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1.
Acta Med Indones ; 53(3): 352-359, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34611077

RESUMO

BACKGROUND: COVID-19 is an infectious disease that is easily widespread and has clinical manifestations as mild, moderate, or severe disease. COVID-19 patients are required to be isolated during treatment to reduce transmission. This can cause anxiety and depression, which in turn worsens the patient's illness. Providing supportive psychotherapy can help provide a feeling of safety, comfort and calm for patients. The choice of method in providing supportive psychotherapy can be done online/teleconsultation or internet-based. This clinical review aims to determine the effect of online teleconsultation or internet-based psychotherapy on COVID-19 patients. METHODS: A systematic search was performed using online databases, such as PubMed, Cochrane, EBSCO/CINAHL and ProQuest. The identified articles were screened using eligibility criteria. There were 2 studies (Zhou et al, and Wei et al) which were analyzed critically using the Newcastle Ottawa Scale. RESULTS: Both studies showed that management of psychotherapy through teleconsultation or internet-based on COVID-19 patients can help relieve the patient's psychological symptoms. Zhou et al studied 63 suspected COVID-19 with 23.8% (n = 15) having a Hospital Anxiety Depression Scale (HADS) score of 8 or more. There was a significant decrease in HADS-A nxiety (HADS-A) scores (p <0.01) and HADS-Depression (HADS-D) scores (p <0.01) in 15 patients, and from the overall HADS scores (p < 0.01). Wei et al. Showed 17-HAMD and HAMA scores in the online psychological intervention group also showed a significant reduction in symptoms of depression and anxiety compared to controls. CONCLUSION: Psychotherapy through online teleconsultation or internet-based on COVID-19 patients can help relieve symptoms of anxiety and depression and teleconsultation and also effective in dealing with psychological complications in patients with COVID-19.


Assuntos
Ansiedade , COVID-19/psicologia , Depressão , Intervenção Baseada em Internet , Psicoterapia/métodos , Consulta Remota/métodos , Ansiedade/etiologia , Ansiedade/terapia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Depressão/etiologia , Depressão/terapia , Humanos , SARS-CoV-2
2.
An. psicol ; 37(2): 210-220, mayo-sept. 2021. tab
Artigo em Inglês | IBECS | ID: ibc-202545

RESUMO

BACKGROUND: Prison victimization has been a focus of attention by the scientific community with studies that indicate a high prevalence and negative effects on mental health and social reintegration of prisoners. However, there is few information on intervention responses, so it is relevant to obtain reliable data about intervention strategies that seeks to mitigate its consequences and provide support to victims. OBJECTIVE: accomplish a detailed description of the literature on psychological intervention that seeks to respond to victimization in prison and its consequences. METHOD: Systematic review (SR) using the PRISMA-P method. The research was carried out in 10 electronic databases and the data collection and analysis process carried out by two independent researchers. RESULTS: Five publications were included, three quantitative studies and two theoretical articles although none specifically focuses on intervention with individuals subject to prison victimization. This feature is addressed and theoretically analyzed throughout the discussion. CONCLUSION: There are few publications on intervention with victims of pris-on victimization and existing ones do not focus on specific intervention in the context of this type of victimization. However, important guidelines were obtained to be included into future intervention proposals. There is a consensus regarding the need to adopt empirically validated intervention models, referring to the Cognitive Behavior Therapy (CBT), specifically to the Trauma-Informed Treatment (TIT)


INTRODUCCIÓN: La victimización penitenciaria ha sido el foco de atención de la comunidad científica con estudios que indican una alta prevalencia y efectos negativos en la salud mental y en la reintegración social de los presidiarios. Sin embargo, existe poca información sobre las intervenciones, por lo que es relevante obtener datos confiables sobre estrategias de intervención que busquen mitigar sus consecuencias y ofrecer apoyo a las víctimas. OBJETIVO: realizar una descripción detallada de la literatura sobre intervención psicológica que busca dar respuesta a la victimización en prisión y sus consecuencias. MÉTODO: Revisión sistemática (RS) mediante el método PRISMA-P. La investigación se realizó en 10 bases de datos electrónicas y el proceso de recolección y análisis de datos fue realizado por dos investigadores independientes. RESULTADOS: Se incluyeron cinco publicaciones, tres estudios cuantitativos y dos artículos teóricos, aunque ninguno se centra específicamente en la intervención con personas sometidas a victimización penitenciaria. Este as-pecto se aborda y analiza teóricamente a lo largo de la discusión. CONCLUSIÓN: Existen pocas publicaciones sobre intervención con personas victimizadas en prisión y las existentes no enfocan en detalle en la intervención en este tipo de victimización. Sin embargo, se obtuvieron datos relevantes para ser incluidos en futuras propuestas de intervención. Existe consenso en cuanto a la necesidad de adoptar modelos de intervención valida-dos empíricamente, refiriéndose a la Terapia Cognitivo Conductual (TCC), específicamente al Tratamiento Informado por Trauma (TIT)


