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1.
Estud. pesqui. psicol. (Impr.) ; 18(4): 1106-1117, out.-dez. 2019.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-994977

RESUMO

O presente artigo se propõe a apresentar as práticas psicoterapêuticas utilizadas pela psiquiatria brasileira no Hospício Nacional de Alienados, instituição psiquiátrica situada no Rio de Janeiro e fundada no ano de 1852. A pesquisa se debruçou sobre artigos, livros autorais e manuais médicos do Hospital Nacional de Alienados e professores da cátedra de Psiquiatria e Moléstias Mentais da Faculdade de Medicina do Rio de Janeiro. Como referencial teórico, o artigo se apoia em Chartier (1990) para indicar que, ao circular no Brasil do início do século XX, as diferentes psicoterapias tiveram que se acomodar ao contexto para poderem circular. Em especial, demonstra-se como a psicanálise foi apropriada e negociada de acordo com os repertórios disponíveis no contexto psiquiátrico local, bem como frente aos diversos interesses individuais e profissionais presentes, tendo que se adaptar para ganhar credibilidade e aceitação no ambiente da medicina mental brasileira da primeira metade do século XX. Apenas no final da década de 1950 é que se constituiria como uma disciplina independente e autônoma frente aos outros saberes psi com os quais teve que se mesclar ao longo do século.(AU)


This article proposes to present the psychotherapeutic practices used by the Brazilian psychiatry in the Hospício Nacional de Alienados, a psychiatric institution located in Rio de Janeiro and founded in the year 1852. The research focused on articles, books and medical manuals of the Hospital Nacional de Alienados and professors of the chair of Psychiatry and Mental Disorders of the Faculty of Medicine of Rio de Janeiro. As a theoretical reference, the article is based on Chartier (1990) to indicate that, when circulating in Brazil in the early twentieth century, different psychotherapies had to be accommodated to the context to be able to circulate. In particular, it is shown how psychoanalysis was appropriated and negotiated according to the repertoires available in the local psychiatric context, as well as to the various individual and professional interests present, having to adapt to gain credibility and acceptance in the Brazilian mental medicine environment of the first half of the twentieth century. Only in the late 1950s would it be constituted as an independent and autonomous discipline against the other psychological knowledge with which it had to blend throughout the century.(AU)


El presente artículo se propone presentar las prácticas psicoterapéuticas utilizadas por la psiquiatría brasileña en el Hospicio Nacional de Alienados, institución psiquiátrica situada en Rio de Janeiro y fundada en el año 1852. La investigación se centró en artículos, libros de autor y manuales de médicos del Hospital Nacional de Alienados y de profesores de la cátedra de Psiquiatría y Molestias Mentales de la Facultad de Medicina de Rio de Janeiro. Como referente teórico, el artículo se apoya en Chartier (1990) para indicar que, al circular en Brasil desde el inicio del siglo XX, las diferentes psicoterapias tuvieron que acomodarse al contexto local para poder circular. En particular, se demuestra cómo el psicoanálisis fue apropiado y negociado de acuerdo a los repertorios disponibles en el contexto psiquiátrico local, así como frente a los diversos intereses individuales y profesionales presentes, teniendo que adaptarse para ganar credibilidad y aceptación en el ambiente de la medicina mental brasileña de la primera mitad del siglo XX. Sólo a finales de la década de 1950 se constituiría como una disciplina independiente y autónoma frente a los otros saberes psi con los que tuvo que mezclarse a lo largo del siglo.(AU)


Assuntos
Psicoterapia/história , Psicanálise , Brasil , Metodologia , História
3.
J Clin Psychopharmacol ; 39(6): 541-542, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31688402
4.
Adv Exp Med Biol ; 1192: 313-329, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705502

RESUMO

With vigorous researches related to novel treatment in psychiatric field, paradigm shift is emerging with its design and assessment. Comprehension of the psychiatric phenomenon expanded beyond disease model, with dimensional approach. Assessment of patients' clinical state includes subjective reports related to problematic symptoms, functional change, and quality of life. They also include objective findings collected from mobile e-wearable monitoring system and advanced neuroimaging modalities. Novel treatment protocols are not just limited to pharmacology itself or psychotherapy itself, but the approach is integrated with stratification; pharmacological treatment enhanced by cognitive behavioral management and psychotherapeutic intervention has been emerged and studied for its impact. Numerous studies were conducted to understand placebo response and to differentiate this phenomenon with novel treatments. Trials to draw good adherence to research protocol with good compliance to treatment in real are strengthened by integrated approach, so-called psychopharmacology. With these paradigm shifts observed from recent researches, it is promising for great advance in quality of life and our mental health.


