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1.
Wiad Lek ; 73(1): 134-138, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32124823

RESUMEN

OBJECTIVE: The aim: The aim of our study was to determine the effect of CBT in patients with uncontrolled BA against the background of excess body weight and obesity. PATIENTS AND METHODS: Materials and methods: By the study design there were examined 78 patients who had a primary diagnosis of uncontrolled BA. RESULTS: Results: The patients in the main group had significant positive dynamics regarding a number of AQLQ questionnaires, namely emotions, activity, overall quality of life (p≤0.05). These patients also had a positive dynamics in overcoming anxiety-depressive disorders, namely from 10.23 ± 0.81 points anxiety disorders scored 7.65 ± 0.98 points after CBT, and depressive changes - from 10.01 ± 0.79 points to 7.69 ± 0.67 points by the HADS scale (p ≤0.05). CONCLUSION: Conclusions: The use of CBT has a positive effect on certain indices of the AQLQ questionnaire (p≤0.05) and has a positive effect on the psychological state of the patient, namely, it reduces the manifestations of anxiety and depression (p≤0.05) in patients with uncontrolled asthma as well as improves the course of uncontrolled asthma by a number of indices, namely reducing the frequency of use of short-acting ß-2-agonists, nocturnal symptoms of asthma, the amount of oral and peroral steroids.


Asunto(s)
Asma , Asma/terapia , Cognición , Terapia Cognitivo-Conductual , Depresión , Humanos , Obesidad , Calidad de Vida
2.
BMJ ; 368: m512, 2020 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-32144210

RESUMEN

The studyHewlett S, Almeida C, Ambler N, et al. Reducing arthritis fatigue impact: two-year randomised controlled trial of cognitive behavioural approaches by rheumatology teams (RAFT). Ann Rheum Dis 2019;78:465-72.Hewlett S, Almeida C, Ambler N, et al. Group cognitive behavioural programme to reduce the impact of rheumatoid arthritis fatigue: the RAFT RCT with economic and qualitative evaluations. Health Technol Assess 2019;23:57.This project was funded by the NIHR Health Technology Assessment Programme (project number 11/112/01).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000860/group-cognitive-behavioural-courses-may-reduce-fatigue-from-rheumatoid-arthritis.


Asunto(s)
Artritis Reumatoide/complicaciones , Terapia Cognitivo-Conductual/métodos , Fatiga/prevención & control , Fatiga/terapia , Psicoterapia de Grupo/métodos , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad
3.
Am J Psychother ; 73(1): 8-14, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-32122161

RESUMEN

OBJECTIVE: Although the effectiveness of interpersonal psychotherapy (IPT) and cognitive therapy (CT) for major depression has been established, little is known about how and for whom they work and how they compare in the long term. The latter is especially relevant for IPT because research on its long-term effects has been limited. This overview paper summarizes findings from a Dutch randomized controlled trial on the effects and mechanisms of change of IPT versus CT for major depression. METHODS: Adult outpatients with depression (N=182) were randomly assigned to CT (N=76), IPT (N=75), or a 2-month waitlist control group followed by patient's treatment of choice (N=31). The primary outcome was depression severity. Other outcomes were quality of life, social and general psychological functioning, and scores on various mechanism measures. Interventions were compared at the end of treatment and up to 17 months follow-up. RESULTS: On average, IPT and CT were both superior to waitlist, and their outcomes did not differ significantly from one another. However, the pathway through which change occurred appeared to differ. For a majority of participants, one of the interventions was predicted to be more beneficial than the other. No support for the theoretical models of change was found. CONCLUSIONS: Outcomes of IPT and CT did not appear to differ significantly. IPT may have an enduring effect not different from that of CT. The field would benefit from further refinement of study methods to disentangle mechanisms of change and from advances in the field of personalized medicine (i.e., person-specific analyses and treatment selection methods).