Assuntos
Humanos , Violência/psicologia , Prisioneiros/psicologia , Psicoterapia/métodos , Vítimas de Crime/psicologia , Prisões , Saúde Mental , Resultado do Tratamento
3.
Dan Med J ; 68(9)2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34477098

RESUMO

INTRODUCTION: The recommended treatments for post-traumatic stress disorder (PTSD) are psychological therapies and medication, but the best approach is still discussed. Exposure to traumatic events in psychotherapy tends to cause high drop-out rates. Likewise, little effect or adverse events of medications may lead to attrition. The aim of this study was to compare the outcomes of treatment by psychotherapy and medications. An additional aim was to explore the combinations of treatment modalities in adults with PTSD and to investigate differences in drop-out rates. METHODS: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. PubMed and Embase were searched for relevant randomised clinical trials. The Cochrane risk-of-bias tool was used to assess the quality of the retrieved trials. RESULTS: Seven eligible studies were identified. Three studies showed that psychotherapy was superior to selective serotonin reuptake inhibitors. Two studies showed an augmenting effect with prolonged exposure. Two studies showed no differences across the treatment groups. In four of the included studies, patients treated with psychotherapy were more likely to drop out. CONCLUSIONS: Extant evidence is insufficient to assess whether combined therapy is superior to monotherapy. Both medication and psychotherapy have an effect on PTSD, but psychotherapy tends to provide greater and more long-lasting outcome improvements. Trauma type, PTSD severity and other variables affect drop-out rates and treatment outcomes.


Assuntos
Terapia Cognitivo-Comportamental , Transtornos de Estresse Pós-Traumáticos , Adulto , Humanos , Psicoterapia , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Resultado do Tratamento , Listas de Espera
4.
Z Kinder Jugendpsychiatr Psychother ; 49(5): 334-348, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34503362

RESUMO

Diagnostic work with the conflict axis of the OPD-CA: Empirical results on inpatients and outpatients Abstract. In recent years, the Operationalized Psychodynamic Diagnostics (OPD-CA) is increasingly being used in child and adolescent psychiatry and psychotherapy. This article presents the conflict axis of the OPD-CA, which contains an operationalization of seven psychodynamic conflicts and the processing modes assigned to them. It describes empirical comparisons of the conflict axis ratings and the structure rating in a group of outpatient and inpatient children and adolescents (total N = 186, 12.7 years, 54 % female). The findings in the total sample show that diagnosis-specific gender differences are disappearing, and that male and female patients have largely similar intrapsychic development-impairing conflicts. Patients in inpatient treatment in a child and adolescent psychiatry institution, however, more often show a self-conflict and, as expected, have a lower structural level than patients of the same age in outpatient psychotherapy. The number of highly stressful events before the start of therapy is also significantly higher in this group, which may have contributed to the structural deficits. For outpatients, there is a strikingly higher level of guilt and identity conflicts. In both samples, the mode of processing the conflicts is largely passive. Based on these findings, possible implications for therapeutic practice are discussed.


Assuntos
Pacientes Internados , Terapia Psicanalítica , Adolescente , Psiquiatria do Adolescente , Criança , Feminino , Hospitalização , Humanos , Masculino , Pacientes Ambulatoriais , Psicoterapia
5.
Artigo em Inglês | MEDLINE | ID: mdl-34501635

RESUMO

The COVID-19 pandemic has brought massive changes in the provision of psychotherapy. To avoid or reduce the risk of infection, many therapists switched from face-to-face sessions in personal contact to remote psychotherapy, i.e., psychotherapy delivered by telephone or videoconferencing. This study examined the attitudes toward and practice of remote psychotherapy among Austrian therapists with a psychodynamic orientation at the onset of the pandemic as well as changes in the therapeutic process that were experienced by the therapists due to switching to a remote setting. A total of 161 therapists with psychodynamic orientation took part in an online survey. The results show that attitudes toward remote psychotherapy changed positively in psychodynamically orientated therapists and most are willing to switch to remote settings, if necessary. However, many therapists reported negative effects of remote psychotherapy and prefer seeing their patients in-person. The strongest changes were experienced with regard to transference/countertransference, the therapeutic process and the intensity of session. The analysis further revealed an overall decrease in the number of patients treated, indicating an undersupply of psychotherapy, at least during the first wave of COVID-19 infection in Austria. In summary, the experience during the first COVID-19 lockdown has led to an increase in remote psychotherapy and more openness toward these treatment modalities among psychodynamically oriented therapists. However, in-person therapy will remain the first choice for most therapists.


