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1.
Ciênc. Saúde Colet ; 26(9): 4087-4099, set. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1339604

ABSTRACT

Resumo Esta revisão visa a conhecer e analisar os efeitos dos probióticos na depressão, ansiedade e estresse psicológico. Esses distúrbios estão entre as principais causas de incapacidades no mundo. As farmacoterapias convencionais costumam apresentar fraca resposta ou efeitos colaterais adversos. Estudos mais recentes têm demonstrado uma densa comunicação bidirecional chamada de eixo cérebro-intestino. Pesquisas estão evidenciando as relações entre alterações no microbioma entérico e distúrbios psiquiátricos, abrindo caminho para o surgimento de terapêuticas alternativas. Fez-se uma busca sistemática por ensaios clínicos randomizados duplo/triplo cego controlados por placebo no PubMed, Scopus e Lilacs. Para seleção dos estudos usaram-se as recomendações dos principais itens para relatar revisões sistemáticas e meta-análises (PRISMA). Nove artigos preencheram os critérios e foram analisados quanto aos efeitos na depressão, ansiedade, estresse psicológico e em biomarcadores. Sete encontraram resultados positivos em ao menos um dos itens. Conclui-se que o uso de probióticos para aliviar sintomas desses distúrbios é promissor, principalmente, por seu potencial efeito anti-inflamatório, mas são necessários ensaios clínicos randomizados duplo-cegos mais amplos e rigorosos para balizar tais conclusões.


Abstract This review aims to understand and analyse the effects of probiotics on depression, anxiety and psychological stress. These disorders are among the leading causes of disability worldwide. Conventional pharmacotherapies usually have a poor response or adverse side effects. In this context, recent studies have demonstrated a dense bi-directional communication named gut-brain axis. Evidences are demonstrating the relationship between disturbance in the enteric microbiome and psychiatric disorders, paving the way for the emergence of alternative therapies. A systematic search for randomized double/triple blind placebo-controlled clinical trials was performed in PubMed, Scopus and Lilacs. The studies selection followed the recommendations of the main items for report systematic reviews and meta-analyses (PRISMA). Nine articles met the criteria and were analysed for effects on depression, anxiety, psychological stress and biomarkers. Seven found positive results in at least one of the items. We concluded that the use of probiotics to alleviate depressive symptoms and anxiety is promising, mainly due to its potential anti-inflammatory effect, but additional and more rigorous double blind randomized clinical trials are necessary to endorse such conclusions.


Subject(s)
Humans , Complementary Therapies , Probiotics , Anxiety/therapy , Anxiety Disorders/therapy , Randomized Controlled Trials as Topic , Depression/therapy
2.
Rev. Méd. Clín. Condes ; 31(2): 183-187, mar.-abr. 2020.
Article in Spanish | LILACS | ID: biblio-1223679

ABSTRACT

Los trastornos de salud mental como depresión y ansiedad tienden a coexistir frecuentemente con los trastornos de somatización, siendo estos últimos una causa frecuente de consulta en especialidades médicas en niños y adolescentes. Es necesario poder pesquisarlos y diagnosticarlos para poder tratarlos adecuadamente. En la actualidad se cuenta con tratamientos eficaces y seguros para estos cuadros, ya sea estén aislados o en comorbilidad. Tanto la terapia cognitivo conductual como los inhibidores selectivos de recaptura de serotonina, solos o combinados, han demostrado ser intervenciones exitosas en estos niños y adolescentes. En el presente artículo se realiza una revisión de cómo se conceptualizan como una dimensión psicopatológica actualmente estos trastornos y cómo se relacionan entre ellos.


Psychiatric disorders such as depression and anxiety are frequently comorbid with somatization disorders, the latter ones are a common cause for medical specialties consultation in the pediatric population. It is thus necessary to identify and diagnose these disorders in order to be able to treat them. Currently, there are safe and effective treatments for these disorders, whether they are isolated or comorbid. Both cognitive behavioral therapy and selective serotonin reuptake inhibitors, alone or combined, have proven to be successful in treating these children and adolescents. This is a review of the current conceptualization of this psychopathologic dimension and how these disorders are interrelated.


Subject(s)
Humans , Child , Adolescent , Anxiety Disorders/psychology , Somatoform Disorders/psychology , Somatoform Disorders/therapy , Psychology, Child , Psychology, Adolescent , Depression/psychology , Anxiety Disorders/diagnosis , Anxiety Disorders/therapy , Somatoform Disorders/diagnosis , Depression/diagnosis , Depression/therapy
3.
Medicina (B.Aires) ; 80(supl.2): 17-20, mar. 2020.
Article in Spanish | LILACS | ID: biblio-1125100

ABSTRACT

Partimos de las evidencias que confirman una mayor vulnerabilidad a la ansiedad de las personas con autismo para preguntarnos en qué medida la intolerancia a la incertidumbre media en dicha ansiedad. Además, las alteraciones de las habilidades predictivas en el autismo podrían explicar la coherencia existente entre mayor intolerancia a la incertidumbre y algunas particularidades inherentes al autismo como los patrones de comportamientos, intereses y actividades restrictivos y estereotipados, y las particularidades en el procesamiento de la información sensorial. Esta información nos permitirá desarrollar intervenciones centradas específicamente en este constructo para la prevención y mejora de la sintomatología ansiosa en el autismo en los casos en los que la severidad de la intolerancia a la incer tidumbre constituya un factor de riesgo significativo.


We start from the evidence that confirms a greater vulnerability to anxiety in people with autism and to wonder to what extent the intolerance to the uncertainty mediates in that anxiety. In addition, the alterations of the predictive abilities in autism could explain the coherence between greater intolerance to uncertainty and some peculiarities inherent in autism such as patterns of restrictive and stereotyped behaviors, interests and activities, and particularities in the processing of sensory information. This information will allow us to develop interventions specifically focused on this construct for the prevention and improvement of anxiety symptoms in autism in cases that the severity of intolerance to uncertainty constitutes a significant risk factor.


