Efficacy of Computerized Cognitive Behavioral Therapy in Individuals with Non-Cardiac Chest Discomfort : Review and Suggestions for a New Protocol

Since non-cardiac chest discomfort (NCCD) can result in substantial healthcare burden and lower quality of life, interventions such as cognitive behavioral therapy (CBT) have been investigated for the relief of NCCD. In this review, we aimed to summarize the evidence on the efficacy of the CBT for the treatment of NCCD while introducing a newly-developed computerized CBT program for NCCD. Studies applying CBT to individuals with NCCD were searched for from both English and Korean electronic databases. Among 37 studies, 11 randomized controlled trials, 4 case-control studies, 1 case series, and 2 review articles were eligible for this review. Efficacy of conventional CBT for NCCD was shown in a series of studies as most of them reported improved symptom severity of NCCD or NCCD-related anxiety. However, a substantial variability existed among these studies in participants, treatment procedures and durations. High attrition rates were also reported in these studies on conventional CBT. Computerized CBT could be an alternative to the conventional CBT as it can be standardized and more easily accessible, but it was only reported in one previous study. In addition to the literature review, we presented a newly-developed computerized CBT program for NCCD which may overcome some of the limitations of conventional CBT. A computerized CBT could be an alternative treatment of NCCD, however, need further studies on its usefulness.

Adolescents' Attitudes and Intentions toward Help-Seeking and Computer-Based Treatment for Depression

OBJECTIVE: Many depressed adolescents do not seek professional help despite there being evidence-based treatments for depression, such as cognitive behavioral therapy or computer-based therapy. To increase professional help-seeking behavior in depressed adolescents, it is necessary to positively change help-seeking attitudes. This study aimed to explore the effect of sub-groups of help-seeking attitudes, gender, and depression level on adolescents' help-seeking intentions and their perceptions of computer-based psychotherapy. METHODS: Participants were 246 adolescents aged 13–18 years recruited from six middle and high schools in South Korea. Measures were self-administered questionnaires, and included the Patient Health Questionnaire-9, the Attitudes Toward Seeking Professional Psychological Help Scale, the Intention to Seek Counseling Inventory, Preferences for Depression Treatment, and the Perceptions of Computerized Therapy Questionnaire. RESULTS: Help-seeking intentions were positively related with female gender and the recognition of the need for help. A higher level of confidence in therapists was related to high preference for computer-based therapy and face-to-face therapy. Adolescents with more severe depression were more likely to prefer pharmacotherapy. The perceptions of computer-based therapy were more positive in male adolescents, and in adolescents with a higher level of confidence in therapists yet a lower level of interpersonal openness. CONCLUSION: To promote adolescents' help-seeking behavior, improvement of the recognition of the need for help is required, especially among male adolescents. Computer-based therapy provides an alternative for male adolescents with high confidence in therapists yet low interpersonal openness. Consideration of the help-seeking attitudes and gender is needed when providing therapeutic intervention to depressed adolescents.

Computer-assisted cognition training for schizophrenic patients / 中华物理医学与康复杂志

Objective To investigate the effect of computer-assisted cognition training on the cognitive functioning of schizophrenic patients.Methods One hundred and four persons with schizophrenia were randomly divided into a research group of 51 cases and a control group of 53.The former were given computerized cognition training covering attention,memory and executive functions.The training lasted 2 months.The controls received regular occupational and recreational therapy.Before and after the treatment the 2 groups were evaluated using the Positive and Negative Syndrome scale (PANSS),the Trail Making tests A and B (TMTs),Wechsler's memory scale (WMS) and the Wisconsin card sorting test (WCST).Results The average total PANSS score of the research group declined significantly from (70.23 ±7.62) before treatment to (59.82 ± 8.41) after treatment;so did that of the control group from (68.32 ± 10.14) to (59.45 ± 9.05).The average negative symptoms scale score of the treatment group and the control group also decreased significantly for (21.46 ± 3.26) before treatment to (16.67 ±3.20),and from (20.82 ±4.21) to (17.08 ±3.23) respectively,but there was no significant difference between the groups in the magnitude.The research group's average TMT A and TMT B scores also decreased from(51.76±21.18) and (114.31 ±35.76) to (44.14 ±17.51) and (96.47 ±34.43),while no significant difference was observed before and after the treatment in the control group.The WMS recognition and regeneration scores of the research group improved significantly from (5.83 ± 3.12) and (8.63 ± 3.45) to (8.21 ± 3.96) and (10.24 ±3.52) after intervention,while no improvement was found in the control group.The same trend was observed in the total test number,the continuous error numbers,the correct numbers and the classification number scores in the WCST.Conclusion Computerized cognition training can improve the cognition of persons with schizophrenia to some extent.