Assuntos
COVID-19 , Psicoterapia Psicodinâmica , Áustria , Controle de Doenças Transmissíveis , Estudos Transversais , Humanos , Pandemias , Psicoterapia , SARS-CoV-2
6.
BMC Health Serv Res ; 21(1): 1005, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34551770

RESUMO

BACKGROUND: Most US adults with posttraumatic stress disorder (PTSD) do not initiate mental health treatment within a year of diagnosis. Increasing treatment uptake can improve health and quality of life for those with PTSD. Individuals with PTSD are more likely to report poor physical functioning, which may contribute to difficulty with treatment initiation and retention. We sought to determine the effects of poor physical functioning on mental health treatment initiation and retention for individuals with PTSD. METHODS: We used data for a national cohort of veterans in VA care; diagnosed with PTSD in June 2008-July 2009; with no mental health treatment in the prior year; and who responded to baseline surveys on physical functioning and PTSD symptoms (n = 6,765). Physical functioning was assessed using Veterans RAND 12-item Short Form Health Survey, and encoded as limitations in physical functioning and role limitations due to physical health. Treatment initiation (within 6 months of diagnosis) was determined using VA data and categorized as none (reference), only medications, only psychotherapy, or both. Treatment retention was defined as having ≥ 4 months of appropriate antidepressant or ≥ 8 psychotherapy encounters. RESULTS: In multinomial models, greater limitations in physical functioning were associated with lower odds of initiating only psychotherapy (OR 0.82 [95 % CI 0.68, 0.97] for limited a little and OR 0.74 [0.61, 0.90] for limited a lot, compared to reference "Not limited at all"). However, it was not associated with initiation of medications alone (OR 1.04 [0.85, 1.28] for limited a little and OR 1.07 [0.86, 1.34] for limited a lot) or combined with psychotherapy (OR 1.03 [0.85, 1.25] for limited a little and OR 0.95 [0.78, 1.17] for limited a lot). Greater limitations in physical functioning were also associated with lower odds of psychotherapy retention (OR 0.69 [0.53, 0.89] for limited a lot) but not for medications (e.g., OR 0.96 [0.79, 1.17] for limited a lot). Role limitations was only associated with initiation of both medications and psychotherapy, but there was no effect gradient (OR 1.38 [1.03, 1.86] for limitations a little or some of the time, and OR 1.18 [0.63, 1.06] for most or all of the time, compared to reference "None of the time"). Accounting for chronic physical health conditions did not attenuate associations between limitations in physical functioning (or role limitations) and PTSD treatment; having more chronic conditions was associated with lower odds of both initiation and retention for all treatments (e.g., for 2 + conditions OR 0.53 [0.41, 0.67] for initiation of psychotherapy). CONCLUSIONS: Greater limitations in physical functioning may be a barrier to psychotherapy initiation and retention. Future interventions addressing physical functioning may enhance uptake of psychotherapy.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Veteranos , Adulto , Humanos , Saúde Mental , Estudos Prospectivos , Psicoterapia , Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/terapia
7.
BMJ Open ; 11(9): e047771, 2021 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-34497078