Asunto(s)
Terapia Cognitivo-Conductual , Depresión/psicología , Depresión/terapia , Adulto , Femenino , Humanos , Masculino , Calidad de Vida , Resultado del Tratamiento
4.
Soins Gerontol ; 25(141): 38-40, 2020.
Artículo en Francés | MEDLINE | ID: mdl-32200989

RESUMEN

How can we respond differently to the demographic challenge of the growing population of seniors with cognitive-behavioural problems? The gerontology pole of the University Hospital Centre of Nîmes has installed a simulation room through a call for projects that has made it possible to develop nursing skills to improve care.


Asunto(s)
Competencia Clínica , Terapia Cognitivo-Conductual , Enfermería Geriátrica , Anciano , Investigación Biomédica , Francia , Hospitales Universitarios , Humanos , Personal de Enfermería en Hospital/educación , Dinámica Poblacional , Entrenamiento Simulado
5.
Lancet Psychiatry ; 7(4): 337-343, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32199509

RESUMEN

BACKGROUND: Better understanding of the heterogeneity of treatment responses could help to improve care for adolescents with depression. We analysed data from a clinical trial to assess whether specific symptom clusters responded differently to various treatments. METHODS: For this secondary analysis, we used data from the Treatment for Adolescents with Depression Study (TADS), in which 439 US adolescents aged 12-17 with a DSM-IV diagnosis of major depressive disorder and a minimum score of 45 on the Children's Depression Rating Scale-Revised (CDRS-R) were randomly assigned (1:1:1:1) to treatment with fluoxetine, cognitive behavioural therapy (CBT), fluoxetine plus CBT, or pill placebo. Our analysis focuses on the acute phase of the trial (ie, the first 12 weeks). Groups of co-occurring symptoms were established by clustering scores for each CDRS-R item at baseline with Ward's method, with Euclidean distances for hierarchical agglomerative clustering. We then used a linear mixed-effects model to investigate the relationship between symptom clusters and treatment efficacy, with the sum of symptom scores within each cluster as the dependent measure. As fixed effects, we entered cluster, time, and treatment assignment, with all two-way and three-way interactions, into the model. The random effect providing better fit was established to be a by-subject random slope for cluster based on improvement in the Schwarz-Bayesian information criterion. OUTCOMES: We identified two symptom clusters: cluster 1 comprised depressed mood, difficulty having fun, irritability, social withdrawal, sleep disturbance, impaired schoolwork, excessive fatigue, and low self-esteem, and cluster 2 comprised increased appetite, physical complaints, excessive weeping, decreased appetite, excessive guilt, morbid ideation, and suicidal ideation. For cluster 1 symptoms, CDRS-R scores were reduced by 5·8 points (95% CI 2·8-8·9) in adolescents treated with fluoxetine plus CBT, and by 4·1 points (1·1-7·1) in those treated with fluoxetine, compared with those given placebo. For cluster 2 symptoms, no significant differences in improvements in CDRS-R scores were detected between the active treatment and placebo groups. INTERPRETATION: Response to fluoxetine and CBT among adolescents with depression is heterogeneous. Clinicians should consider clinical profile when selecting therapeutic modality. The contrast in response patterns between symptom clusters could provide opportunities to improve treatment efficacy by gearing the development of new therapies towards the resolution of specific symptoms. FUNDING: Conselho Nacional de Desenvolvimento Científico e Tecnológico.


