Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 41
Filter
1.
BMJ Open ; 12(4): e059939, 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1784841

ABSTRACT

INTRODUCTION: Cost-effectiveness evaluations of psychological interventions, such as internet-delivered cognitive behavioural therapy (iCBT) programmes, in patients with cardiovascular disease (CVD) are rare. We recently reported moderate to large effect sizes on depressive symptoms in CVD outpatients following a 9-week iCBT programme compared with an online discussion forum (ODF), in favour of iCBT. In this paper, we evaluate the cost-effectiveness of this intervention. METHODS: Cost-effectiveness analysis of a randomised controlled trial. The EQ-5D-3L was used to calculate quality-adjusted life-years (QALYs). Data on healthcare costs were retrieved from healthcare registries. RESULTS: At 12-month follow-up, the QALY was significantly higher in iCBT compared with the ODF group (0.713 vs 0.598, p=0.007). The mean difference of 0.115 corresponds with 42 extra days in best imaginable health status in favour of the iCBT group over the course of 1 year. Incremental cost-effectiveness ratio (ICER) for iCBT versus ODF was €18 865 per QALY saved. The cost-effectiveness plane indicated that iCBT is a cheaper and more effective intervention in 24.5% of the cases, and in 75% a costlier and more effective intervention than ODF. Only in about 0.5% of the cases, there was an indication of a costlier, but less effective intervention compared with ODF. CONCLUSIONS: The ICER of €18 865 was lower than the cost-effectiveness threshold range of €23 400-€35 100 as proposed by the NICE guidelines, suggesting that the iCBT treatment of depressive symptoms in patients with CVD is cost-effective. TRIAL REGISTRATION NUMBER: NCT02778074; Post-results.


Subject(s)
Cardiovascular Diseases , Cognitive Behavioral Therapy , Cardiovascular Diseases/complications , Cardiovascular Diseases/therapy , Cognitive Behavioral Therapy/methods , Cost-Benefit Analysis , Depression/therapy , Humans , Internet , Quality-Adjusted Life Years
2.
Autism ; 26(3): 640-653, 2022 04.
Article in English | MEDLINE | ID: covidwho-1759642

ABSTRACT

LAY ABSTRACT: Cognitive behavioral therapy helps to treat anxiety symptoms in autistic youth, but it is difficult for families to access cognitive behavioral therapy in the community. Training school providers to deliver cognitive behavioral therapy may help autistic youth and their families to access these programs. Unfortunately, we do not know how cognitive behavioral therapy programs can be delivered by school providers and how these programs help the autistic students who access them. This study addressed this gap and was part of a larger study that looked at the effectiveness of Facing Your Fears-School-Based in 25 public schools. The study goals were to understand whether Facing Your Fears-School-Based helped students and the factors that made it easy or difficult to deliver Facing Your Fears-School-Based in schools. Thirty providers participated in interviews guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Participants shared information that fell into several major categories that included (1) delivering Facing Your Fears-School-Based to many different students; (2) the positive impact of Facing Your Fears-School-Based on students' school participation; and (3) plans to continue using Facing Your Fears-School-Based. School providers also shared that Facing Your Fears-School-Based was easy to use for non-mental health providers and reported adapting Facing Your Fears-School-Based to meet student needs. The results of this study suggest that Facing Your Fears-School-Based may help autistic students and highlight the importance of using mental health programs in schools that are flexible, able to be adapted, and that are able to be used by many different types of school providers.


Subject(s)
Autism Spectrum Disorder , Autistic Disorder , Cognitive Behavioral Therapy , Adolescent , Anxiety/psychology , Anxiety/therapy , Autism Spectrum Disorder/psychology , Autism Spectrum Disorder/therapy , Autistic Disorder/therapy , Cognitive Behavioral Therapy/methods , Humans , Students
3.
J Med Internet Res ; 24(2): e28093, 2022 02 15.
Article in English | MEDLINE | ID: covidwho-1714881