Assuntos
Psicofarmacologia , Psicoterapia , Protocolos Clínicos , Humanos , Psicotrópicos , Qualidade de Vida , Pesquisa
5.
Adv Exp Med Biol ; 1192: 583-627, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705515

RESUMO

Mental disorders are highly prevalent and often remain untreated. Many limitations of conventional face-to-face psychological interventions could potentially be overcome through Internet-based and mobile-based interventions (IMIs). This chapter introduces core features of IMIs, describes areas of application, presents evidence on the efficacy of IMIs as well as potential effect mechanisms, and delineates how Artificial Intelligence combined with IMIs may improve current practices in the prevention and treatment of mental disorders in adults. Meta-analyses of randomized controlled trials clearly show that therapist-guided IMIs can be highly effective for a broad range of mental health problems. Whether the effects of unguided IMIs are also clinically relevant, particularly under routine care conditions, is less clear. First studies on IMIs for the prevention of mental disorders have shown promising results. Despite limitations and challenges, IMIs are increasingly implemented into routine care worldwide. IMIs are also well suited for applications of Artificial Intelligence and Machine Learning, which provides ample opportunities to improve the identification and treatment of mental disorders. Together with methodological innovations, these approaches may also deepen our understanding of how psychological interventions work, and why. Ethical and professional restraints as well as potential contraindications of IMIs, however, should also be considered. In sum, IMIs have a high potential for improving the prevention and treatment of mental health disorders across various indications, settings, and populations. Therefore, implementing IMIs into routine care as both adjunct and alternative to face-to-face treatment is highly desirable. Technological advancements may further enhance the variability and flexibility of IMIs, and thus even further increase their impact in people's lives in the future.


Assuntos
Inteligência Artificial , Transtornos Mentais/terapia , Aplicativos Móveis , Psicoterapia/métodos , Adulto , Humanos , Internet , Telemedicina
6.
Psychiatr Prax ; 46(8): 460-467, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31683336

RESUMO

OBJECTIVE: A pilot study was conducted to test a newly developed inventory for the assessment of malpractice in psychotherapy and its consequences. We aimed to examine the frequency of boundary crossings and violations in the context of psychotherapy from a patient's perspective and the resulting burden as well as to identify potential predictors. METHODS: Data assessment was realized in an online-based survey. The final sample existed of N  = 165 patients who underwent prior psychotherapeutic treatment. RESULTS: Patients reported M = 16.21 events which can be interpreted in terms of malpractice resulting in a mediocre level of distress. While malpractice summarized as "inadequate use of diagnostics/techniques" was reported most frequently, sexual boundary violations were associated with the highest levels of distress. CONCLUSION: The results demonstrate the need of a differential and systematic assessment of malpractice in psychotherapy. The new inventory especially seems to be suited for research purposes.


Assuntos
Imperícia , Relações Médico-Paciente , Psicoterapia , Alemanha , Humanos , Imperícia/estatística & dados numéricos , Projetos Piloto , Psicoterapia/legislação & jurisprudência , Delitos Sexuais/legislação & jurisprudência , Comportamento Sexual
7.
Psychiatr Prax ; 46(8): 468-475, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31683337

RESUMO

The development of treatment guidelines alone does not improve patient care. The implementation of guidelines depends on various conditions, including structural conditions. The update of the S3 guideline "Psychosocial therapies for severe mental illnesses" systematically describes very different psychosocial therapies and reviews their effectiveness. The implementation of the resulting recommendations, which are coordinated in a complex consensus process, is hampered by the structured social legislation in Germany. The present article shows to what extent the recommendations of the update of the S3 Guideline Psychosocial Therapies follow the Federal Participation Act (BTHG).


Assuntos
Transtornos Mentais , Guias de Prática Clínica como Assunto , Psicoterapia/métodos , Medicina Baseada em Evidências , Alemanha , Fidelidade a Diretrizes , Humanos , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Programas Nacionais de Saúde , Psicoterapia/normas
8.
Soins Psychiatr ; 40(324): 33-36, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623805

RESUMO

Transcultural consultations receive unaccompanied minors experiencing psychological distress as a result of their personal history in their country of origin, their harrowing journey until their arrival in France and their vulnerable situation. Presentation of the mental health pathway and identity issues of one of these young unaccompanied foreigners, and asylum seeker.


