Smartphone-assisted online brief cognitive behavioral therapy to treat maternal depression: findings of a randomized controlled trial

Objective: To test the efficacy of smartphone-assisted online brief cognitive behavioral therapy (b-CBT) to treat maternal depression compared to online brief CBT plus an active control app. Methods: A randomized controlled trial was conducted. Assessments were performed at baseline (T0), midpoint (T1, week 4-5), post-treatment (T2, week 8), and follow-up (T3, 2-month postnatal follow-up) by blinded interviewers. The primary outcome was depression measured by the Edinburgh Postnatal Depression Scale (EPDS) at T2. We also assessed anxiety, stress, sleep quality, well-being, physical activity, treatment response, and offspring child behavior problems. Results: Eighty-one participants were randomized to the intervention (n=37) or active control (n=44) groups. Seventy-one participants completed the post-treatment assessment or reported primary outcome data. No differences were found between the intervention and active control groups regarding maternal depression or other mental health outcomes. Overall, we found large within-group effect sizes, with 80% of the total sample responding to treatment. Conclusions: Our data showed no difference between the groups, suggesting that adding apps to psychotherapy treatment may not enhance treatment effects on prenatal depression. A within-groups analysis showed that most participants with depression responded to treatment; however, future studies are needed to confirm whether this effect is related to factors other than the intervention.

Effect of cognitive behavioral therapy for insomnia on sleep quality and cognitive function in patients with chronic insomnia disorder / 四川精神卫生

BackgroundInsomnia disorder has become a common disease in the current society. Cognitive Behavior Therapy for Insomnia （CBTI） is one of the non-drug treatment methods for insomnia disorder， but relevant studies of its effect on sleep quality and cognitive function of patients with insomnia disorder are limited. ObjectiveTo explore the effects of CBTI on sleep quality and cognitive function in patients with insomnia disorder， so as to provide references for non-drug treatment of insomnia disorder. MethodsA total of 47 patients with insomnia disorder were recruited as the study subjects. They all met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and have visited Sichuan Mental Health Center from January 2021 to October 2022. The patients underwent CBTI for 6 weeks. Before the treatment， depression and anxiety symptoms were assessed using Hamilton Depression Scale-24 item （HAMD-24） and Hamilton Anxiety Scale （HAMA）. Sleep status and cognitive function were assessed using Pittsburgh Sleep Quality Index （PSQI） and Montreal Cognitive Assessment （MoCA） before and 6 weeks after the treatment. Spearman correlation analysis was used to examine the correlation between the reduction of PSQI score and the increase of MoCA score after treatment. ResultsAfter the 6-week treatment， the factor scores and total score of PSQI across 6 subscales （the sleep quality， sleep onset time， sleep time， sleep efficiency， sleep disorder and daytime dysfunction） were lower than those before the treatment， and the score differences were of statistical significance （t=5.569~15.290， P<0.01）. Both factor and total scores of MoCA across 6 items （visuospatial and executive， naming， attention， language， abstraction and memory） were significantly higher than those before the treatment with score differences reaching statistical significance （t=-11.273~-4.277， P<0.01）. Spearman correlation analysis demonstrated that there was a positive correlation between the decrease in PSQI total score and the increase in MoCA total score after the 6-week CBTI treatment （r=0.323， P=0.027）. ConclusionCBTI may help improve sleep quality and cognitive function in patients with insomnia disorders. The improvement of sleep quality after CBTI intervention may be related to the improvement of cognitive function. ［Funded by Scientific Research Project of Sichuan Provincial Health Commission （number， 19PJ216）］

Implicações neurológicas da meditação do tipo terapia cognitiva baseada em mindfulness em pacientes com transtorno de ansiedade ou transtorno depressivo: uma revisão integrativa / Neurological implications of mindfulness-based cognitive therapy in patients with anxiety or depressive disorders: an integrative review / Implicaciones neurológicas de la meditación de la terapia cognitiva basada en mindfulness en pacientes con trastorno de ansiedad o trastorno depresivo: una revisión integradora

A Terapia Cognitiva Baseada em Mindfulness (MBCT, do inglês Mindfulness-Based Cognitive Therapy) é uma técnica baseada na combinação da Terapia Cognitiva-Comportamental e da meditação mindfulness, na busca pela melhoria de sintomas psiquiátricos. O presente trabalho tem como objetivo a busca por publicações que discutam as implicações neurológicas de pacientes diagnosticados com transtorno depressivo e transtorno de ansiedade e que buscaram nessa técnica a melhoria de sua condição clínica ou qualidade de vida. Nossos resultados preliminares mostraram que os benefícios dessa prática foram colhidos na totalidade dos estudos encontrados, elucidando as áreas cerebrais modificadas e o motivo pelo qual elas foram ativadas. Procuramos abordar ainda a diferença entre essa técnica e o uso de medicamentos e tratamento usual. PALAVRAS-CHAVE: Terapia Cognitiva-Comportamental; Cérebro; Transtornos Psiquiátricos; Antidepressivos.

