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1.
Fortschr Neurol Psychiatr ; 88(10): 677-689, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-33049789

RESUMO

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.


Assuntos
Intervenção Baseada em Internet , Psicoterapia/métodos , Telemedicina , Humanos
2.
Rev Prat ; 70(5): 514-519, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-33058637

RESUMO

Innovations in child psychotherapy. The psychotherapeutic approach represents the main focus of care in the field of child and adolescent mental health because of the limited place of psychopharmacology at this period of life. In recent years we have witnessed a diversification of theoretical models and the development of new focused approaches which explicitly raise the question of the formalization of therapeutic objectives and their sharing with the child/adolescent and his/her family. The aim of this article is to present some of the main innovations developed in recent years in the field of child and adolescent psychotherapy and in particular : parental guidance, mindfulness meditation, trauma-focused psychotherapies and psychotherapies delivered via the internet. Beyond the specificities of these models, all these approaches converge to underline the involvement of the entourage and the perception on the part of the child of being understood by the therapist as the two main mechanisms at the heart of change in psychotherapy and as levers capable of promoting the re-emergence of a capacity to learn in the interpersonal and social world.


Assuntos
Psicoterapia , Psicotrópicos , Adolescente , Criança , Feminino , Humanos , Masculino , Saúde Mental , Pais
3.
Rev Med Suisse ; 16(709): 1877-1880, 2020 Oct 07.
Artigo em Francês | MEDLINE | ID: mdl-33026731

RESUMO

This article is the result of the joint work of psychiatrists-psychotherapists working with patients with gender dysphoria (children, adolescents and adults) in Lausanne and Geneva university hospitals. It emphasizes the importance of their clinical interventions when hormone therapy and sex reassignment surgery are requested.


Assuntos
Disforia de Gênero/diagnóstico , Disforia de Gênero/terapia , Papel do Médico , Psiquiatria , Psicoterapia , Disforia de Gênero/psicologia , Identidade de Gênero , Humanos , Cirurgia de Readequação Sexual
4.
Artigo em Russo | MEDLINE | ID: mdl-33081443

RESUMO

OBJECTIVE: To study a role of traumatic brain injury (TBI) in the development of posttraumatic stress disorder (PTSD) in ex combatants. MATERIAL AND METHODS: Eighty-seven ex combatants were studied. The duration of follow-up was 15-18 years. The diagnosis was established in accordance with ICD-10 criteria. Patients were stratified by diagnosis into main group (PTSD) and comparison group (organic brain injury with reduced symptoms of PTSD ). A psychopathological method and a battery of questionnaires and scales, including those adapted for assessment of consequences of combat trauma, were administered. RESULTS AND CONCLUSION: Clinical presentations of both groups in posttraumatic period show the similarity and homogeneity of posttraumatic disorders in these groups. In the future, the pathogenetic role of TBI severity appears more clearly, which, depending on the severity, leads to the formation of an organic lesion of the brain or performs only a pathoplastic role, giving some features to the clinical picture of PTSD. It was found that the more severe the injury, the greater the likelihood of PTSD transition to organic brain damage. It is emphasized that PTSD treatment is a continuous, long-term, complex and graded process that includes pharmacotherapy, psychotherapy, psychosocial interventions.


Assuntos
Lesões Encefálicas Traumáticas , Lesões Encefálicas , Transtornos de Estresse Pós-Traumáticos , Encéfalo , Lesões Encefálicas Traumáticas/diagnóstico , Humanos , Psicoterapia , Transtornos de Estresse Pós-Traumáticos/diagnóstico
5.
An. psicol ; 36(2): 254-261, mayo 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-192062

RESUMO

The existence of early maladaptive schemas (EMS) is the core concept of Schema Therapy (ST). Several studies have demonstrated that EMSs are involved in many psychiatric disorders. The Young Schema Questionnaire is a self-report measure developed to assess the 18 EMSs and has long form (YSQ-L) and short form (YSQ-S) versions. It is currently in its third version (YSQ-S3). To the best of our knowledge, this is the first study that aims to validate the YSQ-S3 according to the new proposed organization of EMSs into four domains. A non clinical sample of 1372 Italian population was involved in this research. Confirmatory Factor Analysis (CFA) was conducted to examine the latent structure of the YSQ-S3, including both first- and second-order structures. Cronbach's alpha and intra-class correlation coefficients were calculated to evaluate internal consistency and test-retest reliability. Correlations between the YSQ-S3 and anxiety and mood symptoms were calculated to measure construct validity. Cronbach's alpha of almost all EMSs were higher than 0.7, which indicated good internal reliability, and test-retest reliability was excellent. CFA supports the new proposed organization of EMSs into four domains. Regarding concurrent validity, each schema in the YSQ-S3 was highly correlated with anxiety and mood symptoms. The new four-domains model of the YSQ-S3 has demonstrated that it can be a useful and valid tool for clinicians and researchers in the self-report measurement of EMSs


