who assisted in Wuhan, China during the pandemic. From the personal perspective, it explains why psychiatrists need to go to Wuhan, discusses the psychological problems faced by the front-line medical staff and confirmed COVID-19 patients and the corresponding psychological interventions provided to them, describes the particularity and coping methods of psychological issues related to COVID-19 epidemic.


Asunto(s)
/psicología , Cuerpo Médico de Hospitales/psicología , Rol del Médico/psicología , Psiquiatría/métodos , Psicoterapia/métodos , Adulto , China , Humanos
11.
Int J Biol Sci ; 16(15): 2828-2834, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33061799

RESUMEN

During the novel coronavirus disease 2019 (COVID-19) outbreak, traditional face-to-face psychological interventions have been suspended due to high risks of rapid transmission. Developing an effective online model of psychological intervention is deemed necessary to deal with the mental health challenges brought up by this disease. An integrated psychological intervention model coined 'COVID-19 Psychological Resilience Model' was developed in Chengdu, China including live media, 24-hour hotline consultations, online video intervention and on-site crisis intervention sessions to provide services to those in need. A total of 45 episodes of live media programs on COVID-19 outbreak-related psychological problems were broadcasted with over 10 million views. A total of 4,236 hotline consultations were completed. More than 50% of the clients had positive feedback about the hotline consultations. A total of 223 cases received online video intervention, of which 84.97% were redirected from the hotline consultation and 15.03% from COVID-19-designated hospital and community-based observation spots. Seventy one-on-one psychological interventions were conducted with 39 COVID-19 patients, and one-third were treated with medication. Additionally, 5 training sessions were conducted to 98 frontline medical staff. This 'COVID-19 Psychological Resilience Model' is proven effective to the general population during the COVID-19 pandemic. We have greatly improved the overall mental health of our target population during the COVID-19 pandemic. This model could provide valuable experiences and serve as a reference guide for other countries to offer effective psychological intervention, and reduce detrimental negative mental health outcomes in public health emergency.


Asunto(s)
Infecciones por Coronavirus/psicología , Servicios de Salud Mental/organización & administración , Neumonía Viral/psicología , Resiliencia Psicológica , Estrés Psicológico/psicología , Telemedicina/métodos , Betacoronavirus , China/epidemiología , Brotes de Enfermedades , Accesibilidad a los Servicios de Salud , Líneas Directas , Humanos , Internet , Modelos Organizacionales , Modelos Psicológicos , Pandemias , Psicoterapia/métodos , Estrés Psicológico/terapia
12.
Fortschr Neurol Psychiatr ; 88(10): 677-689, 2020 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-33049789

RESUMEN

Over the past few years, research and application of internet-based psychotherapeutic interventions has grown rapidly. This kind of new therapeutic format offers a variety of chances for treating patients with psychotherapeutic disorders, but also arouses skepticism and concerns. This overview focuses on different forms of internet-based psychotherapeutic interventions, reflects the current state of research, and points out new areas of development as well as its implementation in daily practice.


Asunto(s)
Intervención basada en la Internet , Psicoterapia/métodos , Telemedicina , Humanos
13.
PLoS One ; 15(10): e0239997, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33052965

RESUMEN

BACKGROUND: Chronic posttraumatic stress disorder (PTSD) is a disabling condition that generates considerable morbidity, mortality, and both medical and indirect social costs. Treatment options are limited. A novel therapy using 3,4-methylenedioxymethamphetamine (MDMA) has shown efficacy in six phase 2 trials. Its cost-effectiveness is unknown. METHODS AND FINDINGS: To assess the cost-effectiveness of MDMA-assisted psychotherapy (MAP) from the health care payer's perspective, we constructed a decision-analytic Markov model to portray the costs and health benefits of treating patients with chronic, severe, or extreme, treatment-resistant PTSD with MAP. In six double-blind phase 2 trials, MAP consisted of a mean of 2.5 90-minute trauma-focused psychotherapy sessions before two 8-hour sessions with MDMA (mean dose of 125 mg), followed by a mean of 3.5 integration sessions for each active session. The control group received an inactive placebo or 25-40 mg. of MDMA, and otherwise followed the same regimen. Our model calculates net medical costs, mortality, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. Efficacy was based on the pooled results of six randomized controlled phase 2 trials with 105 subjects; and a four-year follow-up of 19 subjects. Other inputs were based on published literature and on assumptions when data were unavailable. We modeled results over a 30-year analytic horizon and conducted extensive sensitivity analyses. Our model calculates expected medical costs, mortality, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio. Future costs and QALYs were discounted at 3% per year. For 1,000 individuals, MAP generates discounted net savings of $103.2 million over 30 years while accruing 5,553 discounted QALYs, compared to continued standard of care. MAP breaks even on cost at 3.1 years while delivering 918 QALYs. Making the conservative assumption that benefits cease after one year, MAP would accrue net costs of $7.6 million while generating 288 QALYS, or $26,427 per QALY gained. CONCLUSION: MAP provided to patients with severe or extreme, chronic PTSD appears to be cost-saving while delivering substantial clinical benefit. Third-party payers are likely to save money within three years by covering this form of therapy.