Mindfulness-Based Cognitive Therapy (MBCT) is a technique based on the combination of Cognitive-Behavioral Therapy and mindfulness meditation, in the search of improving psychiatric symptoms. This present work aims to search for studies and articles that discuss the neurological implications of patients diagnosed with anxiety and major depressive disorders who sought improvement in their clinical condition or life quality through this technique. The preliminary results showed that the benefits of this practice were observed in all of the studies found, elucidating the modified brain areas and the reason why they were activated. The differences between this technique and the use of medication and treatment-as-usual was also addressed.

La Terapia Cognitiva Basada en Mindfulness (MBCT) es una técnica basada en la combinación de la Terapia Cognitivo-Conductual y la meditación mindfulness, en la búsqueda de la mejora de los síntomas psiquiátricos. El presente trabajo tiene como objetivo buscar publicaciones que discutan las implicaciones neurológicas de pacientes diagnosticados con trastorno depresivo y trastorno de ansiedad y que busquen en esta técnica mejorar su condición clínica o calidad de vida. Nuestros resultados preliminares mostraron que los beneficios de esta práctica se cosecharon en todos los estudios encontrados, dilucidando las áreas cerebrales modificadas y la razón por la cual se activaron. También tratamos de abordar la diferencia entre esta técnica y el uso de medicación y tratamiento habitual.

Application of cognitive behavior therapy for insomnia in treating psychiatric disorders / 中华行为医学与脑科学杂志

Insomnia symptom is one of the most common types of sleep disturbances.Apart from being a risk factor for psychiatric disorders, insomnia symptom has been found to affect the course of psychiatric disorders and increase the relapse rate of psychiatric disorders.Therefore, insomnia treatment is beneficial to mitigate the psychiatric symptoms among chronic insomnia patients, which may help prevent mental health disorders.On the other hand, insomnia treatment for psychiatric patients is conductive to reduce the harm consequence in social function, which can help improving the prognosis of psychiatric disorders.Cognitive behavior therapy for insomnia (CBT-I) is a first-line treatment for chronic insomnia.This paper reviews the research progress on the efficiency of CBT-I on the psychiatric symptoms of chronic insomnia patients, as well as its application in comorbid psychiatric conditions.Findings from previous research suggested that CBT-I is effective to improve the psychiatric symptoms of insomnia patients through insomnia improvement, and it can also promote the remission of depression and anxiety symptoms, reduce the risk of substance disorder and suicide behaviors, and reduce the impairment of life quality and costs of treatment through insomnia improvement among psychiatric patients comorbid with insomnia, which indicated that CBT-I is a safe and effective treatment for insomnia symptoms in psychiatric patients.Moreover, this paper listed the contraindications and the decision-to-treat algorithm of CBT-I among psychiatric patients, as well as the CBT-I availability and adherence that limited the clinical application.More understanding of CBT-I is beneficial to provide support for a broad clinical application in mental health services.

Current situation and enlightenment of researches on culturally adapted cognitive behavior therapy / 中华行为医学与脑科学杂志

Cognitive behavior therapy(CBT) is one of the most widely used psychotherapy methods in the world.However, its origin in Western culture makes many researchers doubt whether it can be effectively applied to other cultural groups.The discussion on this issue is conducive to further adjusting CBT from an international perspective to better serve different cultural groups.This review focuses on the research progress of acculturation in CBT at home and abroad.Firstly, it discusses the necessity of acculturation and introduces the relevant major researchers in this field abroad, so as to explain how to carry out the work of acculturation.Then the effectiveness of current acculturation work is demonstrated, and the research progress of acculturation related to Chinese culture is introduced emphatically.In previous studies, most scholars supported the development of acculturation, and preliminary evidence has shown that CBT after acculturation has equal or even better effectiveness.Based on this, different researchers have put forward their own acculturation framework or adaptation suggestions.However, there are still many shortcomings in current research, which are mainly reflected in six aspects: few comparative studies, lack of unified framework, blank fields in some areas, shallow level of acculturation, unknown mechanism and lack of bottom-up research.Thus, this review is aimed to point out the urgency and necessity of CBT cultural adaptation in China, and put forward some suggestions and preliminary ideas for the further development of more culturally adaptable CBT in China, in order to better promote the application of CBT in China.