Asunto(s)
Terapia Cognitivo-Conductual/métodos , Trastorno Depresivo Mayor/terapia , Fluoxetina/uso terapéutico , Inhibidores de la Captación de Serotonina/uso terapéutico , Adolescente , Teorema de Bayes , Niño , Terapia Combinada , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Resultado del Tratamiento , Estados Unidos
6.
Medicine (Baltimore) ; 99(12): e19549, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32195962

RESUMEN

BACKGROUND: Evidences suggest that cognitive training facilitates cognitive function, and most studies have targeted adults and children older than 4 years of age. This study investigated the applicability and efficacy of a tablet computer-based cognitive training program for young children with cognitive impairment of cognitive age between 18 and 36 months. METHODS: Thirty-eight children were randomly assigned to the intervention (n = 20, administered a tablet computer-based cognitive training program, for 30 minutes per session and twice a week over a period of 12 weeks) and control (n = 18, received the traditional rehabilitation program) groups. Mental scale of Bayley Scales of Infant Development II (BSID II), Pediatric Evaluation of Disability Inventory (PEDI), interest/persistence domain of the Laboratory Temperament Assessment Battery (LAP-TAB), Early Childhood Behavior Questionnaire (ECBQ), and Goal Attainment Scale (GAS) were evaluated before and after 12 weeks of therapeutic intervention. RESULTS: The tablet computer-based cognitive training program was applicable to all children in the intervention group without any problems including irritable behavior or obsession about a tablet computer. After 12 weeks, Mental scale of BSID II, PEDI (social function), LAB-TAB (observation), LAB-TAB (manipulation), and GAS showed statistically significant improvements in the intervention group, compared with the values in the control group (P < .05). After adjusting for the pre-treatment measurements and cognitive age, the tablet computer-based cognitive training program had significant effect on the post-treatment measurements of Mental scale of BSID II, PEDI (social function), LAB-TAB (observation), LAB-TAB (manipulation), and GAS (P < .05). There was no association between the change in the scores and the severity of cognitive delay in the most of the measurements, however, the self-care domain of PEDI showed a negative association with the severity of the cognitive delay (r = -0.462, P = .04). CONCLUSIONS: Application of a tablet computer-based cognitive training program was feasible and showed improvements in cognitive function in young children with cognitive impairment of cognitive age between 18 and 36 months, regardless of the severity of the cognitive delay. But severe cognitive delay can be related with less improvement in the self-care domain of PEDI. TRIAL REGISTRATION NUMBER: https://cris.nih.go.kr (KCT0002889).


Asunto(s)
Terapia Cognitivo-Conductual/instrumentación , Disfunción Cognitiva/terapia , Computadores de Bolsillo/estadística & datos numéricos , /métodos , Niño , Preescolar , Cognición/fisiología , Terapia Cognitivo-Conductual/métodos , Disfunción Cognitiva/diagnóstico , Evaluación de la Discapacidad , Femenino , Humanos , Lactante , Masculino , Índice de Severidad de la Enfermedad
7.
Medicine (Baltimore) ; 99(6): e18774, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32028389

RESUMEN

BACKGROUND/OBJECTIVE: The study's objective was to determine the efficacy of guided internet-assisted intervention (GIAI) on depression reduction among educational technology students of Nigerian universities. METHODS: The design of the study was a 10-weeks group-randomized trial (GRT) which involved a pre-test, post-test, and follow-up assessment. A total of 192 educational technology students who were identified as having depression formed the sample of the study. Beck's Depression Inventory-II (BDI-II) was the measure used for data collection in the study. Data collected were analyzed using ANOVA with repeated measures. RESULTS: The initial assessment results showed that the participants in both treatment and usual-care control groups had depression. After 10-weeks participation in GIAI, the assessment results showed a significant reduction in depression among students in the treatment group when compared to those in the usual-care control group. The follow-up assessment indicated a further significant reduction in the depression among participants in the treatment group when compared to those in the usual-care control group. CONCLUSION: The authors concluded that GIAI was significantly effective in reducing depression among university students in the treatment group compared to those in the usual-care control group. Therefore, educational technologists, counselors, psychologists, health workers, and other social workers should adopt educational intervention using GIAI in helping university students undergo depression reduction.


