BACKGROUND Public employees worldwide are increasingly concerned about work anxiety and depression.Cognitive-behavioral career coaching has emerged as a promising strategy for addressing these mental health disorders,...BACKGROUND Public employees worldwide are increasingly concerned about work anxiety and depression.Cognitive-behavioral career coaching has emerged as a promising strategy for addressing these mental health disorders,which can negatively impact on a person's overall well-being and performance.AIM To examine whether cognitive-behavioral career coaching reduces work anxiety and depression among Nigerian public employees.METHODS A total of 120 public employees(n=60)suffering from severe anxiety and depression were randomly assigned to the treatment or control groups in this study.Cognitive behavioral coaching was provided twice a week to those in the treatment group,whereas no treatment was given to those in the control group.As part of the study,the Hamilton Anxiety Rating Scales and Beck Depression Inventory were used to collect data.RESULTS Analysis of covariance of the data from participants indicates a significant effect of cognitive-behavioral career coaching on work anxiety and depression.CONCLUSION Insights into the underlying mechanisms by which cognitive behavior career coaching exerts its effects have been gained from this study.Also,the study has gathered valuable data that can inform future practice and guide the development of strategies for supporting mental health at work.展开更多
Irritable bowel syndrome(IBS)is a common disorder,reported to be found in 5%-20%of the general population.Its management accounts for up to 25%of a gastroenterologist’s workload in the outpatient department,and the m...Irritable bowel syndrome(IBS)is a common disorder,reported to be found in 5%-20%of the general population.Its management accounts for up to 25%of a gastroenterologist’s workload in the outpatient department,and the main symptoms are abdominal pain,bloating,and altered bowel habits.Despite a great amount of available pharmacological treatments aimed at a wide variety of gastrointestinal and brain targets,many patients have not shown adequate symptom relief.In recent years,there has been increasing evidence to suggest that psychological treatments,in particular cognitive-behavioral therapy(CBT),are effective for the management of IBS.This review discusses CBT for the management of IBS.CBT has proved to be effective in alleviating the physical and psychological symptoms of IBS and has thus been recommended as a treatment option for the syndrome.展开更多
Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed...Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed manualized group CBT. We examined associations between the personality dimensions of NEO Five Factor Index (NEO-FFI) and the subscales of Symptom Checklist-90 Revised (SCL-90-R) in SAD patients after CBT using multiple regression analysis. Results: High levels of conscientiousness at baseline predicted symptom reduction on 4 SCL-90-R scales, including somatization, obsessive-compulsive, anxiety and global severity index in patients with SAD after CBT. And high levels of agreeableness predicted symptom reduction on 2 SCL-90-R scales, including Hostility and Paranoid Ideation. High levels of openness predicted psychoticism. Conclusion: The present study suggested that high levels of three NEO-FFI dimensions (openness, agreeableness, conscientiousness) might predict comorbid psychological symptoms reduction in SAD patients after CBT. For the purpose of improving comorbid psychological symptoms with SAD patients, it might be useful to pay more attention to these dimensions of NEO-FFI at baseline.展开更多
Objective To investigate the efficacy of cognitivebehavioraltherapy for insomnia (CBT-i) or combinationwith tapered hypnotic agents. Methods Seventy-five patientswere randomized into either CBT-i group (n = 37)or comb...Objective To investigate the efficacy of cognitivebehavioraltherapy for insomnia (CBT-i) or combinationwith tapered hypnotic agents. Methods Seventy-five patientswere randomized into either CBT-i group (n = 37)or combination group ( n = 38). The duration of treatmentlasted for 8 weeks. The efficacy was evaluated byPittsburgh sleep quality index (PSQI),Beck depressionindex (BDI),Beck anxiety inventory (BAI) and sleepdiary variables at baseline,in the process and end oftreatment. Results ( 1 ) Compared with the results atbaseline,the total scores of PSQI,BDI and BAI in bothgroups significantly decreased at the end of treatment:CBT-i group,PSQI (4. 