Efectividad de la terapia cognitivo conductual para trastorno obsesivo compulsivo en pacientes con trastorno del espectro autista: Artículo de revisión / Effectiveness of cognitive behavioral therapy for obsessive compulsive disorder in patients with autism spectrum disorde: Review article

La terapia cognitivo conductual (TCC), es el tratamiento de elección para el trastorno obsesivo compulsivo (TOC), principalmente la exposición con prevención de respuesta (EPR). En pacientes que presentan TOC co-ocurrente con trastorno del espectro autista (TEA) se cree que la TCC tendría un menor efecto debido al empobrecimiento de la comprensión de las propias emociones y de la rigidez cognitiva de estos pacientes. A través de la siguiente revisión se busca evaluar la efectividad de la TCC en pacientes que tengan TOC en asociación a TEA en niños, adolescentes y adultos. Métodos: Se realizó una búsqueda de artículos, de los últimos 10 años, que abordasen la efectividad de la TCC en niños, adolescentes o adultos con TOC y TEA en conjunto. Resultados: A pesar de que no todos los estudios concuerdan en sus resultados, la mayoría de éstos, indican que hay efectividad en la TCC en disminuir la sintomatología del TOC en pacientes con TEA co-ocurrente tanto en niños como en adolescentes y adultos. Existen terapias de TCC con ciertas adaptaciones que mejorarían los resultados de estos pacientes al personalizar su tratamiento, por lo que se incentiva al mayor desarrollo de este tipo de terapias. Conclusión: Los estudios revisados respaldan que a pesar de la rigidez que presentan los pacientes con TEA co-ocurrente, la TCC es efectiva para tratar TOC en niños, adolescentes y adultos, especialmente al realizar adaptaciones de esta.

The treatment of choice for obsessive compulsive disorder (OCD) is cognitive behavioral therapy (CBT), mainly exposure with response prevention (ERP). In patients with OCD co-occurring with autism spectrum disorder (ASD), it is believed that CBT should have a lesser effect due to the impoverishment of the understanding of their own emotions and the cognitive rigidity of these patients. The following review seeks to evaluate the effectiveness of CBT in patients who have OCD in association with ASD in children, adolescents and adults. Methods: A search was carried out for articles, from the last 10 years, that addressed the effectiveness of CBT in children, adolescents or adults with OCD and ASD together. Results: Although not all studies agree on their results, most of these indicate that CBT is effective in reducing OCD symptoms in patients with co-occurring ASD in children, adolescents and adults. There are CBT therapies with certain adaptations that would improve the results of these patients by personalizing their treatment, which is why the further development of this type of therapy is encouraged. Conclusion: The reviewed studies support that despite the rigidity that patients with co-occurring ASD present, CBT is effective to treat OCD in children, adolescents and adults, especially when making adaptations to it.

Parent-led, stepped-care cognitive-behavioral therapy for youth with autism and co-occurring anxiety: study rationale and method

Anxiety disorders affect up to 50% of individuals with autism spectrum disorder (ASD) and are significantly impairing to the person affected, as well as to their loved ones. Cognitive-behavioral therapy (CBT) has been established as the gold-standard treatment for anxiety disorders among typically developing youth and adults, and demonstrates similar efficacy among youth with high-functioning autism (HFA). Many CBT interventions utilize a "full-package" treatment approach to treat co-occurring anxiety in youth with ASD. However, these service delivery systems are often therapist-intensive, costly, and impractical, thereby compromising full engagement and treatment adherence. This paper describes the design, rationale, and methodology of a study examining stepped-care CBT for youth with HFA and co-occurring anxiety - a clinical trial examining the efficacy of low-intensity, parent-led CBT as the first line of treatment and utilizing a more intensive, therapist-led intervention for nonresponders. The study will evaluate the potential benefits of stepped-care and parent-led therapist-assisted interventions, predictors of treatment response, and the economic value of using a stepped-care model. Implications for practice will be discussed.