RESUMO

IMPORTANCE: Borderline personality disorder (BPD) is a severe mental disorder that is often inadequately treated. OBJECTIVE: To determine if adding a self-management intervention to care as usual (CAU) is effective and safe. DESIGN: Randomised, controlled, rater-blind trial. Duration of treatment and assessments: 12 months. SETTING: Secondary care, recruited mainly via the internet. PARTICIPANTS: Patients with BPD and BPD Severity Index (BPDSI) of at least 15. INTERVENTIONS: CAU by treating psychiatrist and/or psychotherapist alone or adjunctive use of an internet-based self-management intervention that is based on schema therapy (priovi). MAIN OUTCOME MEASURE: Outcomes were assessed by trained raters. The primary outcome was change in BPDSI. The safety outcome was the number of serious adverse events (SAEs). The primary outcome time point was 12 months after randomisation. RESULTS: Of 383 participants assessed for eligibility, 204 were included (91.7% female, mean age: 32.4 years; 74% were in psychotherapy and 26% were in psychiatric treatment). The slope of BPDSI change did not differ significantly between groups from baseline to 12 months (F3,248= 1.857, p=0.14). At 12 months, the within-group effect sizes were d=1.38 (95% CI 1.07 to 1.68) for the intervention group and d=1.02 (95% CI 0.73 to 1.31) for the control group. The between-group effect size was d=0.27 (95% CI 0.00 to 0.55) in the intention-to-treat sample and d=0.39 (95% CI 0.09 to 0.68) for those who used the intervention for at least 3 hours (per-protocol sample). We found no significant differences in SAEs. CONCLUSIONS: We have not found a significant effect in favour of the intervention. This might be due to the unexpectedly large effect in the group receiving CAU by a psychiatrist and/or psychotherapist alone. TRIAL REGISTRATION: NCT03418142.


Assuntos
Transtorno da Personalidade Borderline , Autogestão , Adulto , Transtorno da Personalidade Borderline/terapia , Análise Custo-Benefício , Feminino , Humanos , Internet , Masculino , Psicoterapia , Resultado do Tratamento
8.
Medicine (Baltimore) ; 100(35): e26821, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477119

RESUMO

ABSTRACT: Although reminiscence therapy alleviates mental illness and improves quality of life in neurocognitive disorders patients, little study reports its clinical application in cancer patients. Thus, this study aimed to explore the effect of reminiscence therapy on anxiety, depression, quality of life, and survival profile in postoperative gastric cancer patients.One hundred sixty surgical gastric cancer patients were enrolled in this randomized, controlled study, then randomly assigned to Reminiscence therapy group (N = 80) and Control group (N = 80) as 1:1 ratio. The evaluation was carried at baseline (M0), month 3 (M3), month 6 (M6), month 9 (M9), and month 12 (M12) after intervention by Hospital Anxiety and Depression Scale and European Organization for Research and Treatment of Cancer quality of life Questionnaire-Core 30 (QLQ-C30). Furthermore, disease-free survival and overall survival were analyzed using follow-up data.Reminiscence therapy decreased HADS for anxiety score at M6, M9, and M12, decreased anxiety rate at M9 and M12 compared to control care; while it did not affect HADS for depression score or depression rate at any time-point. Also, reminiscence therapy raised QLQ-C30 global health status score at M12, reduced QLQ-C30 symptoms score at M6, while did not affect QLQ-C30 function score at any time-point compared to control care. Reminiscence therapy did not affect disease-free survival and overall survival, either. Further subgroup analyses (divided by age and gender) observed that the effect of reminiscence therapy seemed more obvious in patients with age ≤60 years and male patients.Reminiscence therapy exhibits alleviation of anxiety and improvement of quality of life in postoperative gastric cancer patients.


Assuntos
Ansiedade/terapia , Psicoterapia de Grupo/normas , Qualidade de Vida/psicologia , Neoplasias Gástricas/complicações , Idoso , Ansiedade/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Psicoterapia/métodos , Psicoterapia/normas , Psicoterapia/estatística & dados numéricos , Psicoterapia de Grupo/métodos , Psicoterapia de Grupo/estatística & dados numéricos , Neoplasias Gástricas/terapia , Inquéritos e Questionários
9.
Artigo em Russo | MEDLINE | ID: mdl-34481442

RESUMO

Brief information about the causes of depressive disorders in COVID-19 and general strategies of their treatment is presented. According to the biopsychosocial model of the development of mental diseases, depressive disorders in COVID-19 develop due to the toxic effect of the coronavirus on nervous system and other organism systems, possible side-effects of COVID-19 therapy, the psychogenic effect of excessive and inaccurate information about the coronavirus infection and the consequences of its spread, adverse social changes during the pandemic. If infection with the SARS-CoV-2 did not develop, depressive disorders may arise due to psychogenic information and negative social influences. If coronavirus infection is present, depressive disorders can manifest during the acute period of COVID-19 and after recovery from COVID-19. Depressive disorders may occur for the first time in a patient with COVID-19 or infection can aggravate depression that has been in remission. Care should consistently include psychosocial activities, psychocorrection and psychopharmacotherapy. For the prevention of onset of depressive disorders, it is better to implement social-hygienic and psychological-pedagogical measures. Psychotherapy and psychopharmacotherapy become more important in the development of clinically expressed depressive disorders.