La existencia de esquemas maladaptativos tempranos (EMTs) es el concepto central de Schema Therapy (ST). Varios estudios han demostrado que los EMS están involucrados en muchos trastornos psiquiátricos. El Young Schema Questionnaire es una medida de autoinforme desarrollada para evaluar los 18 EMTs y tiene versiones de forma larga (YSQ-L) y forma corta (YSQ-S). Actualmente se encuentra en su tercera versión (YSQ-S3). Hasta donde tenemos conocimiento, este es el primer estudio que tiene como objetivo validar la versión italiana del YSQ-S3 de acuerdo con la nueva organización propuesta de EMTs en cuatro dominios. Una muestra no clínica de 1372 estudiantes italianos participó en esta investigación. El análisis factorial confirmatorio (CFA) se realizó para examinar la estructura latente del YSQ-S3, incluidas las estructuras de primer y segundo orden. Se calcularon la omega coeficiente de McDonald y la correlación interclase para evaluar la consistencia interna y la fiabilidad test-retest. Las correlaciones entre el YSQ-S3 y la ansiedad y los síntomas del estado de ánimo se calcularon para medir la validez de constructo. El omega de McDonald de casi todos los EMTs fue superior a 0.7, lo que indicó una buena confiabilidad interna, y la confiabilidad test-retest fue excelente. CFA apoya la nueva organización propuesta de EMS en cuatro dominios. Con respecto a la validez concurrente, cada esquema en el YSQ-S3 estaba altamente correlacionado con la ansiedad y los síntomas del estado de ánimo. El nuevo modelo de cuatro dominios del YSQ-S3 ha demostrado que puede ser una herramienta útil y válida para los médicos e investigadores en la medición del autoinforme de los EMTs


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Inquéritos e Questionários/normas , Modelos Psicológicos , Autorrelato/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Psicometria/métodos , Psicoterapia , Autorrelato/normas , Estudantes/psicologia , Psicometria/estatística & dados numéricos
6.
Psychiatr Danub ; 32(Suppl 1): 167-171, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32890384

RESUMO

BACKGROUND: Video game has become the preferred form of play among youth. Substantial research has mainly examined problems related to potential negative effects of video games ranging from sedentary screen time, exposure to violence, and excessive or problematic gaming. However, over the past two decades, the use of video games in psychotherapy has become increasingly popular with a lot of applications. SUBJECTS AND METHODS: After a review of the use and the effectiveness of commercial video games in the psychotherapy framework, we will share our experience in the use of video games in a child and adolescent psychiatric unit. We will illustrate it with the presentation of specific case reports. RESULT: As video games are highly popular among children and adolescents, they are also interesting tools in the psychotherapeutic work with them. It's a new kind of play therapy, considering the setting, the psychological material that expresses during the game, the interpersonal relationships between gamers, the projective representation within the avatars, the cognitive strategies within the game. CONCLUSIONS: Video games represent an essential tool in taking care of child psychiatric patients because of their popularity. They contribute greatly to build the patient/psychotherapist relationship. They help to approach cognitive, emotional and social patient's functioning, and also psychopathologic understanding and then psychiatric diagnosis.


Assuntos
Comportamento do Adolescente , Transtornos Mentais , Jogos de Vídeo , Adolescente , Criança , Humanos , Relações Interpessoais , Psicoterapia
7.
Z Kinder Jugendpsychiatr Psychother ; 48(5): 369-379, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32880227

