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1.
Arch Microbiol ; 206(7): 300, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38861201

RESUMO

Microorganisms produce diverse classes of metabolites under various physiological conditions. Many bacterial strains have been reported to carry out the process of desulfurization in a cost-effective manner by converting dibenzothiophene (DBT) into 2-hydroxybiphenyl (2-HBP) and then using the 2-HBP as a carbon source for growth and development. Key rate-limiting factors and an increased concentration of 2HBP (400 µM) affect the biodesulfurization activity of bacteria through the produced metabolites. Thus, this study was designed to explore the nature of the metabolites produced by Rhodococcus erythropolis in the presence of DBT and 2HBP supplemented with a culture medium. A total of 330 metabolites were detected, and the key metabolites identified were 11Z-eicosaenoyl-EA, 1-carboxyethylisoleucine, 1(3)-glyceryl-PGF2alpha, taurine, 2-hydroxynicotinic acid, 4,4-dimethyl-14alpha-hydroxymethyl-5alpha-cholest-8-en-3beta-ol, and 10-nitrooleic acid. The supplementation of DBT and DBT-2HBP resulted in the differential regulation of these metabolites, either through downregulation or overexpression. Furthermore, at high concentrations of 2-HBP, 1-carboxyethylisoleucine, taurine, 2-hydroxynicotinic acid, and nicotinic acid were upregulated. This work proposes that the identified metabolites may play a role in bacteria-mediated desulphurization and could be beneficial in developing a cost-effective method of desulphurization for refining petroleum.


Assuntos
Compostos de Bifenilo , Petróleo , Rhodococcus , Tiofenos , Rhodococcus/metabolismo , Rhodococcus/crescimento & desenvolvimento , Petróleo/metabolismo , Compostos de Bifenilo/metabolismo , Tiofenos/metabolismo , Biodegradação Ambiental , Meios de Cultura/química , Meios de Cultura/metabolismo , Enxofre/metabolismo
2.
Eur Radiol ; 34(2): 1388-1398, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37589906

RESUMO

OBJECTIVES: Digital breast tomosynthesis (DBT) can improve diagnostic accuracy compared to 2D mammography, but DBT reporting is time-consuming and potentially more fatiguing. Changes in diagnostic accuracy and subjective and objective fatigue were evaluated over a DBT reporting session, and the impact of taking a reporting break was assessed. MATERIALS AND METHODS: Forty-five National Health Service (NHS) mammography readers from 6 hospitals read a cancer-enriched set of 40 DBT cases whilst eye tracked in this prospective cohort study, from December 2020 to April 2022. Eye-blink metrics were assessed as objective fatigue measures. Twenty-one readers had a reporting break, 24 did not. Subjective fatigue questionnaires were completed before and after the session. Diagnostic accuracy and subjective and objective fatigue measures were compared between the cohorts using parametric and non-parametric significance testing. RESULTS: Readers had on average 10 years post-training breast screening experience and took just under 2 h (105.8 min) to report all cases. Readers without a break reported greater levels of subjective fatigue (44% vs. 33%, p = 0.04), which related to greater objective fatigue: an increased average blink duration (296 ms vs. 286 ms, p < 0.001) and a reduced eye-opening velocity (76 mm/s vs. 82 mm/s, p < 0.001). Objective fatigue increased as the trial progressed for the no break cohort only (ps < 0.001). No difference was identified in diagnostic accuracy between the groups (accuracy: 87% vs. 87%, p = 0.92). CONCLUSIONS: Implementing a break during a 2-h DBT reporting session resulted in lower levels of subjective and objective fatigue. Breaks did not impact diagnostic accuracy, which may be related to the extensive experience of the readers. CLINICAL RELEVANCE STATEMENT: DBT is being incorporated into many mammography screening programmes. Recognising that reporting breaks are required when reading large volumes of DBT studies ensures this can be factored in when setting up reading sessions. TRIAL REGISTRATION: Clinical trials registration number: NCT03733106 KEY POINTS: • Use of digital breast tomosynthesis (DBT) in breast screening programmes can cause significant reader fatigue. • The effectiveness of incorporating reading breaks into DBT reporting sessions, to reduce mammography reader fatigue, was investigated using eye tracking. • Integrating breaks into DBT reporting sessions reduced reader fatigue; however, diagnostic accuracy was unaffected.