Assuntos
COVID-19/psicologia , Transtorno Depressivo , Depressão , Transtorno Depressivo/etiologia , Transtorno Depressivo/terapia , Humanos , Pandemias , Psicoterapia
10.
BMJ Open ; 11(9): e046017, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34489269

RESUMO

OBJECTIVE: Positive psychotherapy (PPT) aims at increasing positive affect, meaning and engagement. We aimed to synthesise the available evidence on PPT efficacy. DESIGN: We conducted a preregistered systematic literature search and meta-analysis of randomised controlled trials examining the efficacy of PPT for increasing positive (eg, satisfaction with life) or decreasing negative psychological outcomes (eg, depression). DATA SOURCES: Medline, PsycINFO and Web of Science from 2006 (ie, inception of PPT) to February 2020 as well as related systematic reviews and meta-analyses. RESULTS: We included 20 randomised controlled trial with a total of 1360 participants. Moderate effect sizes were found for increasing positive outcomes (g=-0.72, 95% CI: -1.31 to -0.14, k=10, numbers needed to treat (NNT)=2.55) and reducing negative outcomes (g=0.48, 95% CI: 0.18 to 0.78, k=8, NNT=3.76) when PPT was compared with waitlist control conditions at post-treatment assessment. When compared with active control conditions, PPT yielded large effect sizes for increasing positive outcomes (g=-0.92, 95% CI: -1.74 to -0.11, k=6, NNT=2.05) and reducing depression (g=0.94, 95% CI: 0.18 to 1.70, k=6, NNT=2.03) at post-treatment assessment. No significant differences in efficacy were found when compared with established treatments such as cognitive-behavioural therapy. Evidence was found to support an association between trial quality and effect sizes. For positive outcomes, higher trial quality was related to larger effect size. Whereas higher trial quality was associated with smaller effect size for depression. Follow-up assessments remained too scarce for most planned analyses. CONCLUSIONS: Our findings support the short-term efficacy of PPT. However, results are to be regarded with due caution in the light of low number of trials. More high-quality trials that assess efficacy at follow-ups are needed to draw firmer conclusions on the long-term efficacy of PPT. PROSPERO REGISTRATION NUMBER: CRD42020173567.


Assuntos
Terapia Cognitivo-Comportamental , Depressão , Depressão/terapia , Humanos , Psicoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Prax Kinderpsychol Kinderpsychiatr ; 70(6): 541-558, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34519620

RESUMO

The manualized focused infant/toddler-parent psychotherapy fSKEPT is a psychodynamic focal treatment of early childhood regulatory disorders, in which either a conflict-related or a personality functioning-related treatment focus is carried out. The aim of the study is to review the effectiveness of fSKEPT depending on two different therapeutic treatment focuses. For this purpose, n = 81 families who received fSKEPT were examined as part of secondary analyzes of a randomized controlled study. The therapeutic treatment focus did not predict the effectiveness for any of the examined target criteria (maternal psychological stress F(1,70) = 0.71, p = .401, maternal depression F(1,70) = 0.18, p = .678, infant regulatory symptoms F(1,70) = 0.11, p = .753, maternal self-efficacy F(1,70) = 0.038, p = .847, maternal reflective functioning F(1,50) = 0.56, p = .458). In a subsample of n = 33 families (40 % of the total sample) we tested whether the therapeutic interventions used in the therapy correspond to the treatment focus of the therapists. No significant difference was found between personality functioning-specific interventions (t(28) = 1.71, p = .099) and unspecific interventions (t(28) = 1.77, p = .087) when comparing the two treatment focus groups. In the conflict focus group significantly more conflict-specific interventions were used (t(28) = 2,71, p = .011). The results demonstrate the effectiveness of the focus concept of the fSKEPT treatment. The focus and the flexible individual adaptation of the interventions in the course of the treatment may help offering parents with different psychological vulnerabilities and ressources an equally effective treatment. In addition, the relevance of unspecific interventions and relationship-promoting aspects of the treatment are discussed.