7 ± 2. 5) vs. (12. 9 ± 3. 5);BDI (3. 2 ± 4. 4) vs. (9. 7 ± 6. 4);BAI (4. 2 ± 5. 6)vs. ( 10. 7 ± 8. 1 );and combination group, PSQI(5. 8 ± 2. 8) vs. (13. 9 ± 3. 1);BDI (4. 5 ± 4. 8) vs.(13. 8 ± 8. 7);BAI (4. 4 ± 4. 0) vs. (14. 1 ± 6. 3) (allP < 0. 01). (2) Compared with the results at baseline,subjective sleep quality ( SQ ), sleep onset latency(SOL),sleep efficiency (SE),sleep disturbance (SD)and used sleep medication (USM) in PSQI in combinationgroup significantly decreased at week 4 and 8 ( allP < 0. 05). The total sleep time (TST) and daytime dysfunction(DF) in PSQI significantly decreased at week 8( both P < 0. 05 ). ( 3 ) Compared with combinationgroup,improvement of SOL and SE in CBT-i group wassuperior (both P = 0. 01). Conclusion CBT-i for chronicinsomnia is effective in both CBT-i alone and combinationwith tapered hypnotic agents. CBT-i group is superiorin improving SOL and SE. Combination regimen in ourstudy can significantly reduce the doses of medication.展开更多
BACKGROUND Patients with chronic hepatitis B(CHB)experience various problems,including low psychological flexibility,negative emotions,and poor sleep quality.Therefore,effective nursing interventions are required to r...BACKGROUND Patients with chronic hepatitis B(CHB)experience various problems,including low psychological flexibility,negative emotions,and poor sleep quality.Therefore,effective nursing interventions are required to reduce adverse events.Acceptance and commitment therapy(ACT)combined with enabling cognitivebehavioral education(ECBE)can improve patients'psychological and sleep.Therefore,we speculate that this may also be effective in patients with CHB.AIM To investigate the effects of different intervention methods on psychological flexibility,negative emotions,and sleep quality in patients with CHB.METHODS This retrospective study examined clinical and evaluation data of 129 patients with CHB.Intervention methods were divided into a conventional group(routine nursing,n=69)and a combination group(ACT combined with ECBE,n=60).We observed changes in psychological flexibility,negative emotions,sleep quality,and self-care ability in both groups.Observation items were evaluated using the Acceptance and Action Questionnaire-2nd Edition(AAQ-II),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Pittsburgh Sleep Quality Index(PSQI),and Exercise of Self-Care Agency Scale(ESCA).RESULTS Compared with the conventional group,the AAQ-II score of the combined group was lower(F_(between-group effect)=8.548;F_(time effects)=25.020;F_(interaction effects)=52.930;all P<0.001),the SAS score(t=5.445)and SDS score(t=7.076)were lower(all P<0.001),as were the PSQI dimensions(tsleep quality=4.581,tfall sleep time=2.826,tsleep time=2.436,tsleep efficiency=5.787,tsleep disorder=5.008,thypnotic drugs=3.786,tdaytime dysfunction=4.812);all P<0.05).The ESCA scores for all dimensions were higher(thealth knowledge level=6.994,t self-concept=5.902,tself-responsibility=19.820,tself-care skills=8.470;all P<0.001).CONCLUSION ACT combined with ECBE in patients with CHB can improve psychological flexibility and sleep quality,alleviate negative emotions,and improve self-care.展开更多
Objectives:Prevalence rates of overweight and obesity are dramatically ever-increasing across the world.Therefore,this study was to evaluate the effect of mindfulness-based cognitive therapy(MBCT)on weight loss,hypert...Objectives:Prevalence rates of overweight and obesity are dramatically ever-increasing across the world.Therefore,this study was to evaluate the effect of mindfulness-based cognitive therapy(MBCT)on weight loss,hypertension,and attentional bias towards food cues in a group of women affected with this condition.Methods:A total of 45 participants were selected out of women referring to the Nutrition and Diet Therapy Clinic affiliated to Shahid Beheshti University of Medical Sciences,Iran,and then randomized into three groups of 15.The first experimental group was subjected to an energy-restricted diet therapy together with MBCT during 8 sessions,the second group took the diet therapy alone,and the third group received no intervention.Body mass index(BMI),hypertension,and attentional bias towards food cues were correspondingly evaluated before,at the end,and four weeks after the completion of the interventions.Results:The results of this study revealed that MBCT,along with diet therapy,had been significantly more effective in weight loss,decrease in BMI,lower systolic blood pressure(SBP),and attentional bias towards food cues compared with the diet therapy alone(P≤0.01).MBCT had no significant impact on the decline in diastolic blood pressure(DBP)in participants in the follow-up phase.Conclusion:This study demonstrated that MBCT along with the conventional diet therapy was more effective in weight loss,decrease in BMI,hypertension control,as well as attentional bias towards food cues than the diet therapy alone.展开更多