Assuntos
Neoplasias da Mama , Leitura , Humanos , Feminino , Estudos Prospectivos , Medicina Estatal , Mamografia/métodos , Mama/diagnóstico por imagem , Detecção Precoce de Câncer/métodos , Neoplasias da Mama/diagnóstico por imagem
3.
Eur Arch Psychiatry Clin Neurosci ; 274(1): 87-96, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37710135

RESUMO

Specialized psychotherapeutic treatments like dialectical behavioral therapy (DBT) are recommended as first treatment for borderline personality disorder (BPD). In recent years, studies have emerged that focus on repetitive transcranial magnetic stimulation (rTMS) in BPD. Both have independently demonstrated efficacy in the treatment of BPD. Intermitted theta burst stimulation (iTBS), a modified design of rTMS, is thought to increase the excitability of neurons and could be a supplement to psychotherapy in addition to being a standalone treatment. However, no studies to date have investigated the combination of DBT and rTMS/iTBS. This study protocol describes the methods and design of a randomized, single-blinded, sham-controlled clinical pilot study in which BPD patients will be randomly assigned to either iTBS or sham during four consecutive weeks (20 sessions in total) in addition to standardized DBT treatment. The stimulation will focus on the unilateral stimulation of the left dorsolateral prefrontal cortex (DLPFC), which plays an important role in the control of impulsivity and risk-taking. Primary outcome is the difference in borderline symptomatology, while secondary target criteria are depressive symptoms, general functional level, impulsivity and self-compassion. Statistical analysis of therapy response will be conducted by Mixed Model Repeated Measurement using a 2 × 2-factorial between-subjects design with the between-subject factor stimulation (TMS vs. Sham) and the within-subject factor time (T0 vs. T1). Furthermore, structural magnetic resonance imaging (MRI) will be conducted and analyzed. The study will provide evidence and insight on whether iTBS has an enhancing effect as add-on to DBT in BPD.Trial registration: drks.de (DRKS00020413) registered 13/01/2020.


Assuntos
Transtorno da Personalidade Borderline , Estimulação Magnética Transcraniana , Humanos , Terapia Comportamental , Transtorno da Personalidade Borderline/terapia , Personalidade , Projetos Piloto , Córtex Pré-Frontal/fisiologia , Método Simples-Cego , Estimulação Magnética Transcraniana/métodos , Resultado do Tratamento , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
BMC Psychiatry ; 24(1): 447, 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38877441

RESUMO

BACKGROUND: Self-harm and suicidal ideation are prevalent among adolescents, cause physical and psychosocial disability, and have potentially life-threatening consequences. Dialectical behavioral therapy for Adolescents (DBT-A) is an evidence-based intervention for reducing self-harm. However, few studies have investigated the effectiveness of DBT-A when delivered in routine clinical practice. METHODS: A follow-up cohort study, based on data from a quality assessment register of DBT-A in child and adolescent mental health services including seven outpatient clinics. Inclusion criteria were ongoing or a history of self-harming behavior the last 6 months; current suicidal behavior; at least 3 criteria of DSM-IV Borderline personality disorder (BPD), or at least the self-destruction criterion of DSM-IV BPD, in addition to minimum 2 subthreshold criteria; and fluency in Norwegian. Participants received 20 weeks of DBT-A consisting of multifamily skills training groups and individual therapy sessions. Outcomes from 41 participants included frequency of self-harm, suicide attempts and hospitalizations caused by self-harm or suicide attempts, assessed pre-, during, and post-treatment by self-report and reviews of the patient's medical records. Suicidal ideation, urge to self-harm and perceived feelings of happiness and sadness were assessed by the patients' diary cards at week 1, 5, 10, 15 and 20 of the treatment program. RESULTS: Participants attended an average of 17.9 (SD = 4.7) individual sessions, 14.7 (SD = 3.4) group-based skills training sessions and 4.6 (SD = 4.1) brief intersession telephone consultations. Moderate to large within-group effect sizes (ES) were found in self-harm from pre-treatment to 1-5 weeks (d = 0.64), 6-10 weeks (d = 0.84), 11-15 weeks (d = 0.99), 16-20 weeks (d = 1.26) and post-treatment (d = 1.68). Nine participants were admitted to hospitalization during DBT-A, whereas five had attempted suicide, but no suicides were completed. No statistically significant changes were found in suicidal ideation, urge to self-harm or perceived feelings of happiness or sadness from pre to post treatment. CONCLUSION: The findings of the current study are promising as the participants reported considerably reduced self-harm behavior after DBT-A treatment in a child and adolescent mental health outpatient setting.


