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RESUMO Objetivo: Neste estudo relatamos o caso de uma profissional de saúde com vivência de imobilidade tônica (IT) e posterior desenvolvimento de transtorno de estresse pós-traumático (TEPT) crônico em decorrência de trauma laboral por conta da COVID-19 que recebeu tratamento remoto com terapia cognitivo-comportamental focada no trauma (TCC-FT). Métodos: Relato de caso de uma paciente acompanhada por seis meses após o recebimento de TCC-FT remota. Resultados: Paciente do sexo feminino, de 36 anos, fisioterapeuta, que desenvolveu TEPT crônico e experienciou IT por medo da contaminação por coronavírus. As escalas psicométricas demonstraram que a TCC-FT reduziu consideravelmente os sintomas de TEPT e depressão e aumentou o apoio social e a resiliência. De acordo com o relato, o tratamento melhorou a concentração e a motivação, e reduziu o sentimento de culpa, a irritabilidade, a insegurança e o desconforto em lidar com outras pessoas. Conclusão: Este artigo demonstra que traumas decorrentes da COVID-19 podem ser capazes de desencadear IT e exemplifica um favorável desempenho da TCC-FT na melhoria global da saúde mental dos pacientes com TEPT crônico com vivência de IT.
ABSTRACT Objective: In this study, we report the case of a health professional with experience of tonic immobility (TI) and subsequent development of post-traumatic stress disorder (PTSD) as a result of occupational trauma due to COVID-19 who received remote treatment with Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Methods: A case report of a patient followed for six months after receiving remote TF-CBT. Results: A 36-year-old female patient, the physiotherapist who developed chronic PTSD and experienced TI for fear of coronavirus contamination. Psychometric scales demonstrated that TF-CBT considerably reduced PTSD and depression symptoms and increased social support and resilience. According to the report, the treatment improved concentration and motivation, and reduced feelings of guilt, irritability, insecurity, and discomfort in dealing with other people. Conclusion: This article demonstrates that trauma resulting from COVID-19 can trigger TI and exemplifies a favorable performance of TF-CBT in the global improvement of the mental health of patients with chronic PTSD who experience TI.
ABSTRACT
Clinicians working with youth exposed to trauma may be at increased risk for experiencing elevated levels of stress and symptoms of secondary traumatic stress, which can negatively impact clinician wellbeing and ultimately contribute to reduced access to quality care for clients. An innovative Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training incorporating self-care practices (i.e., Practice What You Preach; PWYP) was developed to help facilitate the implementation of TF-CBT and to enhance clinicians' coping and decrease stress. The primary purpose of this study was to determine whether the PWYP-augmented training met three Objectives: (1) increase clinicians' feelings of TF-CBT competency; (2) improve clinicians' coping abilities/reduce clinicians' stress; and (3) increase clinicians' insight into the benefits and/or challenges clients may experience in treatment. An exploratory aim was also developed to identify additional facilitators and barriers of TF-CBT implementation. The written reflections of 86 community-based clinicians who participated in the PWYP-augmented TF-CBT training were examined using qualitative methods. The majority of clinicians indicated increased feelings of competency and improved coping abilities and/or stress levels; almost half mentioned increased insight into clients' experiences. The most frequently mentioned additional facilitators were related to elements of the TF-CBT treatment model. Anxiety/self-doubt was the barrier most frequently mentioned, though all clinicians who mentioned this barrier indicated it lessened or resolved over the course of the training. Incorporating self-care strategies into trainings may serve as a facilitator for TF-CBT implementation by enhancing the competency and well-being of clinicians. The additional insights into barriers and facilitators can be used to further improve the PWYP initiative and future training and implementation efforts.