Subject(s)
Humans , Anxiety Disorders/psychology , Autistic Disorder/psychology , Uncertainty , Anxiety Disorders/therapy , Autistic Disorder/therapy , Stereotyped Behavior , Risk Factors , Sensation Disorders/psychology
4.
Chinese Acupuncture & Moxibustion ; (12): 1187-1190, 2020.
Article in Chinese | WPRIM | ID: wpr-877584

ABSTRACT

OBJECTIVE@#To observe the therapeutic effect of acupuncture combined with cranial electrotherapy stimulation (CES) on generalized anxiety disorder (GAD).@*METHODS@#A total of 200 patients with GAD were randomized into an acupuncture+CES group, an acupuncture group, a CES group and a medication group, 50 cases in each one. In the medication group, patients were treated with tandospirone citrate tablet orally, 10 mg after breakfast, lunch and dinner respectively. In the CES group, CES was adopted by SCS brain electromedical instrument, 60 min each time, once a day. In the acupuncture group, acupuncture was applied to Baihui (GV 20), Sishencong (EX-HN 1), Yintang (GV 29), Shenting (GV 24), etc., 30 min each time, once a day. In the acupuncture+CES group, CES was adopted before acupuncture. Treatment of sixty days was required in the 4 groups. Before and after treatment, the scores of Hamilton anxiety scale (HAMA), World Health Organization's quality of life questionnaire-brief version (WHOQOL-BREF) and treatment emergent symptom scale (TESS) were observed, the clinical effect was evaluated, and the relapse of anxiety during follow-up of 1 year after treatment was recorded in the 4 groups.@*RESULTS@#Compared before treatment, the scores of HAMA after treatment were decreased (@*CONCLUSION@#Acupuncture combined with CES can effectively relieve the symptoms in patients with GAD, improve the quality of life, reduce the occurrence of adverse reactions and the relapse rate, and its clinical effect is obviously superior to the western medication, the simple application of acupuncture or CES.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Anxiety Disorders/therapy , Electric Stimulation Therapy , Humans , Quality of Life , Treatment Outcome
6.
Trends psychiatry psychother. (Impr.) ; 41(3): 276-282, July-Sept. 2019. tab
Article in English | LILACS | ID: biblio-1043528

ABSTRACT

Abstract Introduction Preeclampsia is a serious complication during pregnancy that not only influences maternal and fetal physical health, but also has maternal mental health outcomes such as anxiety. Prenatal anxiety has negative short- and long-term effects on pre- and postpartum maternal mental health, delivery, and mental health in subsequent pregnancies. Objective To investigate the effectiveness of individual psycho-educational counseling on anxiety in pregnant women with preeclampsia. Methods This was a randomized, intervention-controlled study involving two governmental hospitals in the municipality of Sirjan, Kerman, from January 30 2017 to March 31 2017. A total of 44 pregnant women with preeclampsia were assessed. The women were randomized into two groups: control (n=22) and intervention (n=22). The intervention consisted of two sessions of individual psycho-educational counseling. The level of anxiety was measured using the Spielberger State-Trait Anxiety Inventory (STAI) as pretest before the first session and as posttest after the second session during the hospitalization period. Results There was a significant reduction in the anxiety level after the counselling sessions in the intervention group (p<0.005). In addition, there was a slight increase in the anxiety level in the control group after the study. Conclusion According to the results, psycho-educational counseling can significantly reduce the anxiety level in pregnant women with preeclampsia. Therefore, it is recommended that healthcare providers provide this type of therapeutic intervention for pregnant women after hospitalization, in order to reduce their anxiety level and its subsequent negative outcomes. Clinical trial registration: IRCT2017082029817N3.


Resumo Introdução A pré-eclâmpsia é uma complicação séria durante a gravidez que não apenas influencia a saúde física da mãe e do feto, mas também tem consequências para a saúde mental materna, por exemplo ansiedade. A ansiedade pré-natal tem efeitos negativos e de longo prazo sobre a saúde mental da mãe antes e após o parto, sobre o parto, assim como sobre a saúde mental em gestações subsequentes. Objetivo Investigar a eficácia do aconselhamento psicoeducacional individual com relação aos níveis de ansiedade em gestantes com pré-eclâmpsia. Métodos Este foi um estudo randomizado, controlado, que envolveu dois hospitais governamentais na cidade de Sirjan, Kerman, de 30 de janeiro de 2017 a 31 de março de 2017. Um total de 42 gestantes com pré-eclâmpsia foram avaliadas. As mulheres foram randomicamente divididas em dois grupos: controle (n=22) e intervenção (n=22). A intervenção consistiu de duas sessões de aconselhamento psicoeducacional individual. O nível de ansiedade foi medido usando-se o Spielberger State-Trait Anxiety Inventory (STAI) antes da primeira sessão (pré-teste) e após a segunda seção (pós-teste), durante o período de hospitalização. Resultados Houve uma redução significativa no nível de ansiedade após as sessões de aconselhamento no grupo intervenção (p<0,005). Além disso, houve um discreto aumento no nível de ansiedade no grupo controle após o estudo. Conclusão De acordo com os resultados deste estudo, o aconselhamento psicoeducacional pode reduzir de forma significativa o nível de ansiedade em gestantes com pré-eclâmpsia. Assim, recomenda-se que os profissionais de saúde ofereçam esse tipo de intervenção terapêutica para gestantes após a hospitalização, a fim de reduzir o nível de ansiedade e seus desfechos negativos. Registro do ensaio clínico: IRCT2017082029817N3.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Anxiety Disorders/therapy , Pre-Eclampsia/psychology , Psychotherapy/methods , Patient Education as Topic/methods , Counseling/methods , Anxiety Disorders/etiology , Prenatal Care , Treatment Outcome , Middle Aged
7.
Trends psychiatry psychother. (Impr.) ; 41(1): 43-50, Jan.-Mar. 2019. tab
Article in English | LILACS | ID: biblio-1004839