Effect of cognitive-behavioral therapy after treatment for adults with major depression / Efeito da terapia cognitivo-comportamental um ano após tratamento para adultos com transtorno depressivo maior / Efecto de la terapia cognitiva comportamental un año después tratamiento para transtorno depresivo mayor

In Brazil, little is known about the maintenance of results after treatment of cognitive-behavioral therapy (CBT) for major depressive disorder (MDD). The objective of this study was to verify the effectiveness of individual psychotherapeutic treatment from CBT for depressive symptoms within 6 and 12 months after the intervention. We evaluated 94 participants with MDD from the Beck Depression Inventory (BDI-II). There was significant posttreatment response (p < 0.001), with no difference between the end of the treatment and the symptom assessment at 6 (p = 0.486) and 12 months (p = 0.098). A significant positive correlation was observed between the intensity of depressive symptoms at the baseline and the reduction of initial symptoms for 12-month follow-up (r = 0.49; p < 0.001). CBT significantly reduces depressive symptoms by maintaining this condition up to 12 months post-intervention without significant influence of other characteristics beyond the intensity of depressive symptoms at the beginning of the therapeutic process.

No Brasil, pouco se sabe sobre a manutenção dos resultados pós-tratamento da terapia cognitivo-comportamental (TCC) para o transtorno depressivo maior (TDM). Objetivou-se verificar a efetividade do tratamento psicoterápico individual a partir da TCC para os sintomas depressivos em um período de 6 e 12 meses pós-intervenção. Avaliaram-se 94 participantes com TDM a partir do Inventário Beck de Depressão (BDI-II). Houve resposta significativa pós-tratamento (p < 0,001), não ocorrendo diferenças entre o final do tratamento e a avaliação dos sintomas aos 6 (p = 0,486) e 12 meses (p = 0,098). Uma correlação positiva significativa foi observada entre a intensidade dos sintomas depressivos no baseline e a redução de sintomas iniciais para o acompanhamento de 12 meses (r = 0,49; p < 0,001). A TCC reduz significativamente os sintomas depressivos mantendo essa condição até 12 meses pós-intervenção sem influência significativa de outras características além da intensidade dos sintomas depressivos no início do processo terapêutico.

Este estudio verificó la efectividad del tratamiento psicoterápico individual a partir de la terapia cognitiva conductual (TCC) para los síntomas depresivos dentro de los 6 y 12 meses post-intervención. Se evaluaron 94 participantes con TDM a partir del Inventario Beck de depresión (BDI-II). Se observó una respuesta significativa post-tratamiento (p < 0,001), no ocurrieron diferencias entre el final del tratamiento y la evaluación de los síntomas a los 6 (p = 0,486) y 12 meses (p = 0,098). Había una correlación positiva significativa entre la intensidad de los síntomas depresivos en el baseline y la reducción de los síntomas iniciales para el seguimiento de 12 meses (r = 0,49; p < 0,001). La TCC reduce significativamente los síntomas depresivos manteniendo esa condición hasta 12 meses después de la intervención sin influencia significativa de otras características además de la intensidad de los síntomas depresivos al inicio del proceso terapéutico.

Internet-Delivered Psychological Treatment Options for Panic Disorder: A Review on Their Efficacy and Acceptability

BACKGROUND: Internet-delivered psychological treatments have been suggested as a chance to expand the access to professional help. However, little is known about the usefulness of different support formats and approaches of digital treatments for panic disorder among clinicians. OBJECTIVE: This narrative review aimed to explore the recent evidence base on the efficacy and acceptability of different internet-delivered treatments for adults with panic disorder. METHODS: A systematic search in electronic databases (Pubmed/Medline, PSYNDEX) and a hand search were performed to identify articles on randomized controlled trials published within the past five years (2012/12/10–2017/12/12) in English peer-reviewed journals. RESULTS: Eight studies (1,013 participants) involving 10 interventions met the inclusion criteria. Nine interventions were primarly based on Cognitive Behavioral Therapy principles. Most interventions were effective, when compared to a control condition (6 of 8 comparisons). Minimal guidance was associated with improved outcomes in one study and adherence in two studies (3 comparisons). Furthermore, no differences were found based on treatment approach (2 comparisons). Regarding acceptability, the attrition rates were moderate to high, ranging from 9.8% to 42.1% of randomized participants. Adherence rates also varied largely (7.8–75%), whereas participant satisfaction of program completers was assessed overall high (5 studies). CONCLUSION: Diverse effective internet-delivered treatments are available for the self-management of panic symptoms. Especially selfguided and transdiagnostic Cognitive Behavioral Therapy approaches appear being efficient options for the dissemination in routine care. However, due to the limited evidence base, further efforts are required to improve the actual uptake of internet-delivered treatments and identify moderators of outcomes.