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This pilot study aims to analyze the effects of the presence and absence of initial in-person contact and written feedback in RE&CBT e-supervision, comparing it on the Supervisory Working Alliance Inventory, the Supervisor Satisfaction Questionnaire, and the Trainee Disclosure Scale. During a period of six months, five supervisees performed ten e-supervision divided into two groups, a control group that did only the initial meetings in-person and an experimental group in which two supervisees completed whole process online. Additionally, in the first five e-supervision, the supervisor reviewed an entire session with written feedback with an additional meeting for each group. In the last five e-supervision, the supervisor only partially reviewed client sessions during supervision. After ten e-supervision, an individual post-interview was conducted with each participant. This study's primary statistical method for calculating and combining effect sizes was Tarlow Baseline Corrected Tau and Open Meta Analyst software. Both groups scored above average on the first two scales, but the disclosure scale had highly irregular and inconsistent patterns. The combined qualitative and quantitative results suggest that novice therapists generally prefer to have their entire sessions reviewed with written feedback and that a single in-person contact is unlikely to influence e-supervision satisfaction and working alliance. Given that there are no adequately validated e-supervision models, this pilot study used a pilot model named Supported Model of Electronic Supervision (SMeS). This model showed potential, but it needs further testing on a larger sample with more clearly operationalized steps. This study experimentally supports the effectiveness of RE&CBT supervision for the first time. Supplementary Information: The online version contains supplementary material available at 10.1007/s10942-023-00505-2.
ABSTRACT
Tourism village empowerment needs to collaborate with other communities/institutions (stakeholders), in order to accelerate and expand the tourism village movement to achieve its goals. This study aims to: 1) find out the potential of the Terong Belitung Creative Tourism Village destination;2) find out the forms of collaboration that have been carried out by stakeholders in developing the Terong Belitung Creative Tourism Village;and 3) find out the steps taken by the manager of the Terong Creative Tourism Village in managing the village which is done in accordance with the community interests. This study used a qualitative approach and data collection methods by doing interviews, observation, and documentation. Participants or informants as a source of research data were 6 (six) parties consisting of BNI Bank, BCA Bank, PLN, Tourism Office of Belitung Region, The Government of Terong District, and the Tourism Village Managers. The results of this study indicate that 1) Potential destinations include: River and Sea Tourism in Mangrove Forest in Terong Village, Aik Rusa' Berehun Tourism, Tebalu Simpor Laki Hill Tourism, Agritourism (Agriculture and Plantation), Catfish Pond Groups, Weaving Handicraft Group, Gambus Art and Culture Group, and the Community of Tourism Halfway House Management. 2) The roles of stakeholders are as Police Creator, Coordinator, Facilitator, Implementer, and also BNI, BCA, and PLN as the Accelerators. 3) The real form or contribution of the stakeholders especially from the bank and PLN is to build the homestays and the entrance gates to tourism village areas including the lighting system around the tourist village of Air Rusa Berehum (ARB), and also to conduct various culinary trainings and improvement of human resources training (HR). In improving the development of tourism villages, the role of stakeholders should run well. 4) The steps in managing a tourism village are being carried out by the planning stage, the implementation stage, and the last is the impact of benefits aspect stage. [ FROM AUTHOR] Copyright of Technium Social Sciences Journal is the property of Technium Press Constanta and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
The COVID-19 pandemic created an unprecedented situation, whereby essential services within child and adolescent mental health services (CAMHS) were suspended. This created a need to modify regular methods of treatment at a rapid pace, to avoid cessation of clinical intervention and prevent potential regression in mental health. Eighteen children with moderate-to-severe mental health disorders and their parents were attending weekly group cognitive behaviour therapy-based sessions ('The Secret Agent Society' programme) when the Irish Department of Health suspended face-to-face intervention. This report describes how the group sessions were adapted to individualised, online therapeutic triads between each child, his/her parent and their clinician. Whilst internet technology has emerged as a promising solution to shortfalls in therapy services, in-depth exploration is needed to confirm the efficacy of telehealth for children attending CAMHS.