Asunto(s)
Análisis Costo-Beneficio , Alucinógenos/uso terapéutico , N-Metil-3,4-metilenodioxianfetamina/uso terapéutico , Psicoterapia/economía , Trastornos por Estrés Postraumático/terapia , Adulto , Enfermedad Crónica , Ensayos Clínicos Fase II como Asunto , Método Doble Ciego , Femenino , Humanos , Masculino , Cadenas de Markov , Persona de Mediana Edad , Psicoterapia/métodos , Calidad de Vida , Años de Vida Ajustados por Calidad de Vida , Índice de Severidad de la Enfermedad , Trastornos por Estrés Postraumático/tratamiento farmacológico , Trastornos por Estrés Postraumático/mortalidad , Trastornos por Estrés Postraumático/patología , Tasa de Supervivencia
14.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(5): 279-285, sept.-oct. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-199481

RESUMEN

INTRODUCCIÓN: Ante el fenómeno del envejecimiento de la población, los problemas de salud relacionados con la edad tales como las demencias o la discapacidad visual asociada a enfermedades crónicas han ido aumentando progresivamente. El presente trabajo describe y analiza la eficacia y viabilidad de una intervención individualizada dirigida a dos varones usuarios de un centro de día con un diagnóstico de demencia y discapacidad visual severa que les dificulta la realización de las actividades propias del centro. MATERIAL Y MÉTODO: El proyecto tuvo una duración de tres meses y contó con una fase de evaluación pre- y postintervención. Para la evaluación se utilizaron los instrumentos Mini-Examen Cognoscitivo, Escala de Depresión Geriátrica y un instrumento de registro observacional basado en el Dementia Categorization Recordin Observational System. La fase de intervención tuvo una duración de ocho semanas y se realizaron diferentes dinámicas adaptadas a los gustos e intereses de los participantes. RESULTADOS Y CONCLUSIONES: Tras la fase de intervención se observó una reducción clínicamente significativa de la sintomatología depresiva de ambos usuarios, así como una disminución en la frecuencia de conductas apáticas durante las horas que pasaban en el centro. Asimismo, se observó un aumento en las conductas de tipo prosocial y en las de implicación con las tareas realizadas. Los resultados obtenidos apuntan a que la personalización de las actividades que se realizan en centros a usuarios concretos incrementa la estimulación de los participantes, mejorando su bienestar mediante pequeñas adaptaciones poco costosas de las intervenciones que se realizan


INTRODUCTION: The ageing of the population has led to a progressive increase in age-related diseases, such as dementia or visual impairment, due to chronic diseases. This work describes and analyses the efficacy and feasibility of an individualised intervention carried out with two male users of a day-care centre with a diagnosis of dementia and a severe visual impairment, which made it difficult for them to take part in the regular activities of the centre. MATERIAL AND METHOD: The intervention process had a time frame of three months, and had an assessment phase before and after the intervention. For the assessment, use was made of the Mini-Mental State Examination, Geriatric Depression Scale, and an observational tool based on the Dementia Categorization Recording Observational System. The intervention lasted for eight weeks, and consisted of different dynamics adjusted to the preferences of the participants. RESULTS AND CONCLUSIONS: After the intervention, a clinically significant reduction in the depressive symptomatology was observed for both participants, along with a reduction in the frequency of apathetic behaviour during the time they spent in the centre. Furthermore, an increase was observed in the prosocial behaviour and on the engagement with the task. The results show that the personalisation of the activities for particular users increases the stimulation of the participants, improving their well-being through small and inexpensive adaptations to the interventions that are carried out in the centres