Asunto(s)
Trastorno Depresivo/terapia , Estudiantes/psicología , Telemedicina , Adolescente , Adulto , Terapia Cognitivo-Conductual , Tecnología Educacional , Femenino , Humanos , Internet , Masculino , Nigeria , Psicometría , Resultado del Tratamiento , Universidades , Adulto Joven
8.
Adv Exp Med Biol ; 1191: 465-485, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32002942

RESUMEN

In almost all treatments for prevalent psychiatric conditions, particular attention has been devoted to stress and its consequences; this has led to an involuntary and unavoidable reinforcement of negative aspects of life. Because of the important influence of individual and cultural influences on positive health, well-being is a challenge from a clinical and scientific perspective and interventions aimed at enhancing it represent an area of growing interest for the future of clinical practice and research. Well-being therapy (WBT) is a short-term psychotherapeutic strategy aimed at enhancing well-being based on the model originally developed in 1958 by Marie Jahoda. It emphasizes self-observation, with the use of a structured diary, interaction between patients and therapists, and homework. WBT may be used as the only therapeutic strategy or in sequential combination with other psychotherapeutic strategies, mainly cognitive behavioral therapy. WBT can be differentiated from positive interventions based on several features which are described in detail in the present chapter. We also report the clinical use of WBT in the treatment of anxiety disorders, mainly generalized anxiety disorder, panic disorder, and agoraphobia. Potential further clinical application of WBT is withdrawal after antidepressants discontinuation and side effects during long-term antidepressant treatment.


Asunto(s)
Trastornos de Ansiedad/terapia , Psicoterapia , Agorafobia/terapia , Antidepresivos/efectos adversos , Terapia Cognitivo-Conductual , Humanos , Trastorno de Pánico/terapia
9.
Adv Exp Med Biol ; 1191: 291-329, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32002935

RESUMEN

Anxiety disorders are an enormous societal burden given their high lifetime prevalence among adult populations worldwide. A variety of anxiety disorders can be successfully treated with psychological treatments such as cognitive behavioral therapy (CBT), mindfulness-based cognitive therapy (MBCT), and acceptance and commitment therapy (ACT), either as stand-alone individual or group treatment or as adjunctive treatment to pharmacotherapy. Furthermore, a growing body of evidence suggests that therapist-guided Internet-delivered CBT (iCBT) and, to some degree, digitalized mindfulness- and acceptance-based interventions may be an efficacious complement to traditional face-to-face therapy. In view of the current advances regarding the integration of traditional and innovative treatment approaches, this chapter provides an overview on the theory and evidence base for different delivery modes of CBT-related interventions for specific phobia, panic disorder, agoraphobia, social anxiety disorder, and generalized anxiety disorder in adults. Finally, implications for clinical practice and research will be derived, and future directions for the psychological treatment of anxiety disorders will be outlined.


Asunto(s)
Terapia de Aceptación y Compromiso , Trastornos de Ansiedad/psicología , Trastornos de Ansiedad/terapia , Terapia Cognitivo-Conductual , Atención Plena , Humanos , Trastornos Fóbicos/psicología , Trastornos Fóbicos/terapia , Resultado del Tratamiento
10.
Adv Exp Med Biol ; 1191: 489-521, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32002943

RESUMEN

Anxiety disorders (ADs) are common psychiatric disorders, with a lifetime prevalence estimated at 33.7% in epidemiological studies. ADs are associated with serious disability and severe impairment in quality of life. Although several treatments [e.g. selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs), pregabalin, tricyclic antidepressants and benzodiazepines and/or cognitive-behaviour therapy (CBT)] are recommended, a large number of patients (i.e. from 30 to 70%) do not achieve complete remission. According to the novel paradigm of personalized medicine, the search of possible predictors of both disease vulnerability and treatment response might be the best way to prevent more accurately disease risk and to tailor the most effective treatment for each individual. Although a growing body of studies have proposed several endophenotypes/markers (i.e. neurochemical, neuroimaging, physiological, genetic and epigenetic endophenotypes/markers) as possible predictors of ADs susceptibility and/or treatment response, findings are not robust enough to be considered acceptable to incorporate in the clinical practice. In order to obtain more reliable results, larger studies with a multimodal approach, based on a combination of different biomarkers, are needed.