ABSTRACT
BACKGROUND: An increase in depression, anxiety, and stress symptoms worldwide, attributed to the COVID-19 pandemic, has been reported. If not treated, it may negatively affect a person's everyday life by altering physical and social well-being and productivity and increasing expenditure on health care. Cognitive behavioral therapy (CBT)-based interventions are gaining popularity as a means to reduce stress and alleviate anxiety and depression symptoms. Moreover, CBT delivered through a mobile app has the same elements as traditional CBT training (eg, guided discovery). However, unlike conventional training, users of mobile apps are allowed to tailor their own experience at their own speed and schedule. OBJECTIVE: This study aims to analyze Sensa users' retrospective data and explore the dose-duration effect to find the optimal usage time when the user showed results. METHODS: The study cohort comprised 381 consecutive community-based nonclinical users who started using Sensa between October 2021 and March 2022. All users included in the study took the Depression Anxiety Stress Scale-21 (DASS-21) assessment at least 2 times. Other parameters from the database containing all self-reported data were gender, number of active days, total time of use, and age. The primary outcome of the study was a change in the DASS-21 score. Statistical analyses were performed using GraphPad Prism (version 9, GraphPad Software). In addition, a logistic regression model was created to predict how the obtained independent parameters influenced the DASS-21 score. RESULTS: The main finding of our study was that the majority of participants who started using Sensa were experiencing depression, anxiety, and stress symptoms (92.13%, 80.05%, and 87.93%, respectively). There was a statistically significant decrease of the DASS-21 subdomain scores after the use of the application (anxiety: mean 7.25, SD 4.03 vs mean 6.12, SD 4.00; P=.001; depression: mean 11.05, SD 4.26 vs mean 9.01, SD 4.77; P=.001; stress: mean 11.42, SD 3.44 vs mean 9.96, SD 3.65; P<.001). Finally, the logistic regression model showed that users who were using the app for more than 24 days and had at least 12 active days during that time had 3.463 (95% CI 1.142-11.93) and 2.644 (95% CI 1.024-7.127) times higher chances to reduce their DASS-21 subdomain scores of depression and anxiety, respectively. CONCLUSIONS: Using the Sensa mobile app was related to decreased depression, anxiety, and stress symptoms.
ABSTRACT
Fear of choking is a relatively understudied phenomenon in older adults, despite the higher incidence of choking to death in this population and the associated mental health burden. This case report presents the use of a cognitive-behavioral (CBT) approach to treating choking phobia in an older adult in her 80s, with sessions conducted over the telephone during the COVID-19 pandemic. A reliable change in self-reported avoidance of solid food was observed, although indices of general distress appeared to have remained stable. By placing a seemingly focal problem (choking phobia) within a comprehensive conceptualization framework using gerontology, we were able to consider additional complexity related to aging-related beliefs and experiences of distress to address therapeutic opportunities and challenges, including the COVID-19 context.Copyright © 2022 Hogrefe.
ABSTRACT
Insomnia is a key risk factor for depression and mental disorders, both in general and during peripartum. Covid-19 pandemic outbreak was associated with an alarming increase of insomnia symptoms. This case report aims to describe a digital Cognitive Behavioral Therapy for Insomnia (CBT-I) intervention adapted for pregnancy during the pandemic situation. This article describes the case of a 38 years old woman with significant problems in initiating and maintaining sleep. The intervention was conducted online. The assessment included a clinical psychological interview, semi-structured interview about sleep, sleep diaries and validated questionnaires. Adapted CBT-I protocol was performed including 5 sections lasting 45 minutes each. The case-report description follows CAse REport (CARE) guidelines. The intervention was effective in reducing insomnia symptoms as highlighted by questionnaires and sleep diaries. Furthermore, results showed positive findings with regard to depression symptomatology, stress levels and difficulties in emotion regulation. These positive results were confirmed at post-partum follow ups. Evidence-based CBT-I protocol was applied with relevant benefits for the patient. Furthermore, it was stressed the importance of considering emotions during psychotherapy. High-quality clinical trials evaluating the efficacy of adapted CBT-I in large samples of expecting mothers are suggested to guide changes in gynecological primary care for pregnancy, especially for the post-pandemic time. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Italian) L'insonnia e un fattore di rischio per la depressione e i disturbi mentali. La pandemia dovuta al Covid-19 e stata associata a un allarmante aumento dell'insonnia. Questo caso clinico ha lo scopo di descrivere un intervento digitale di terapia cognitivo comportamentale per l'insonnia (CBT-I) adattato per la gravidanza durante la pandemia. Viene descritto il caso di una donna di 38 anni con insonnia. La valutazione ha previsto un colloquio clinico psicologico, un'intervista semi-strutturata sul sonno, diari del sonno e questionari. E stato eseguito un protocollo CBT-I comprendente 5 sessioni di 45 minuti ciascuna. L'intervento eseguito e stato efficace nel ridurre i sintomi dell'insonnia e ha mostrato risultati positivi per quanto riguarda la sintomatologia depressiva, i livelli di stress e le difficolta nella regolazione delle emozioni. Questi risultati sono stati confermati anche ai follow-up. I risultati a favore dell'efficacia della CBT-I per l'insonnia in gravidanza sono stati confermati, evidenziando inoltre, l'importanza di considerare le emozioni durante il trattamento. Si suggeriscono futuri studi clinici di alta qualita che valutino l'efficacia della CBT-I adattata in grandi campioni di madri in gravidanza per guidare i cambiamenti nell'assistenza ginecologica primaria per la gravidanza, specialmente nel periodo post-pandemico. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
Depression prevalence is high, impacting approximately 20% of Americans during their lifetime, and on the rise due to stress and loss associated with the COVID-19 pandemic. Despite the high prevalence of depression, unacceptable treatment access disparities persist. When depression goes untreated, it leads to substantial negative impacts in multiple life domains. Cognitive behavioral therapy (CBT), the gold-standard psychosocial treatment for depression, remains largely unavailable to individuals living with depression, particularly individuals who are members of underrepresented groups in our society. Digital mental health interventions (DMHI) have led to important advances in extending the reach of CBT for depression; however, they are underutilized and treatment engagement remains low. We sought to address some of the current gaps in DMHI by developing an online platform for delivering CBT for depression that is entertaining, simple and straightforward, and tailorable. First, this article introduces our online platform, Entertain Me Well (EMW) and its key innovations, including the use of an engaging, character-driven storyline presented as "episodes" within each session, as well as customizable content that allows for tailoring of text, images, and examples to create content most relevant to the target client population, context, or setting. Next, we describe two EMW depression treatment programs that have been tailored: one for delivery in the rural church setting, called Raising Our Spirits Together, and one tailored for delivery in dialysis centers, called Doing Better on Dialysis. Finally, we discuss future directions for the EMW platform, including the ability to create programs for other common mental health and health conditions, the development of additional character-driven storylines with greater treatment personalization, translation of content in multiple languages, and the use of additional technological innovation, such as artificial intelligence like natural language processing, to enhance platform interactivity.
ABSTRACT
Several in-person and remote delivery formats of cognitive-behavioural therapy (CBT) for panic disorder are available, but up-to-date and comprehensive evidence on their comparative efficacy and acceptability is lacking. Our aim was to evaluate the comparative efficacy and acceptability of all CBT delivery formats to treat panic disorder. To answer our question we performed a systematic review and network meta-analysis of randomised controlled trials. We searched MEDLINE, Embase, PsycINFO, and CENTRAL, from inception to 1st January 2022. Pairwise and network meta-analyses were conducted using a random-effects model. Confidence in the evidence was assessed using Confidence in Network Meta-Analysis (CINeMA). The protocol was published in a peer-reviewed journal and in PROSPERO. We found a total of 74 trials with 6699 participants. Evidence suggests that face-to-face group [standardised mean differences (s.m.d.) -0.47, 95% confidence interval (CI) -0.87 to -0.07; CINeMA = moderate], face-to-face individual (s.m.d. -0.43, 95% CI -0.70 to -0.15; CINeMA = Moderate), and guided self-help (SMD -0.42, 95% CI -0.77 to -0.07; CINeMA = low), are superior to treatment as usual in terms of efficacy, whilst unguided self-help is not (SMD -0.21, 95% CI -0.58 to -0.16; CINeMA = low). In terms of acceptability (i.e. all-cause discontinuation from the trial) CBT delivery formats did not differ significantly from each other. Our findings are clear in that there are no efficacy differences between CBT delivered as guided self-help, or in the face-to-face individual or group format in the treatment of panic disorder. No CBT delivery format provided high confidence in the evidence at the CINeMA evaluation.