Over the past three decades, obsessive-compulsive disorder(OCD) has moved from an almost untreatable,life-long psychiatric disorder to a highly manageable one. This is a very welcome change to the 1%-3% of children an...Over the past three decades, obsessive-compulsive disorder(OCD) has moved from an almost untreatable,life-long psychiatric disorder to a highly manageable one. This is a very welcome change to the 1%-3% of children and adults with this disorder as, thanks to advances in both pharmacological and psychological therapies, prognosis for those afflicted with OCD is quite good in the long term, even though most have comorbid disorders that are also problematic. We still have far to go, however, until OCD can be described as either easily treatable or the effective treatments are widely known about among clinicians. This review focuses on the current state of the art in treatment for OCD and where we still are coming up short in our work as a scientific community. For example, while the impact of medications is quite strong for adults in reducing OCD symptoms, current drugs are only somewhat effective for children. In addition, there are unacceptably high relapse rates across both populations when treated with pharmacological alone. Even in the cognitive-behavioral treatments, which show higher effect sizes and lower relapse rates than drug therapies, drop-out rates are at a quarter of those who begin treatment. This means a sizable portion of the OCD population who do obtain effective treatments(which appears to be only a portion of the overall population) are not effectively treated.Suggestions for future avenues of research are also presented. These are primarily focused on(1) increased dissemination of effective therapies;(2) augmentation of treatments for those with residual symptoms, both for psychotherapy and pharmacotherapy; and(3) the impact of comorbid disorders on treatment outcome.展开更多
The Persian Gulf War of 1990 to 1991 involved the deployment of nearly 700,000 American troops to the Middle East.Deployment-related exposures to toxic substances such as pesticides,nerve agents,pyridostigmine bromide...The Persian Gulf War of 1990 to 1991 involved the deployment of nearly 700,000 American troops to the Middle East.Deployment-related exposures to toxic substances such as pesticides,nerve agents,pyridostigmine bromide(PB),smoke from burning oil wells,and petrochemicals may have contributed to medical illness in as many as 250,000 of those American troops.The cluster of chronic symptoms,now referred to as Gulf War Illness(GWI),has been studied by many researchers over the past two decades.Although over$500 million has been spent on GWI research,to date,no cures or condition-specific treatments have been discovered,and the exact pathophysiology remains elusive.Using the 2007 National Institute of Health(NIH)Roadmap for Medical Research model as a reference framework,we reviewed studies of interventions involving GWI patients to assess the progress of treatment-related GWI research.All GWI clinical trial studies reviewed involved investigations of existing interventions that have shown efficacy in other diseases with analogous symptoms.After reviewing the published and ongoing registered clinical trials for cognitivebehavioral therapy,exercise therapy,acupuncture,coenzyme Q10(CoQ10),mifepristone,and carnosine in GWI patients,we identified only four treatments(cognitive-behavioral therapy,exercise therapy,CoQ10,and mifepristone)that have progressed beyond a phase II trial.We conclude that progress in the scientific study of therapies for GWI has not followed the NIH Roadmap for Medical Research model.Establishment of a standard case definition,prioritized GWI research funding for the characterization of the pathophysiology of the condition,and rapid replication and adaptation of early phase,single site clinical trials could substantially advance research progress and treatment discovery for this condition.展开更多