Assuntos
Transtorno da Personalidade Borderline , Terapia do Comportamento Dialético , Comportamento Autodestrutivo , Ideação Suicida , Tentativa de Suicídio , Humanos , Adolescente , Feminino , Terapia do Comportamento Dialético/métodos , Masculino , Comportamento Autodestrutivo/terapia , Comportamento Autodestrutivo/psicologia , Tentativa de Suicídio/psicologia , Transtorno da Personalidade Borderline/terapia , Transtorno da Personalidade Borderline/psicologia , Resultado do Tratamento , Seguimentos , Criança
5.
Behav Cogn Psychother ; 52(4): 337-355, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38586939

RESUMO

BACKGROUND: Sexuality and gender minoritised (SGM) adolescents are at increased risk of self-injury and suicide, and experience barriers to accessing mental health support. Dialectical behaviour therapy (DBT) is an effective treatment for self-injury and emotion dysregulation in adolescent populations, but few studies have published outcomes of DBT for SGM young people. AIMS: This study aimed to investigate treatment outcomes and completion for SGM adolescents and their cisgender and heterosexual peers, in the National & Specialist CAMHS, DBT service (UK). METHOD: Treatment completion, and opting out before and during treatment were examined for sexual and gender identity groups, as well as changes by the end of treatment in emotion dysregulation, self-injury, in-patient bed-days, emergency department attendances, and borderline personality disorder, depression and anxiety symptoms. RESULTS: SGM adolescents were over-represented in this service, even after considering their increased risk for self-injury. No statistically significant differences were found for treatment completion between the sexual orientation and gender identity groups, although there were patterns indicating possible lower treatment uptake and completion that warrant further investigation. Clinical outcomes for treatment-completers showed improvement by the end of DBT for each group, with few exceptions. DISCUSSION: These results are from relatively small subsamples, and it was not possible to separate by sex assigned at birth. Findings should be treated tentatively and as early indications of effect sizes to inform future studies. This study suggests that DBT could be a useful treatment for SGM adolescents in a highly specialist treatment setting.


Assuntos
Terapia do Comportamento Dialético , Comportamento Autodestrutivo , Minorias Sexuais e de Gênero , Humanos , Adolescente , Masculino , Feminino , Minorias Sexuais e de Gênero/psicologia , Comportamento Autodestrutivo/terapia , Comportamento Autodestrutivo/psicologia , Resultado do Tratamento , Transtorno da Personalidade Borderline/terapia , Transtorno da Personalidade Borderline/psicologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-38296896

RESUMO

The COVID-19 pandemic has led to significant psychological distress among frontline healthcare workers (HCWs), with a particular increase in trauma-related symptoms. This study investigated the longitudinal course of trauma-associated symptoms and behaviors in HCWs and the effectiveness of a brief dialectical behavior therapy (DBT)-informed intervention in mitigating these symptoms over 12 months. The trial included 225 HCWs randomly assigned to one of three groups: no intervention (control), in-person DBT-informed intervention, or online DBT-informed intervention. Over time, a natural decrease in PTSD symptoms was observed in all groups. Contrary to expectations, no difference was found between the control and intervention groups. However, for participants with severe PTSD symptoms, the intervention significantly mitigated their distress. No differences emerged between in-person and online interventions, suggesting equal effectiveness. Females reported higher trauma-related symptoms, while no differences emerged among different professional roles. These findings underscore the importance of targeted interventions for HCWs experiencing severe symptoms and highlight the potential of online modalities. Further research is needed to optimize the deployment of mental health resources within the healthcare setting, particularly during crises.