Subject(s)
Cognitive Behavioral Therapy , Panic Disorder , Humans , Panic Disorder/therapy , Network Meta-Analysis , Cognitive Behavioral Therapy/methods , Health Behavior , Waiting Lists , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: A growing number of adolescents seek treatment for mental health problems, a circumstance that stresses the importance of implementing accessible treatment options. This study evaluates the impacts of brief, mental well-being intervention for adolescents in a school environment. As mental health interventions are often targeted at specific disorders, we sought a comprehensive approach to reach adolescents with a range of mental health symptoms. METHODS: Single-group intervention study with a pretest-posttest design was utilized and conducted in lower, upper secondary, and vocational schools on adolescents ages 12-18 who sought medical attention for mental health symptoms. The cut-off point for inclusion was ≥ 14, for the Young Persons Clinical Outcomes for routine Evaluation (YP-CORE) measurement. The intervention included six face-to-face visits implemented by psychiatric nurses who received a 3-day training course. The impacts were evaluated after 6 weeks (n = 87) and again at 6 months (n = 68) and assessed using the YP-CORE, Beck Depression Inventory (BDI-II) and Overall Anxiety Severity and Impairment Scale (OASIS). RESULTS: The participants reported significant levels of mental distress at baseline with a YP-CORE mean score = 21.48, a BDI-II mean score = 23.60, OASIS mean score = 10.98. Post-intervention results at 6 weeks for the primary outcome YP-CORE showed a significant (p < .001) mean score decrease of - 3.82, a medium effect size d = .627. For participants attending upper secondary and vocational schools the YP-CORE scores changed significantly from baseline to 6-weeks (p = .005) and from baseline to 6-months (p < .001). Long-term outcomes at 6-months showed a - 1.14 decrease (p = non-significant), effect size d = .175. After the 6-week intervention, 12% of the participants were assessed as not requiring additional visits. CONCLUSIONS: This easily accessible intervention in a school setting indicated improvement for those participants with mild to moderate mental disorder symptoms and attending upper secondary and vocational schools. After the 6-week intervention, significant positive effects were observed. Participants reported substantial levels of mental distress at the baseline, which could contribute to the decline of symptoms and need for extended care during the 6 months follow-up. Trial registration Retrospectively registered with Clinicaltrials.gov identifier NCT05356949.
ABSTRACT
Prior to the COVID-19 pandemic, we demonstrated the efficacy of a novel Cognitive Behavioural Therapy programme for the treatment of Non-Rapid Eye Movement Parasomnias (CBT-NREMP) in reducing NREM parasomnia events, insomnia and associated mood severities. Given the increased prevalence and worsening of sleep and affective disorders during the pandemic, we examined the sustainability of CBT-NREMP following the U.K.'s longest COVID-19 lockdown (6 January 2021-19 July 2021) by repeating the investigations via a mail survey in the same 46 patient cohort, of which 12 responded. The survey included validated clinical questionnaires relating to NREM parasomnia (Paris Arousal Disorder Severity Scale), insomnia (Insomnia Severity Index) and anxiety and depression (Hospital Anxiety and Depression Scale). Patients also completed a targeted questionnaire (i.e., Impact of COVID-19 Lockdown Questionnaire, ICLQ) to assess the impact of COVID-19 lockdown on NREM parasomnia severity, mental health, general well-being and lifestyle. Clinical measures of NREM parasomnia, insomnia, anxiety and depression remained stable, with no significant changes demonstrated in questionnaire scores by comparison to the previous investigatory period prior to the COVID-19 pandemic: p (ISI) = 1.0; p (HADS) = 0.816; p (PADSS) = 0.194. These findings support the longitudinal effectiveness of CBT-NREMP for up to three years following the clinical intervention, and despite of the COVID-19 pandemic.