Asunto(s)
Trastornos de Ansiedad/terapia , Terapia Cognitivo-Conductual , Humanos , Inhibidores de la Captación de Serotonina/uso terapéutico , Inhibidores de Captación de Serotonina y Norepinefrina/uso terapéutico
11.
Aten. prim. (Barc., Ed. impr.) ; 52(1): 38-46, ene. 2020. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-185982

RESUMEN

Objetivo: Aportar evidencias de la eficacia de una intervención comunitaria en salud, que incluye un programa de estimulación cognitiva, para prevenir el deterioro de las capacidades cognitivas en nuestra población de personas mayores con cognición normal que viven en la comunidad. Diseño: Ensayo clínico aleatorizado (normas grupo CONSORT). Emplazamiento: Centro de salud San José Norte-Centro y Fundación La Caridad (Zaragoza). Participantes: Doscientas una personas de 65 años o más, con puntuación MEC de 28 puntos o más, 101 aleatorizados en el grupo intervención y 100 en el grupo control. Intervenciones: La intervención se realizó en 10 sesiones de 45 min, una por semana, con material propio, los cuadernos de colores de activación mental. Estos cuadernos trabajan las áreas de memoria, orientación, lenguaje, praxis, gnosis, cálculo, percepción, razonamiento lógico, atención-concentración y programación. Mediciones principales: Las variables de resultado fueron MEC, Set-test, Barthel y Lawton-Brody. Resultados: Analizando los incrementos sobre el nivel basal, para la variable MEC el grupo intervención obtiene, en media, 1,58 puntos más que el grupo control en la evaluación realizada inmediatamente después de la intervención. A los 6meses la mejora es de 1,51 puntos y al año de 2,04 puntos. Todos estos incrementos son estadísticamente significativos al nivel usual del 5%. No se observan diferencias estadísticamente significativas entre el grupo intervención y control en las variaciones sobre el nivel basal de las variables en Set-test, Barthel y Lawton-Brody. Conclusiones: La estimulación cognitiva con nuestro programa es eficaz para mantener el rendimiento cognitivo, medido con la variable MEC, en nuestra población de personas mayores con cognición normal que viven en la comunidad. No hay evidencia de que esa mejora se transfiera a las actividades de la vida diaria medidas con Barthel y Lawton-Brody


Objective: To provide evidence of the effectiveness of a community health intervention, that includes a cognitive stimulation program, to prevent the deterioration of cognitive abilities in our population of elderly people with normal cognition that are living in the community. Design: Randomized clinical trial (CONSORT group norms). Location: San José Norte-Centro Health Center and La Caridad Foundation (Zaragoza, Spain). Participants: 201 people aged 65 or older, with a MEC score of at least 28 points, which were randomized between the Intervention group (101) and the Control group (100). Intervention: The intervention was applied in 10 sessions of 45minutes, one per week. It used materials designed by one of the authors, which addressed the following areas: memory, orientation, language, praxis, gnosis, calculation, perception, logical reasoning, attention-concentration and programming. Main measurements: The main outcome variables were MEC, Set-Test, Barthel and Lawton-Brody. Results: Increases of the main result variables over their baseline level were analized. For MEC variable, the Intervention group obtained, on average, 1.58 points more than the Control group in the evaluation performed immediately after the intervention. After 6months, the improvement was 1.51 points and after a year, it was of 2.04 points. All these differences were statistically significant. For Set-Test, Barthel and Lawton-Brody variables, no statistically significant differences were observed between Intervention group and Control group. Conclusions; Cognitive stimulation with our program is effective to maintain or improve cognitive performance, measured with the variable MEC, our population of elderly people with normal cognition that are living in the community. There is no evidence that this improvement is transferred to the activities of daily life measured with Barthel and Lawton-Brody variables