Asunto(s)
Humanos , Demencia/psicología , Ceguera/psicología , Psicoterapia/métodos , Trastorno Depresivo/psicología , Técnicas Psicológicas/organización & administración , Pruebas Neuropsicológicas/estadística & datos numéricos , Envejecimiento , Evaluación de Resultados de Intervenciones Terapéuticas , Habilidades Sociales
17.
Medicine (Baltimore) ; 99(39): e22151, 2020 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-32991409

RESUMEN

INTRODUCTION: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most common diseases in urology, which 50% of men are infected at some point in their lives. Type III CP/CPPS is the most complex and controversial of all types of prostatitis, the highest incidence rate, uncertain efficacy, the long-term treatment that affects the patient's psychopathic symptoms, increases the psychological burden of patients. Psychological intervention for patients with CP/CPPS, which is difficult to treat with drugs and physics, can effectively improve clinical efficacy and improve the psychological condition. The researchers found a high prevalence of psychosocial problems and catastrophic distress in CP/CPPS patients, such as serious mental disorders, especially depression, anxiety and stress, and the high incidence of pain-devastating illness. In this study, we will evaluate psychological interventions as an effective way to relieve chronic prostatitis. METHODS AND ANALYSIS: The databases of English databases (PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library) and Chinese databases (China National Knowledge Infrastructure, China Biology Medicine Database, Wanfang Database, VIP Database) will be retrieved. The search strategy that will be run in the PubMed and tailored to the other database when necessary is presented in this article. RevMan 5.3 and Stata 11.0 will be used for Systematic Review and Meta-analysis. This protocol reported under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. RESULTS: The study is a protocol for systematic review and meta-analysis without results, and data analysis will be carried out after the protocol. We will share our findings in the third quarter of 2021. CONCLUSION: This systematic review will provide more evidence to assess whether psychological is an effective intervention for patients with chronic prostatitis/chronic pelvic pain syndrome. Besides, the results will be published in a public issue journal and offer the urologists help to make clinical decisions. ETHICS AND DISSEMINATION: Formal ethical approval is not required in this protocol. We will collect and analyze data based on published research. Since this research does not involve patients, personal privacy will not be affected. The results of this review will be distributed to peer-reviewed journals or submitted to relevant conferences. PROTOCOL REGISTRATION NUMBER: INPLASY202080021.


Asunto(s)
Dolor Pélvico/psicología , Prostatitis/psicología , Psicoterapia/métodos , Factores de Edad , Enfermedad Crónica , Humanos , Masculino , Investigación Cualitativa , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación , Índice de Severidad de la Enfermedad , Factores Socioeconómicos
18.
Medicine (Baltimore) ; 99(39): e22344, 2020 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-32991449

RESUMEN

BACKGROUND: Depression is a disease with a high incidence and easy to relapse. It not only affects the work and life of patients, but also brings a heavy economic burden. University is the peak of depression, and the prevalence of depression among college students is much higher than that of ordinary people. The purpose of this research is to evaluate depression symptoms, life satisfaction, self-confidence, substance use, social adjustment, and dropout rates of the use of psychological intervention for college students. METHODS: We will identify relevant trials from systematic searches in the following electronic databases: PubMed, Embase, Web of Science and The Cochrane Library. We will also search Clinical Trials.gov, the WHO International Clinical Trials Registry Platform for unpublished data. Additional relevant studies will be searched through search engines (such as Google), and references included in the literature will be tracked. All relevant randomized controlled trials (RCTs) will be included. There are no date restrictions. Use Cochrane Collaboration's Risk of bias tool to conduct risk of bias analysis. Use the Grades of Recommendation, Assessment, Development, and Evaluation to assess the quality of evidence. All statistical analysis will be performed using Stata (V.15.0.) and Review Manager (V.5.2.0). RESULTS: A total of 6238 records were obtained by searching the database and 27 records were obtained by other sources. After removing duplicate records, there are 4225 records remaining. We excluded 3945 records through abstract and title, leaving 280 full-text articles. CONCLUSION: This will be the first study to compare the effects of different psychological treatments on depression in college students. We hope that this study will guide clinical decision-making of psychotherapy to better treat depression in college students. PROTOCOL REGISTRATION: INPLASY202070134.