RESUMO

Effectiveness of stabilization training for adolescent refugees with trauma-induced disorders: A randomized controlled trial Abstract. Unaccompanied minor refugees (UMR) are a group particularly vulnerable to mental illness. They pose a great challenge not only for child and youth psychiatric and psychotherapeutic care, but also for youth-welfare institutions. The study examines the effectiveness of Stabilization Training for Adolescent Refugees with Trauma Induced Disorders in inpatient youth-welfare facilities. Methods: We conducted a randomized controlled trial with pre-post design in a naturalistic setting, randomly assigning 9 housing groups for UMRs to the intervention or waiting control condition. The mental stress of 46 UMRs was assessed by both self-report and educational staff-report. Two educational staff members conducted the Stabilization Training for Adolescent Refugees with Trauma Induced Disorders as an intervention in each of the respective residential groups. Results: Participation in training led to a reduction in subjective general psychological stress. At the end of the training, psychological stress in self-judgment was significantly lower in the intervention group than in the waiting control condition. The effectiveness of the training is apparently not reflected by educational staff assessments. Conclusions: Stabilization training is a suitable instrument for the preclinical care of UMR and thus an essential basis for further psychotherapy.


Assuntos
Psicoterapia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Estresse Psicológico/psicologia , Estresse Psicológico/terapia , Adolescente , Humanos , Resultado do Tratamento
8.
Rev Med Suisse ; 16(707): 1748-1750, 2020 Sep 23.
Artigo em Francês | MEDLINE | ID: mdl-32969611

RESUMO

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.


Assuntos
Comportamento Aditivo/tratamento farmacológico , Alucinógenos/uso terapêutico , Psicoterapia/métodos , Animais , Comportamento Aditivo/terapia , Humanos
11.
Medicine (Baltimore) ; 99(33): e21484, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871994

RESUMO

BACKGROUND: The objective of this study is to investigate the effects of humanistic care and psychological counseling (HCPC) on psychological disorders (PD) in medical students after coronavirus disease 2019 (COVID-19) outbreak. METHODS: We will search randomized controlled trials or case-controlled studies of HCPC on PD in medical students after COVID-19 outbreak in the following electronic databases: PUBMED/MEDLINE, EMBASE, Cochrane Library, CINAHL, AMED, WANGFANG, and CNKI. The time is restricted from the construction of each database to the present. All process of study selection, data collection, and study quality evaluation will be carried out by two independent authors. Any different opinions will be solved by a third author through discussion. We will employ RevMan 5.3 software to conduct statistical analysis. RESULTS: This study will provide a better understanding of HCPC on PD in medical students after COVID-19 outbreak. CONCLUSIONS: This study may offer strong evidence for clinical practice to treat PD in medical students after COVID-19 outbreak. STUDY REGISTRATION: CRD42020193199.


Assuntos
Infecções por Coronavirus/psicologia , Aconselhamento/métodos , Transtornos Mentais/terapia , Pneumonia Viral/psicologia , Psicoterapia/métodos , Estudantes de Medicina/psicologia , Adulto , Betacoronavirus , Estudos de Casos e Controles , Feminino , Humanismo , Humanos , Masculino , Transtornos Mentais/psicologia , Pandemias , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Adulto Jovem
12.
Medicine (Baltimore) ; 99(33): e21451, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871992

RESUMO

BACKGROUND: Mental health is closely related to the occurrence of hypertension, particularly the prognosis of hypertension patients. The role of psychotherapy in the occurrence, development, prevention, and prognosis of hypertension, remains to be clarified. METHODS/DESIGN: We will conduct a prospective, double-blind, randomized, multiple-centers study. Eighty patients enrolled in this trial will be randomized at 1:1 ratio. The primary endpoint is will be the reduction of the patient psychological scale (PHQ-9) score. Secondary endpoints will be the drop in blood pressure, awareness of physical and mental health and self-efficacy scale. Measurements will be performed at baseline, 5-week (questionnaires only), 10-week (primary endpoint), using the Anxiety Screening Questionnaire (GAD-7) and Depression Scale (PHQ-9). Data analysis will be carried out using the SPSS v.25 software assuming a level of significance of 5%. Results will be analyzed using multilevel, regression analysis and hierarchical linear models. DISCUSSION: We hope to provide some insight in the understanding the underlying mechanism of the novel mindfulness in the management of hypertension related psychological stress/disturbance, and will enable us to develop novel approach to manage essential hypertension and its related psychological disorders. CLINICAL TRIAL REGISTRY:: http://www.chictr.org.cn (ChiCTR1900028258).