ABSTRACT

BACKGROUND: Symptoms of anxiety are common in pregnancy, with severe symptoms associated with negative outcomes for women and babies. Low-level psychological therapy is recommended for women with mild to moderate anxiety, with the aim of preventing an escalation of symptoms and providing coping strategies. Remotely delivered interventions have been suggested to improve access to treatment and support and provide a cost-effective, flexible, and timely solution. OBJECTIVE: This study identifies and evaluates remotely delivered, digital, or web-based interventions to support women with symptoms of anxiety during pregnancy. METHODS: This mixed methods systematic review followed a convergent segregated approach to synthesize qualitative and quantitative data. The ACM Digital Library, Allied and Complementary Medicine Database, Applied Social Sciences Index and Abstracts, Centre for Reviews and Dissemination database, the Cochrane Central Register of Controlled Trials, the Cochrane Library, CINAHL, Embase, Health Technology Assessment Library, IEEE Xplore, Joanna Briggs Institute, Maternity and Infant Care, MEDLINE, PsycINFO, and the Social Science Citation Index were searched in October 2020. Quantitative or qualitative primary research that included pregnant women and evaluated remotely delivered interventions reporting measures of anxiety, fear, stress, distress, women's views, and opinions were included. RESULTS: Overall, 3 qualitative studies and 14 quantitative studies were included. Populations included a general antenatal population and pregnant women having anxiety and depression, fear of childbirth, insomnia, and preterm labor. Interventions included cognitive behavioral therapy, problem solving, mindfulness, and educational designs. Most interventions were delivered via web-based platforms, and 62% (8/13) included direct contact from trained therapists or coaches. A meta-analysis of the quantitative data found internet-based cognitive behavioral therapy and facilitated interventions showed a beneficial effect in relation to the reduction of anxiety scores (standardized mean difference -0.49, 95% CI -0.75 to -0.22; standardized mean difference -0.48, 95% CI -0.75 to -0.22). Due to limitations in the amount of available data and study quality, the findings should be interpreted with caution. Synthesized findings found some evidence to suggest that interventions are more effective when women maintain regular participation which may be enhanced by providing regular contact with therapists or peer support, appropriate targeting of interventions involving components of relaxation and cognitive-based skills, and providing sufficient sessions to develop new skills without being too time consuming. CONCLUSIONS: There is limited evidence to suggest that women who are pregnant may benefit from remotely delivered interventions. Components of interventions that may improve the effectiveness and acceptability of remotely delivered interventions included providing web-based contact with a therapist, health care professional, or peer community. Women may be more motivated to complete interventions that are perceived as relevant or tailored to their needs. Remote interventions may also provide women with greater anonymity to help them feel more confident in disclosing their symptoms.


Subject(s)
Anxiety Disorders , Cognitive Behavioral Therapy , Anxiety/therapy , Cognitive Behavioral Therapy/methods , Cost-Benefit Analysis , Female , Humans , Infant, Newborn , Pregnancy , Pregnant Women
4.
J Med Internet Res ; 24(2): e27584, 2022 02 14.
Article in English | MEDLINE | ID: covidwho-1714878

ABSTRACT

BACKGROUND: Tinnitus is a symptom that can be very distressing owing to hearing sounds not related to any external sound source. Managing tinnitus is notoriously difficult, and access to evidence-based care is limited. Cognitive behavioral therapy (CBT) is a tinnitus management strategy with the most evidence of effectiveness but is rarely offered to those distressed by tinnitus. The provision of internet-based CBT for tinnitus overcomes accessibility barriers; however, it is not currently readily available in the United States. OBJECTIVE: The aim of this study is to investigate the efficacy of internet-based CBT compared with that of weekly monitoring for the management of tinnitus in reducing tinnitus distress; reducing tinnitus-related comorbidities, including tinnitus cognitions, insomnia, anxiety, and depression; and assessing the stability of the intervention effects 2 months after the intervention. METHODS: A 2-arm randomized clinical trial comparing audiologist-guided internet-based CBT (n=79) to a weekly monitoring group (n=79) with a 2-month follow-up assessed the efficacy of internet-based CBT. Eligible participants included adults seeking help for tinnitus. Recruitment was conducted on the web using an open-access website. Participants were randomized via 1:1 allocation, but blinding was not possible. The study was undertaken by English or Spanish speakers on the web. The primary outcome was a change in tinnitus distress as measured using the Tinnitus Functional Index. Secondary outcome measures included anxiety, depression, insomnia, tinnitus cognition, hearing-related difficulties, and quality of life. RESULTS: Internet-based CBT led to a greater reduction in tinnitus distress (mean 36.57, SD 22) compared with that in weekly monitoring (mean 46.31, SD 20.63; effect size: Cohen d=0.46, 95% CI 0.14-0.77) using an intention-to-treat analysis. For the secondary outcomes, there was a greater reduction in negative tinnitus cognition and insomnia. The results remained stable over the 2-month follow-up period. No important adverse events were observed. Further, 16% (10/158) of participants withdrew, with low overall compliance rates for questionnaire completion of 72.3% (107/148) at T1, 61% (91/148) at T2, and 42% (62/148) at T3. CONCLUSIONS: This study is the first to evaluate and indicate the efficacy of audiologist-delivered internet-based CBT in reducing tinnitus distress in a US population. It was also the first study to offer internet-based CBT in Spanish to accommodate the large Hispanic population in the United States. The results have been encouraging, and further work is indicated in view of making such an intervention applicable to a wider population. Further work is required to improve compliance and attract more Spanish speakers. TRIAL REGISTRATION: ClinicalTrials.gov NCT04004260; https://clinicaltrials.gov/ct2/show/NCT04004260.