Asunto(s)
Depresión/terapia , Psicoterapia/métodos , Estudiantes/psicología , Adolescente , Adulto , Depresión/epidemiología , Depresión/psicología , Femenino , Carga Global de Enfermedades/economía , Humanos , Incidencia , Masculino , Metaanálisis en Red , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Satisfacción Personal , Prevalencia , Psicoterapia/tendencias , Calidad de Vida/psicología , Ensayos Clínicos Controlados Aleatorios como Asunto , Autoimagen , Ajuste Social , Trastornos Relacionados con Sustancias/epidemiología , Universidades , Adulto Joven
19.
Rev Med Suisse ; 16(707): 1748-1750, 2020 Sep 23.
Artículo en Francés | MEDLINE | ID: mdl-32969611

RESUMEN

There is a renewed interest in the use of psychedelics in the treatment of addictions. The mode of action of psychedelics could be explained by the addictolytic effect of the substance or by an amplifying effect a unique experience. If studies are lacking on the intrinsic addictolytic effects of psychedelics in humans, animals and in vitro experiences show an increase in neurogenesis. In humans, the effectiveness could be explained by the intensity of the lived experience. If the purely experiential aspect is the key to the effectiveness of treatment, it strengthens the idea that psychedelics act as reinforcers of the psychotherapeutic experience by exposure to intense and unusual internal stimuli.


Asunto(s)
Conducta Adictiva/tratamiento farmacológico , Alucinógenos/uso terapéutico , Psicoterapia/métodos , Animales , Conducta Adictiva/terapia , Humanos
20.
Cochrane Database Syst Rev ; 9: CD007668, 2020 09 03.
Artículo en Inglés | MEDLINE | ID: mdl-32880104