ABSTRACT

Abstract Introduction Long-term psychodynamic psychotherapy (LTPP) emphasizes the centrality of intrapsychic and unconscious conflicts and their relation to development. Although there is evidence supporting the efficacy of LTPP in mental disorders, little research has been published on the efficacy of LTPP for depressive and anxiety disorders. Objective To examine whether patients with anxiety and depressive disorders demonstrate improvement in their attachment styles, defense styles, psychiatric symptoms, anxiety/depressive symptoms, and alexithymia with LTPP. Methods In this retrospective, descriptive study, the psychological outcomes of patients who were treated at the psychoanalytic clinic of Babol University of Medical Sciences were assessed. Fourteen patients diagnosed with depressive or anxiety disorder participated in the study of LTPP using the self-psychology approach. The Beck Depression Inventory II, Beck Anxiety Inventory, Adult Attachment Scale, 40-item Defense Style Questionnaire, and the 20-item Toronto Alexithymia Scale were administered at pre-treatment, post-treatment, and 6-month follow-up. Generalized estimating equations were used to analyze changes in psychological outcomes after each of the three assessments. Results The mean scores of depression and anxiety and secure attachment improved significantly after LTPP with self-psychology approach from baseline to post-treatment and follow-up. Also, the mean scores of neurotic and immature defenses, difficulty in identifying feelings, difficulty in describing feelings, externally oriented thinking, and total alexithymia scores decreased significantly from baseline to post-treatment and follow-up. Conclusion Symptoms of anxiety disorders, depressive disorders, insecure attachment styles, alexithymia, and neurotic/immature defense styles improved after the LTPP with self-psychology approach. Moreover, the improvements persisted at the 6-month follow-up.


Resumo Introdução A psicoterapia psicodinâmica de longo prazo (PPLP) enfatiza a centralidade dos conflitos intrapsíquicos e inconscientes e sua relação com o desenvolvimento. Apesar da evidência em favor da eficácia da PPLP em transtornos mentais, há poucos dados sobre a eficácia da PPLP em transtornos de depressão/ansiedade. Objetivo Examinar se pacientes com transtornos de depressão/ansiedade demonstram melhora em seus estilos de apego, estilos defensivos, sintomas psiquiátricos, sintomas de ansiedade/depressão e alexitimia com PPLP. Métodos Neste estudo retrospectivo, descritivo, os desfechos psicológicos de pacientes tratados na clínica psicanalítica da Babol University of Medical Sciences foram avaliados. Quatorze pacientes com diagnóstico de transtorno de depressão ou ansiedade participaram do estudo sobre PPLP com abordagem de psicologia do self. O Inventário de Depressão de Beck II, o Inventário de Ansiedade de Beck, a Escala de Apego do Adulto, o Questionário de Estilo de Defesa-40 e a Escala de Alexitimia de Toronto-20 foram administrados antes e após o tratamento e no seguimento de 6 meses. Equações de estimação generalizadas foram usadas para analisar mudanças nos desfechos psicológicos após cada avaliação. Resultados Os escores médios de depressão/ansiedade e apego seguro melhoraram significativamente após PPLP com abordagem de psicologia do self do início do estudo ao pós-tratamento e seguimento. Além disso, os escores médios de defesas neuróticas e imaturas, dificuldade em identificar sentimentos, dificuldade em descrever sentimentos, pensamentos orientados externamente e escores totais de alexitimia diminuíram significativamente do início do estudo ao pós-tratamento e seguimento. Conclusão Sintomas de transtornos de ansiedade, transtornos depressivos, estilos de apego inseguro, alexitimia e estilos de defesa neuróticos/imaturos melhoraram após PPLP com abordagem de psicologia do self. Além disso, as melhoras persistiram no seguimento de 6 meses.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Anxiety Disorders/therapy , Outcome Assessment, Health Care , Affective Symptoms/therapy , Defense Mechanisms , Depressive Disorder/therapy , Psychotherapy, Psychodynamic/methods , Object Attachment , Anxiety Disorders/physiopathology , Time Factors , Retrospective Studies , Affective Symptoms/physiopathology , Depressive Disorder/physiopathology , Iran , Middle Aged
8.
Clinics ; 74: e1316, 2019. tab, graf
Article in English | LILACS | ID: biblio-1039541

ABSTRACT

The aim of this study was to review emerging evidence of novel treatments for anxiety disorders. We searched PubMed and EMBASE for evidence-based therapeutic alternatives for anxiety disorders in adults, covering the past five years. Eligible articles were systematic reviews (with or without meta-analysis), which evaluated treatment effectiveness of either nonbiological or biological interventions for anxiety disorders. Retrieved articles were summarized as an overview. We assessed methods, quality of evidence, and risk of bias of the articles. Nineteen systematic reviews provided information on almost 88 thousand participants, distributed across 811 clinical trials. Regarding the interventions, 11 reviews investigated psychological or nonbiological treatments; 5, pharmacological or biological; and 3, more than one type of active intervention. Computer-delivered psychological interventions were helpful for treating anxiety of low-to-moderate intensity, but the therapist-oriented approaches had greater results. Recommendations for regular exercise, mindfulness, yoga, and safety behaviors were applicable to anxiety. Transcranial magnetic stimulation, medication augmentation, and new pharmacological agents (vortioxetine) presented inconclusive benefits in patients with anxiety disorders who presented partial responses or refractoriness to standard treatment. New treatment options for anxiety disorders should only be provided to the community after a thorough examination of their efficacy.