ABSTRACT
Acceptance and commitment therapy (ACT) is a process-based, transdiagnostic approach to treatment that seeks to increase values-based, adaptive functioning (i.e., engaged living [EL]) in part through attenuating the impact of experiential avoidance (EA). The present case-series study examined EL and EA as mechanisms of change within a 10-week course of individual ACT delivered via a telehealth platform. Participants were two adult women with mental health concerns associated with clinically elevated EA. Throughout the study, we collected (a) daily self-monitored clinically relevant behaviors, (b) daily and weekly measures of EL and EA, and (c) pre-, mid-, post-treatment, and 3-month follow-up measures of psychopathology, quality of life, and ACT-related outcome variables. Results showed support for the efficacy of ACT, with both participants demonstrating slight improvements in clinically relevant behaviors, along with expected improvements in EL and EA. These favorable results were most pronounced for Participant 1. Results are discussed in the context of COVID-19-related adaptations (including telehealth), and within the framework of process-based ACT and its transdiagnostic applicability to a range of mental health concerns. [ FROM AUTHOR]
ABSTRACT
The mental health impact of the COVID-19 pandemic has been significant, with many regions across the globe reporting significant increases in anxiety, depression, trauma, and insomnia. This study aims to validate a potential cognitive model of maintenance factors of COVID-19 related distress by examining psychological predictors of distress, and their goodness-of-fit as a coherent model. Participants from the general population (n = 555) were recruited using a cross-sectional on-line survey design, assessing Demographic factors, Anxiety, Depression, Loneliness, COVID-19 related distress, Trauma Cognitions related to COVID-19, Rumination, Safety Behaviours, Personality Factors, and Mental Effort related to COVID-19. A series of stepwise linear regressions found that components of the model were significant and accounted for a large percentage of variance when examining Covid-19 related distress (R2 = 0.447 Covid Stress Scale), Anxiety (R2 = 0.536 DASS-Anxiety Subscale) and Depression (R2 = 0.596 Depression DASS-subscale). In a confirmatory factor analysis, Loneliness, Post-Traumatic Cognitions about Self, Post-Traumatic Cognitions about the World, Emotional Stability, and Mental Effort related to COVID-19 loaded onto a single factor. The final model showed adequate fit (CFI = 0.990, TLI = 0.983, RMSEA = 0.053 (0.027-0.080), GFI = 0.986, SRMR = 0.0216, χ2 = 23.087, p = .006). The results highlight the importance of cognitive factors, such as post-traumatic cognitions, rumination, and mental effort in maintaining COVID-19 related distress.
Subject(s)
COVID-19 , Humans , Depression/etiology , Depression/psychology , Pandemics , Cross-Sectional Studies , Anxiety/etiology , Anxiety/psychology , Cognition , Factor Analysis, Statistical , Stress, Psychological/psychologyABSTRACT
While teletherapy is not a new phenomenon, most clinicians have not been trained and do not routinely practice it. The current study was designed to ascertain challenges and opportunities presented by the widescale usage of teletherapy especially for traumatized children, which was necessitated by the COVID-19 pandemic. Two hundred and fifty clinicians across the United States providing teletherapy to traumatized children completed an online survey. Results revealed that many logistical aspects of treatment were perceived to be easier when implemented remotely. Some clinical aspects of care were also perceived to be easier, notably engagement with caregivers. Developing rapport, assessing emotions, and keeping children's attention, however, were perceived as more challenging. Child characteristics such as age, attention span, and screen fatigue were viewed as creating challenges. Most clinicians had not received training in relevant topics for teletherapy and were eager to receive such training. These results suggest many avenues for refining and fine-tuning remote mental health services especially for children.