7.
Psychother Res ; : 1-17, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38359387

RESUMO

OBJECTIVE: The current study aims to examine the efficacy of an add-on dialectical behavior therapy skills training (DBT-ST) on adult attention-deficit/hyperactivity disorder (ADHD). The DBT-ST was applied online under the pandemic conditions that occurred after the study had started. METHODS: The current randomized controlled trial consists of an intervention group to whom the DBT-ST was applied in online setting and a waitlist control group who received treatment as usual (TAU). Data were collected pre-, post-, and mid-treatment. ADHD symptoms (with the sub-dimensions of inattention and hyperactivity), impulsivity, mindfulness, difficulty with emotion regulation, interpersonal effectiveness, distress tolerance, life satisfaction, functionality in daily life, and general psychological symptom levels were measured with self-report scales. The data were analyzed using mixed-design ANOVA. RESULTS: The global ADHD, inattention, and hyperactivity symptoms of the DBT-ST group significantly decreased more than those in the TAU control group. The DBT-ST group also showed a significant decrease regarding difficulty with emotion regulation and increases in life satisfaction and functionality, though the group × time effect was not significant. CONCLUSION: DBT-ST was found effective against the participants' ADHD symptoms. The treatment was additionally found to improve their emotion regulation and quality of life. Further investigation is needed to investigate DBT-ST in an online setting.

8.
BMC Psychiatry ; 23(1): 838, 2023 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-37964237

RESUMO

BACKGROUND: Dialectical Behaviour Therapy (DBT) is recognized as a leading evidence-based treatment, effective in reducing symptoms of borderline personality disorder (BPD), as well as co-occurring clinical syndromes. However, symptom remission may not be the same as a life experienced as worth living. The purpose of the study was to understand, from the perspective of individuals with lived experience, the concepts of recovery, life experienced as worth living and flourishing after treatment for BPD, and to describe the pathways to wellness after symptom remission. METHODS: Semi-structured interviews were conducted with nine adult women previously diagnosed with BPD, co-occurring clinical syndromes and severe self-harm behaviour who self-identified as recovered for a minimum of two years, recruited from a network for individuals with lived experience. The average duration of recovery was 5.7 years with a range from 2 to 10 + years. Data were analysed using thematic analysis. RESULTS: Four main themes and 14 subthemes were generated from our analyses. Main themes indicated that loved ones helped recovery and to create a life worth living, that participants identified as recovered and as healthy and beyond, and that becoming well is a long process associated in part with reclaiming a healthy identity. Participants defined recovery as separate but related to a life worth living, which in turn was separate but related to being healthy and having lives they described as being beyond health and well-being. The wellness process was described as lengthy and non-linear, including setbacks that with time no longer derailed daily life. A proposed theoretical model depicting the wellness process over time from symptom remission to the experience of a life beyond health and wellness is presented. CONCLUSIONS: This qualitative study contributes knowledge of what a life experienced as worth living means, as well as how wellness progressed into flourishing for some participants within a sample of individuals with lived experience. Our findings may inform treatment development that targets more than symptom reduction, which in turn may shorten trajectories from symptom remission to health, wellness, and flourishing.


Assuntos
Transtorno da Personalidade Borderline , Terapia do Comportamento Dialético , Comportamento Autodestrutivo , Adulto , Humanos , Feminino , Transtorno da Personalidade Borderline/terapia , Resultado do Tratamento , Comportamento Autodestrutivo/terapia , Pesquisa Qualitativa
9.
Cogn Behav Ther ; 52(2): 110-131, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36426727

RESUMO

While dialectical behavior therapy (DBT) appears effective for some psychiatric conditions commonly associated with alexithymia, it is unclear whether DBT improves difficulties experienced by alexithymic individuals. This review investigated the current evidence on the effectiveness of DBT-based interventions in improving alexithymia. A qualitative synthesis of studies that investigated the efficacy of DBT on self-reported alexithymia was performed, identifying eligible studies using EBSCO/Essentials, Google Scholar, PubMed, Web of Science, and PsychINFO databases. Eight studies were identified. Overall, the results were inconclusive due to the heterogeneity of the studies but suggest that DBT-based interventions may be associated with self-reported decreases in alexithymia and increases in the ability to identify emotional states. The literature is limited by significant methodological problems, such as the low number of controlled trials, small samples, and high variability between DBT programs, which increases the risk of bias across study outcomes. More research is needed to reach conclusions regarding the effectiveness of DBT in improving alexithymia. Future studies should conduct randomized controlled trial designs (primarily with active treatment control conditions), greater standardization of DBT-based interventions, and a more in-depth examination of the level of participant involvement in long-term DBT-based interventions may help to understand whether DBT improves alexithymia difficulties.