Effect of Group Occupational Training Based on Cognitive Behavioral Therapy on Post-stroke Cognitive Impairment / 中国康复理论与实践

Objective:To explore the clinical effect of group occupational training based on cognitive behavior on patients with post-stroke cognitive impairment. Methods:From May, 2018 to March, 2019, 56 patients with post-stroke cognitive impairment were randomly divided into control group (n = 29) and experimental group (n = 27). Both groups received routine rehabilitation, and the experimental group received group occupational therapy, three times a week, for twelve times. They were assessed with Montreal Cognition Assessment (MoCA), modified Barthel Index (MBI) and the Short Form of Health Survey (SF-36) before and after intervention. Results:The scores of MoCA, MBI and SF-36 increased in both groups after intervention (t > 2.275, P < 0.05), and their difference before and after intervention was more in the experimental group than in the control group (t > 2.835, P < 0.01). Conclusion:Group occupational training can improve the cognitive function of patients with post-stroke cognitive impairment and improve their activities of daily living and quality of life.

Effect of cognitive-behavior therapy combined with mirtazapine on clinical efficacy in patients with functional dyspepsia / 中华行为医学与脑科学杂志

Objective@#To evaluate the efficacy of cognitive-behavioral therapy (CBT) combined with mirtazapine for patients with functional dyspepsia (FD).@*Methods@#Totally 121 patients with FD who met Rome Ⅳ diagnostic criteria in clinic of clinical psychiatry of a general hospital were collected.They were randomly divided into combined treatment group(n=61) and single drug group(n=60). The treatment period was 8 weeks.All patients with FD were given mirtazapine.The combined treatment group received 8 times systemic CBT treatments at the same time.Symptom checklist-90 (SCL-90) and gastrointestinal integral scale (GIS) were evaluated in all patients before and after 8-week intervention.@*Results@#After 8 weeks of intervention, the total score of SCL-90 scale, somatization, compulsion, depression, paranoia and other factors in the combined treatment group were lower than those in the single group(130.26±36.18 vs 147.95±45.55, 1.34±0.44 vs 1.51±0.5, 1.66±0.50 vs 1.90±0.66, 1.47±0.52 vs 1.69±0.63, 1.48±0.49 vs 1.70±0.61, 1.47±0.50 vs 1.73±0.68, respectively)(all P<0.05). After 8 weeks of intervention, the total score of the GIS scale in the combined treatment group (6.77±5.05 vs 9.49±5.24), vomiting (0.57±0.77 vs 0.88±0.91), spastic upper abdominal pain (0.43±0.74 vs 0.90±1.08) and post-sternal discomfort (0.57±0.89 vs 1.05±1.19) were significantly lower than that of the simple drug group after intervention(6.77±5.05 vs 9.49±5.24, 0.57±0.77 vs 0.88 ±0.91, 0.43±0.74 vs 0.90±1.08 and 0.57±0.89 vs 1.05±1.19, respectively), and the differences were statistically significant (all P<0.05).@*Conclusion@#CBT combined with mirtazapine in the treatment of FD is superior to drug therapy alone.CBT combined with mirtazapine can improve the emotional problems in the treatment of FD and further improving the digestive function.

Programa de Orientação de Pais em Grupo: Um estudo exploratório na abordagem Cognitivo-Comportamental / Group Parent Orientation Program: An Exploratory Study on the Cognitive-Behavioral Approach

As atuais dificuldades enfrentadas pelos pais na educação dos filhos os levam cada vez mais a buscar ajuda especializada. O Programa de Orientação de Pais da USP-RP (PROPAIS), fundamentado na Terapia Cognitivo Comportamental, objetiva promover a melhoria no convívio familiar. Os pais participantes do programa têm seus filhos atendidos por estagiários da Terapia Cognitivo Comportamental, e a orientação de pais é complementar ao tratamento da criança. O objetivo do estudo é avaliar de forma preliminar os efeitos destas intervenções, com um delineamento quantitativo de pré e pós-teste, baseando-se nos escores do Inventário de Estilos Parentais (IEP) de uma amostra de 17 pais, identificando se houve diferenças entre pré e pós-teste no que tange ao estilo parental. As análises indicaram diferença significativa entre os testes, sendo que os pais, no geral, conseguiram melhorar seu estilo parental e apresentar diminuição nas práticas parentais negativas e, embora sejam necessários estudos com amostras ampliadas, os resultados sugerem que o programa tem atingido o seu propósito.