ABSTRACT
BACKGROUND: Insomnia and poor sleep quality are highly prevalent conditions related to coronavirus disease 2019 (COVID-19) complications among clinical nurses. Although cognitive behavioral therapy for insomnia (CBT-I) is a first-line treatment, CBT-I suffers from several major drawbacks. This study investigates whether the application of the internet-delivered mindfulness-based stress reduction (iMBSR) intervention will produce effects that are non-inferior to the internet-delivered CBT-I (iCBT-I) intervention in reducing the severity of insomnia in clinical nurses with insomnia at the end of the study. METHODS: This study protocol presents an internet-delivered, parallel-groups, assessor-blinded, two-arm, non-inferiority randomized controlled trial. The primary outcome is sleep quality, assessed by the Insomnia Severity Index. Secondary outcomes include depression, dysfunctional beliefs, five facets of mindfulness, and client satisfaction. CONCLUSION: It is expected that this study may address several gaps in the literature. The non-inferiority study design is a novel approach to evaluating whether a standardized, complementary treatment (i.e., MBSR) is as practical as a gold standard treatment rather than its potential benefits. This approach may lead to expanded evidence-based practice and improve patient access to effective treatments. TRIAL REGISTRATION: Trial registration number: ISRCTN36198096 . Registered on 24th May 2022.
Subject(s)
COVID-19 , Cognitive Behavioral Therapy , Mindfulness , Nursing Staff , Sleep Initiation and Maintenance Disorders , Humans , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/therapy , Cognitive Behavioral Therapy/methods , Treatment Outcome , Internet , Cognition , Randomized Controlled Trials as TopicABSTRACT
Depression was common before COVID-19 and became the top 25 burdens of disease in 2019 according to the annual Global Burden of Disease Study. With the continued spreading of COVID-19, researchers predict that depression may increase larger in the future. With the development in both neuroscience and psychology, the major depressive disorder can be released by different kinds of methods. From the medical aspect, most of the antidepressants which are widely used can be divided into 4 types: Tetracyclic Antidepressants (TeCAs), Tricyclic Antidepressants (TCAs) ， Selective Serotonin Reuptake Inhibitors (SSRIs), and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs). The advantages of them involve high efficiency and can be absorbed easily. However, the main drawback of these medications is the side effects that they can cause ranging from somnolence to drowsiness after starting treatment. Research shows that some level of sexual dysfunction may occur in 40 to 65 percent of people who use SSRIs due to the sexual side effects. In this way, some of the psychological methods were explored including cognitive behavior therapy (CBT) and interpersonal psychotherapy (IPT) which focus on changing the mind or opinions of the patients to achieve goals. The content of this article not only focuses on different methods to treat depression but also compares their advantages and disadvantages of them. It may provide some pieces of evidence and viewpoints for clinical decision-making. © 2022 SPIE. All rights reserved.
ABSTRACT
E-Mental Health in older age Ulrich Hegerl, Caroline Oehler Department of Psychiatry, Psychosomatics, and Psychotherapy, Goethe Universitat Frankfurt/M, Germany European Alliance against Depression e.V. (www.EAAD.net) The implementation and uptake of digital tools for self management or psychotherapy for people suffering from depression or other mental disorders has gained momentum during the Covid-19 pandemia. While studies using waiting list or treatment as usual control groups are of limited value, meta-analyses of RCTs with face-to-face psychotherapy as control condition have found a comparable antidepressant effect, especially when the interventions were provided together with professional guidance. The iFightDepression-tool offered by the European Alliance against Depression (EAAD) is available in 10 different languages and is broadly used in several European countries. Data will be presented concerning the attitude of older people concerning iCBT and also concerning effects of age, guidance, and gender on both adherence to the iFightDepression-tool and antidepressant effects.