Subject(s)
Cognitive Behavioral Therapy , Tinnitus , Adult , Audiologists , Cognitive Behavioral Therapy/methods , Humans , Internet , Quality of Life , Tinnitus/therapy , Treatment Outcome
5.
J Med Internet Res ; 24(2): e33337, 2022 02 23.
Article in English | MEDLINE | ID: covidwho-1699900

ABSTRACT

BACKGROUND: Studies have shown a high prevalence of depression during pregnancy, and there is also evidence that cognitive behavioral therapy (CBT) is one of the most effective psychosocial interventions. Emerging evidence from randomized controlled trials (RCTs) has shown that technology has been successfully harnessed to provide CBT interventions for other populations. However, very few studies have focused on their use during pregnancy. This approach has become increasingly important in many clinical areas due to the COVID-19 pandemic, and our study aimed to expand the knowledge in this particular clinical area. OBJECTIVE: Our systematic review aimed to bring together the available research-based evidence on digitalized CBT interventions for depression symptoms during pregnancy. METHODS: A systematic review of the Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, Embase, PsycINFO, Scopus, ClinicalTrials.gov, and EBSCO Open Dissertations databases was carried out from the earliest available evidence to October 27, 2021. Only RCT studies published in English were considered. The PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-analyses) guidelines were followed, and the protocol was registered on the Prospective Register of Systematic Reviews. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. RESULTS: The review identified 7 studies from 5 countries (the United States, China, Australia, Norway, and Sweden) published from 2015 to 2021. The sample sizes ranged from 25 to 1342 participants. The interventions used various technological elements, including text, images, videos, games, interactive features, and peer group discussions. They comprised 2 guided and 5 unguided approaches. Using digitalized CBT interventions for depression during pregnancy showed promising efficacy, with guided intervention showing higher effect sizes (Hedges g=1.21) than the unguided interventions (Hedges g=0.14-0.99). The acceptability of the digitalized CBT interventions was highly encouraging, based on user feedback. Attrition rates were low for the guided intervention (4.5%) but high for the unguided interventions (22.1%-46.5%). A high overall risk of bias was present for 6 of the 7 studies. CONCLUSIONS: Our search only identified a small number of digitalized CBT interventions for pregnant women, despite the potential of this approach. These showed promising evidence when it came to efficacy and positive outcomes for depression symptoms, and user feedback was positive. However, the overall risk of bias suggests that the efficacy of the interventions needs to be interpreted with caution. Future studies need to consider how to mitigate these sources of biases. Digitalized CBT interventions can provide prompt, effective, evidence-based interventions for pregnant women. This review increases our understanding of the importance of digitalized interventions during pregnancy, including during the COVID-19 pandemic. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020216159; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216159.


Subject(s)
COVID-19 , Cognitive Behavioral Therapy , Cognition , Cognitive Behavioral Therapy/methods , Depression/therapy , Female , Humans , Pregnancy , SARS-CoV-2
6.
BMJ Open ; 12(1): e058214, 2022 01 20.
Article in English | MEDLINE | ID: covidwho-1642873

ABSTRACT

OBJECTIVES: This scoping review aimed to describe available interventions for decreasing (post-traumatic stress disorder) PTSD symptoms among healthcare professionals in hospital care. METHOD: A scoping review was conducted following Arksey and O'Malley's framework. PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, Web of Science, Scopus and ProQuest were searched for original research published in English from 2011 to 2021, on 8 July 2021. We included studies that described interventions that focused on reducing the PTSD symptoms of healthcare professionals. A narrative synthesis was adopted to synthesise the data. RESULTS: A total of eight studies out of 2558 articles were identified. Six used a quantitative study design and two adopted qualitative methods. cognitive behavioural therapy and mindfulness-based interventions were the most commonly adopted. Most studies used a combination of different intervention strategies. Trauma-related knowledge, emotion regulation and relaxation skill training, and psychological support from peers and psychologists were three core intervention components. The duration ranged from 2 weeks to 6 months. Healthcare professionals who participated in training programmes reported both positive experiences and suggestions for the improvement of PTSD-reducing interventions in their qualitative feedback. CONCLUSIONS: The scoping review provides a practical summary of the intervention characteristics for reducing the PTSD symptoms of healthcare professionals. Hospitals and managers could use the overview of interventions to assist healthcare professionals with PTSD symptoms. More research investigating the effects of PTSD symptom-reducing interventions for healthcare professionals with appropriate follow-up assessments is needed in the future.


Subject(s)
Cognitive Behavioral Therapy , Stress Disorders, Post-Traumatic , Cognitive Behavioral Therapy/methods , Health Personnel , Humans , Stress Disorders, Post-Traumatic/prevention & control , Stress Disorders, Post-Traumatic/psychology
7.
Nat Hum Behav ; 6(2): 258-268, 2022 02.
Article in English | MEDLINE | ID: covidwho-1565719

ABSTRACT

The COVID-19 pandemic has potentially increased the risk for adolescent depression. Even pre-pandemic, <50% of youth with depression accessed care, highlighting needs for accessible interventions. Accordingly, this randomized controlled trial (ClinicalTrials.gov: NCT04634903 ) tested online single-session interventions (SSIs) during COVID-19 in adolescents with elevated depression symptoms (N = 2,452, ages 13-16). Adolescents from all 50 US states, recruited via social media, were randomized to one of three SSIs: a behavioural activation SSI, an SSI teaching that traits are malleable and a supportive control. We tested each SSI's effects on post-intervention outcomes (hopelessness and agency) and three-month outcomes (depression, hopelessness, agency, generalized anxiety, COVID-19-related trauma and restrictive eating). Compared with the control, both active SSIs reduced three-month depressive symptoms (Cohen's d = 0.18), decreased post-intervention and three-month hopelessness (d = 0.16-0.28), increased post-intervention agency (d = 0.15-0.31) and reduced three-month restrictive eating (d = 0.12-17). Several differences between active SSIs emerged. These results confirm the utility of free-of-charge, online SSIs for high-symptom adolescents, even in the high-stress COVID-19 context.