Assuntos
Pais , Psicoterapia , Pré-Escolar , Humanos , Lactente , Transtornos da Personalidade , Estresse Psicológico , Resultado do Tratamento
12.
Prax Kinderpsychol Kinderpsychiatr ; 70(6): 559-561, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34519622

RESUMO

In Germany, cognitive-behavioral therapy, psychodynamic therapy, and systemic therapy are scientifically and legally approved as suitable procedures for treating mental disorders. While all methods have provided empirical evidence of their effectiveness in adults according to defined criteria of the "Scientific Advisory Board for Psychotherapy" (in German: "Wissenschaftlicher Beirat Psychotherapie"), i. e., the official board which decides upon the formal scientific approval of psychotherapeutic approaches in Germany, an evaluation is lacking for the psychodynamic methods in children and adolescents. Against this background, we evaluated the available empirical data for psychodynamic therapy in children and adolescents based on the methods paper of the "Scientific Advisory Board for Psychotherapy" (2019; version 2.9). Published reviews served as the basis for identifying relevant studies, supplemented by a systematic literature search. We identified 91 potentially relevant studies but could not consider the majority of these due to formal exclusion criteria (mainly not disorder-specific, no control group). Up to 26 of the remaining studies provide evidence of efficacy as defined by the "Scientific Advisory Board for Psychotherapy". These cover 10 of the 18 areas of application as defined by the "Scientific Advisory Board for Psychotherapy". According to our evaluation, the reviewed studies provide empirical evidence for the three most relevant areas of application (i. e., affective disorders; anxiety disorders and obsessive-compulsive disorders; hyperkinetic disorders and conduct disorders). Thus, the available evidence supports the suitability of psychodynamic therapy as a method for the treatment of children and adolescents.


Assuntos
Terapia Cognitivo-Comportamental , Psicoterapia , Adolescente , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/terapia , Criança , Alemanha , Humanos
13.
Prax Kinderpsychol Kinderpsychiatr ; 70(6): 479-498, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34519624

RESUMO

In Germany, cognitive-behavioral therapy, psychodynamic therapy, and systemic therapy are scientifically and legally approved as suitable procedures for treating mental disorders. While all methods have provided empirical evidence of their effectiveness in adults according to defined criteria of the "Scientific Advisory Board for Psychotherapy" (in German: "Wissenschaftlicher Beirat Psychotherapie"), i. e., the official board which decides upon the formal scientific approval of psychotherapeutic approaches in Germany, an evaluation is lacking for the psychodynamic methods in children and adolescents. Against this background, we evaluated the available empirical data for psychodynamic therapy in children and adolescents based on the methods paper of the "Scientific Advisory Board for Psychotherapy" (2019; version 2.9). Published reviews served as the basis for identifying relevant studies, supplemented by a systematic literature search. We identified 91 potentially relevant studies but could not consider the majority of these due to formal exclusion criteria (mainly not disorder-specific, no control group). Up to 26 of the remaining studies provide evidence of efficacy as defined by the "Scientific Advisory Board for Psychotherapy". These cover 10 of the 18 areas of application as defined by the "Scientific Advisory Board for Psychotherapy". According to our evaluation, the reviewed studies provide empirical evidence for the three most relevant areas of application (i. e., affective disorders; anxiety disorders and obsessive-compulsive disorders; hyperkinetic disorders and conduct disorders). Thus, the available evidence supports the suitability of psychodynamic therapy as a method for the treatment of children and adolescents.


Assuntos
Terapia Cognitivo-Comportamental , Psicoterapia Psicodinâmica , Adolescente , Adulto , Transtornos de Ansiedade/terapia , Criança , Alemanha , Humanos , Psicoterapia , Resultado do Tratamento
14.
Am J Psychother ; 74(3): 103-111, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34521212

RESUMO

OBJECTIVE: Patient choice is recognized as a factor that influences clinical outcomes and treatment evaluation in mental health care. However, research on how having a choice affects patients with depression has been rare. This Dutch study examined whether patients randomly selected to choose between two types of depression psychotherapy benefited more from treatment than patients randomly assigned to an intervention. METHODS: Data were derived from a trial of outpatients with depression who were randomly assigned to cognitive therapy (CT), interpersonal psychotherapy (IPT), or a 2-month waitlist control condition followed by the patient's choice of CT or IPT. Treatment groups were combined into a no-choice condition (N=151), with the waitlist as the choice condition (N=31). Multilevel regression was used to compare depression severity (measured with the Beck Depression Inventory-II [BDI-II]) and general psychological distress (measured with the Brief Symptom Inventory [BSI]) posttreatment and at the 5-month follow-up. Differences in patients' pretreatment expectations, beliefs about treatment credibility, and posttreatment evaluation were examined. RESULTS: No significant differences in clinical outcomes were found between the choice and no-choice conditions (mean difference: BDI-II posttreatment=-0.55, 95% confidence interval [CI]=-5.25 to 4.15; follow-up=2.10, 95% CI=-4.01 to 8.20; BSI posttreatment=-1.89, 95% CI=-15.35 to 11.58; follow-up=3.13, 95% CI=-12.32 to 18.57). Patients in both groups reported comparable scores on pretreatment expectations, credibility beliefs, and posttreatment evaluation. Neither expectations nor credibility beliefs were predictive of clinical outcomes. CONCLUSIONS: Our findings did not support the value of patient choice. Considering the exploratory nature of the trial, future studies designed to examine the effects of choice in depression treatment are recommended.