Subject(s)
Humans , Anxiety Disorders/therapy , Practice Patterns, Physicians' , Practice Guidelines as Topic , Evidence-Based Medicine
9.
Poiésis (En línea) ; 37(Jul.-Dic): 104-134, 2019.
Article in Spanish | LILACS, COLNAL | ID: biblio-1047958

ABSTRACT

Esta presentación de caso, expone una intervención de Constructos Personales centrada en dilemas implicativos en una adolescente de 16 años de la ciudad de Medellín diagnosticada con Porfiria Aguda Intermitente de acuerdo con la Clasificación Internacional de Enfermedades (CIE 10) y con Trastorno De Ansiedad Generalizada (TAG) acorde a los criterios del Manual Diagnóstico y Estadístico de los Trastornos Mentales, quinta edición (DSM 5). El proceso terapéutico se desarrolló en deciseís sesiones, teniendo como punto de referencia los parámetros propuestos por Senra, Feixas y Fernandes (2005), quienes plantean un protocolo general para el abordaje de estructuras dilemáticas, igualmente se consideró la elaboración posterior de Feixas y Compañ (2015) para el diseño del proceso terapéutico. Se definieron los dilemas implicativos a partir de la entrevista, la técnica de rejilla y la autocaracterización (Kelly, 1955). Durante la psicoterapia se abordaron dos de las configuraciones dilemáticas, las cuales se relacionaban con competencia personal e interacción social. En la etapa de finalización del tratamiento se evidenciaron cambios significativos a nivel del sistema de construcciones personales tales como el aumento de la autoestima, mayor percepción de cercanía con las personas significativas, así como una mayor adecuación de éstos a sus construcciones valoradas, transformaciones cuantificadas gracias a la Técnica de Rejilla de Kelly. Igualmente, a nivel sintomático se lograron cambios notables, partiendo de la comparación de las mediciones pre-post tratamiento obtenidas con el inventario de ansiedad y depresión de Beck (BAI, BDI II). Estos resultados aportan evidencia a la Psicología de Constructos Personales, confirmando hallazgos anteriormente expuestos en la literatura científica.


This case presentation exposes an intervention of personal constructs, focused on implicative dilemmas in a 16-year-old girl from Medellin diagnosed with intermittent acute porphyria (AIP) according to the International Classification of Diseases (ICD 10) and with disorder of generalized anxiety (DGA) according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM 5). The therapeutic process was developed in sixteen sessions, having as reference the parameters proposed by Senra, Feixas, and Fernandes (2005), who propose a general protocol for the approach of dilemmatic structures, the subsequent elaboration of Feixas and Compañ was also considered (2015) for the design of the therapeutic process. The implicative dilemmas were defined from the interview, the grid technique and the self-characterization (Kelly, 1955). During psychotherapy, two of the dilemmatic configurations were addressed, which related to personal competence and social interaction. In the stage of completion of the treatment, significant changes were evidenced at the level of the personal construction system such as the increase of self-esteem, greater perception of closeness with significant people, as well as, a greater adaptation of these to their value constructions; quantified transformations thanks to Kelly's Grid Technique. Similarly, significant changes were achieved at the symptomatic level, based on the comparison of pre-post treatment measurements obtained with Beck's anxiety and depression inventory (BAI, BDI II). These results provide evidence to the psychology of personal constructs, which confirms findings previously exposed in the scientific literature.


Subject(s)
Humans , Anxiety Disorders/therapy , Porphyrias/therapy , Psychotherapy/methods , Personal Construct Theory
10.
Rev. bras. psiquiatr ; 40(3): 256-263, July-Sept. 2018. tab, graf
Article in English | LILACS | ID: biblio-959240

ABSTRACT

Objective: There are few quantitative studies on art therapy for the treatment of depression. The objective of this study was to evaluate if art therapy is beneficial as an adjuvant treatment for depression in the elderly. Methods: A randomized, controlled, single-blind study was carried out in a sample of elderly women with major depressive disorder (MDD) stable on pharmacotherapy. The experimental group (EG) was assigned to 20 weekly art therapy sessions (90 min/session). The control group (CG) was not subjected to any adjuvant intervention. Patients were evaluated at baseline and after 20 weeks, using the Geriatric Depression Scale (GDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and cognitive measures. Results: Logistic regression analysis adjusted for age revealed that women in EG (n=31) had significant improvement in GDS (p = 0.007), BDI (p = 0.025), and BAI (p = 0.032) scores as compared with controls (n=25). No difference was found in the cognitive measures. Conclusion: Art therapy as an adjunctive treatment for MDD in the elderly can improve depressive and anxiety symptoms. Clinical trial registration: RBR-2YXY7Z


Subject(s)
Humans , Female , Middle Aged , Aged , Art Therapy/standards , Geriatric Assessment , Depressive Disorder, Major/therapy , Anxiety Disorders/therapy , Psychiatric Status Rating Scales , Psychotherapy , Socioeconomic Factors , Time Factors , Single-Blind Method , Treatment Outcome , Combined Modality Therapy , Neuropsychological Tests
11.
Rev. bras. psiquiatr ; 40(2): 192-199, Apr.-June 2018. tab, graf
Article in English | LILACS | ID: biblio-959213

ABSTRACT

Objective: To investigate the reactions of women with driving phobia to a therapeutic program of scheduled virtual reality exposure treatment (VRET) sessions. Methods: The study intervention consisted of a computer game with car-driving scenarios that included several traffic situations. We investigated the participants' sense of presence, subjective distress, and physiological responses during eight virtual-reality exposures. We also evaluated clinical characteristics, driving cognitions, and quality of life in the participants. Results: Thirteen women were selected. Eight were able to complete the protocol. After VRET, there was a decrease in the frequency of distorted thoughts and state anxiety scores, as well as a slight improvement in quality of life. Subjective discomfort scores, heart rate variation, and sense of presence scores confirmed that there was sense of presence in the virtual reality environment. Conclusion: All patients showed some degree of improvement and demonstrated different levels of anxiety in subsequent in vivo driving experiences. Our findings suggest that VRET could be used to facilitate in vivo exposure, because it can induce presence/immersion and reduce anxiety in patients with specific phobia. Furthermore, VRET is not associated with any type of risk.