ABSTRACT
(Italian) L'insonnia e un fattore di rischio per la depressione e i disturbi mentali. La pandemia dovuta al Covid-19 e stata associata a un allarmante aumento dell'insonnia. Questo caso clinico ha lo scopo di descrivere un intervento digitale di terapia cognitivo comportamentale per l'insonnia (CBT-I) adattato per la gravidanza durante la pandemia. Viene descritto il caso di una donna di 38 anni con insonnia. La valutazione ha previsto un colloquio clinico psicologico, un'intervista semi-strutturata sul sonno, diari del sonno e questionari. E stato eseguito un protocollo CBT-I comprendente 5 sessioni di 45 minuti ciascuna. L'intervento eseguito e stato efficace nel ridurre i sintomi dell'insonnia e ha mostrato risultati positivi per quanto riguarda la sintomatologia depressiva, i livelli di stress e le difficolta nella regolazione delle emozioni. Questi risultati sono stati confermati anche ai follow-up. I risultati a favore dell'efficacia della CBT-I per l'insonnia in gravidanza sono stati confermati, evidenziando inoltre, l'importanza di considerare le emozioni durante il trattamento. Si suggeriscono futuri studi clinici di alta qualita che valutino l'efficacia della CBT-I adattata in grandi campioni di madri in gravidanza per guidare i cambiamenti nell'assistenza ginecologica primaria per la gravidanza, specialmente nel periodo post-pandemico. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
BACKGROUND: Symptoms of depression and anxiety, suicidal ideation, and self-harm have escalated among adolescents to crisis levels during the COVID-19 pandemic. As a result, primary care providers (PCPs) are often called on to provide first-line care for these youth. Digital health interventions can extend mental health specialty care, but few are evidence based. We evaluated the feasibility of delivering an evidence-based mobile health (mHealth) app with an embedded conversational agent to deliver cognitive behavioral therapy (CBT) to symptomatic adolescents presenting in primary care settings during the pandemic. OBJECTIVE: In this 12-week pilot study, we evaluated the feasibility of delivering the app-based intervention to adolescents aged 13 to 17 years with moderate depressive symptoms who were treated in a practice-based research network (PBRN) of academically affiliated primary care clinics. We also obtained preliminary estimates of app acceptability, effectiveness, and usability. METHODS: This small, pilot randomized controlled trial (RCT) evaluated depressive symptom severity in adolescents randomized to the app or to a wait list control condition. The primary end point was depression severity at 4-weeks, measured by the 9-item Patient Health Questionnaire (PHQ-9). Data on acceptability, feasibility, and usability were collected from adolescents and their parent or legal guardian. Qualitative interviews were conducted with 13 PCPs from 11 PBRN clinics to identify facilitators and barriers to incorporating mental health apps in treatment planning for adolescents with depression and anxiety. RESULTS: The pilot randomized 18 participants to the app (n=10, 56%) or to a wait list control condition (n=8, 44%); 17 participants were included in the analysis, and 1 became ineligible upon chart review due to lack of eligibility based on documented diagnosis. The overall sample was predominantly female (15/17, 88%), White (15/17, 88%), and privately insured (15/17, 88%). Mean PHQ-9 scores at 4 weeks decreased by 3.3 points in the active treatment group (representing a shift in mean depression score from moderate to mild symptom severity categories) and 2 points in the wait list control group (no shift in symptom severity category). Teen- and parent-reported usability, feasibility, and acceptability of the app was high. PCPs reported preference for introducing mHealth interventions like the one in this study early in the course of care for individuals presenting with mild or moderate symptoms. CONCLUSIONS: In this small study, we demonstrated the feasibility, acceptability, usability, and safety of using a CBT-based chatbot for adolescents presenting with moderate depressive symptoms in a network of PBRN-based primary care clinics. This pilot study could not establish effectiveness, but our results suggest that further study in a larger pediatric population is warranted. Future study inclusive of rural, socioeconomically disadvantaged, and underrepresented communities is needed to establish generalizability of effectiveness and identify implementation-related adaptations needed to promote broader uptake in pediatric primary care. TRIAL REGISTRATION: ClinicalTrials.gov NCT04603053; https://clinicaltrials.gov/ct2/show/NCT04603053.