Depression is a prevalent psychiatric disorder that often leads to poor quality of life and impaired functioning.Treatment during the acute phase of a major depressive episode aims to help the patient reach a remissio...Depression is a prevalent psychiatric disorder that often leads to poor quality of life and impaired functioning.Treatment during the acute phase of a major depressive episode aims to help the patient reach a remission state and eventually return to their baseline level of functioning.Pharmacotherapy,especially selective serotonin reuptake inhibitors antidepressants,remains the most frequent option for treating depression during the acute phase,while other promising pharmacological options are still competing for the attention of practitioners.Depressionfocused psychotherapy is the second most common option for helping patients overcome the acute phase,maintain remission,and prevent relapses.Electroconvulsive therapy is the most effective somatic therapy for depression in some specific situations;meanwhile,other methods have limits,and their specific indications are still being studied.Combining medications,psychotherapy,and somatic therapies remains the most effective way to manage resistant forms of depression.展开更多
In the treatment of OCD, several therapeutic approaches have been developed, including individual, group and/or pharmacological therapeutic methods. However, group therapy on OCD has received little research attention...In the treatment of OCD, several therapeutic approaches have been developed, including individual, group and/or pharmacological therapeutic methods. However, group therapy on OCD has received little research attention in comparison with other therapeutic methods and some studies demonstrated that OCD can be treated in group settings. In the literature, mentioned group therapies to treat OCD involve behavioral therapy, cognitive therapy, ERP (exposure and response prevention), cognitive behavioral therapy, ACT (acceptance and commitment therapy), supportive groups and individual therapy with family member involvement. In relation to their effectiveness, research indicated inconsistent findings. Therefore, the aim of this study was to address and to review whether group treatments on OCD are efficacious. This review focused on cognitive-behavioral group therapy (CBGT), ERP, and ACT.展开更多
AIM To provide an updated of recent findings about efficacy of cognitive-behavior therapy(CBT) in reduction of command hallucinations.METHODS Pub Med/MEDLINE,Cochrane Library,the Cumulative Index to Nursing and Allied...AIM To provide an updated of recent findings about efficacy of cognitive-behavior therapy(CBT) in reduction of command hallucinations.METHODS Pub Med/MEDLINE,Cochrane Library,the Cumulative Index to Nursing and Allied Health Literature,PsycI NFO,Clinical Trial.gov searches were performed using the keywords "hallucinations","behavioural therapy" and " cognitive therapy" in order to identify relevant articles published during the years of 2011 to 2016.No language limits were used.Studies conducted within control group,reviews,editorials,were excluded.Data on efficacy,acceptability and tolerability were extracted by three authors independently.Disagreements were resolved in a consensus meeting or by another reviewer.RESULTS A total of eight articles were eligible for inclusion.Two are randomized clinical trials(RCTs) and six are observational studies.The two RCTs included showed a greater efficacy of CBT compared to standard care on auditory hallucinations(AHs).Nevertheless,they considered different CBT models,particularly Treatment of Resistant Command Hallucinations and Cognitive Therapy for Command Hallucinations.As regards non RCT-studies,all papers included showed reduction on frequency and severity of AHs and distress related to them.However,the lack of content details within non-RCTs studies decreased their comparability.In terms of predictive variables,our findings show that negative symptoms at baseline appeared to be the strongest predictor of the treatment efficacy.Indeed,negative symptoms showed a significant negative correlation on outcome.CONCLUSION Although more conclusive studies are still needed,we found some preliminary evidence for the efficacy of CBT in the treatment of command hallucinations.展开更多