Subject(s)
Humans , Female , Adult , Phobic Disorders/therapy , Automobile Driving/psychology , Virtual Reality Exposure Therapy/methods , Anxiety Disorders/classification , Anxiety Disorders/therapy , Phobic Disorders/etiology , Quality of Life , Brazil , Educational Status , Fear , Virtual Reality , Heart Rate
12.
Rev. bras. psiquiatr ; 40(1): 97-104, Jan.-Mar. 2018. tab, graf
Article in English | LILACS | ID: biblio-899404

ABSTRACT

Objective: Current treatment of borderline personality disorder (BPD) consists of psychotherapy and pharmacological interventions. However, the use of repetitive transcranial magnetic stimulation (rTMS) could be beneficial to improve some BPD symptoms. The objective of this study was to evaluate clinical improvement in patients with BPD after application of rTMS over the right or left dorsolateral prefrontal cortex (DLPFC). Method: Twenty-nine patients with BPD from the National Institute of Psychiatry, Mexico, were randomized in two groups to receive 15 sessions of rTMS applied over the right (1 Hz, n=15) or left (5 Hz, n=14) DLPFC. Improvement was measured by the Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity Over Time (BEST), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), and Barratt Impulsiveness Scale (BIS). Results: Intragroup comparison showed significant (p < 0.05) reductions in every psychopathologic domain of the CGI-BPD and in the total scores of all scales in both groups. Conclusions: Both protocols produced global improvement in severity and symptoms of BPD, particularly in impulsiveness, affective instability, and anger. Further studies are warranted to explore the therapeutic effect of rTMS in BPD. Clinical trial registration: NCT02273674.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Borderline Personality Disorder/therapy , Transcranial Magnetic Stimulation/methods , Anxiety Disorders/psychology , Anxiety Disorders/therapy , Psychiatric Status Rating Scales , Severity of Illness Index , Borderline Personality Disorder/psychology , Treatment Outcome , Prefrontal Cortex , Depressive Disorder, Major/psychology , Depressive Disorder, Major/therapy , Mexico
13.
Rev. peru. med. exp. salud publica ; 3(2): 55-62, 2018. tab
Article in Spanish | LILACS | ID: biblio-1145634

ABSTRACT

Objetivo. Comprobar la eficacia de la Meditación Método Xirione en la reducción del nivel de ansiedad ­ estado en pacientes diagnosticados con trastorno mixto ansioso ­ depresivo. Materiales y Métodos: Un ensayo clínico aleatorizado, de grupos paralelos. Se incluyeron a cuarenta pacientes diagnosticados por un médico psiquiatra con trastorno mixto ansioso-depresivo (F41.2), los cuales fueron distribuidos al azar, con una relación 1:1, en un grupo experimental (n=20) y un grupo control (n=20). La intervención de estudio se desarrolló a lo largo de ocho sesiones cuya duración fue de dos horas, dos veces por semana y se centró en el aprendizaje y práctica de los 5 principales primeros pasos de la Meditación Trascendente - Método Xirione. El outcome a medir antes y después de la intervención fue la medida del inventario de ansiedad rasgo-estado (IDARE). Resultados. Después de la intervención con el Taller de Meditación Método Xirione se observó que, en el grupo experimental, el 60% de integrantes presentó ansiedad-estado baja. Se encontraron diferencias significativas entre los niveles de ansiedad-estado de los grupos de estudio después de concluida la intervención (p<0.05). Además, se encontró un tamaño de efecto calificado como alto de acuerdo a los resultados de la D de Cohen=0.92. Conclusión. La intervención con Meditación Método Xirione en pacientes diagnosticados con trastorno mixto ansioso­depresivo, redujo significativamente el nivel de ansiedad­estado en comparación a los pacientes que solo recibieron terapia farmacológica.


Objectives. To verify the effectiveness of the Xirione Method of Trascendental Meditation. in reducing the level of anxiety - status in patients diagnosed with mixed anxiety - depressive disorder. Materials and Methods. A randomized, parallel group clinical trial. Forty patients diagnosed with mixed anxietydepressive disorder (F41.2) were included, who were randomized, with a 1: 1 ratio, in an experimental group (n = 20) and a control group (n = 20). The intervention is developed in eight sessions, which were extended for two hours, twice a week. The sessions were focused on learning and practicing the 5 main steps of Xirione Method. The outcome was the score of anxiety-state inventory (IDARE) before and after the intervention. Results. On experimental group, a 60% of intervened had low anxiety-state levels, after intervention. This differences were statistically significant (p <0.05). Additionally, a high effect size was found (Cohen's D = 0.92). Conclusion. The intervention with Xirione Method of Transcendental Meditation in patients diagnosed with mixed anxiety - depressive disorder, significantly reduced the level of anxiety - state in comparison with patients who only receive pharmacological therapy.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Anxiety Disorders/therapy , Meditation/methods , Depressive Disorder/therapy , Peru , Complementary Therapies , Mental Disorders
14.
Trends psychiatry psychother. (Impr.) ; 39(3): 207-215, July-Sept. 2017. tab, graf
Article in English | LILACS | ID: biblio-904588