Assuntos
Terapia Cognitivo-Comportamental , Depressão , Depressão/terapia , Humanos , Preferência do Paciente , Psicoterapia , Resultado do Tratamento
15.
Tijdschr Psychiatr ; 63(7): 535-542, 2021.
Artigo em Holandês | MEDLINE | ID: mdl-34523705

RESUMO

BACKGROUND: The quality of the therapeutic alliance is an important factor in the treatment of both adult and adolescent patients in psychiatry. Little is known about the importance of the therapeutic alliance among youths who seek help for their substance abuse problems in addiction treatment. AIM: We investigated the importance of first treatment session therapeutic alliance for outcome in youth mental health and addiction treatment, considering both the youths' and therapists' perspective. METHOD: 127 adolescents participated in a prospective clinical cohort study, with favorable or unfavorable treatment outcome after 4 months as primary outcome measure. At the end of the first treatment session, youths and their therapists were asked to rate the therapeutic alliance. RESULTS: Youths' and therapists' perceptions about the therapeutic alliance at the start of treatment were predictive of treatment outcome at four months follow-up. In particular, the combined perspective on first-session alliance by both youths and therapists appeared a strong predictor for treatment outcome. If both youths and therapists rated the therapeutic alliance as weak, the percentage of youths showing a favorable treatment outcome was much lower (23%), than if youths and therapists rated the alliance as strong (70%). CONCLUSION: The present study confirms the importance of a combined perspective on the therapeutic alliance for predicting treatment outcome among patients in youth mental health and addiction treatment.


Assuntos
Aliança Terapêutica , Adolescente , Adulto , Estudos de Coortes , Humanos , Relações Profissional-Paciente , Estudos Prospectivos , Psicoterapia , Resultado do Tratamento
16.
Am J Psychother ; 74(3): 101-102, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34521213
17.
BMC Psychol ; 9(1): 126, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34446114

RESUMO

BACKGROUND: Recent studies have suggested that therapeutic climbing/bouldering may have positive effects on perceived self-efficacy. Nevertheless, there is still an urgent need for high-quality studies, as many existing studies have suffered from methodological problems. Therefore, the current work was aimed at investigating the effect of a manualized bouldering psychotherapy (BPT) on perceived self-efficacy in people with depression, compared with a home-based physical exercise program (EP) and state-of-the-art cognitive behavioral group therapy (CBT). METHODS: In a prospective, multicenter, randomized controlled trial, 233 people with depression were randomly assigned to one group (BPT, EP, or CBT). Perceived self-efficacy was assessed at baseline (t0) and directly after the 10-week intervention period (t1) with the GSE. In addition, depression was assessed with the PHQ-9 and the MADRS. We computed t tests, analyses of variance (ANOVAs), confounder-adjusted hierarchical regression analyses, mediation analyses, and several sensitivity analyses. RESULTS: BPT participants showed a significantly larger increase in perceived self-efficacy on the GSE compared with the EP (an increase of 3.04 vs. 1.26 points, p = .016, Cohen's d = 0.39). In the confounder-adjusted hierarchical multiple regression analysis, group allocation (BPT vs. EP) was found to be the only significant predictor of the postintervention GSE score (ß = .16, p = .014) besides the baseline GSE score (ß = .69, p < .001). No differences were found between BPT and CBT participants regarding the effect on perceived self-efficacy. Only in the CBT group, the relationship between depression at baseline and postintervention was partially mediated (23%) by perceived self-efficacy. CONCLUSIONS: Participation in the manualized BPT in a group setting leads to a clinically relevant enhancement of perceived self-efficacy in people with depression. This effect is superior to that of physical exercise alone. The results provide also initial indications that BPT is comparable to CBT in enhancing perceived self-efficacy, suggesting a strong case for a broader use of BPT as a supplement to existing health services. Future studies should focus on the modes of action of BPT and its effect on perceived self-efficacy in people with other mental or physical disorders. Trial registration ISRCTN12457760, registered partly retrospectively, 26 July 2017.