A significant association exists between lower urinary tract symptoms and anxiety. Despite the efficacy of cognitive behavior therapies in treating a variety of phobic disorders, there are few published reports about ...A significant association exists between lower urinary tract symptoms and anxiety. Despite the efficacy of cognitive behavior therapies in treating a variety of phobic disorders, there are few published reports about the use of such treatments for urinary problems. We report a case of the phobia of urinary incontinence treated with cognitive behavioral techniques, which involved cognitive restructuring, distraction, relaxation training, and exposure to feared situations.展开更多
本研究拟在传统社交焦虑障碍团体认知行为疗法的基础上构建新治疗模式——"团体实证认知行为疗法(Empirical Group Cognitive-Behavioral Therapy,EGCBT)",模式鼓励来访者以科学研究的方式深入调研治疗关系以外"第三方&q...本研究拟在传统社交焦虑障碍团体认知行为疗法的基础上构建新治疗模式——"团体实证认知行为疗法(Empirical Group Cognitive-Behavioral Therapy,EGCBT)",模式鼓励来访者以科学研究的方式深入调研治疗关系以外"第三方"他人对社交焦虑相关问题的观念,进行认知取证,同时强调来访者对自我"正面和负面评价恐惧"内容进行实证检验。"团体实证认知行为疗法"注重利用"第三方"视角的真实信息为社交焦虑个体认知合理化提供更客观的依据,在传统认知行为治疗的基础上丰富实证模块及增强治疗模块间的递进关系。展开更多
文摘BACKGROUND Public employees worldwide are increasingly concerned about work anxiety and depression.Cognitive-behavioral career coaching has emerged as a promising strategy for addressing these mental health disorders,which can negatively impact on a person's overall well-being and performance.AIM To examine whether cognitive-behavioral career coaching reduces work anxiety and depression among Nigerian public employees.METHODS A total of 120 public employees(n=60)suffering from severe anxiety and depression were randomly assigned to the treatment or control groups in this study.Cognitive behavioral coaching was provided twice a week to those in the treatment group,whereas no treatment was given to those in the control group.As part of the study,the Hamilton Anxiety Rating Scales and Beck Depression Inventory were used to collect data.RESULTS Analysis of covariance of the data from participants indicates a significant effect of cognitive-behavioral career coaching on work anxiety and depression.CONCLUSION Insights into the underlying mechanisms by which cognitive behavior career coaching exerts its effects have been gained from this study.Also,the study has gathered valuable data that can inform future practice and guide the development of strategies for supporting mental health at work.
文摘Irritable bowel syndrome(IBS)is a common disorder,reported to be found in 5%-20%of the general population.Its management accounts for up to 25%of a gastroenterologist’s workload in the outpatient department,and the main symptoms are abdominal pain,bloating,and altered bowel habits.Despite a great amount of available pharmacological treatments aimed at a wide variety of gastrointestinal and brain targets,many patients have not shown adequate symptom relief.In recent years,there has been increasing evidence to suggest that psychological treatments,in particular cognitive-behavioral therapy(CBT),are effective for the management of IBS.This review discusses CBT for the management of IBS.CBT has proved to be effective in alleviating the physical and psychological symptoms of IBS and has thus been recommended as a treatment option for the syndrome.
文摘Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed manualized group CBT. We examined associations between the personality dimensions of NEO Five Factor Index (NEO-FFI) and the subscales of Symptom Checklist-90 Revised (SCL-90-R) in SAD patients after CBT using multiple regression analysis. Results: High levels of conscientiousness at baseline predicted symptom reduction on 4 SCL-90-R scales, including somatization, obsessive-compulsive, anxiety and global severity index in patients with SAD after CBT. And high levels of agreeableness predicted symptom reduction on 2 SCL-90-R scales, including Hostility and Paranoid Ideation. High levels of openness predicted psychoticism. Conclusion: The present study suggested that high levels of three NEO-FFI dimensions (openness, agreeableness, conscientiousness) might predict comorbid psychological symptoms reduction in SAD patients after CBT. For the purpose of improving comorbid psychological symptoms with SAD patients, it might be useful to pay more attention to these dimensions of NEO-FFI at baseline.