The current difficulties faced by parents in raising their children lead them to seek more specialized help. The USP-RP Parent Guidance Program (PROPAIS), based on Cognitive-Behavioral Therapy, aims to promote the improvement of family life. Parents participating in the program have their children attended by trainees of Behavioral Cognitive Therapy I, and parental guidance is complementary to the child’s treatment. The objective of the study is to preliminarily evaluate the effects of these interventions, with a quantitative pre and post test design, based on the scores of the Parenting Styles Inventory (IEP) of 17 participants, identifying if there were differences between pre and post test regarding parental style. The analyzes indicated a significant difference between the tests, being that parents, in general, were able to improve their parental style and present a decrease in negative parental practices and, although studies with enlarged samples are required, the results suggest that the program has achieved its purpose.

Cognitive Behavior Therapy for Psychogenic Cough in Children : a case series

Introduction: Cough is the most common presenting symptom in pediatric primary care settings. Coughcan impact a child's activity level and ability to sleep, play or attend school and is often a source ofparental anxiety. However, an etiology of cough is not always easily identified even after a thoroughsystematic investigation and psychological and neurological conditions are in the differential diagnosis.Psychogenic cough is diagnosed in cases without a clear pulmonary or extrapulmonary etiology in thepresence of some suggestive clinical characteristics and/or an association with psychological issue.Psychogenic cough has been reported to be the second most common cause of chronic cough in children ofage 6-16 years.Methodology: The present paper highlights four case reports of children who presented with symptoms ofpsychogenic cough in the OPD of CNBC hospital, Delhi.The presenting nature of the symptoms alongwith the underlying psychological factors have been discussed. Cognitive Behavioural techniques likedistraction and cognitive restructuring interventions with the children along with family interventions wereused.Conclusions: All the children showed significant improvement at the end of therapy. Three month followup showed that the results were maintained. Cognitive Behavioural approaches are found to be effective inmanaging psychogenic cough and the present paper highlights the process of cognitive behaviouralmanagement of psychogenic cough in children.Key words: cognitive behavior therapy, cough,

Study on Cognitive-Behavior Therapy for Improving the Mental Status among Family Members of Terminal Tumor Patients / 中国医学伦理学

Objective:To investigate the influence of cognitive-behavior therapy on the psychological status of family members of terminal cancer patients. Method:A total of 60 families of terminal cancer patients were selected and randomly divided into observation group (30 cases) and control group (30 cases). The observation group was treated with cognitive-behavior therapy, while the control group was given general supportive psychological care. The Hamilton Depression Scale ( HAMD) , Hamilton Anxiety Scale ( HAMA) and Pittsburgh Sleep Quality Index ( PSQL) were used to evaluate the family members of the two groups of patients before and after the intervention. Results: Before the intervention, there was no statistical significance difference in the scores of HAMA, HAMD and PSQI between the two groups (P>0. 05). After the intervention, the scores of HAMA, HAMD and PSQI in the observation group were significantly lower than those before the intervention ( P <0 . 05 ); and the scores of HAMA, HAMD and PSQI in the observation group were significantly lower than those in the control group ( P<0 . 05 ) . Conclusion:Cognitive-behavior therapy can significantly improve the negative emotions of depression, anxiety and sleep disorder among family members of terminal tumor patients.