Subject(s)
Anxiety , COVID-19/psychology , Cognitive Behavioral Therapy/methods , Depression , Feeding Behavior/psychology , Internet-Based Intervention , Adolescent , Adolescent Behavior , Anxiety/psychology , Anxiety/therapy , Behavioral Symptoms/diagnosis , Behavioral Symptoms/therapy , Depression/diagnosis , Depression/psychology , Depression/therapy , Female , Humans , Male , Outcome Assessment, Health Care/methods , SARS-CoV-2 , Social Isolation/psychology
8.
Eur J Psychotraumatol ; 12(1): 1987687, 2021.
Article in English | MEDLINE | ID: covidwho-1541466

ABSTRACT

Background: Losing a loved one during the COVID-19 pandemic is a potentially traumatic loss that may result in symptoms of persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD), and depression. To date, grief-specific cognitive-behavioural therapy (CBT) has mostly been delivered through individual face-to-face formats, while studies have shown that online treatment also yields promising results. Offering treatment online is now more than ever relevant during the pan demic and may offer important benefits compared with face-to-face CBT, such as lower costs and higher accessibility. Our expectation is that grief-specific online CBT is effective in reducing PCBD, PTSD, and depression symptoms. Objective: Our aim is to evaluate the short-term and long-term effectiveness of grief-specific online CBT in reducing PCBD, PTSD, and depression symptom-levels for adults who lost a loved one during the COVID-19 pandemic. Method: This study consists of two parts. In part 1, a two-armed (unguided online CBT versus waitlist controls) randomized controlled trial will be conducted. In part 2, a two-armed (guided online CBT versus unguided online CBT) controlled trial will be conducted. Symptoms of PCBD, PTSD, and depression will be assessed via telephone interviews at pre-treatment/pre-waiting period, post-treatment/post-waiting period, and six months post-treatment. Potential participants are people who lost a loved one at least three months earlier during the COVID-19 pandemic with clinically relevant levels of PCBD, PTSD, and/or depression. Analysis of covariance and multilevel modelling will be performed. Discussion: This is one of the first studies examining the effectiveness of online grief-specific CBT. More research is needed before implementing online grief-specific CBT into clinical practice.


Antecedentes: Perder a un ser querido durante la pandemia de COVID-19 es una pérdida potencialmente traumática que puede resultar en síntomas de trastorno de duelo complejo persistente (PCBD en su sigla en inglés), trastorno de estrés postraumático (TEPT) y depresión. Hasta la fecha, la terapia cognitivo-conductual (TCC) específica para el duelo se ha proporcionado principalmente a través de formatos individuales cara a cara, mientras que los estudios han demostrado que el tratamiento en línea también produce resultados prometedores. Ofrecer tratamiento en línea es ahora más relevante que nunca durante la pandemia y puede ofrecer importantes beneficios en comparación con la TCC presencial, como menores costos y mayor accesibilidad. Nuestra expectativa es que la TCC en línea específica para el duelo sea eficaz para reducir el PCBD, el TEPT y los síntomas de depresión.Objetivo: Nuestro objetivo es evaluar la efectividad a corto y largo plazo de la TCC en línea específica para el duelo en la reducción de los niveles de PCBD, TEPT y síntomas de depresión en adultos que perdieron a un ser querido durante la pandemia de COVID-19.Método: Este estudio consta de dos partes. En la parte 1, se llevará a cabo un ensayo controlado aleatorio de dos brazos (TCC en línea no guiado versus controles con la lista de espera). En la parte 2, se llevará a cabo un ensayo controlado de dos brazos (TCC en línea guiada versus TCC en línea no guiada). Los síntomas de PCBD, TEPT y depresión se evaluarán mediante entrevistas telefónicas en el período de pretratamiento/pre-espera, post-tratamiento/post-período de espera y seis meses post-tratamiento. Los participantes potenciales son personas que perdieron a un ser querido al menos tres meses antes durante la pandemia de COVID-19 con niveles clínicamente relevantes de PCBD, TEPT y/o depresión. Se realizarán análisis de covarianza y modelado multinivel.Discusión: Este es uno de los primeros estudios que examinan la efectividad de la TCC en línea específica para el duelo. Se necesita más investigación antes de implementar la TCC en línea específica para el duelo en la práctica clínica.


