Individualized and Standardized Outcome Measures: Further Arguments in Favor of Cohabitation.

Ashworth et al. (Admin Policy Ment Health Ment Health Serv Res 46:425-428, 2019) recently published a paper in this journal making a cogent argument for the cohabitation of standardized and individualized outcome measures. In the present Point of View article, we consider additional arguments in favor of this cohabitation.

Patient-reported outcome measures: are they patient-generated, patient-centred or patient-valued?

BACKGROUND: In the past two decades, there has been a growing interest in the development of a more patient-centred approach to assessing treatment outcomes. This interest has resulted in the increasing use of patient-reported outcome measures (PROMs) in both clinical trials and usual clinical practice. AIMS: To briefly discuss the paucity of efficacy and effectiveness studies in the field of mental health (exemplified by schizophrenia, depression and opioid dependence) that significantly incorporate the patient's perspective. The limited concordance between the perspectives of patients and clinicians in outcome assessment is also addressed. Finally, we propose a new PROM classification system based on the degree to which these instruments incorporate the patient's perspective. CONCLUSIONS: PROMs may differ little from traditional instruments unless they truly incorporate the patient's perspective and not just the perspectives of clinicians and researchers. Efforts to develop new PROMs that provide a more patient-centred outcome assessment should use qualitative and participatory methods to capture and incorporate patient perspectives and values.

[Effectiveness of exercise as a complementary intervention in addictions: a review]. / Efectividad del ejercicio físico como intervención coadyuvante en las adicciones: una revisión.

Given the benefits that exercise brings to physical and mental health, several authors have investigated its effectiveness as a treatment for various pathologies such as addictive disorders. The aim of this paper is to review the literature regarding the effectiveness of exercise as a complementary intervention for treatment of psychoactive substance dependence. To achieve this aim, a bibliographic search was conducted in the following databases: PubMed, Scopus, ISI Web of Knowledge, The Cochrane Library, TESEO and TDX. Those articles which evaluated the effectiveness of exercise on craving, withdrawal symptoms and abstinence rates were selected. Regarding nicotine dependence, those studies which evaluated the effectiveness of exercise for reducing weight gain after quitting smoking were also chosen. Seventeen articles met the selection criteria. The usefulness of exercise as a complementary strategy along with habitual therapeutic treatments for psychoactive substance dependence seems to be demonstrated, especially in nicotine dependence for the following variables: achieving or maintaining abstinence, and reducing craving or withdrawal symptoms. Further studies are nevertheless required, especially on illegal psychoactive substance dependence to be able to achieve conclusive results. We must also equally note that this kind of intervention is widely accepted by the drug using community, fact that would make of it a particularly useful tool in treating people with addictive disorders.

Dialectical behaviour therapy skills training compared to standard group therapy in borderline personality disorder: a 3-month randomised controlled clinical trial.

Dialectical behaviour therapy (DBT) has proven to be an effective treatment in borderline personality disorder (BPD). However, the effectiveness in BPD of DBT skills training (DBT-ST) alone is not known. This study aimed at comparing the efficacy of DBT-ST and standard group therapy (SGT) for outpatients with BPD. Sixty patients meeting the DSM-IV diagnostic criteria for BPD, as assessed by two semi-structured diagnostic interviews, were included in a 3-month, single-blind randomised controlled trial. A total of 13 weekly group psychotherapy sessions of 120 min of either SGT or DBT-ST were conducted. Assessments were carried out every 2 weeks by two blinded evaluators. Observer-rater, self-report scales and behavioural reports were used as outcome measures. DBT-ST was associated with lower dropout rates, 34.5% compared to 63.4% with SGT. It was superior to SGT in improving several mood and emotion areas, such as: depression, anxiety, irritability, anger and affect instability. A reduction in general psychiatric symptoms was also observed. Three-months weekly DBT-ST proved useful. This therapy was associated with greater clinical improvements and lower dropout rates than SGT. DBT-ST seems to play a role in the overall improvement of BPD seen with standard DBT intervention. It allows straightforward implementation in a wide range of mental health settings and provides the additional advantage that it is cost effective.

Efectividad del ejercicio físico como intervención coadyuvante en las adicciones: una revisión / Effectiveness of exercise as a complementary intervention in addictions: a review

Dados los beneficios que aporta el ejercicio físico sobre la salud física y mental, varios autores han explorado la efectividad del mismo como tratamiento en diversas patologías, entre ellas los trastornos adictivos. El objetivo de este artículo fue revisar la literatura existente sobre la efectividad del ejercicio físico como intervención coadyuvante en el tratamiento de la dependencia de sustancias psicoactivas. Para conseguir dicho objetivo se realizó una búsqueda bibliográfica en las siguientes bases de datos: PubMed, Scopus, ISI Web of Knowledge, The Cochrane Library, TESEO y TDX. Se seleccionaron aquellos artículos que evaluaban la efectividad del ejercicio físico sobre el craving, la sintomatología de abstinencia, el mantenimiento de la abstinencia y en el caso de la dependencia de nicotina también aquellos que evaluaban el efecto del ejercicio sobre el aumento de peso al dejar de fumar. Diecisiete artículos cumplieron los criterios de selección. La utilidad del ejercicio físico como estrategia coadyuvante en los tratamientos habituales para la dependencia de sustancias psicoactivas parece demostrada, tanto para favorecer la reducción del consumo como para facilitar la disminución del craving y la sintomatología de abstinencia, especialmente en el caso de la dependencia de nicotina. Sin embargo, especialmente en el caso de la dependencia de sustancias psicoactivas ilegales, son necesarios más estudios para llegar a resultados concluyentes. Destacar igualmente que se trata de un tipo de intervención bien aceptada por parte de la población adicta, hecho que la convertiría en una herramienta especialmente útil en personas en tratamiento de su trastorno adictivo(AU)

Given the benefits that exercise brings to physical and mental health, several authors have investigated its effectiveness as a treatment for various pathologies such as addictive disorders. The aim of this paper is to review the literature regarding the effectiveness of exercise as a complementary intervention for treatment of psychoactive substance dependence. To achieve this aim, a bibliographic search was conducted in the following databases: PubMed, Scopus, ISI Web of Knowledge, The Cochrane Library, TESEO and TDX. Those articles which evaluated the effectiveness of exercise on craving, withdrawal symptoms and abstinence rates were selected. Regarding nicotine dependence, those studies which evaluated the effectiveness of exercise for reducing weight gain after quitting smoking were also chosen. Seventeen articles met the selection criteria. The usefulness of exercise as a complementary strategy along with habitual therapeutic treatments for psychoactive substance dependence seems to be demonstrated, especially in nicotine dependence for the following variables: achieving or maintaining abstinence, and reducing craving or withdrawal symptoms. Further studies are nevertheless required, especially on illegal psychoactive substance dependence to be able to achieve conclusive results. We must also equally note that this kind of intervention is widely accepted by the drug using community, fact that would make of it a particularly useful tool in treating people with addictive disorders(AU)