ABSTRACT

Abstract Introduction The objective of this study was to conduct a review of the literature covering the use of different mindfulness-based therapy approaches in treatment of mood and anxiety disorders, including mindfulness skills and mindfulness linked to emotional regulation and fear of negative appraisal. Methods A review was conducted of literature identified by searching the scientific databases PubMed and PsycINFO with the following keywords: mindfulness, mood disorders, and anxiety disorders. The search covered the past 10 years. The search returned 532 articles, 24 were selected, their full texts were read, and 16 were included in this review. Results Six articles about mindfulness-based stress reduction, four about mindfulness-based cognitive therapy, and three about fear of negative appraisal and emotional regulation were reviewed. All of the articles covered mindfulness in relation to mood and anxiety disorders. Conclusions The literature in this field suggests that mindfulness is an effective strategy for the treatment of mood and anxiety disorders and is effective in therapy protocols with different structures including virtual modalities. Use of mindfulness in scientific models continues to expand.


Resumo Introdução O objetivo deste estudo foi fazer uma revisão da literatura abrangendo o uso das diferentes abordagens da terapia baseada em mindfulness no tratamento dos transtornos de humor e ansiedade, incluindo suas habilidades e sua relação com a regulação emocional e com o medo da avaliação negativa. Métodos Uma revisão de literatura foi realizada através de busca pelas bases científicas PubMed e PsycINFO, com as seguintes palavras-chave: mindfulness, transtornos do humor e transtornos de ansiedade. A pesquisa abrangeu os últimos 10 anos. A busca resultou em 532 artigos, sendo 24 selecionados e 16 incluídos nesta revisão. Resultados Foram revisados seis artigos sobre programa de redução de estresse baseado em mindfulness, quatro artigos sobre terapia cognitiva baseada em mindfulness, e três sobre medo da avaliação negativa e regulação emocional. Todos os artigos abordaram mindfulness com relação aos transtornos de humor e ansiedade Conclusão A literatura nessa área sugere que mindfulness é uma estratégia eficaz no tratamento dos transtornos de humor e ansiedade e é eficaz no protocolo de terapia em diferentes formatos, incluindo virtual. O uso de mindfulness continua a se expandir nos modelos científicos.


Subject(s)
Humans , Anxiety Disorders/therapy , Mood Disorders/therapy , Mindfulness , Cognitive Behavioral Therapy/methods
15.
Trends psychiatry psychother. (Impr.) ; 39(2): 88-97, Apr.-June 2017. tab
Article in English | LILACS | ID: biblio-904578

ABSTRACT

Abstract Introduction Anxiety disorders in primary school-aged children negatively affect their mental health and psychological development. Available non-medical treatments for these conditions are time-consuming and expensive. In this context, eclectic therapy is a therapeutic approach that incorporates some therapeutic techniques and philosophies to create the ideal treatment. In this study, eclectic therapy consisted of art therapy and cognitive-behavioral therapy designed for children suffering from high level of anxiety in their middle childhood years. The therapy also included group guidance sessions for their mothers. The effectiveness of this intervention was examined in the study. Methods 61 students aged 9-12 years with high levels of anxiety participated in the study. Intervention A (n = 20) consisted of 9-hour eclectic therapy for children with 3-hour group guidance sessions for their mothers. Intervention B (n = 20) consisted of 9-hour eclectic therapy for children. There was also a control group (n = 21). Results Teacher ratings of children's mental health difficulties and self-report ratings of anxiety disorders indicated a significant difference from pretest to posttest, revealing a large effect size between the two interventions. Higher levels of pretest scores significantly predicted higher posttest scores for all domains of anxiety and mental health difficulties. Furthermore, age, gender, mothers working a 15-hour day, mother's educational level, parental divorce rates, parental death, and family monthly income predicted therapy outcomes. Conclusion Results provide support for the effectiveness of eclectic art and CBT to improve children's mental health and reduce anxiety through changing thoughts, beliefs, emotions, and behaviors that may cause fear and anxiety.


Resumo Introdução Transtornos de ansiedade em escolares afetam sua saúde mental e seu desenvolvimento psicológico. Tratamentos alternativos disponíveis consomem tempo e são dispendiosos. Nesse contexto, a terapia eclética é uma abordagem terapêutica que incorpora algumas técnicas e filosofias terapêuticas para criar o tratamento ideal. Neste estudo, terapia eclética consistiu de terapia artística e terapia cognitivo-comportamental (TCC) planejada para escolares com altos níveis de ansiedade. A terapia também incluiu sessões de orientação em grupo para as mães. A eficácia da intervenção foi examinada. Métodos 61 escolares com idade de 9-12 anos e altos níveis de ansiedade participaram do estudo. A intervenção A (n = 20) consistiu de 9 horas de terapia eclética para crianças com sessões de 3 horas de orientação em grupo para as mães. A intervenção B (n = 20) consistiu de 9 horas de terapia eclética para crianças. Houve também um grupo controle (n = 21). Resultados Escores atribuídos pelos professores às dificuldades de saúde mental das crianças e escores de ansiedade autoaplicados indicaram diferenças significativas entre resultados pré-teste e pós-teste, revelando grande tamanho de efeito entre as duas intervenções. Escores pré-teste maiores foram preditores significativos de escores pós-teste mais altos para todos os domínios de ansiedade e dificuldades de saúde mental. Idade, gênero, mães trabalhando 15 horas/dia, nível educacional da mãe, índice de divórcio, morte de um dos pais e renda familiar mensal foram preditores de desfechos da terapia. Conclusão Os resultados sugerem a eficácia de arte eclética e TCC para melhorar a saúde mental de crianças e reduzir a ansiedade através de mudança em pensamentos, crenças, emoções e comportamentos que possam causar medo e ansiedade.