Subject(s)
Cognitive Behavioral Therapy/methods , Depression/therapy , Stress Disorders, Post-Traumatic/therapy , Adult , COVID-19/epidemiology , Depression/psychology , Female , Humans , Male , Netherlands , Pandemics , Randomized Controlled Trials as Topic , SARS-CoV-2 , Stress Disorders, Post-Traumatic/psychology , Telemedicine
9.
Br J Clin Psychol ; 61(2): 364-384, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1405168

ABSTRACT

OBJECTIVES: Remote psychotherapy and the prevalence of Severe Health Anxiety (SHA) are both growing as a result of the COVID-19 pandemic. Remotely delivered Cognitive Behavioural Therapy (rCBT) for SHA is evidenced as effective, but many who seek help do not benefit. Motivational processes can influence outcomes, but it is unclear what assessment methods offer the best clinical utility in rCBT for SHA. DESIGN: This study compared the predictive validity of patient, therapist and in-session ratings of motivational factors taken at session two of rCBT for SHA among high healthcare users experiencing multimorbidity. METHODS: Motivational factors were assessed for 56 participants who attended at least two sessions of CBT for SHA delivered via video-conferencing or telephone. Following session two, therapists and patients completed online assessments of patient motivation. Two trained observers also rated motivational factors and therapeutic alliance from in-session interactions using session two recordings and transcripts. Multilevel modelling was used to predict health anxiety and a range of secondary health outcomes from motivation assessments. RESULTS: Where patients were more actively engaged in discussion of positive changes during session two, greater outcome improvements ensued in health anxiety and all secondary outcomes. Conversely, larger proportions of session two spent describing problems predicted poorer outcomes. Therapist and patient assessments of motivation did not predict health anxiety, but therapist assessments of client confidence and motivation predicted all secondary outcomes. CONCLUSIONS: Motivation remains an important process in CBT when delivered remotely, and motivational factors may predict outcomes more consistently from in-session interactions, compared to self-reports.


Subject(s)
COVID-19 , Cognitive Behavioral Therapy , Anxiety , Cognitive Behavioral Therapy/methods , Humans , Motivation , Pandemics , Treatment Outcome
10.
Nutrients ; 13(9)2021 Aug 24.
Article in English | MEDLINE | ID: covidwho-1376921

ABSTRACT

Bariatric surgery is the most efficacious treatment for obesity, though it is not free from complications. Preoperative conditioning has proved beneficial in various clinical contexts, but the evidence is scarce on the role of prehabilitation in bariatric surgery. We describe the protocol and pilot study of a randomized (ratio 1:1), parallel, controlled trial assessing the effect of a physical conditioning and respiratory muscle training programme, added to a standard 8-week group intervention based on therapeutical education and cognitive-behavioural therapy, in patients awaiting bariatric surgery. The primary outcome is preoperative weight-loss. Secondary outcomes include associated comorbidity, eating behaviour, physical activity, quality of life, and short-term postoperative complications. A pilot sample of 15 participants has been randomized to the intervention or control groups and their baseline features and results are described. Only 5 patients completed the group programme and returned for assessment. Measures to improve adherence will be implemented and once the COVID-19 pandemic allows, the clinical trial will start. This is the first randomized, clinical trial assessing the effect of physical and respiratory prehabilitation, added to standard group education and cognitive-behavioural intervention in obese patients on the waiting list for bariatric surgery. Clinical Trial Registration: NCT0404636.


Subject(s)
Bariatric Surgery/adverse effects , Postoperative Complications/epidemiology , Preoperative Care/methods , Preoperative Exercise , Adult , Breathing Exercises/methods , Cognitive Behavioral Therapy/methods , Female , Follow-Up Studies , Humans , Male , Middle Aged , Patient Education as Topic , Pilot Projects , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Quality of Life , Randomized Controlled Trials as Topic , Treatment Outcome , Weight Loss
11.
Behav Res Ther ; 144: 103902, 2021 09.
Article in English | MEDLINE | ID: covidwho-1267616

ABSTRACT

The COVID-19 pandemic has had a severe impact on mental health worldwide, with increased rates of anxiety and depression widely documented. The aim of this study was to examine unguided low intensity cognitive behaviour therapy for anxiety and depression during the pandemic. A sample of 225 individuals in Australia and the United Kingdom (M age 37.79, SD = 14.02, range 18-80 years; 85% female) were randomised into intervention or waitlist control. The intervention group demonstrated significant decreases in anxiety (d = 0.36 [0.18, 0.54]) and depression (d = 0.28 [0.11, 0.45]) compared to controls. The majority of participants (96%) rated the intervention as useful, and most (83%) reported they spent 30 min or less reading the guide, with 83% agreeing the intervention was easy to read. The results indicate that low intensity cognitive behaviour therapy has efficacy in reducing anxiety and depression during the COVID-19 pandemic. There is an urgent need to disseminate low intensity psychological therapies to improve mental health in this challenging time.