Asunto(s)
Humanos , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Remediación Cognitiva/métodos , Envejecimiento/psicología , Disfunción Cognitiva/prevención & control , Envejecimiento Cognitivo/psicología , Servicios de Salud para Ancianos/organización & administración , Centros de Salud , Salud Mental , Terapia Cognitivo-Conductual
12.
J Consult Clin Psychol ; 88(2): 172-178, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31894997

RESUMEN

OBJECTIVE: To test the validity and clinical utility of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) severity specifiers for binge-eating disorder (BED) in predicting treatment outcomes. METHOD: Participants (N = 521) were patients in randomized controlled trials (RCTs) at 1 medical center testing treatments for BED; data were aggregated from RCTs testing cognitive-behavioral therapy (CBT), behavioral weight loss (BWL), and/or multimodal (i.e., CBT or BWL plus pharmacotherapy) treatment. Participants were categorized according to DSM-5 severity specifiers for BED: "mild" (n = 273; 52.5%), "moderate" (n = 182; 34.9%), and "severe/extreme" (n = 58; 11.1%). Participants had their weight and height measured and were assessed using established interviews and self-report measures at baseline, throughout treatment, and post treatment. RESULTS: Mixed models revealed that severity category did not significantly predict treatment response. However, there were main effects of BED severity category: "Severe/extreme" BED had greater binge-eating frequency and had greater global eating-disorder psychopathology than did "mild" BED across all time points. "Severe/extreme" BED was less likely to have remission from binge eating than was "mild" BED. Weight loss and depression scores did not significantly differ by severity category. CONCLUSION: In a large series of treatment-seeking individuals with BED aggregated across RCTs at 1 medical center testing psychological and pharmacological treatments for BED, DSM-5 severity specifiers for BED had limited validity and utility predicting response to treatments. Future research is needed to identify more robust severity indicators with clinical utility to inform future DSM revisions and clinical practice. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Trastorno por Atracón/terapia , Terapia Cognitivo-Conductual , Adolescente , Adulto , Anciano , Trastorno por Atracón/diagnóstico , Trastorno por Atracón/psicología , Peso Corporal , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Pérdida de Peso , Adulto Joven
13.
Medicine (Baltimore) ; 99(4): e18456, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31977844

RESUMEN

BACKGROUND: In this study, we aim to assess the psychological effects of cognitive behavioral therapy (CBT) on internet addiction (IA) in adolescents. METHODS: This study will search the following databases of Cochrane Library, PUBMED, EMBASE, Scopus, Web of Science, PsycINFO, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All these electronic databases will be searched from inception to the September 30, 2019 without any language limitation. Two authors will conduct study selection, data extraction, and study quality assessment, respectively. Any disagreements between 2 authors will be solved by a third author through discussion. Statistical analysis will be performed using RevMan 5.3 software. RESULTS: This study will investigate the psychological effects of CBT on IA in adolescents by measuring psychopathological symptoms, depression, anxiety, time spent on the internet (hours/day), and health-related quality of life. CONCLUSION: This study summarizes current evidence of CBT on IA in adolescents and may provide guidance for both intervention and future researches.PROSPERO registration number: PROSPERO CRD42019153290.


Asunto(s)
Conducta Adictiva/terapia , Terapia Cognitivo-Conductual/métodos , Internet , Adolescente , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación
14.
Medicine (Baltimore) ; 99(4): e18833, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31977878