文摘Objective To investigate the efficacy of cognitivebehavioraltherapy for insomnia (CBT-i) or combinationwith tapered hypnotic agents. Methods Seventy-five patientswere randomized into either CBT-i group (n = 37)or combination group ( n = 38). The duration of treatmentlasted for 8 weeks. The efficacy was evaluated byPittsburgh sleep quality index (PSQI),Beck depressionindex (BDI),Beck anxiety inventory (BAI) and sleepdiary variables at baseline,in the process and end oftreatment. Results ( 1 ) Compared with the results atbaseline,the total scores of PSQI,BDI and BAI in bothgroups significantly decreased at the end of treatment:CBT-i group,PSQI (4. 7 ± 2. 5) vs. (12. 9 ± 3. 5);BDI (3. 2 ± 4. 4) vs. (9. 7 ± 6. 4);BAI (4. 2 ± 5. 6)vs. ( 10. 7 ± 8. 1 );and combination group, PSQI(5. 8 ± 2. 8) vs. (13. 9 ± 3. 1);BDI (4. 5 ± 4. 8) vs.(13. 8 ± 8. 7);BAI (4. 4 ± 4. 0) vs. (14. 1 ± 6. 3) (allP < 0. 01). (2) Compared with the results at baseline,subjective sleep quality ( SQ ), sleep onset latency(SOL),sleep efficiency (SE),sleep disturbance (SD)and used sleep medication (USM) in PSQI in combinationgroup significantly decreased at week 4 and 8 ( allP < 0. 05). The total sleep time (TST) and daytime dysfunction(DF) in PSQI significantly decreased at week 8( both P < 0. 05 ). ( 3 ) Compared with combinationgroup,improvement of SOL and SE in CBT-i group wassuperior (both P = 0. 01). Conclusion CBT-i for chronicinsomnia is effective in both CBT-i alone and combinationwith tapered hypnotic agents. CBT-i group is superiorin improving SOL and SE. Combination regimen in ourstudy can significantly reduce the doses of medication.
文摘BACKGROUND Patients with chronic hepatitis B(CHB)experience various problems,including low psychological flexibility,negative emotions,and poor sleep quality.Therefore,effective nursing interventions are required to reduce adverse events.Acceptance and commitment therapy(ACT)combined with enabling cognitivebehavioral education(ECBE)can improve patients'psychological and sleep.Therefore,we speculate that this may also be effective in patients with CHB.AIM To investigate the effects of different intervention methods on psychological flexibility,negative emotions,and sleep quality in patients with CHB.METHODS This retrospective study examined clinical and evaluation data of 129 patients with CHB.Intervention methods were divided into a conventional group(routine nursing,n=69)and a combination group(ACT combined with ECBE,n=60).We observed changes in psychological flexibility,negative emotions,sleep quality,and self-care ability in both groups.Observation items were evaluated using the Acceptance and Action Questionnaire-2nd Edition(AAQ-II),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Pittsburgh Sleep Quality Index(PSQI),and Exercise of Self-Care Agency Scale(ESCA).RESULTS Compared with the conventional group,the AAQ-II score of the combined group was lower(F_(between-group effect)=8.548;F_(time effects)=25.020;F_(interaction effects)=52.930;all P<0.001),the SAS score(t=5.445)and SDS score(t=7.076)were lower(all P<0.001),as were the PSQI dimensions(tsleep quality=4.581,tfall sleep time=2.826,tsleep time=2.436,tsleep efficiency=5.787,tsleep disorder=5.008,thypnotic drugs=3.786,tdaytime dysfunction=4.812);all P<0.05).The ESCA scores for all dimensions were higher(thealth knowledge level=6.994,t self-concept=5.902,tself-responsibility=19.820,tself-care skills=8.470;all P<0.001).CONCLUSION ACT combined with ECBE in patients with CHB can improve psychological flexibility and sleep quality,alleviate negative emotions,and improve self-care.