Subject(s)
Anxiety/therapy , COVID-19/psychology , Cognitive Behavioral Therapy/methods , Depression/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Anxiety/psychology , Australia , Depression/psychology , Female , Humans , Male , Middle Aged , Pandemics , Treatment Outcome , United Kingdom , Young Adult
12.
Trends Psychiatry Psychother ; 43(2): 141-150, 2021.
Article in English | MEDLINE | ID: covidwho-1248610

ABSTRACT

OBJECTIVE: Cognitive-behavioral interventions can be effective for relieving anxiety associated with coronavirus disease 2019 (COVID-19), but complications such as social distancing, quarantine, a shortage of experts, and delayed care provisions have made it difficult to access face-to-face therapeutic interventions. The purpose of this study was to investigate the efficacy of a video-based cognitive-behavioral intervention for reducing COVID-19 anxiety. METHOD: In the present randomized controlled trial, 150 college students with severe COVID-19 anxiety were randomly assigned to either an intervention (n = 75) or a waiting list control (n = 75) group. The intervention group participated in a video-based cognitive-behavioral program consisting of nine 15-20-minute sessions (three days a week for three weeks). Dependent measures included the COVID-19 Anxiety Questionnaire, Short Health Anxiety Inventory, Anxiety Sensitivity Index-3, Somatosensory Amplification Scale, Experience of Parasocial Interaction Scale, and Source Credibility Scale. RESULTS: Participants who were randomly assigned to the cognitive-behavioral program reported high parasocial interaction, source credibility, and satisfaction with the intervention. Eighty percent reported that the video-based intervention was a beneficial alternative to traditional face-to-face therapeutic intervention. At post-treatment evaluation, the video-based cognitive-behavioral intervention group showed a significant reduction in COVID-19 anxiety, health anxiety, anxiety sensitivity, and somatosensory amplification when compared to the wait-listed control group. CONCLUSIONS: This study suggests that video-based cognitive-behavioral interventions can be an affordable, feasible, and effective method to reduce anxiety during a large-scale pandemic.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Cognitive Behavioral Therapy/methods , Video Recording , Anxiety/therapy , COVID-19/complications , Female , Humans , Male , Psychiatric Status Rating Scales , Surveys and Questionnaires , Video Recording/methods , Young Adult
13.
J Natl Cancer Inst ; 113(11): 1495-1505, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1246732

ABSTRACT

BACKGROUND: Fear of recurrence (FoR) is a prevalent concern among breast cancer survivors (BCS), yet few accessible interventions exist. This study evaluated a targeted eHealth intervention, "FoRtitude," to reduce FoR using cognitive behavioral skills training and telecoaching. METHODS: BCS (N = 196) were recruited from an academic medical center and 3 National Cancer Institute Community Oncology Research Program community sites, had stage 0-III breast cancer, were 1-10 years postprimary treatment, with moderate to high FoR and familiarity with the internet. Using the Multiphase Optimization Strategy, participants were independently randomly assigned to 3 cognitive behavioral skills (relaxation, cognitive restructuring, worry practice) vs an attention control condition (health management content [HMC]) and to telecoaching (motivational interviewing) vs no telecoaching. Website content was released across 4 weeks and included didactic lessons, interactive tools, and a text-messaging feature. BCS completed the Fear of Cancer Recurrence Inventory at baseline and at 4 and 8 weeks. Fear of Cancer Recurrence Inventory scores over time were compared using mixed-effects models. All statistical tests were 2-sided. RESULTS: FCRI scores [SD] decreased statistically significantly from baseline to postintervention (T0 = 53.1 [17.4], T2 = 41.9 [16.2], P < .001). The magnitude of reduction in FCRI scores was comparable across cognitive behavior therapy (CBT) and attention control HMC conditions and was predicted by increased self-efficacy. Telecoaching was associated with lower attrition and greater website use (mean adherence score [SD] = 26.6 [7.2] vs 21.0 [10.5], P < .001). CONCLUSIONS: BCS experienced statistically significant reductions in FoR postintervention, but improvements were comparable between CBT and attention controls. Telecoaching improved adherence and retention. Future research is needed on optimal integration of CBT and HMC, dose, and features of eHealth delivery that contributed to reducing FoR. In the COVID-19 era, remote delivery has become even more essential for reaching survivors struggling with FoR.


Subject(s)
Breast Neoplasms/therapy , Cancer Survivors/psychology , Cognitive Behavioral Therapy/methods , Fear/psychology , Neoplasm Recurrence, Local/prevention & control , Telemedicine/methods , Adult , Aged , Breast Neoplasms/psychology , Female , Humans , Middle Aged , Quality of Life
14.
J Med Internet Res ; 23(5): e26883, 2021 05 14.
Article in English | MEDLINE | ID: covidwho-1229125