Assuntos
Terapia do Comportamento Dialético , Transtornos Mentais , Humanos , Psicoterapia , Terapia do Comportamento Dialético/métodos , Sintomas Afetivos/complicações , Sintomas Afetivos/terapia , Emoções
10.
Telemed J E Health ; 29(4): 593-601, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-35984847

RESUMO

Objective: This study aimed to evaluate the acceptability of Dialectical Behavior Therapy (DBT) delivered through telehealth to complex, suicidal patients during the COVID-19 pandemic. Methods: We surveyed 163 adult participants enrolled in outpatient services at a private, free-standing DBT clinic certified by the DBT-Linehan Board of Certification for its fidelity to the treatment. Treatment satisfaction was assessed, as well as ease of telehealth over time, differences in satisfaction between patients who had previously experienced face-to-face treatment and those who had only experienced telehealth, patients' beliefs regarding the impact of telehealth on their progress, and preference for face-to-face versus telehealth services. Additionally, participants' reasons for liking and disliking telehealth were reported. Results: The average overall satisfaction rating was 82.26 (±18.71) on a 100-point scale. Factors identified as being relevant to satisfaction included increased access to care, saving time and money, and increased comfort participating in therapy from home. Factors identified as relevant to dissatisfaction included feeling less connected to therapists and other patients. The majority of participants reported that telehealth positively impacted or did not impact treatment progress. Satisfaction was significantly related to participants' perception of telehealth's impact on progress in treatment. Demographic variables were also included in the analyses, but were unrelated to satisfaction. Conclusions: Findings indicate that, from the point of view of consumer satisfaction, telehealth appears satisfactory for delivery of DBT and may play an increased role in behavioral health care postpandemic.


Assuntos
COVID-19 , Terapia do Comportamento Dialético , Telemedicina , Adulto , Humanos , COVID-19/epidemiologia , Ideação Suicida , Pandemias
11.
Fam Process ; 62(4): 1524-1541, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37602926

RESUMO

Previous research demonstrates that parents' communication skills may contribute to the development and maintenance of their young person's borderline personality disorder (BPD). Carers of people with BPD also experience their own psychosocial stressors and feel unsupported. Consequently, Dialectical Behavior Therapy for adolescents (DBT-A) invites parents to partake in group therapy alongside their young person. Despite this involvement, little research exists examining parents' perspective of engaging in a DBT-A program, and specifically whether they experience their own benefits and changes from being part of the program. To examine this, the current study interviews 34 parents who engaged in an early intervention DBT-A program. Thematic analysis resulted in seven key themes and 16 subthemes beginning with parents' expectations of the program, followed by the key elements of the program that facilitated change, and the actual changes and benefits attributed to these elements. Overall, parents were surprised by their own gains from the program, and how the skills they learned facilitated personal development that improved family communication and functioning with their young person and more broadly. This study addresses the gap in understanding the parent perspective with clinical implications for the benefits of involving parents in therapy more generally.


Assuntos
Transtorno da Personalidade Borderline , Psicoterapia de Grupo , Adolescente , Humanos , Terapia Comportamental/métodos , Transtorno da Personalidade Borderline/terapia , Transtorno da Personalidade Borderline/psicologia , Emoções , Resultado do Tratamento
12.
J Clin Psychol ; 79(9): 1929-1942, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-36920177