Effect of group cognitive-behavior therapy intervention on dysthymic disorders in children and adolescents / 中华行为医学与脑科学杂志

Objective To explore the effect of group cognitive-behavior therapy intervention on dys-thymic disorders in children and adolescents.Methods From July 2015 to December 2017,68 cases of chil-dren and adolescents treated in Lishui Second People's Hospital were divided into two groups randomly. The study group ( 34 cases) were treated with group cognitive-behavior therapy,and the control group ( 34 cases) were treated with selective 5-hydroxytryptamine reuptake blocker ( SSRI ) . The achenbach child behavior check list(CBCL),self-rating depression scale(SDS) and self-rating anxiety scale(SAS) scores of the two groups before and after the intervention were compared.Results Before the intervention,there was no differ-ence in the score of CBCL,SDS and SAS between the study group and the control group (P>0.05). After drug treatment or cognitive-behavior therapy, the social, activity, thinking and aggressive behavior of both groups were obviously improved. The SDS and SAS scores were 43.64±4.86 and 42.27±3.74 in cognitive-be-havior therapy group,which had significant difference (P<0.05) compared with pre-intervention score of SDS (82.91±3.95) and SAS (78.61±6.28). The scores of SDS (45.61±8.03) and SAS (44.09±7.04) in treat-ment group were significantly (P<0.05) decreased compared with those before treatment (84.03±5.11 and 77.30±9.55,respectively). The satisfaction of the study group and control group was 94.1％ and 67.6％,re-spectively,and the difference was significant between the two groups(P<0.05).Conclusion The effect of cognitive-behavior therapy in children and adolescents on reducing the negative emotion is remarkable,which is equivalent to the drug treatment.The cognitive-behavior therapy in children and adolescents can be used as a auxiliary means to treat children's dysthymic disorders in clinical practice.

Effect of cognitive behavior therapy and acceptance commitment therapy on anxiety and depression in the elderly / 中华行为医学与脑科学杂志

Objective To compare the effects of Acceptance Commitment Therapy(ACT) and Cognitive Behavior Therapy(CBT) on anxiety and depression in the elderly,and to explore the psychological mechanism of ACT to improve anxiety and depression.Methods A total of 25 elderly people were screened from four communities in Beijing.According to the place of residence,12 persons were enrolled in the ACT group and 13 persons were enrolled in the CBT group.The mindful attention awareness scale,geriatric anxiety inventory,geriatric depression scale,the acceptance and action questionnaire-Ⅱ and cognitive fusion questionnaire were evaluated before regrouping (T1),after six regiments (T2) and 5 weeks after the end of the intervention (T3).Results (1) On the level of mindfulness,the score of ACT group was higher than that in CBT group at T2(ACT:80.31 ±6.18,CBT:74.20±4.48,t=2.52,P＜0.05) and T3 (ACT:82.20±4.48,CBT:70.00± 12.23,t=4.56,P＜0.01).(2) On the level of anxiety there was significant difference between the two groups at T2(ACT:2.88±1.86,CBT:8.87±2.80,t=-8.15,P＜0.01) and T3(ACT:5.38±2.02,CBT:10.50±2.66,t=-6.93,P＜0.01),and ACT group was higher than the CBT group.(3)On the levels of depression there was significant difference between the two groups at T 1 (ACT:4.59 ± 3.97,CBT:7.89± 6.39,t =-2.25,P＜0.05),the ACT group was lower than the CBT group.The CBT group on the levels of depression there was a significant difference T1 and T2 (t=2.92,P＜0.05).(4) On the level of psychological flexibility,there was a significant difference between the two groups at T2 (ACT:41.38 ± 8.28,CBT:49.60± 3.52,t =-3.64,P＜0.01)and T3(ACT:40.80±7.66,CBT:52.47±6.23,t=-4.98,P＜0.01),and ACT group was lower than the CBT group.(5) Empirical avoidance only achieved a significant level of intermediate effects between ACT therapy and anxiety.In the ACT group,the median effect of empirical avoidance on anxiety was 11.40％.Conclusion The effect of CBT on depression is better than that of ACT,while the effect of ACT on the level of mindfulness,anxiety and mental flexibility is better than that of CBT.ACT with psychological flexibility as a psychological mechanism can improve the mental flexibility of the individual more than the CBT.

The effectiveness of cognitive behavioral therapy for mental disorder / 中华行为医学与脑科学杂志

Large numbers of studies have proved that cognitive behavior therapy (CBT) made great effects on the treatment of psychiatic disorders.Based on evidence of effects on various psychiatry disorders,especially on major depressive disorder,anxiety disorder,obsessive-compulsive disorder,post-traumatic stress disorder,bipolar disorder,schizophrenia,somatoform disorder,substance abuse,eating disorders and personality disorders treated by CBT,this article aims to provide a new perspective of future research.