RESUMEN

BACKGROUND: Antisocial personality disorder (AsPD) is associated with poor mental health, criminality, substance use and relationship difficulties. This review updates Gibbon 2010 (previous version of the review). OBJECTIVES: To evaluate the potential benefits and adverse effects of psychological interventions for adults with AsPD. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, 13 other databases and two trials registers up to 5 September 2019. We also searched reference lists and contacted study authors to identify studies. SELECTION CRITERIA: Randomised controlled trials of adults, where participants with an AsPD or dissocial personality disorder diagnosis comprised at least 75% of the sample randomly allocated to receive a psychological intervention, treatment-as-usual (TAU), waiting list or no treatment. The primary outcomes were aggression, reconviction, global state/functioning, social functioning and adverse events. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: This review includes 19 studies (eight new to this update), comparing a psychological intervention against TAU (also called 'standard Maintenance'(SM) in some studies). Eight of the 18 psychological interventions reported data on our primary outcomes. Four studies focussed exclusively on participants with AsPD, and 15 on subgroups of participants with AsPD. Data were available from only 10 studies involving 605 participants. Eight studies were conducted in the UK and North America, and one each in Iran, Denmark and the Netherlands. Study duration ranged from 4 to 156 weeks (median = 26 weeks). Most participants (75%) were male; the mean age was 35.5 years. Eleven studies (58%) were funded by research councils. Risk of bias was high for 13% of criteria, unclear for 54% and low for 33%. Cognitive behaviour therapy (CBT) + TAU versus TAU One study (52 participants) found no evidence of a difference between CBT + TAU and TAU for physical aggression (odds ratio (OR) 0.92, 95% CI 0.28 to 3.07; low-certainty evidence) for outpatients at 12 months post-intervention. One study (39 participants) found no evidence of a difference between CBT + TAU and TAU for social functioning (mean difference (MD) -1.60 points, 95% CI -5.21 to 2.01; very low-certainty evidence), measured by the Social Functioning Questionnaire (SFQ; range = 0-24), for outpatients at 12 months post-intervention. Impulsive lifestyle counselling (ILC) + TAU versus TAU One study (118 participants) found no evidence of a difference between ILC + TAU and TAU for trait aggression (assessed with Buss-Perry Aggression Questionnaire-Short Form) for outpatients at nine months (MD 0.07, CI -0.35 to 0.49; very low-certainty evidence). One study (142 participants) found no evidence of a difference between ILC + TAU and TAU alone for the adverse event of death (OR 0.40, 95% CI 0.04 to 4.54; very low-certainty evidence) or incarceration (OR 0.70, 95% CI 0.27 to 1.86; very low-certainty evidence) for outpatients between three and nine months follow-up. Contingency management (CM) + SM versus SM One study (83 participants) found evidence that, compared to SM alone, CM + SM may improve social functioning measured by family/social scores on the Addiction Severity Index (ASI; range = 0 (no problems) to 1 (severe problems); MD -0.08, 95% CI -0.14 to -0.02; low-certainty evidence) for outpatients at six months. 'Driving whilst intoxicated' programme (DWI) + incarceration versus incarceration One study (52 participants) found no evidence of a difference between DWI + incarceration and incarceration alone on reconviction rates (hazard ratio 0.56, CI -0.19 to 1.31; very low-certainty evidence) for prisoner participants at 24 months. Schema therapy (ST) versus TAU One study (30 participants in a secure psychiatric hospital, 87% had AsPD diagnosis) found no evidence of a difference between ST and TAU for the number of participants who were reconvicted (OR 2.81, 95% CI 0.11 to 74.56, P = 0.54) at three years. The same study found that ST may be more likely to improve social functioning (assessed by the mean number of days until patients gain unsupervised leave (MD -137.33, 95% CI -271.31 to -3.35) compared to TAU, and no evidence of a difference between the groups for overall adverse events, classified as the number of people experiencing a global negative outcome over a three-year period (OR 0.42, 95% CI 0.08 to 2.19). The certainty of the evidence for all outcomes was very low. Social problem-solving (SPS) + psychoeducation (PE) versus TAU One study (17 participants) found no evidence of a difference between SPS + PE and TAU for participants' level of social functioning (MD -1.60 points, 95% CI -5.43 to 2.23; very low-certainty evidence) assessed with the SFQ at six months post-intervention. Dialectical behaviour therapy versus TAU One study (skewed data, 14 participants) provided very low-certainty, narrative evidence that DBT may reduce the number of self-harm days for outpatients at two months post-intervention compared to TAU. Psychosocial risk management (PSRM; 'Resettle') versus TAU One study (skewed data, 35 participants) found no evidence of a difference between PSRM and TAU for a number of officially recorded offences at one year after release from prison. It also found no evidence of difference between the PSRM and TAU for the adverse event of death during the study period (OR 0.89, 95% CI 0.05 to 14.83, P = 0.94, 72 participants (90% had AsPD), 1 study, very low-certainty evidence). AUTHORS' CONCLUSIONS: There is very limited evidence available on psychological interventions for adults with AsPD. Few interventions addressed the primary outcomes of this review and, of the eight that did, only three (CM + SM, ST and DBT) showed evidence that the intervention may be more effective than the control condition. No intervention reported compelling evidence of change in antisocial behaviour. Overall, the certainty of the evidence was low or very low, meaning that we have little confidence in the effect estimates reported. The conclusions of this update have not changed from those of the original review, despite the addition of eight new studies. This highlights the ongoing need for further methodologically rigorous studies to yield further data to guide the development and application of psychological interventions for AsPD and may suggest that a new approach is required.


Asunto(s)
Trastorno de Personalidad Antisocial/terapia , Psicoterapia/métodos , Adulto , Agresión/psicología , Trastorno de Personalidad Antisocial/mortalidad , Trastornos Relacionados con Cocaína/terapia , Terapia Cognitivo-Conductual/métodos , Conducir bajo la Influencia , Femenino , Humanos , Masculino , Prisioneros/estadística & datos numéricos , Ensayos Clínicos Controlados Aleatorios como Asunto , Reincidencia/estadística & datos numéricos , Recompensa , Resultado del Tratamiento
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