RESUMO

OBJECTIVE: An adapted, time-limited dialectical behavior therapy (DBT) skills training group therapy can prove to be an evidence-based treatment that can easily fit the needs, demands, and limitations of University Counseling Centers to serve college students with mental disorders. The present naturalistic study investigated the effectiveness, acceptability, and sustainability of a 4-week DBT-informed group therapy in enhancing psychological resilience. METHODS: Participants included 59 college students with heterogeneous mental health concerns. They attended weekly 1.5-hr DBT-informed, resilience-building group therapy for 4 weeks. Psychological resilience, mindfulness, emotional dysregulation, and overall distress were assessed at pretreatment and posttreatment, as well as at 1- and 3-month follow-ups. RESULTS: Findings showed increased psychological resilience among the participants at posttreatment and follow-ups, and provided preliminary evidence for the role of mindfulness as an important contributor to enhancing psychological resilience even after controlling for risk factors, treatment dosage, pregroup psychological resilience, and changes in emotion dysregulation and overall distress. CONCLUSION: A 4-week DBT-informed skills training group therapy can be utilized as a time-efficient, cost-effective, well-accepted preventative treatment with the potential longitudinal impact to boost psychological resilience for college students with mental health issues.


Assuntos
Terapia do Comportamento Dialético , Psicoterapia de Grupo , Resiliência Psicológica , Humanos , Saúde Mental , Estudantes/psicologia , Resultado do Tratamento
13.
Molecules ; 28(9)2023 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-37175161

RESUMO

The so-called dibenzyltoluene (H0-DBT) heat transfer oil contains numerous isomers of dibenzyltoluene as well as (benzyl)benzyltoluene (methyl group on the central vs. the side aromatic ring). As it is used as a liquid organic hydrogen carrier (LOHC), a detailed analysis of its composition is crucial in assessing the kinetic rate of hydrogenation for each constituent and studying the mechanism of H0-DBT hydrogenation. To identify all of the compounds in the oil, an in-depth analysis of the GC-MS spectra was performed. To confirm peak attribution, we synthesized some DBTs and characterized the pure compounds using NMR and Raman spectroscopies. Moreover, a fast-GC analysis was developed to rapidly determine the degree of hydrogenation of the mixture.

14.
Behav Cogn Psychother ; 51(1): 110-115, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36305087

RESUMO

BACKGROUND: An earlier evaluation (Fox et al., ) highlighted reductions in risk behaviours and restrictive practices for women admitted to low secure dialectical behaviour therapy (DBT) unit. Since then, a value-based healthcare model has been adopted. AIMS: To explore changes in health, social and psychological functioning, risk, quality of life, and in incidents of violence and restrictive practices, over the initial 12-month period of admission to a specialist DBT service. METHOD: Data were extracted from electronic clinical records for 41 women with emotionally unstable personality disorder admitted to a specialist integrated practice unit (IPU) providing a comprehensive DBT programme. Secondary analysis was conducted on an anonymous dataset of routinely collected outcome measures at baseline admission, and 6 and 12 months post-admission. ANOVAs and pairwise post hoc comparisons, and non-parametric equivalents, were conducted to examine changes in outcomes. RESULTS: Findings showed statistically significant improvements in mental health scores on the ReQOL (p<.01), global, wellbeing, problems, functioning and risk scores on the COREOM (all p<.01), and severe disturbance, emotional wellbeing, socioeconomic status, risk and need scores on the HoNOS-Secure (all p<.05). Significant reductions in risk behaviours (p<.01) and restrictive practices (p<.01) were also apparent. The most substantiative improvements were largely demonstrated over a 12-month admission period. CONCLUSIONS: Admission to the DBT IPU yielded significant improvements on outcomes pertaining to quality of life, psychological distress, and risk. Importantly, these are outcomes that aligned with patients' perceptions of recovery.


Assuntos
Terapia do Comportamento Dialético , Humanos , Feminino , Seguimentos , Qualidade de Vida
15.
Artigo em Inglês | MEDLINE | ID: mdl-38116846

RESUMO

Psychological distress is the most common complication of pregnancy. High-risk concerns can include severe emotion dysregulation, suicidality and self-injury, and health risk behaviours, which bear substantial consequences for caregivers and families. Yet, effective, comprehensive interventions for high-risk caregivers have received limited attention. Dialectical behaviour therapy (DBT) is a frontline treatment for such concerns. Accordingly, we conducted a scoping review on the implementation of DBT in the perinatal period. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Seven studies were identified; study designs included case studies and single-arm pilot trials. Most studies used DBT-informed protocols with significant adaptations, few included multiple components of DBT (i.e. skills group, individual therapy, phone coaching and consultation team), and none met criteria for adherent delivery of all four modes of DBT treatment. Findings suggest DBT-informed interventions may be successfully implemented to treat a range of perinatal mental health symptoms, including borderline personality disorder, depression, anxiety, and post-traumatic stress, and to promote emotion regulation and positive parenting behaviours. While results provide preliminary support for perinatal DBT, this literature is scant and empirical rigour considerably lacking. Clinical implications and future directions are outlined to aid researchers and providers in addressing the ongoing perinatal mental health crisis and developing sorely needed interventions to address the needs of high-risk caregivers.