文摘Objectives:Prevalence rates of overweight and obesity are dramatically ever-increasing across the world.Therefore,this study was to evaluate the effect of mindfulness-based cognitive therapy(MBCT)on weight loss,hypertension,and attentional bias towards food cues in a group of women affected with this condition.Methods:A total of 45 participants were selected out of women referring to the Nutrition and Diet Therapy Clinic affiliated to Shahid Beheshti University of Medical Sciences,Iran,and then randomized into three groups of 15.The first experimental group was subjected to an energy-restricted diet therapy together with MBCT during 8 sessions,the second group took the diet therapy alone,and the third group received no intervention.Body mass index(BMI),hypertension,and attentional bias towards food cues were correspondingly evaluated before,at the end,and four weeks after the completion of the interventions.Results:The results of this study revealed that MBCT,along with diet therapy,had been significantly more effective in weight loss,decrease in BMI,lower systolic blood pressure(SBP),and attentional bias towards food cues compared with the diet therapy alone(P≤0.01).MBCT had no significant impact on the decline in diastolic blood pressure(DBP)in participants in the follow-up phase.Conclusion:This study demonstrated that MBCT along with the conventional diet therapy was more effective in weight loss,decrease in BMI,hypertension control,as well as attentional bias towards food cues than the diet therapy alone.
文摘Over the past three decades, obsessive-compulsive disorder(OCD) has moved from an almost untreatable,life-long psychiatric disorder to a highly manageable one. This is a very welcome change to the 1%-3% of children and adults with this disorder as, thanks to advances in both pharmacological and psychological therapies, prognosis for those afflicted with OCD is quite good in the long term, even though most have comorbid disorders that are also problematic. We still have far to go, however, until OCD can be described as either easily treatable or the effective treatments are widely known about among clinicians. This review focuses on the current state of the art in treatment for OCD and where we still are coming up short in our work as a scientific community. For example, while the impact of medications is quite strong for adults in reducing OCD symptoms, current drugs are only somewhat effective for children. In addition, there are unacceptably high relapse rates across both populations when treated with pharmacological alone. Even in the cognitive-behavioral treatments, which show higher effect sizes and lower relapse rates than drug therapies, drop-out rates are at a quarter of those who begin treatment. This means a sizable portion of the OCD population who do obtain effective treatments(which appears to be only a portion of the overall population) are not effectively treated.Suggestions for future avenues of research are also presented. These are primarily focused on(1) increased dissemination of effective therapies;(2) augmentation of treatments for those with residual symptoms, both for psychotherapy and pharmacotherapy; and(3) the impact of comorbid disorders on treatment outcome.
文摘The Persian Gulf War of 1990 to 1991 involved the deployment of nearly 700,000 American troops to the Middle East.Deployment-related exposures to toxic substances such as pesticides,nerve agents,pyridostigmine bromide(PB),smoke from burning oil wells,and petrochemicals may have contributed to medical illness in as many as 250,000 of those American troops.The cluster of chronic symptoms,now referred to as Gulf War Illness(GWI),has been studied by many researchers over the past two decades.Although over$500 million has been spent on GWI research,to date,no cures or condition-specific treatments have been discovered,and the exact pathophysiology remains elusive.Using the 2007 National Institute of Health(NIH)Roadmap for Medical Research model as a reference framework,we reviewed studies of interventions involving GWI patients to assess the progress of treatment-related GWI research.All GWI clinical trial studies reviewed involved investigations of existing interventions that have shown efficacy in other diseases with analogous symptoms.After reviewing the published and ongoing registered clinical trials for cognitivebehavioral therapy,exercise therapy,acupuncture,coenzyme Q10(CoQ10),mifepristone,and carnosine in GWI patients,we identified only four treatments(cognitive-behavioral therapy,exercise therapy,CoQ10,and mifepristone)that have progressed beyond a phase II trial.We conclude that progress in the scientific study of therapies for GWI has not followed the NIH Roadmap for Medical Research model.Establishment of a standard case definition,prioritized GWI research funding for the characterization of the pathophysiology of the condition,and rapid replication and adaptation of early phase,single site clinical trials could substantially advance research progress and treatment discovery for this condition.