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Hipertensão/psicologia , Hipertensão/terapia , Psicoterapia/métodos , Método Duplo-Cego , Humanos , Prognóstico , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Artigo em Alemão | MEDLINE | ID: mdl-32916737

RESUMO

Interdisciplinary multimodal pain therapy (IMPT) is based on the biopsychosocial model of pain and describes an integrated treatment for patients with chronic pain. IMPT incorporates a close cooperation of different disciplines, including physicians, psychotherapists, physiotherapists, and others. IMPT mainly aims to restore and increase patients' physical, social and psychological functional capacity. The efficacy of IMPT has been evidenced by systematic reviews and meta-analyses. A number of studies further indicate IMPT's cost-efficiency. Psychotherapy is an essential component of IMPT. Its main goal within the framework of IMPT is to identify and modify dysfunctional patterns of pain coping, and to diagnose and potentially treat psychological comorbidities. Pain psychotherapy comprises mostly cognitive-behavioral interventions which address dysfunctional coping at the three levels of the pain experience (i.e., cognitive, emotional, and behavioral). Research into the efficacy of pain psychotherapy is rather sparse and studies have mostly focused on chronic back pain, yet existing results show promising evidence both for psychotherapy within IMPT and for psychotherapy as a monotherapy. This paper aims at providing an overview of (a) commonly employed cognitive-behavioral psychotherapeutic approaches and strategies in the treatment of chronic pain, and (b) the existing empirical evidence of pain psychotherapy both within the framework of IMPT and as a monotherapy. Future research should include a wider range of pain diagnoses and also investigate the potential benefit of individually-tailored treatments.


Assuntos
Dor Crônica , Psicoterapia , Dor nas Costas , Terapia Combinada , Humanos , Metanálise como Assunto , Manejo da Dor , Revisões Sistemáticas como Assunto
14.
Lancet Psychiatry ; 7(10): 851-864, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32866459

RESUMO

BACKGROUND: The effectiveness of digital psychological interventions in low-income and middle-income countries (LMICs) remains unclear. We aimed to systematically investigate the available evidence for digital psychological interventions in reducing mental health problems in LMICs. METHODS: In this systematic review and meta-analysis, we searched PubMed, PsycINFO, Embase, and Cochrane databases for articles published in English from database inception to March 9, 2020. We included randomised controlled trials investigating digital psychological interventions in individuals with mental health problems in LMICs. We extracted data on demographics, inclusion and exclusion criteria, details of the intervention, including the setting, digital delivery method, control group conditions, number of sessions, therapeutic orientation (eg, cognitive therapy or behaviour therapy), presence or absence of guidance, and length of follow-up, and statistical information to calculate effect sizes. If a study reported insufficient data to calculate effect sizes, the corresponding authors were contacted to provide data that could be aggregated. We did random-effects meta-analyses, and calculated the standardised mean difference in scores of digital psychological interventions versus control conditions (Hedges'g). Quality of evidence was assessed by use of the Grading of Recommendations Assessment, Development, and Evaluation approach. The primary outcome was post-intervention mental health problems, as measured by self-reporting instruments or clinical interviews. This study is registered with PROSPERO, CRD42019137755. FINDINGS: We identified 22 eligible studies that were included in the meta-analysis. The included studies involved a total of 4104 participants (2351 who received a digital psychological intervention and 1753 who were in the control group), and mainly focused on young adults (mean age of the study population was 20-35 years) with depression or substance misuse. The results showed that digital psychological interventions are moderately effective when compared with control interventions (Hedges'g 0·60 [95% CI 0·45-0·75]; Hedges'g with treatment as usual subgroup for comparison 0·54 [0·35-0·73]). Heterogeneity between studies was substantial (I2=74% [95% CI 60-83]). There was no evidence of publication bias, and the quality of evidence according to the GRADE criteria was generally high. INTERPRETATION: Digital psychological interventions, which have been mostly studied in individuals with depression and substance misuse, are superior to control conditions, including usual care, and are moderately effective in LMICs. However, the considerable heterogeneity observed in our analysis highlights the need for more studies to be done, with standardised implementation of digital psychological intervention programmes to improve their reproducibility and efficiency. Digital psychological interventions should be considered for regions where usual care for mental health problems is minimal or absent. FUNDING: None. TRANSLATIONS: For the Persian, Chinese, Hindi, Portuguese, Bahasa, Turkish, Romanian, Spanish and Thai translations of the abstract see Supplementary Materials section.