RESUMEN

BACKGROUND: Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread musculoskeletal pain and multiple symptoms. It is a common clinical condition whose etiology is unclear. Currently, there is no gold standard treatment for FM. Management of this condition is therefore aimed at reducing symptoms and maintaining the individual's ability to function optimally. Based on the principal symptoms and characteristics of individuals with FM, we hypothesized that the implementation of a multicomponent treatment (with physical exercise, cognitive behavioral therapy adding to a graded motor imagery program, and therapeutic neuroscience education) would be more effective than conventional treatment in women with FM. This paper describes the rationale and methods of study intended to test the effectiveness of multicomponent treatment versus conventional treatment in patients with FM. METHOD/DESIGN: Fifty-six female individuals between 18 and 65 years of age, who were referred to the physical therapy department of the Rehabilitar Center in Chile, will be randomized into two treatment arms. The intervention group will receive a multicomponent treatment program for duration of 12 weeks. The control group will receive a conventional treatment for this condition for 12 weeks. The primary outcome measure will be the pain intensity score, measured by the numeric pain rating scale (NPRS), and the secondary outcomes will be the FM Impact Questionnaire (FIQ), and affective components of pain, such as catastrophizing using the Pain Catastrophizing Scale (PCS), fear of movement using the Tampa Scale Kinesiophobia (TSK), and sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI). DISCUSSION: This paper reports the design of a randomized clinical trial aimed at assessing the effectiveness of the multicomponent treatment versus conventional treatment in women with FM. TRIAL REGISTRATION: Brazilian registry of clinical trials UTN number U1111-1232-0862. Registered 22 April 2019.


Asunto(s)
Terapia Cognitivo-Conductual/métodos , Terapia por Ejercicio/métodos , Fibromialgia/terapia , Adulto , Anciano , Catastrofización/prevención & control , Catastrofización/psicología , Femenino , Fibromialgia/psicología , Humanos , Persona de Mediana Edad , Dolor/psicología , Dimensión del Dolor , Ensayos Clínicos Controlados Aleatorios como Asunto , Adulto Joven
16.
J Consult Clin Psychol ; 88(2): 106-118, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31894993

RESUMEN

OBJECTIVE: The sudden gain (SG; large symptom improvements in one between-session interval) has been identified as a consistent predictor of better outcomes at posttreatment and over follow-up in cognitive-behavioral therapy (CBT) for depression. Other defined trajectories of symptom change in CBT, including linear (consistent changes in depression), log-linear (symptom change concentrated in early or late sessions), one-step (substantial change in depression symptoms between two adjacent sessions), and cubic (symptom decrease, increase, and decrease), also predict better treatment outcomes. METHOD: We explored whether these patterns of symptom change occurred and predicted outcome in a sample of 156 adults with treatment-resistant depression who participated in a randomized controlled trial of CBT as an adjunct to pharmacotherapy (Wiles et al., 2013). Depression symptoms were assessed weekly with the Beck Depression Inventory-II. RESULTS: Multilevel modeling revealed that both SGs and having a defined trajectory predicted lower depression severity at 6- and 12-month follow-up, even controlling for baseline depression symptoms, early slopes of change, and symptom variability. CONCLUSIONS: These findings highlight the importance of examining longitudinal data and the robustness of the sudden gain pattern. They further suggest that having a defined symptom trajectory might confer its own advantages in predicting depression outcomes. Clinicians could use weekly depression scores to identify these key patterns of change to guide treatment decisions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Terapia Cognitivo-Conductual , Trastorno Depresivo Resistente al Tratamiento/terapia , Adulto , Trastorno Depresivo Resistente al Tratamiento/diagnóstico , Trastorno Depresivo Resistente al Tratamiento/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Síntomas , Resultado del Tratamiento
18.
Nervenarzt ; 91(1): 43-49, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31828353

RESUMEN

The current treatment guidelines recommend several effective psychotherapeutic approaches for different indications or aims in the therapy of patients with psychotic disorders. In particular, cognitive behavior therapy (CBTp) is recommended for the treatment of positive and general symptoms in all phases of the disorder without any restriction. Although CBTp could be easily implemented in routine care, very few of the affected patients have access to this evidence-based procedure in inpatient or outpatient settings. The interventions in CBTp directly address the psychotic symptoms themselves as well as the factors involved in the development and maintenance of symptoms. The core features of CBTp are a normalizing attitude of the therapist towards symptoms, an individualized approach and cognitive interventions. Recent developments include symptom-specific, metacognitive as well as mindfulness and acceptance-based approaches. Moreover, the reduction of comorbid symptoms can add to the benefit of the treatment. This article provides an overview of the basic CBTp techniques and of some of the latest developments in this field. It is hoped that this will contribute to the training of therapists and to the better implementation of evidence-based and guideline-based psychotherapy in the care of patients with psychotic disorders.