16.
Psychiatr Q ; 94(4): 691-704, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37792150

RESUMO

PURPOSE: Dialectical behavior therapy (DBT) is a treatment originally developed för chronically suicidal adults. It is common to adapt it by using one specific component, the DBT skills training (DBT-ST) and apply it in a group therapy setting for a variety of mental disorders. The primary aim of the study was to explore whether patients with extended care needs would report improved mental health after participating in an intensive form of DBT-ST. The secondary aim was to explore whether the use of psychiatric inpatient care for the group would decrease. METHODS: Thirty-seven participants completed the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), and visual analogue scale (VAS) at three time points: pre-intervention, post-intervention and at 6-month follow-up after intensive DBT-ST. RESULTS: One-way ANOVA showed a significant effect for time on the CORE-OM: F (2,35) = 7.93, p = .001, η2 = 0.312 (large effect size). Post hoc tests indicated a significant difference between pre-intervention and post-intervention (p = .001) and between pre-intervention and follow-up (p = .01). A Friedman test indicated a statistically significant difference in the VAS scale scores across the three time points, with p-values between 0.00 and 0.05. There was no difference in psychiatric healthcare consumption. CONCLUSION: These study results confirm to some extent the feasibility and effectiveness of the intensive DBT-ST in a transdiagnostic clinical setting. The participants had a positive outcome from the skills training program, but psychiatric healthcare consumption did not decrease.


Assuntos
Terapia do Comportamento Dialético , Adulto , Humanos , Terapia do Comportamento Dialético/métodos , Pacientes Ambulatoriais , Estudos de Viabilidade , Resultado do Tratamento , Ideação Suicida , Terapia Comportamental/métodos
17.
Child Adolesc Ment Health ; 28(3): 458-460, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-36373508

RESUMO

BACKGROUND: Suicide is a leading cause of death for adolescents in the United States. Widespread implementation of evidence-based practices for this population remains challenging due to resource shortages and system barriers. Dialectical Behavior Therapy for Adolescents (DBT-A) has robust research support, with positive clinical outcomes when implemented with fidelity. At the same time, implementation requires individual therapy with trained clinicians, a resource which may not be available at the level required in some communities. The current study uses theoretical frameworks from adult implementations of Dialectical Behavior Therapy (DBT) where treatment was provided in a DBT Skills Training format without weekly individual therapy to examine skills training for adolescent clients with suicidal behaviors and is the first published study regarding feasibility of skills training for this population. METHODS: Adolescents and their families were offered DBT Skills Training while on the waitlist for DBT-A. Of the 125 families referred, 48 chose DBT Skills Training and 77 opted to wait for DBT-A, creating a natural quasi-experimental design useful in exploring differences between DBT-Skills Training and DBT-A. RESULTS: There were no significant differences between the two groups at baseline. Rates of treatment completion were similar between the two groups. CONCLUSIONS: Results from the current study demonstrate similar rates of treatment drop-out and treatment completion between DBT Skills Training and DBT-A, suggesting DBT Skills Training without individual therapy for adolescents is feasible and warrants additional research.


Assuntos
Terapia do Comportamento Dialético , Suicídio , Adulto , Humanos , Adolescente , Terapia do Comportamento Dialético/métodos , Estudos de Viabilidade , Ideação Suicida , Psicoterapia
18.
Physiol Mol Biol Plants ; 29(8): 1073-1079, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37829700

RESUMO

We remember Dr Ajay Parida, a leading plant biotechnologist, whose premature passing has deprived the Indian plant science community of a committed scientist and an able administrator. Born on 12 December 1963 in Bhagabanpur, Cuttack District (now Jajpur district), Odisha, he passed away in Guwahati on 19 July 2022. A collegial scientist, his down-to-earth and approachable nature, as well as his resourcefulness were instrumental in advancing the cause of Indian science and harnessing frontier biotechnological tools as vehicles of social consciousness. His expertise in quantitative DNA variation and molecular marker analysis, paved the way for subsequent research on mangrove molecular diversity at the M. S. Swaminathan Research Foundation (MSSRF), Chennai. His contributions to mangrove biology, genetics and genomics as well as extremophile plant species in the Indian context over two decades are a benchmark in his field. He also provided commendable leadership in his capacity as Director, Institute of Life Sciences (ILS), Bhubaneshwar during the COVID-19 pandemic.