Assuntos
Criança Abandonada/psicologia , Menores de Idade/psicologia , Transtornos Psicóticos/terapia , Refugiados/psicologia , Estresse Psicológico/psicologia , Adolescente , Criança , Características Culturais , França , Humanos , Psicoterapia
10.
Nervenarzt ; 90(11): 1125-1134, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31659372

RESUMO

Psychotherapy has been proven to be effective; however, this statement applies in particular to the "average patient" in randomized controlled trials. As a considerable proportion of patients do not show any benefits despite the constant development of new therapy methods and the mechanisms of action are still too little understood, innovative psychotherapy research has to address both problems. In addition, the idea of personalization that originated in somatic medicine or - from our point of view more appropriately - individualization or person-centering should be taken up. After providing an overview of further developments in psychotherapy beyond disorder-specific methods, this article presents an evidence- and process-based individualized and modular psychotherapy as a visionary goal of psychotherapeutic research: Beyond syndromes and disorders, as many biopsychosocial characteristics as possible and the processes and mechanisms underlying the mental problems should be analyzed and bundled in an individual comprehensive functional analysis. Based on this functional analysis, evidence-based techniques and modules should be selected. The individual response during the course of therapy should be continuously documented, so that feedback helps to determine the further therapeutic procedure. In order to pursue this vision, studies are needed that are oriented towards the individual patient, investigate the central mechanisms of action and generate large translational datasets. These should be analyzed by ideographic analyses and reduce the gap between research and practice, thus contributing to the paradigm of a practice research network, which is now consistently moving to the centre of research.


Assuntos
Psicoterapia , Psicotrópicos , Medicina Baseada em Evidências , Humanos , Psicoterapia/normas , Psicotrópicos/efeitos adversos , Psicotrópicos/uso terapêutico , Resultado do Tratamento
11.
Ther Umsch ; 76(5): 247-251, 2019.
Artigo em Alemão | MEDLINE | ID: mdl-31577181

RESUMO

Treatment of Psychosomatic Disorders - Psychotherapy with Eye-Movement Desensitization and Reprocessing Abstract. Dysfunctional stored memory information is a possible cause of psychosomatic disorders. EMDR (Eye-Movement Desensitization and Reprocessing) is based on the Adaptive Information Processing Model. This psychotherapeutic approach can be used to treat psychosomatic disorders to activate the pathogenic information and convert it from a dysfunctional to an adaptive state. EMDR has been scientifically proven for the treatment of posttraumatic stress disorders, while the treatment of psychosomatic disorders is a new field of application. Recently, studies have documented the effectiveness of EMDR with migraine headaches, skin diseases, gastrointestinal diseases, chronic fatigue syndrome, chronic pain syndrome, and phantom limb pain.


Assuntos
Dessensibilização e Reprocessamento através dos Movimentos Oculares , Transtornos Psicofisiológicos/terapia , Doença Crônica , Humanos , Psicoterapia , Transtornos de Estresse Pós-Traumáticos/terapia , Resultado do Tratamento
12.
Ther Umsch ; 76(5): 239-246, 2019.
Artigo em Alemão | MEDLINE | ID: mdl-31577183

RESUMO

Schema Therapy for psychosomatic disorders Abstract. Schema Therapy (ST) was developed as an advancement of Cognitive Behavioural Therapy (CBT) to form a comprehensive psychotherapeutic concept for patients with profound and chronic mental disorders. In this integrative psychotherapeutic treatment, cognitive, emotional, and behavioural interventions as well as the work with the therapeutic relationship are connected to establish a goal-oriented, flexible and transparent approach. The efficacy of schema therapy is particularly emphasised by studies investigating the treatment of different personality disorders. Moreover, pilot studies exist for different axis-I disorders, such as eating disorders or obsessive-compulsive disorders. Furthermore, schema therapy seems promising for patients with chronic psychosomatic symptoms. With this approach, symptoms, behavioural patterns, and central biographic events underlying the complex set of conditions, may be approached with the aid of the schema mode model, which can be conceptualised and processed in a way that is easily accessible for the patient.