Subject(s)
Humans , Male , Female , Child , Anxiety Disorders/therapy , Art Therapy/methods , Rural Population , Socioeconomic Factors , Severity of Illness Index , Cognitive Behavioral Therapy , Cross-Sectional Studies , Analysis of Variance , Treatment Outcome , Counseling , Self Report , School Teachers , Mothers
16.
MedicalExpress (São Paulo, Online) ; 4(2)Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-841475

ABSTRACT

OBJECTIVE: To investigate the effectiveness of a treatment for Internet addiction and anxiety disorders, using cognitive behavioral therapy combined with medication, and to analyze the relationship between anxiety and Internet addiction. METHOD: An open clinical trial included 84 patients (42 in the "comorbidities" group; 42 in the "no comorbidities" group) seeking treatment for anxiety symptoms and/or Internet Addiction. The subjects responded to The Mini International Neuropsychiatric Interview 5.0; the Hamilton Anxiety Scale (HAM-A), the Hamilton Depression Scale (HDRS), Clinical Global Impressions Severity and Improvement (CGI-S and CGI-I) and the Young Internet Addiction Scale (IAT). Patients who had only Internet addiction received psychoeducation on conscious internet use and bibliotherapy; they were defined as the group without comorbidities; patients diagnosed with Internet addiction and anxiety disorder (the group with comorbidities) were forwarded for pharmacotherapy and psychotherapy. RESULTS: Both Internet Addiction and anxiety decreased after treatment; the average of Hamilton Anxiety Scale of the "comorbidities" group at the beginning was 33.9 ± 7.6, suggesting severe anxiety, and at the end of treatment it was 15.0 ± 5.1, suggesting mild anxiety and a significant improvement. The average Internet Addiction score at the beginning was 67.8 ± 9.0; at the end of the psychotherapy an average score of 37.7 ± 11.4 was registered, indicating a notable and highly significant improvement. CONCLUSIONS: The relationship between anxiety and Internet Addiction existed and was strong. Treatment significantly improved both.


OBJETIVO: Investigar a eficácia de tratamento para dependência de internet e transtornos de ansiedade, utilizando terapia cognitivo comportamental combinada com medicação, e analisar a relação entre ansiedade e dependência de internet. MÉTODO: Ensaio clínico aberto realizado no Laboratório de Pânico e Respiração no Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB/UFRJ) com 84 pacientes (42 do grupo com comorbidades e 42 do grupo sem comorbidades) que procuravam tratamento para transtornos de ansiedade e/ou dependência de internet. Os sujeitos responderam ao MINI Entrevista Neuropsiquiátrica Internacional 5.0; a Escala Hamilton de Ansiedade (HAM-A), a Escala Hamilton de Depressão (HDRS), a Escala Clínica de Impressão Global de Severidade e de Melhora (CGI-S e CGI-I) e a Escala de Dependência de Internet de Young (IAT). Os pacientes com apenas dependência de internet receberam psicoeducação sobre o uso consciente da internet e biblioterapia, e foram considerados o grupo sem comorbidades, enquanto que, os pacientes com transtornos de ansiedade e dependência de internet foram encaminhados para o tratamento medicamentoso e psicoterapia. RESULTADOS: Tanto a dependência de internet quanto a ansiedade diminuíram após o tratamento, a média da HAM-A no grupo com comorbidades no início foi de 33,9 ± 7,6, sugerindo ansiedade grave e ao final do tratamento foi de 15 ± 5,1, sugerindo uma significativa melhora. A media de dependência de internet obtida na IAT no início do tratamento foi de 67.8 ± 9.0 e ao final da psicoterapia a maioria dos participantes apresentou média de 37.7 ± 11.4 indicando uma melhora notável. CONCLUSÃO: A relação entre ansiedade e dependência de internet existe e é forte.


Subject(s)
Anxiety Disorders/therapy , Behavior, Addictive/therapy , Bibliotherapy , Cognitive Behavioral Therapy/methods , Treatment Outcome , Dependency, Psychological
17.
Ter. psicol ; 35(1): 71-79, Apr. 2017. graf, tab
Article in English | LILACS | ID: biblio-846333

ABSTRACT

This study aimed to analyze the effects of a mindfulness training program on anxiety, worry, and geriatric depression in a sample of older adults. A randomized controlled trial with pretest-posttest measurements was used on an experimental group (n = 42) and a control group (waiting list; n = 45). Participants in the experimental group completed the Short Cognitive Examination, the Penn State Worry Questionnaire (PSWQ), and the Geriatric Depression Scale. Analyses showed significantly stronger reductions in geriatric depression, anxiety and worry in the experimental group than in the control group, confirming the effectiveness of mindfulness techniques in reducing these conditions and, especially, for the trait-worry variable, followed by important changes in anxiety, depression and meta-worry. This is one of the few studies examining the effects of mindfulness training in the elderly. Results are especially noteworthy because traits are quite resistant to change. Implications for future research and intervention are underlined.


Se analizan los efectos de un programa de entrenamiento en mindfulness en la ansiedad, la preocupación y la depresión en una muestra de adultos mayores en este estudio controlado y aleatorizado con medidas pretrest-posttest con un grupo experimental (n = 42) y control (lista de espera; n = 42). El grupo experimental completó el Mini-Examen cognitivo, el Inventario de Preocupación de Pensilvania, y la Escala de Depresión Geriátrica. Se obtuvieron mayores reducciones significativas en este grupo comparado con el grupo control, confirmándose la efectividad de las técnicas de mindfulness en la reducción de estos transtornos y, especialmente, en la variable preocupación de rasgo, seguida de importantes cambios en ansiedad, depresión y metapreocupación. Este es uno de los pocos estudios que examinan los efectos del entrenamiento en mindfulness en la tercera edad. Los resultados son especialmente importantes porque los rasgos son resistentes al cambio. Se destacan implicaciones para la investigación futura e intervención.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Aged/psychology , Anxiety Disorders/therapy , Depression/therapy , Mindfulness/methods , Anxiety Disorders/diagnosis , Depression/diagnosis , Meditation , Psychometrics , Surveys and Questionnaires
18.
Arq. neuropsiquiatr ; 74(10): 829-835, Oct. 2016.
Article in English | LILACS | ID: lil-796831