ABSTRACT

BACKGROUND: The prevalence of depressive and anxiety symptoms in patients with COVID-19 is higher than usual. Previous studies have shown that there are drug-to-drug interactions between antiretroviral drugs and antidepressants. Therefore, an effective and safe treatment method was needed. Cognitive behavioral therapy (CBT) is the first-line psychological therapy in clinical treatment. Computerized CBT (cCBT) was proven to be an effective alternative to CBT and does not require face-to-face therapy between a therapist and the patient, which suited the COVID-19 pandemic response. OBJECTIVE: This study aims to evaluate the efficacy of the cCBT program we developed in improving depressive and anxiety symptoms among patients with COVID-19. METHODS: We customized a cCBT program focused on improving depressive and anxiety symptoms among patients with COVID-19, and then, we assessed its effectiveness. Screening was based on symptoms of depression or anxiety for patients who scored ≥7 on the Hamilton Depression Rating Scale (HAMD17) or the Hamilton Anxiety Scale (HAMA). A total of 252 patients with COVID-19 at five sites were randomized into two groups: cCBT + treatment as usual (TAU; n=126) and TAU without cCBT (n=126). The cCBT + TAU group received the cCBT intervention program for 1 week. The primary efficacy measures were the HAMD17 and HAMA scores. The secondary outcome measures were the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Athens Insomnia Scale (AIS). Assessments were carried out pre- and postintervention. The patients' symptoms of anxiety and depression in one of the centers were assessed again within 1 month after the postintervention assessment. RESULTS: The cCBT + TAU group displayed a significantly decreased score on the HAMD17, HAMA, SDS, SAS, and AIS after the intervention compared to the TAU group (all P<.001). A mixed-effects repeated measures model revealed significant improvement in symptoms of depression (HAMD17 and SDS scores, both P<.001), anxiety (HAMA and SAS scores, both P<.001), and insomnia (AIS score, P=.002) during the postintervention and follow-up periods in the cCBT + TAU group. Additionally, the improvement of insomnia among females (P=.14) and those with middle school education (P=.48) in the cCBT + TAU group showed no significant differences when compared to the TAU group. CONCLUSIONS: The findings of this study suggest that the cCBT program we developed was an effective nonpharmacological treatment for symptoms of anxiety, depression, and insomnia among patients with COVID-19. Further research is warranted to investigate the long-term effects of cCBT for symptoms of anxiety, depression, and insomnia in patients with COVID-19. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000030084; http://www.chictr.org.cn/showprojen.aspx?proj=49952.


Subject(s)
Anxiety/therapy , COVID-19/psychology , Cognitive Behavioral Therapy/methods , Depression/therapy , Adult , Female , Humans , Male , Pandemics , Prospective Studies , SARS-CoV-2/isolation & purification
15.
Psychol Trauma ; 12(S1): S67-S68, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-1202369

ABSTRACT

Patients suffering from obsessive-compulsive disorder are vulnerable to exacerbation of symptoms related to contamination and illness during the current pandemic. A cognitive-behavioral psychotherapy group for adolescent females with obsessive-compulsive disorder made effective adaptations to promote resilience to stressors and social isolation during the pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Attitude to Health , COVID-19/psychology , Cognitive Behavioral Therapy/methods , Obsessive-Compulsive Disorder/psychology , Obsessive-Compulsive Disorder/therapy , Quarantine/psychology , Adolescent , Female , Humans , Pandemics , Resilience, Psychological , SARS-CoV-2 , Treatment Outcome
16.
Asian J Psychiatr ; 60: 102656, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1184783

ABSTRACT

BACKGROUND AND AIM: Recently, the availability and usefulness of mobile self-help mental health applications have increased, but few applications deal with COVID-19-related psychological problems. This study explored the intervention efficacy of a mobile application on addressing psychological problems related to COVID-19. METHODS: A longitudinal control trial involving 129 Chinese participants with depression symptoms was conducted through the mobile application "Care for Your Mental Health and Sleep during COVID-19" (CMSC) based on WeChat. Participants were divided into two groups: mobile internet cognitive behavioral therapy (MiCBT) and wait-list. The primary outcome was improvement in depression symptoms. Secondary outcomes included improvement in anxiety and insomnia. The MiCBT group received three self-help CBT intervention sessions in one week via CMSC. RESULTS: The MiCBT group showed significant improvement in depression and insomnia (allP < 0.05) compared with the wait-list group. Although both groups showed significant improvement in anxiety at the intervention's end, compared with the wait-list group, the MiCBT group had no significant advantage. Correlation analysis showed that improvement in depression and anxiety had a significant positive association with education level. Changes in insomnia were significantly negatively correlated with anxiety of COVID-19 at the baseline. CMSC was considered helpful (n=68, 81.9 %) and enjoyable (n=54, 65.9 %) in relieving depression and insomnia during the COVID-19 outbreak. CONCLUSIONS: CMSC is verified to be effective and convenient for improving COVID-19-related depression and insomnia symptoms. A large study with sufficient evidence is required to determine its continuous effect on reducing mental health problems during the pandemic.