Virtual reality-based exposure therapy for anxiety disorders: A meta-analysis for randomized controlled trials / 中国心理卫生杂志

Objective:To review the efficacy of virtual reality-based exposure therapy (VRET) for anxiety disorders. Methods: Through literature search, 31 studies that used randomized controlled trial design to examine the efficacy of VRET for anxiety disorders between 1995 and 2017 were recruited. The sample size was 1231. The data of these studies were converted to effect sizes in order to conduct the meta-analysis. Results: Comparing to the waiting list, VRET group showed lower level of anxiety (Hedge's g = 1.027, 95％ CI:0.75 - 1.30) and subjective distress (Hedge's g = 1.018, 95％ CI:0.18 -1.84). VRET group gained more improvements in cognition (Hedge's g=1.092, 95％ CI:0.34 -1.84), behavior (Hedge's g =0.550, 95％ CI: 0.19 -0.91) and psychophysiological index (Hedge's g =0.652, 95％ CI:0.11 -1.42). The effects of VRET remained 6 months or 1 year after the treatment. The random effects analysis showed that traditional treatment was not significantly more effective than VRET(Hedge's g= -0.028, 95％ CI: -0.21 -0.15). Conclusion:It suggests that virtual reality-based exposure therapy tends to be a viable treatment option for anxiety disorders.

The efficacy of cognitive behavioral therapy in insomnic patients with or without comorbidities:a pilot study / 中华内科杂志

Objectives To evaluate the effectiveness of cognitive behavior therapy for insomnia (CBT-i) in chronic insomnia patients in terms of the improvements of psychological and sleep diary parameters. Methods Patients who met the diagnostic criteria of chronic insomnia, were divided into primary group or comorbid group. Both groups received standard CBT-i interventions. Psychological scales and sleep diaries were used to evaluate participants' severity of insomnia and psychological conditions related to insomnia at four time points:before intervention (baseline), immediate after intervention, 4 weeks and 16 weeks after intervention. Results Both groups achieved significant improvements after intervention on psychological measurements and sleep diary parameters. Such improvements were maintained at 4-week and 16-week follow-ups. The sleep diary data indicated that by the end of the intervention, there were significant differences on sleep onset latency(51.72 min to 10.53 min in primary group, P<0.01;59.26 min to 15.67min in comorbid group, P<0.01)and sleep efficiency (71％to 95％in primary group, P<0.01;68％to 90％in comorbid group, P<0.01). There were differences on sleep onset latency (10.00 min vs. 13.93 min,P<0.05), total sleep time (355.71 min vs. 327.85 min, P<0.05) and sleep efficiency (95％vs. 91％, P<0.01) in primary group and comorbid group respectively. No differences were found on wake after sleep onset in the two groups. Conclusions Chronic insomnia patients with or without comorbidities both have improvements after CBT-i. Sleep diary parameters rather than psychological measurements are different in two groups. Thus, CBT-i is an effective non-pharmaceutical therapy inpatients with chronic insomnia.

The utilization pattern of Cognitive Behavior Therapy for anxiety disorders in adults: A naturalistic study from a Medical College Hospital

Background: Cognitive Behavior Therapy (CBT) for anxiety disorders is proved to be equally efficacious to medications in research settings. Is CBT effective in naturalistic settings? Studies in naturalistic setting are recently surfacing world over. Indian studies in this area are almost nonexistent. Material and methods: Eighty adult patients satisfying criteria for an anxiety disorders as per Diagnostic and Statistical Manual of Mental disorders, 5th edition (DSM-5) were evaluated using appropriate rating scale and treated with medication only, CBT only or a combination. Sociodemographic variables between CBT (n=33) and no CBT (n=47) were compared. Various utilization parameters were evaluated. Results analyzed using statistical tests. Results: Education, economic status, closeness to hospital, younger age and male gender was associated with taking up psychotherapy. Panic disorder was 4 times prevalent than all other anxiety disorders. There was 59% primary dropout/refusal, 37% premature termination of CBT. Both refusal of 59% and premature termination of 14% of total sample add up to 73%. This indicated intent to treat number was 4. In this panic disorder dominant sample mean number of CBT sessions were 3.2 Conclusion: Treatment refusal and dropout from CBT is a significant problem among patients with anxiety in the general hospital psychiatry setup. At its darkest light, in this study intent to treat number is roughly 4. Still the silver line is that there are patients who utilize CBT and improve in this setup.