Assuntos
Terapia Cognitivo-Comportamental , Transtornos Psicofisiológicos , Psicoterapia , Terapia Comportamental , Humanos , Transtornos da Personalidade , Transtornos Psicofisiológicos/terapia
13.
Ther Umsch ; 76(5): 252-260, 2019.
Artigo em Alemão | MEDLINE | ID: mdl-31577186

RESUMO

Touching the Soul - Energy Psychology in Psychosomatics Abstract. This article presents two ways to manage stress from the booming field of energy psychology. Despite the already considerable density of publications, they are still less common in primary care and psychotherapeutic practices and institutions. We are talking about the Shiatsu and the Emotional Freedom Techniques. Both methods move at the interface between body and mind. Common to both methods is the emphasis on mindfulness as an important treatment goal in the therapy process. In the current social trend, they are thus increasingly integrating eastern ways of thinking and treatment approaches into our western-oriented medicine. The article gives an overview of the genesis of both methods, possible mechanisms of action, their scientific evidence and their practical application technique.


Assuntos
Transtornos Psicofisiológicos , Estresse Psicológico , Humanos , Psicoterapia
14.
Praxis (Bern 1994) ; 108(14): 911-915, 2019.
Artigo em Alemão | MEDLINE | ID: mdl-31662114

RESUMO

E-Therapies for Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder Abstract. Eating disorders can often be treated with psychotherapy, but mostly due to a lack of trained clinicians, the majority of the persons concerned do not receive any treatment. In recent years, internet-based psychotherapy (e-therapy) was proposed and tested in several pilot projects as a novel possibility to offer a larger number of places on a treatment program with a constant number of available clinicians. Recent results are promising, but before an implementation into standard care can take place, more detailed knowledge must be provided as to which patients may be recommended this type of therapy as an equivalent alternative to traditional face-to-face therapy.


Assuntos
Anorexia Nervosa , Transtorno da Compulsão Alimentar , Bulimia Nervosa , Aconselhamento à Distância , Anorexia Nervosa/terapia , Transtorno da Compulsão Alimentar/terapia , Bulimia Nervosa/terapia , Humanos , Psicoterapia
17.
Medicine (Baltimore) ; 98(38): e17228, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567984

RESUMO

OBJECTIVE: To determine whether psychological intervention (PI) changes the levels of immune indicators in cancer patients. METHODS: We conducted a systematic search published up to July 2018, followed by a manual search. Randomized controlled trials were included. Two reviewers independently screened and extracted data, which were analyzed using Review manager 5.3. RESULTS: Twenty-nine studies were included including four kinds of PI. Only stress management didn't result in immune changes; only cognitive behavior therapy affect NK cell activity. PI did not change immune indicators on cancer patients who completed therapy. Compared to patients not receiving PI, those received PI had significantly higher NK cell count and activity in whole blood; and serum levels of IL-2, IL-4, IFN-γ, lgA, and lgG. However, the differences in the serum levels of IL-6, IL-10, TNF-α, and IgM were not significant (P > .05), and the changes recorded for the CD3, CD4, and CD8 cell count, and CD4/CD8 ratios were inconsistent. CONCLUSIONS: Although there are considerable evidences of PI's immune effect, but its magnitude was moderate. Therefore, it may be premature to conclude whether PI affects immunity of cancer patients. Further research is warranted, with special focus on the PI types and treatment methods.


Assuntos
Neoplasias/psicologia , Psicoterapia , Humanos , Imunidade , Neoplasias/imunologia , Neoplasias/terapia , Psicoterapia/métodos
18.
Medicine (Baltimore) ; 98(39): e17064, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574805