Assuntos
Depressão , Autoeficácia , Depressão/terapia , Humanos , Estudos Prospectivos , Psicoterapia , Estudos Retrospectivos , Resultado do Tratamento
18.
Ned Tijdschr Geneeskd ; 1652021 06 10.
Artigo em Holandês | MEDLINE | ID: mdl-34346579

RESUMO

In this article, the author comments on the research publication 'The effects of once-versus twice-weekly sessions on psychotherapy outcomes in depressed patients'. From a researcher's point of view, it is an excellent article, however, the presentation of the recommendations is more definite than seems appropriate to the results found. This, according to the author, can be seen in the light of perpetuating a 'myth of progress' in the field of psychotherapy. Because this myth has negative effects on clients and therapists, as the exaggerated expectations lead to disappointment and failure, the author calls on researchers to be cautious about making recommendations until findings have been replicated several times.


Assuntos
Emoções , Psicoterapia , Humanos , Resultado do Tratamento
19.
Ned Tijdschr Geneeskd ; 1652021 06 24.
Artigo em Holandês | MEDLINE | ID: mdl-34346632

RESUMO

The prospect of 'disease' in psychiatry has been debated for centuries. In the 21st century, this discussion often focusses on the usefulness of DSM classifications, the diagnostic manual of psychiatry. This criticism on the DSM is exemplary for our struggle to understand, classify and treat psychiatric problems. However, we tend to forget that the DSM system has provided a wealth of knowledge and structure to psychiatric care and science. Moreover, there is no elaborated alternative and an abolishment of the DSM will lead to confusion and polarisation. We should not throw the baby out with the bathwater. In this perspective, we argue how we can build on decades of experience with the DSM and how historical weighting and accurate use of the DSM can offer fertile grounds for refinement and precision of diagnostics in psychiatry.


Assuntos
Transtornos Mentais , Psiquiatria , Confusão , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Transtornos Mentais/diagnóstico , Psicoterapia
20.
BMC Psychol ; 9(1): 123, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34419148

RESUMO

BACKGROUND: Stress-related illnesses constitute a huge problem in society. The primary care services in Sweden form the first line of care whose role is to coordinate interventions for reducing symptoms, as well as health-promoting interventions. There is lack of knowledge concerning health-promoting interventions for these illnesses. The aim of this study is to evaluate whether photo-supported conversations about well-being (Be Well™) as an intervention, in addition to care as usual within the primary care services, improves health and well-being for patients with stress-related illnesses. The intervention will be compared to a control group, who receive care as usual. A further aim is to conduct a process evaluation. METHODS/DESIGN: This ongoing project has a quasi-experimental design, using quantitative and qualitative methods, and includes patients from primary care centres in two Swedish counties. Seventy patients, 20-67 years, with stress-related illnesses will be recruited. They constitute an intervention group, which receive the intervention together with care as usual, and a control group, which receive care as usual. The intervention, photo-supported conversations about well-being, involves 12 sessions. Care as usual entails medication, occupational therapy, physiotherapy and/or psychotherapy. Data collection is carried out at baseline, and outcomes are assessed directly after the intervention, as well as six months after completion of the intervention. The outcomes are evaluated based on factors related to health, well-being and everyday occupations. Furthermore, data concerning experiences of well-being and perceptions of the intervention will be collected in interviews. The therapists will also be interviewed about their experiences of performing the intervention. Data will be analysed with non-parametric statistics, and qualitative methodology. DISCUSSION: The project is based on the concept that focusing on well-being despite living with stress-related illness may positively impact health and well-being as well as activity-related aspects, and that photo-supported conversations about well-being can contribute a complement to other treatment and rehabilitation. A strength is the use of a wide range of methods: such as quantitative measures, photographs, and qualitative interviews with participants and therapists. The results will thus provide knowledge about potential effects of this health-promoting intervention. Trial registration Clinical Trials.gov: NCT04832295; retrospectively registered 2nd April 2021 https://clinicaltrials.gov/ct2/show/NCT04832295.


Assuntos
Terapia Ocupacional , Psicoterapia , Comunicação , Humanos , Projetos de Pesquisa , Suécia
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