Subject(s)
Anxiety/therapy , COVID-19/psychology , Cognitive Behavioral Therapy/methods , Depression/therapy , Sleep Initiation and Maintenance Disorders/psychology , Sleep Initiation and Maintenance Disorders/therapy , Anxiety/psychology , COVID-19/epidemiology , Depression/psychology , Female , Humans , Male , Mental Health , Pandemics , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/diagnosis , Treatment Outcome
18.
Medicine (Baltimore) ; 100(15): e25512, 2021 Apr 16.
Article in English | MEDLINE | ID: covidwho-1180674

ABSTRACT

BACKGROUND: There is no study that has conducted a review or meta-analysis investigating a cognitive behavioral therapy (CBT) intervention to patients with COVID19, with the aim of improving their psychological health. Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the effectiveness of CBT in relieving patients' psychological distress and improving quality of life during the COVID-19 epidemic. METHODS: Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library will be searched in April 2021 by 2 independent reviewers. For search on PubMed, the following search terms will be used: "COVID-19, 2019 Coronavirus Disease, 2019-nCoV, cognitive behavioral therapy, CBT, cognitive behavioral treatment." In order to achieve a consistency (at least 80%) of extracted items, the data extractors will extract data from a sample of eligible studies. The outcomes include any rating scale describing stress, mood, and quality of life. Review Manager software (v 5.4; Cochrane Collaboration) will be used for the meta-analysis. Two independent reviewers will assess the risk of bias of the included studies at study level. Any disagreements will be discussed and resolved in discussion with a third reviewer. RESULTS: The results of our review will be reported strictly following the PRISMA criteria. CONCLUSIONS: The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/DCRPJ. ETHICS AND DISSEMINATION: Ethical approval and patient consent are not required because this study is a literature-based study. This systematic review and meta-analysis will be published in a peer-reviewed journal.


Subject(s)
Affect , COVID-19 , Cognitive Behavioral Therapy/methods , Quality of Life , Stress, Psychological , COVID-19/epidemiology , COVID-19/psychology , Humans , Meta-Analysis as Topic , Research Design , SARS-CoV-2 , Stress, Psychological/etiology , Stress, Psychological/prevention & control , Systematic Reviews as Topic
19.
J Sex Marital Ther ; 47(5): 446-459, 2021.
Article in English | MEDLINE | ID: covidwho-1127223

ABSTRACT

Studies have shown sexual intimacy enhancement-training with cognitive-behavioral can affect women's sexual intimacy. Interventional study to compare online and face-to-face sexual enhancement-training with cognitive-behavioral approach on sexual intimacy was conducted on 48 pregnant women with sexual intimacy scores < 75 who were randomly divided online (n = 25) and face-to-face (n = 23). Six 90-minute session sexual intimacy enhancement-training were conducted. Data were collected Botlani's sexual intimacy questionnaire (primary outcome) and counseling satisfaction scale (secondary outcome) measured baseline and after 6 and 10 weeks. In each group sexual intimacy in 10th week increased significantly compared to baseline (65.88 ± 5.51 vs 87.36 ± 8.39, p < 0.001) and (67.39 ± 5.26 vs 83.70 ± 5.61, p < 0.001) respectively. There was no significant difference between two groups in sexual intimacy scores in 6th (82.32 ± 9.25 vs 79.87 ± 6.35, p = 0.29) and 10th weeks (87.36 ± 8.39 vs 83.70 ± 5.61, p = 0.08) but totally intervention caused significant increase in sexual intimacy in 10th week compared to baseline (p = 0.04). Satisfaction from intervention was significantly different in 6th (65.72 ± 2.57 vs 61.21 ± 7.17, p = 0.021) and 10th weeks (68.92 ± 2.79 vs 64.26 ± 5.15, p = 0.001). Intervention improved sexual intimacy in pregnant women via both online and face-to-face counseling, with more sexual intimacy and satisfaction in online group, could be useful in COVID-19 pandemic.


Subject(s)
Cognitive Behavioral Therapy/methods , Internet-Based Intervention , Pregnant Women/psychology , Sex Counseling/methods , Sexual Behavior/psychology , Adult , Female , Humans , Iran/epidemiology , Patient Satisfaction/statistics & numerical data , Pregnancy , Spouses , Treatment Outcome
20.
Mo Med ; 118(1): 7-12, 2021.
Article in English | MEDLINE | ID: covidwho-1068452

ABSTRACT

Medical students, residents, and practicing physicians experience high burnout, depression, and suicide rates, and the COVID-19 pandemic has exacerbated stress for many.1-6 While laudable, current well-being efforts appear insufficient to meet the challenges that so many are facing. This essay explores approaches that individuals and organizations can take to promote mental health and well-being from medical school to practice.


Subject(s)
COVID-19/psychology , Mental Health/standards , Physicians/psychology , Students, Medical/psychology , Adaptation, Psychological/physiology , Burnout, Professional/epidemiology , Burnout, Professional/therapy , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Cognitive Behavioral Therapy/methods , Depression/epidemiology , Depression/therapy , Humans , Limbic System/physiopathology , Mental Health/statistics & numerical data , Mindfulness/methods , SARS-CoV-2/genetics , Schools, Medical/organization & administration , Schools, Medical/standards , Stress, Psychological/complications , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Suicide/prevention & control , Suicide/psychology , Suicide/statistics & numerical data
SELECTION OF CITATIONS
SEARCH DETAIL