Assuntos
Transtorno Depressivo/terapia , Psicoterapia/métodos , Transtornos Relacionados ao Uso de Substâncias/terapia , Telemedicina/métodos , Países em Desenvolvimento , Humanos , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto
15.
Cochrane Database Syst Rev ; 9: CD007668, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32880104

RESUMO

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.


Assuntos
Transtorno da Personalidade Antissocial/terapia , Psicoterapia/métodos , Adulto , Agressão/psicologia , Transtorno da Personalidade Antissocial/mortalidade , Transtornos Relacionados ao Uso de Cocaína/terapia , Terapia Cognitivo-Comportamental/métodos , Dirigir sob a Influência , Feminino , Humanos , Masculino , Prisioneiros/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Reincidência/estatística & dados numéricos , Recompensa , Resultado do Tratamento
16.
Cochrane Database Syst Rev ; 9: CD012417, 2020 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-32897548

RESUMO

BACKGROUND: People living in 'humanitarian settings' in low- and middle-income countries (LMICs) are exposed to a constellation of physical and psychological stressors that make them vulnerable to developing mental disorders. A range of psychological and social interventions have been implemented with the aim to prevent the onset of mental disorders and/or lower psychological distress in populations at risk, and it is not known whether interventions are effective. OBJECTIVES: To compare the efficacy and acceptability of psychological and social interventions versus control conditions (wait list, treatment as usual, attention placebo, psychological placebo, or no treatment) aimed at preventing the onset of non-psychotic mental disorders in people living in LMICs affected by humanitarian crises. SEARCH METHODS: We searched the Cochrane Common Mental Disorders Controlled Trials Register (CCMD-CTR), the Cochrane Drugs and Alcohol Review Group (CDAG) Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OVID), Embase (OVID), PsycINFO (OVID), and ProQuest PILOTS database with results incorporated from searches to February 2020. We also searched the World Health Organization's (WHO) International Clinical Trials Registry Platform and ClinicalTrials.gov to identify unpublished or ongoing studies. We checked the reference lists of relevant studies and reviews. SELECTION CRITERIA: All randomised controlled trials (RCTs) comparing psychological and social interventions versus control conditions to prevent the onset of mental disorders in adults and children living in LMICs affected by humanitarian crises. We excluded studies that enrolled participants based on a positive diagnosis of mental disorder (or based on a proxy of scoring above a cut-off score on a screening measure). DATA COLLECTION AND ANALYSIS: We calculated standardised mean differences for continuous outcomes and risk ratios for dichotomous data, using a random-effects model. We analysed data at endpoint (zero to four weeks after therapy) and at medium term (one to four months after intervention). No data were available at long term (six months or longer). We used GRADE to assess the quality of evidence. MAIN RESULTS: In the present review we included seven RCTs with a total of 2398 participants, coming from both children/adolescents (five RCTs), and adults (two RCTs). Together, the seven RCTs compared six different psychosocial interventions against a control comparator (waiting list in all studies). All the interventions were delivered by paraprofessionals and, with the exception of one study, delivered at a group level. None of the included studies provided data on the efficacy of interventions to prevent the onset of mental disorders (incidence). For the primary outcome of acceptability, there may be no evidence of a difference between psychological and social interventions and control at endpoint for children and adolescents (RR 0.93, 95% CI 0.78 to 1.10; 5 studies, 1372 participants; low-quality evidence) or adults (RR 0.96, 95% CI 0.61 to 1.50; 2 studies, 767 participants; very low quality evidence). No information on adverse events related to the interventions was available. For children's and adolescents' secondary outcomes of prevention interventions, there may be no evidence of a difference between psychological and social intervention groups and control groups for reducing PTSD symptoms (standardised mean difference (SMD) -0.16, 95% CI -0.50 to 0.18; 3 studies, 590 participants; very low quality evidence), depressive symptoms (SMD -0.01, 95% CI -0.29 to 0.31; 4 RCTs, 746 participants; very low quality evidence) and anxiety symptoms (SMD 0.11, 95% CI -0.09 to 0.31; 3 studies, 632 participants; very low quality evidence) at study endpoint. In adults' secondary outcomes of prevention interventions, psychological counselling may be effective for reducing depressive symptoms (MD -7.50, 95% CI -9.19 to -5.81; 1 study, 258 participants; very low quality evidence) and anxiety symptoms (MD -6.10, 95% CI -7.57 to -4.63; 1 study, 258 participants; very low quality evidence) at endpoint. No data were available for PTSD symptoms in the adult population. Owing to the small number of RCTs included in the present review, it was not possible to carry out neither sensitivity nor subgroup analyses. AUTHORS' CONCLUSIONS: Of the seven prevention studies included in this review, none assessed whether prevention interventions reduced the incidence of mental disorders and there may be no evidence for any differences in acceptability. Additionally, for both child and adolescent populations and adult populations, a very small number of RCTs with low quality evidence on the review's secondary outcomes (changes in symptomatology at endpoint) did not suggest any beneficial effect for the studied prevention interventions. Confidence in the findings is hampered by the scarcity of prevention studies eligible for inclusion in the review, by risk of bias in the studies, and by substantial levels of heterogeneity. Moreover, it is possible that random error had a role in distorting results, and that a more thorough picture of the efficacy of prevention interventions will be provided by future studies. For this reason, prevention studies are urgently needed to assess the impact of interventions on the incidence of mental disorders in children and adults, with extended periods of follow-up.