RESUMO

BACKGROUND: Most systematic reviews have explored the efficacy of treatments on symptoms associated with post-traumatic stress disorder (PTSD), which is a chronic and often disabling condition. Previous network meta-analysis (NMA) had limitations such as focusing on pharmacological or psychotherapies. Our review is aims to explore the relative effectiveness of both pharmacological and psychotherapies and we will establish the differential efficacy of interventions for PTSD in consideration of both symptom reduction and functional recovery. METHODS: We will conduct a network meta-analysis of randomized controlled trials evaluating treatment interventions for PTSD. We will systematically search Medline, PILOT, Embase, CINHAL, AMED, Psychinfo, Health Star, DARE and CENTRAL to identify trials that: (1) enroll adult patients with PTSD, and (2) randomize them to alternative interventions or an intervention and a placebo/sham arm. Independent reviewers will screen trials for eligibility, assess risk of bias using a modified Cochrane instrument, and extract data. Our outcomes of interest include PTSD symptom reduction, quality of life, functional recovery, social and occupational impairment, return to work and all-cause drop outs. RESULTS: We will conduct frequentist random-effects network meta-analysis to assess relative effects of competing interventions. We will use a priori hypotheses to explore heterogeneity between studies, and assess the certainty of evidence using the GRADE approach. CONCLUSION: This network meta-analysis will determine the comparative effectiveness of therapeutic options for PTSD on both symptom reduction and functional recovery. Our results will be helpful to clinicians and patients with PTSD, by providing a high-quality evidence synthesis to guide shared-care decision making.


Assuntos
Transtornos de Estresse Pós-Traumáticos/terapia , Protocolos Clínicos , Pesquisa Comparativa da Efetividade , Avaliação da Deficiência , Humanos , Meta-Análise em Rede , Psicoterapia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Retorno ao Trabalho , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico
19.
Prax Kinderpsychol Kinderpsychiatr ; 68(6): 475-487, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31480944

RESUMO

Chances of Psychotherapeutic Interventions and Stabilization with Unaccompanied Minor Refugees During Clearing Procedure and During the Transition Phase to Youth Welfare In the present clinical report, the experiences with psychotherapeutic crisis intervention for unaccompanied refugee minors in an initial reception and clearing office in Berlin, which have been financed since December 2016 by the association Spatz e. V. from the St Joseph hospital in Berlin-Tempelhof, is reflected. The financing offer results due to the developments in 2015 - a year with an above-average increase in incoming refugees. The significant increase also led to significantly longer waiting times in the clearing process. The forced persistence in a provisional state often led to instability of the psychic coping capacity of the adolescents. However, although there is a high level of psychological distress, post-traumatic as well as depressive symptoms the refugee adolescents have no access to outpatient psychotherapy during the clearing procedure (or the financial coverage of the discussions by health insurance or youth welfare offices). Despite uncertain framework conditions by an unclear future perspective and the resulting lack of "external safety", psychotherapeutic sessions with a focus on stabilization, empowerment and psychoeducation is nevertheless helpful in order to support young people in crisis situation, to counteract acute crisis and to counteract chronification of existing symptoms.


Assuntos
Intervenção na Crise , Menores de Idade/psicologia , Psicoterapia , Refugiados/psicologia , Adolescente , Criança , Depressão/psicologia , Depressão/terapia , Humanos , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia
20.
J Cancer Res Clin Oncol ; 145(11): 2845-2854, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31506739

RESUMO

PURPOSE: We examined whether multi-disciplinary stepped psychosocial care for cancer patients improves quality of care from the patient perspective. METHODS: In a university hospital, wards were randomly allocated to either stepped or standard care. Stepped care comprised screening for distress, consultation between doctor and patient, and the provision of psychosocial services. Quality of care was measured with the Quality of Care from the Patient Perspective questionnaire. The analysis employed mixed-effects multivariate regression, adjusting for age and gender. RESULTS: Thirteen wards were randomized, and 1012 patients participated (n = 570 in stepped care and n = 442 in standard care). Patients who were highly distressed at baseline had 2.3 times the odds of saying they had had the possibility to converse in private with doctors and/or psychologists/social workers when they were in stepped care compared to standard care, 1.3 times the odds of reporting having experienced shared decision-making, 1.1 times the odds of experiencing their doctors as empathic and personal, and 0.6 times the odds of experiencing the care at the ward to be patient oriented. There was no evidence for an effect of stepped care on perceived quality of care in patients with moderate or low distress. CONCLUSIONS: Stepped care can improve some aspects of perceived quality of care in highly distressed patients. TRIAL REGISTRATION: http://www.clinicaltrials.gov . NCT01859429.


Assuntos
Saúde Mental/normas , Neoplasias/psicologia , Neoplasias/terapia , Participação do Paciente/psicologia , Psicoterapia , Qualidade da Assistência à Saúde/normas , Serviço Social em Psiquiatria/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Prognóstico , Psicometria , Melhoria de Qualidade , Encaminhamento e Consulta , Adulto Jovem
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