19.
Am J Med Genet A ; 188(9): 2738-2749, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35799415

RESUMO

Maple syrup urine disease (MSUD) is an intoxication-type inherited metabolic disorder in which hyperleucinemia leads to brain swelling and death without treatment. MSUD is caused by branched-chain alpha-ketoacid dehydrogenase deficiency due to biallelic loss of the protein products from the genes BCKDHA, BCKDHB, or DBT, while a distinct but related condition is caused by loss of DLD. In this case series, eleven individuals with MSUD caused by two pathogenic variants in DBT are presented. All eleven individuals have a deletion of exon 2 (delEx2, NM_001918.3:c.48_171del); six individuals are homozygous and five individuals are compound heterozygous with a novel missense variant (NM_001918.5:c.916 T > C [p.Ser306Pro]) confirmed to be in trans. Western Blot indicates decreased amount of protein product in delEx2;c.916 T > C liver cells and absence of protein product in delEx2 homozygous hepatocytes. Ultrahigh performance liquid chromatography-tandem mass spectrometry demonstrates an accumulation of branched-chain amino acids and alpha-ketoacids in explanted hepatocytes. Individuals with these variants have a neonatal-onset, non-thiamine-responsive, classical form of MSUD. Strikingly, the entire cohort is derived from families who immigrated to the Washington, DC, metro area from Honduras or El Salvador suggesting the possibility of a founder effect.


Assuntos
Doença da Urina de Xarope de Bordo , 3-Metil-2-Oxobutanoato Desidrogenase (Lipoamida)/genética , América Central , Genômica , Humanos , Recém-Nascido , Doença da Urina de Xarope de Bordo/genética , Mutação
20.
BMC Psychiatry ; 22(1): 164, 2022 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-35248015

RESUMO

BACKGROUND: CUIDA-TE is an APP that offers transdiagnostic cognitive behavioral therapy focused on enhancing emotion regulation. As a novelty, it incorporates ecological momentary interventions (EMI), which can provide psychological support in real time, when suffering arises. The main goal of the study is to evaluate the efficacy of CUIDA-TE to improve emotion regulation in healthcare workers, a population that has been particularly emotionally impacted by the COVID-19 pandemic. METHODS: In this three-arm, randomized controlled trial (RCT) the study sample will be composed of a minimum of 174 healthcare workers. They will be randomly assigned to a 2-month EMI group (CUIDA-TE APP, n ≥ 58), a 2-month ecological momentary assessment (EMA) only group (MONITOR EMOCIONAL APP, n ≥ 58), or a wait-list control group (no daily monitoring nor intervention, n ≥ 58). CUIDA-TE will provide EMI if EMA reveals emotional problems, poor sleep quality/quantity, burnout, stress, or low perceived self-efficacy when regulating emotions. Depression will be the primary outcome. Secondary outcomes will include emotion regulation, quality of life, and resilience. Treatment acceptance and usability will also be measured. Primary and secondary outcomes will be obtained at pre- and post-intervention measurements, and at the 3-month follow-up for all groups. DISCUSSION: To our knowledge, this is the first RCT that evaluates the efficacy of an APP-based EMI to improve emotion regulation skills in healthcare workers. This type of intervention might ultimately help disseminate treatments and reach a larger number of individuals than traditional face-to-face individual therapies. TRIAL REGISTRATION: ClinicalTrial.gov : NCT04958941 Registered 7 Jun 2021. STUDY STATUS: Participant recruitment has not started.


Assuntos
COVID-19 , Regulação Emocional , Pessoal de Saúde , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , SARS-CoV-2 , Smartphone , Resultado do Tratamento
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