Assuntos
Países em Desenvolvimento , Transtornos Mentais/prevenção & controle , Psicoterapia , Problemas Sociais/psicologia , Estresse Fisiológico , Estresse Psicológico/complicações , Adolescente , Adulto , Fatores Etários , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Viés , Criança , Depressão/diagnóstico , Depressão/epidemiologia , Países em Desenvolvimento/estatística & dados numéricos , Humanos , Transtornos Mentais/etiologia , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Listas de Espera
17.
Medicine (Baltimore) ; 99(39): e22151, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991409

RESUMO

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.


Assuntos
Dor Pélvica/psicologia , Prostatite/psicologia , Psicoterapia/métodos , Fatores Etários , Doença Crônica , Humanos , Masculino , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Índice de Gravidade de Doença , Fatores Socioeconômicos
18.
Medicine (Baltimore) ; 99(39): e22344, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991449

RESUMO

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.


Assuntos
Depressão/terapia , Psicoterapia/métodos , Estudantes/psicologia , Adolescente , Adulto , Depressão/epidemiologia , Depressão/psicologia , Feminino , Carga Global da Doença/economia , Humanos , Incidência , Masculino , Metanálise em Rede , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Satisfação Pessoal , Prevalência , Psicoterapia/tendências , Qualidade de Vida/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Autoimagem , Ajustamento Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Universidades , Adulto Jovem
19.
Dtsch Arztebl Int ; 117(24): 412-419, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32865492

RESUMO

BACKGROUND: The lifetime prevalence of schizophrenia is 1%. Schizophrenia is among the most severe mental illnesses and gives rise to the highest treatment costs per patient of any disease. It is characterized by frequent relapses, marked impairment of quality of life, and reduced social and work participation. METHODS: The group entrusted with the creation of the German clinical practice guideline was chosen to be representative and pluralistic in its composition. It carried out a systematic review of the relevant literature up to March 2018 and identified a total of 13 389 publications, five source guidelines, three other relevant German clinical practice guidelines, and four reference guidelines. RESULTS: As the available antipsychotic drugs do not differ to any great extent in efficacy, it is recommended that acute antipsychotic drug therapy should be sideeffect- driven, with a number needed to treat (NNT) of 5 to 8. The choice of treatment should take motor, metabolic, sexual, cardiac, and hematopoietic considerations into account. Ongoing antipsychotic treatment is recommended to prevent relapses (NNT: 3) and should be re-evaluated on a regular basis in every case. It is also recommended, with recommendation grades ranging from strong to intermediate, that disorder- and manifestation-driven forms of psychotherapy and psychosocial therapy, such as cognitive behavioral therapy for positive or negative manifestations (effect sizes ranging from d = 0.372 to d = 0.437) or psycho-education to prevent relapses (NNT: 9), should be used in combination with antipsychotic drug treatment. Further aspects include rehabilitation, the management of special treatment situations, care coordination, and quality management. A large body of evidence is available to provide a basis for guideline recommendations, particularly in the areas of pharmacotherapy and cognitive behavioral therapy. CONCLUSION: The evidence-based diagnosis and treatment of persons with schizophrenia should be carried out in a multiprofessional process, with close involvement of the affected persons and the people closest to them.


Assuntos
Antipsicóticos , Terapia Cognitivo-Comportamental , Psicoterapia , Esquizofrenia , Antipsicóticos/uso terapêutico , Humanos , Qualidade de Vida , Esquizofrenia/terapia
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