ABSTRACT

ABSTRACT Transcranial magnetic stimulation (TMS) has recently been investigated as a possible adjuvant treatment for many neuropsychiatric disorders, and has already been approved for the treatment of drug-resistant depression in the United States and in Brazil, among other countries. Although its use in other neuropsychiatric disorders is still largely experimental, many physicians have been using it as an off-label add-on therapy for various disorders. More recently, another technique, transcranial direct current stimulation (tDCS), has also become available as a much cheaper and portable alternative to TMS, although its mechanisms of action are different from those of TMS. The use of off-label therapeutic TMS or tDCS tends to occur in the setting of diseases that are notoriously resistant to other treatment modalities. Here we discuss the case of anxiety disorders, namely panic and post-traumatic stress disorders, highlighting the uncertainties and potential problems and benefits of the clinical use of these neuromodulatory techniques at the current stage of knowledge.


RESUMO A estimulação magnética transcraniana (TMS) foi recentemente proposta como um possível tratamento adjuvante para muitos distúrbios neuropsiquiátricos, e já foi aprovada para o tratamento de depressão fármaco-resistente nos Estados Unidos e no Brasil, entre outros países. Apesar do fato de que seu uso em outros transtornos neuropsiquiátricos ainda é em grande parte experimental, muitos médicos têm utilizado essas técnicas como uma terapia off-label em várias doenças. Mais recentemente, uma outra técnica, a estimulação transcraniana por corrente contínua (ETCC), tornou-se também disponível como uma alternativa muito mais barata e portátil do que a TMS, embora os seus mecanismos de ação sejam diferentes daqueles da TMS. O uso off-label de TMS ou ETCC tende a ocorrer no caso de doenças que são notoriamente resistentes a outras modalidades terapêuticas. Aqui nós discutimos o caso dos transtornos de ansiedade, ou seja, transtorno do pânico e estresse pós-traumático, destacando as incertezas, benefícios e problemas potenciais inerentes ao uso clínico dessas técnicas neuromoduladoras no atual estágio do conhecimento.


Subject(s)
Humans , Anxiety Disorders/therapy , Transcranial Magnetic Stimulation/methods , Transcranial Direct Current Stimulation/methods , Mental Disorders/therapy , Nervous System Diseases/therapy , Anxiety Disorders/physiopathology , Treatment Outcome , Prefrontal Cortex/physiopathology , Mental Disorders/physiopathology , Nervous System Diseases/physiopathology
20.
Bogotá; IETS; mayo 2016. tab, ilus.
Monography in Spanish | LILACS, BRISA | ID: biblio-846437

ABSTRACT

Problema de investigación: Describir los costos y la efectividad de escitalopram comparado con paroxetina, sertralina y venlafaxina como terapia de mantenimiento en adultos con diagnóstico de trastorno de ansiedad generalizada en Colombia. Tipo de evaluación económica: Análisis de costo-utilidad. Población objetivo: Adultos colombianos con diagnóstico de trastorno de ansiedad generalizada. Intervención y comparadores: Intervención: escitalopram, Comparadores: paroxetina, sertralina y venlafaxina. Horizonte temporal: 32 semanas. Perspectiva: SGSSS. Tasa de descuento: No aplica. Estructura del modelo: Se estructuró un árbol de decisión, teniendo en cuenta modelos publicados en la literatura. Fuentes de datos de efectividad y seguridad: Reporte de efectividad y seguridad elaborado en diciembre de 2014 en el IETS, Ensayos clínicos aleatorizados. Desenlaces y valoración: AVAC, Tasa de respuesta al medicamento, Tasa de recaídas con el medicamento. Costos incluidos: Costo de los medicamentos, Costo de procedimientos, Costo de los eventos adversos. Fuentes de datos de costos: SISMED, Manual tarifario ISS 2001. Resultados del caso base: Para el caso base, escitalopram es la alternativa cost-efectiva con un costo esperado de $39.127.045 respecto a sertralina. La RICE de paroxetina fue superior al umbral de costo-efectividad de 3 veces el PIB per cápita. Venlafaxina fue dominada por todos los demás medicamentos. Se encuentra gran incertidumbre en la decisión y una e fectividad esperada muy similar entre todas las alternativas, por lo que estos resultados deben analizarse con precaución. Análisis de sensibilidad: Los análisis de sensibilidad y el diagrama de tornado mostraron que las variables con mayor impacto sobre las estimaciones de costo-utilidad del escitalopram son la probabilidad de respuesta, ponderaciones de utilidad, las dosis de los medicamentos y el desenlace utilizado. Conclusiones y discusión: Escitalopram parece ofrecer una mejorrelación entre costos y efectividad respecto a sus comparadores. No obstante, es necesario tener en cuenta que sertralina y paroxetina pueden llegar a ser costo-efectivas bajo escenarios plausibles. Venlafaxina obtuvo una peor relación de costos y beneficios comparativos. La principal limitación de este estudio se centra en la ausencia de ensayos clínicos de no inferioridad con un horizonte de largo plazo.(AU)


Subject(s)
Adult , Anxiety Disorders/therapy , Preventive Maintenance , Biomedical Technology , Citalopram/administration & dosage , Colombia , Cost-Benefit Analysis/economics , Drug Therapy, Combination , Health Evaluation/economics , Paroxetine/administration & dosage , Sertraline/administration & dosage , Venlafaxine Hydrochloride/administration & dosage
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