Asunto(s)
Terapia Cognitivo-Conductual , Trastornos Psicóticos , Comorbilidad , Humanos , Pacientes Internos , Pacientes Ambulatorios , Trastornos Psicóticos/terapia , Resultado del Tratamiento
19.
J Oral Rehabil ; 47(2): 158-163, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31418908

RESUMEN

BACKGROUND: Oral parafunctional activities such as daytime non-functional tooth contact (nFTC) are considered aetiological factors for temporomandibular disorders (TMD). OBJECTIVES: To evaluate the effectiveness of an email-based recording and reminding system for limiting daytime nFTC in patients with TMDs. METHODS: Thirty patients with TMDs (mean age, 30.7 ± 8.7 years) were randomly assigned to three groups according to the intervention for limiting nFTC: cognitive behavioural therapy (CBT) with an email-based recording and reminding system for 20 days (e-CBT group, n = 10), CBT with a sticky note reminder for 20 days (s-CBT group, n = 10) and simple verbal instructions to avoid nFTC that were provided before the experimental period (control group, n = 10). The frequency of nFTC, range of pain-free unassisted mouth opening and pain intensity during painful unassisted maximum mouth opening was evaluated before and after the experimental period. RESULTS: The frequency of nFTC significantly decreased after the intervention in the e-CBT and s-CBT groups. Among the three groups, the decrease in the nFTC frequency was the maximum in the e-CBT group (P < .01). In addition, the range of pain-free unassisted mouth opening showed a significant increase in all three groups, with the maximum improvement in the e-CBT group (analysis of variance, P < .01). CONCLUSIONS: The present findings suggest that our email-based recording and reminding system may have the potential to effectively control daytime nFTC and could be an effective strategy for the management of TMDs.


Asunto(s)
Correo Electrónico , Trastornos de la Articulación Temporomandibular , Adulto , Terapia Cognitivo-Conductual , Humanos , Dolor , Dimensión del Dolor , Adulto Joven
20.
Z Kinder Jugendpsychiatr Psychother ; 48(1): 57-75, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-30526289

RESUMEN

Quality criteria of internet-based cognitive-behavioral interventions for children and adolescents and their parents - A systematic review Abstract. Introduction: This study provides an overview of existing internet-based evidence-based cognitive behavioral interventions (iCBT) for children/adolescents and their parents. The studies were evaluated based on preliminary defined quality criteria regarding their usability in the healthcare system. Methods: The review was performed according to PRISMA guidelines and evaluated the scientific literature concerning to iCBT. We conducted a comprehensive literature search of PubMed, PsychINFO, PsychARTICLES, PsychNDEX and Science Direct using relevant keywords. Studies were rated according to 10 previously predefined quality measures. Results: A total of 4,479 articles were screened, 62 of which were selected for further analysis. Thereof, 24 international iCBT programs with 50 randomized controlled trials (RCTs) were evaluated and met the quality criteria (M = 7.25, SD = 1.07). Further 13 publications showed preliminary efficacy for another 11 international iCBT programs and met the quality criteria (M = 7.45, SD = .82). There was no significant difference between programs evaluated within and without RCTs t(33) = -.56, p = .58. Conclusions: Our results indicate that multiple international iCBT programs exist. Because in Germany the waiting time for psychotherapeutic or psychiatric treatment is still about five months, iCBT programs have the potential to reduce this gap.


Asunto(s)
Terapia Cognitivo-Conductual/normas , Internet , Padres/psicología , Adolescente , Niño , Alemania , Humanos
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