文摘Depression is a prevalent psychiatric disorder that often leads to poor quality of life and impaired functioning.Treatment during the acute phase of a major depressive episode aims to help the patient reach a remission state and eventually return to their baseline level of functioning.Pharmacotherapy,especially selective serotonin reuptake inhibitors antidepressants,remains the most frequent option for treating depression during the acute phase,while other promising pharmacological options are still competing for the attention of practitioners.Depressionfocused psychotherapy is the second most common option for helping patients overcome the acute phase,maintain remission,and prevent relapses.Electroconvulsive therapy is the most effective somatic therapy for depression in some specific situations;meanwhile,other methods have limits,and their specific indications are still being studied.Combining medications,psychotherapy,and somatic therapies remains the most effective way to manage resistant forms of depression.
文摘In the treatment of OCD, several therapeutic approaches have been developed, including individual, group and/or pharmacological therapeutic methods. However, group therapy on OCD has received little research attention in comparison with other therapeutic methods and some studies demonstrated that OCD can be treated in group settings. In the literature, mentioned group therapies to treat OCD involve behavioral therapy, cognitive therapy, ERP (exposure and response prevention), cognitive behavioral therapy, ACT (acceptance and commitment therapy), supportive groups and individual therapy with family member involvement. In relation to their effectiveness, research indicated inconsistent findings. Therefore, the aim of this study was to address and to review whether group treatments on OCD are efficacious. This review focused on cognitive-behavioral group therapy (CBGT), ERP, and ACT.
文摘AIM To provide an updated of recent findings about efficacy of cognitive-behavior therapy(CBT) in reduction of command hallucinations.METHODS Pub Med/MEDLINE,Cochrane Library,the Cumulative Index to Nursing and Allied Health Literature,PsycI NFO,Clinical Trial.gov searches were performed using the keywords "hallucinations","behavioural therapy" and " cognitive therapy" in order to identify relevant articles published during the years of 2011 to 2016.No language limits were used.Studies conducted within control group,reviews,editorials,were excluded.Data on efficacy,acceptability and tolerability were extracted by three authors independently.Disagreements were resolved in a consensus meeting or by another reviewer.RESULTS A total of eight articles were eligible for inclusion.Two are randomized clinical trials(RCTs) and six are observational studies.The two RCTs included showed a greater efficacy of CBT compared to standard care on auditory hallucinations(AHs).Nevertheless,they considered different CBT models,particularly Treatment of Resistant Command Hallucinations and Cognitive Therapy for Command Hallucinations.As regards non RCT-studies,all papers included showed reduction on frequency and severity of AHs and distress related to them.However,the lack of content details within non-RCTs studies decreased their comparability.In terms of predictive variables,our findings show that negative symptoms at baseline appeared to be the strongest predictor of the treatment efficacy.Indeed,negative symptoms showed a significant negative correlation on outcome.CONCLUSION Although more conclusive studies are still needed,we found some preliminary evidence for the efficacy of CBT in the treatment of command hallucinations.
文摘A significant association exists between lower urinary tract symptoms and anxiety. Despite the efficacy of cognitive behavior therapies in treating a variety of phobic disorders, there are few published reports about the use of such treatments for urinary problems. We report a case of the phobia of urinary incontinence treated with cognitive behavioral techniques, which involved cognitive restructuring, distraction, relaxation training, and exposure to feared situations.
文摘本研究拟在传统社交焦虑障碍团体认知行为疗法的基础上构建新治疗模式——"团体实证认知行为疗法(Empirical Group Cognitive-Behavioral Therapy,EGCBT)",模式鼓励来访者以科学研究的方式深入调研治疗关系以外"第三方"他人对社交焦虑相关问题的观念,进行认知取证,同时强调来访者对自我"正面和负面评价恐惧"内容进行实证检验。"团体实证认知行为疗法"注重利用"第三方"视角的真实信息为社交焦虑个体认知合理化提供更客观的依据,在传统认知行为治疗的基础上丰富实证模块及增强治疗模块间的递进关系。
